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    Old 06-13-2007, 10:48 AM   #1
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    Concerned but dr is not

    Hi, this is my first time around here. I'm having concerns with my lab results. Maybe I should shut up and trust my doctor

    Note: I tried to be brief, but there were alot of details

    Background. I am a runner that averaged 45-55 miles per week before this happened. Given my exercise level, I have always attribtued my fatiguen to the obvious. But, last fall, it went a step further and my motivation was sinking. I attributed it to needing a break, so I cut back to 3 days/week till Dec...this is rare

    In dec, I gradually started to pick things up, I was fatigued still, but tolerable. Normally, when I've had a break due to injury, illness, I come back a little faster--not this time. I had a disappointing New Years race, but it renewed my motivation.

    So, I contitnued, and the followed weekend, I crashed. I was sleeping 14 hours at a time if allowed. This endured to the point where I didn't run for 3 weeks--it didn't improve with rest.

    I am a fitness professional so this makes my job hard

    I was also having tingling in my hands esp while swimming along with purple toe nails

    We attributed B12 to the tingling. My iron was low and my ferritin was borderline. My thyroid panel indicated hypothyroid and I began Synthroid.

    My CBC was "normal." I am a 33 year old female
    WBC: 7.5 (4.8-10.8)
    RBC:n4.15 (4.2-5.4)-my doctor was not concerned with this bec my hemoglobin and hct were normal...but since I'm a runner, I don't like this.
    HGB: 14 (12-16)
    HCT: 39.4 (37-47)
    MCV: 94.9-given low B12 and iron, this number is skewed
    MCH: 33.8 High
    MCHC 35.6
    RDW: 12.4
    PLT: 220 K

    Cell Differential-unremarkable
    neu: 62.6%
    mono: 9.2
    baso: .5
    neu#: 4.7
    Lym #: 2.0

    S, I began iron and synthroid and had a B12 shot.. My iron slowly rose over the next 2 months. When I found the right Synthroid dose, I felt GREAT! Tingling was gone and within 6 weeks, I was doing an hour run-although slower. This was March, and by April, I was exhaused. People had been commenting on my "color"--pale and "worn out"

    *Two additional CBCs (total 3) gave similar results although iron and ferritin were in the normal range. However, the 3rd CBB coincided with my return of fatigue.

    ^ RBCs were slightly lower given my iron and ferritin increase. However, the 3rd WBC differential showed an increase of neutrophils an decrease of lymphocytes out of normal range.

    Misc info: had an allergy test that showed nothing.
    On two occasions, my pinky went numb and stayed numb for a week

    Fast forward to June. My husband called the doctor that was still feeling bad
    For the record, at this point, I did not dream of leukemia

    We did a CBC, reticdulocyte count, thyroid panel, chem panel, folate, methylmalonic acid, B12,and cortisol

    Thyroid: Great
    B12 methymalonic acid: normal--still tingling
    Chem panel: alkaline phosphatase low. Some electrolytes were borderline
    Folate: fine
    Cortisol: 10
    Recitulocyte count: 1% corrected

    Still "normal" although ALL of my readings were lower (or higher in some cases) despite my iron being at its higher.

    Here are a few:

    RBCs: 4.09
    HCT: 38%
    HGB: 13.4.
    PLT: 190

    Even if the RBC count isn't as critical, at some point low is low

    WBC differential
    NEU: 85.5%--streadily increasing (42-76)--no recent infection
    LYM: 9.9%
    MONO: 4.0%
    EOS: .2%--Low
    BASO: .5%

    Even if my WBC isn't high, it is steadily increasing. I'm also concerned about the upward trend in my WBC...

    Also, a reticulocyte count, while within normal limits, is very low. Given that my RBCs are dropping, could have suggest somthing on the marrow level? :

    I had no idea about alkaline phosphate being connected to CML until later..of all random readings to be off.

    The thing is, I don't have all of the classic leukemia sign. I bruise rather easily--I'm not sure about my temp...none of the skin symptoms. I don't have any of the body aches... I have never had headaches until the last few months. Usually, it is a low grade headache, but enough to interfere with my focus.

    think i covered everything--thank you if you read this all the way through

    So, do you all think that this warrants follow-up?

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    Old 06-14-2007, 12:31 AM   #2
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    Re: Concerned but dr is not

    if you had leukemia, your wbc would be thru the roof not just slightly elevated.. alot of other things on your blood tests would be abnormal as well especially your hemoglobin and platelets. Do you suffer from health anxiety by any chance? I know when i get nervous my hands and fingers get numb nd tingly as well. If your doc doesn't seem concerned then I wouldn't be either. If you had leukemia I think you would be rather sick. Good luck!

    Old 06-14-2007, 04:08 AM   #3
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    Re: Concerned but dr is not

    Thanks for your response

    No health anxiety. My numbness correlates with times of intense exercise/temp and blue toenails. Also, my exhaustion, dizziness and paleness are real.

    Overall, we know that something is going on, it's a matter of what. I'm seeing an endo in Aug. By then, it will have been 8 months of interference w/my life. We are both frustrated.

    Other than feeling like utter running, a passion, is non-existant. For those familiar, I've gone from a 3:23 at Boston to barely cracking a 3 mile run at an 8 minute pace. That may be trivial compared to others around here, so I apologize for being insensitive.

    My concern was the increasing maybe if it isn't Leukemia, an issue with the marrow that warranted further investigation. Obviously, I'm not a physician, but my intuition is talking here.

    Thanks again!

    Last edited by kjrunner; 06-14-2007 at 04:11 AM. Reason: edit for typo

    Old 06-14-2007, 09:15 AM   #4
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    Re: Concerned but dr is not

    This may be an answer that I can find reading the anemia forum

    Old 08-15-2007, 09:36 PM   #5
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    Re: Concerned but dr is not

    I was a runner in high school and I have some understanding of those times you gave for the marathon and for the 5k. That seems like a very significant decrease in overall performance to me (no offense! lol) and I would definitely be concerned as you are. good luck!

    Old 08-18-2007, 12:52 PM   #6
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    Unhappy Re: Concerned but dr is not

    My husband passed away just this pass Thanksgiving 2006. He had Leukemia. The Monday before Thanksgiving he went to the doctor with symptoms of headache that did not go away numbing in left hand and red spots and purple patches all over his legs,chest and arms and feeling very tired for weeks. The doctor told him to go to a skin doctor for the red spots and purple patches and then he ordered some blood work to be done. Which we did that on Wed. The day before Thanksgiving. Thanksgiving morning he had a stroke do to bleeding on the brain. I called 911 and they took him to emergency. He went into a coma shortly after arriving at the hospital and was placed on life support.

    The doctors ran test and told me he had Leukemia. He was declared brain dead the very next day. The doctors at the hospital new right away the red spots and purple patches was petechiae and that he had Leukemia. Unlike his primary doctor told him to go to a dermatoligist.

    The day before my husband stroke we took our two boys Ice skating. The only symptoms my husband had was feeling tired, headache, and low grade fever and the red spots. We just thought that he had some kind of a virus. His doctor called on Monday with the blood results and I had to tell him he died.Needless to say the doctor was shocked! Some doctors do not always make the right choices.

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