Hematologists - Anemia Message Board

PaNik5717 · 10-16-2003, 04:35 PM

Can you tell me what tests hematologists run? What have yours looked for and/or found?

My PCP thinks that my gyn problem may be something that should be evaluated by a hematologist. She tried to refer me once before and the local guy looked at my chart and said that I should go back to my gyn.

PaNik5717 · 10-16-2003, 06:32 PM

I'm really more interested in advice about hematologists. I'm guessing the main concern would be leukemia, but I really know nothing.

I thought I would mention, though, that my PCP has always had this notion that anemia can cause heavy uterine bleeding as well as the other way around. She seems to think that my bleeding gets heavier as my anemia gets worse, instead of the other way around. Kind of a chicken and egg thing, but I wonder if this is a supported idea in the medical field or where she got the theory from.

amwood · 10-16-2003, 06:58 PM

Here's what I've found out as I went through the same process you are...my GP referred me to a hematalogist awhile ago, mostly for the IV iron, but also to make sure my bone marrow is working ok and that it isn't the cause of my anemia. The hematalogist gave me a couple rounds of IV iron and then ran a CBC about 5 weeks after the first IV to see where my red blood cell count, hgb, hct, etc, were after the iron. If your bone marrow isn't working properly, you won't be able to create new red blood cells, no matter how much iron they give you. My rbc went up a little, although not quite into the normal range. He also checked my reticulocyte count - which should be above normal if you're anemic since your bone marrow should be constanting making new red blood cells to make up for what it's missing. If the tests indicate that your bone marrow isn't responding as it should be, the hematalogist will probably do a bone marrow biopsy.
My hematalogist told me that my bone marrow appears to be working fine, and sent me back to the GI doctor to find out where I'm losing the blood from. He wasn't too much help in finding out what's causing my anemia, but the IV's of iron have been helpful, so at least he's of some use to me

Good luck!

QuietStorm4000 · 10-17-2003, 02:19 PM

I guess you're finding out that the cause of anemia can be pretty elusive. As for the heavy periods--my hematologist explained to me that iron plays a role in constriction of the blood vessels. If your body is very low in iron you tend to bleed heavier during your periods. I did notice mine were lighter after iron treatment when my ferritin levels were up. He also stated that this wouldn't extend my periods, just cause them to be heavier for the normal duration. I've read some of your other posts and it sounds like you've got a really difficult problem to diagnose. My periods were never that big a deal and they're ALWAYS on time exactly 27 days apart! I'm on the pill now to stop them and I'm lucky in that I respond well to it so I have no periods at all. I also think that there are problems of absorption of iron that aren't determinable. I've had all the GI tests checking for Celiac, Crohns, etc and all of them came back negative. BUT my iron levels never rise on their own and keep dwindling down. Good luck in your continuing quest to find an answer. I know how frustrating it must be for you.
QS

PaNik5717 · 10-17-2003, 04:45 PM

Thanks for your replies so far. I am copying this from another post. I usually hate it when people do that, but you guys are anemic, so I guess you can understand the fatigue and depression of it all.

My D&C went fine, but my old bleeding pattern emerged about a day after the surgery. I waited a week and then I called the doc. She had me wait two more days so I called today. The bleeding is bothersome - especially when I bleed all over myself or someone else's couch - but the anemia is the worst. I have terrible headaches that get much worse for about twenty seconds after I stand up. I get dizzy if I am standing and talking at the same time - not enough oxygen to do both. I get up and cross the living room and I bump into the walls of the hallway. I don't know my numbers, but I know they are low.

The doc called back. She is terribly frustrated and out of ideas. She talked to her senior partner about me and he would have done all the same things. So, he recommended that I get the depo provera shot and get it more often than every twelve weeks. The last doc I had wanted me to get an IUD or depo, but I know both are contraindicated if you have dysfunctional bleeding and I know that both can have HORRIBLE side effects. I had discussed those things with this doc when I first started with her and she agreed, but now she wants to give me the shot. She seemed to want me there today, but she said to come in on Monday if I am still bleeding since I am two hours away - I already have a follow-up for Wednesday, but I guess the lab results from the D&C must show nothing at all.

I don't know what to do!!! My family is terribly worried about me and I have lost all quality of life. I would rather have a hysterectomy than the shot, but I don't know how to get one. My dad did talk to my PCP the other day and she wants me to see a hematologist. The one she told me to call can't see me until the end of November. My PCP already showed my file to a local hematologist and he told me to go back to my gyn who then gave me a script for sleeping pills. The only thing I can find that my PCP might be thinking of is leukemia. Could that possibly cause abnormal uterine bleeding? I know that abnormal bleeding is one symptom as well as anemia and many of the symptoms of anemia.

I guess I am rambling now, but I am devastated at the idea of getting the shot and devastated that no one can think of anything else to do. I guess I am just plain devastated.

Please let me know if you have any advice.