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  • What is wrong when HCT, Hgb, MCV, WBC and MCH are all high?

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    Old 03-07-2010, 11:04 PM   #1
    pegbusymom's Avatar
    Join Date: Mar 2010
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    Question What is wrong when HCT, Hgb, MCV, WBC and MCH are all high?

    Hi all. I am new here and, I apologize if I am not on the correct board for posting this.
    A little bit about me first. I live in MN and was diagnosed as Stage 1, grade 2 breast cancer last July. Cancer is being treated with a drug called Femara(pill.) Side affecdts listed for Femara are: Hot flashes (Oh yeah every night for last 6 months!; Potential for blood clots; weight gain ect.
    I started with a new primary (family) doctor in February 2010. I saw him on the 8th of February. I told him originally, that for year's I have run a high WBC. Not within what some consider normal ranges. Mine have always run 12.0-18.0. The 18.0 is if I usually have a Sinus/Bladder or some other infection going on. He said my WBC was high so, he wanted to do a Peripheal Blood Smear.
    My labs from Fevruary 8th were: WBC-12.3; LY-29.6; MO-7.2; GR-63.2; LY#-3.6 (H)-high; MO#-0.9 (H/high); GR#-7.8 (H/high); RBC-4.87; Hgb-16.0 (H/high); Hct-48.7 (H/high); MCV-100.0-(H/high); MCH-32.8-(H/high); MCHC-32.8 (L/low); RDW-32.9; Plt-334.; MPV-7.9
    The Peripheal Blood smear came back from pathology with the following on it: "Leukocytosis, absolute neutrophilia and monocytosis type. Reactivity noted. Blasts not seen. RBC-Slight macrocytosis; PLTs-adequate. Comments/Recommendations: Macrocytosis without anemia. The differential diagnosis include drug effect, liver disease, alcohol use, and hypothyroidism or complex etiology."
    What does Leukocytosis absolute neutrophilia and monocytosis type mean? I have never heard of these medical words before, or any of the others used in the Pathology report from the Blood Smear done.
    When my family doctor got the blood smear pathology report back he said, "You are right, you just run a high WBC or higher than what is considered normal. The blood smear says you are fine, they couldn't find anything."
    I then had my 6 month Oncologist appointment last Monday. My Oncologist said, "Your family doctor may think these counts are normal/not so far out of range for you, but from an Oncology point of view these are high values. You don't know this but, I am also a blood doctor/Hematologist. I want to do a Bone Marrow Biopsy."
    I came home from my Oncologist appoinment and absolutely had a melt down. I was scared and confused.
    I didn't understand how a family doctor said my Blood Smear was okay based on the pathologists report, but my Oncologist 1-2 days later is saying something different.
    My Oncologist used words like Leukocytosis, Erthrocytosis and Myleophystic Process.
    I asked my Oncologist what all these medical words were in my language. Her response was, "We will discuss that later, after your Bone Marrow Biopsy." I did get to ask her quite blank, "Are you looking for or do you think this this is Cancer?" She said, No but you could have the risk of stroke, if your making too many red blood cells. Then she said, we would have to have you donate blood, except they would not use it and take an aspirn a day."
    Wow was I ever confused and an emotional basket case too! I mean, I had no idea what Leukocytosis, Erthrocytosis, Myelophystic Process and all these medical words mean't. And when I asked about these, all I got is we will discuss this after the Bone Marrow Biopsy .
    Then I got mad and called the Oncologists Office back the next day. I talked to my Oncologists nurse. I said, "I need to know what these medical terms are and what they mean. I need to know what my doctor is looking for by doing a Bone Marrow Biopsy."
    The nurse said: "Leucocytosis is an over production of white cells. Erthrocytosis is a small part of the white blood cell. Your doctor is looking for Myelophystic Process." Which of course I had to ask her, "And what is Myelophystic Process?" She said, "This is where my doctor is looking for bone marrow suppression or mutation in them. Alot of Erthrocytosis/Erthros clot more easily."
    I still don't understand and am still confused, as to how one doctor (Family) doc said Blood smear pathology reports were okay. That I just have higher WBC counts than what is considered the ranges/norms, but Blood smear said I was okay. Then two days later Oncologist said in essence, "No, these are not okay, and I want to do a Bone Marrow Biopsy."
    I left her office terrified and, came home to use my computer to look up the medical words she through at me: Leucocytosis, Erthrocytosis, Myelophystic Process and, what a Bone Marrow Biopsy was and what this consisted of.
    Well then I became more terrified because most places online that I looked at Bone Marrow Biopsy, they were talking about Blood Cancers and Leukemia's and things of this sort.
    For a Blood or Leukemia wouldn't the WBC be alot higher than 18.0? I mean is a WBC of 18.0 extemely high for a WBC?
    I've also been battling a Sinus Infection and, Just today learned coffee is a dehydrator. I NEVER knew this and, had been drinking 3 pots a day! )Yes, I like coffee but, am willing to give this up if it would mean normal labs, or at least close to normal labs. I have been drinkiong 5-12 oz bottles of water everyday since my Oncologist appointment last week. One of those with some Braggs Apple Cider Vinegar in it. (I've heard this has good health benefits.)
    My other question is: How does a Bone Marrow Biopsy diagnose a blood clot?
    I am sorry to take up so much time, and for being so confused and scared. Long winded too
    But if anyone has ever heard of these medical terms; lab results; Blood smear results; or knows anything about any part of this I posted on, please post so I can read something and maybe learn from you, and what your experience has been. Thank you and have a good night! Pegbusymom

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    Old 09-17-2010, 09:48 PM   #2
    thankyou2's Avatar
    Join Date: Sep 2010
    Location: Ridgewood NJ
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    Re: What is wrong when HCT, Hgb, MCV, WBC and MCH are all high?

    Your message was posted way back in March, so you've no doubt gotten everything straightened out by now & my reply is probably a moot point. I'm surprised your dr. didn't order a JAK-2 test which is the test for Polycythemia Vera. All the high blood counts you mentioned certainly could indicate Polycythemia Vera (PV). You should know that even if the JAK-2 is negative it could still be PV -- it is in about 20% of people w/ PV. The standard treatment is taking out a pint of blood as needed (i.e. -- what you were told was "giving blood but they won't use it." Also a daily aspirin. They do the bone marrow biopsy to rule out anything else, but if the JAK-2 is positive they don't need to do the bone marrow biopsy.

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