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  • How do I know if I should go back to hospital?

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    Old 10-19-2008, 03:30 PM   #1
    GreenGal77
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    How do I know if I should go back to hospital?

    Just a quick recap, last time I got my period the bleeding was very heavy and I ended up in the ER with a hemoglobin of 77, ferritin of 0 and hgl (or whatever it is) less than 5.

    They were about to transfuse me but they were out of beds and my period was ending so since I'm "young and otherwise healthy" they sent me home with the instructions to rest tons and eat well.

    The problem is, I followed up with my family doctor who admitted and awknowledged that as soon as I got a period again it would likely be a problem. He said I definitely shouldn't go right away because it will take about 12 hours for my hemoglobin to start dropping again (assuming it's come up a bit since I stopped bleeding (about two and a half weeks).

    So I guess what I'm wondering is with having been that low, should I just automatically go back after a day or two or only if my symptoms worsen? I'm starting to adapt to my symptoms (heart racing, freezing cold, tired etc) so I'm not even sure I would notice them worsen...

     
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    Old 10-19-2008, 07:13 PM   #2
    robinegg
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    Re: How do I know if I should go back to hospital?

    Quote:
    Originally Posted by GreenGal77 View Post
    Just a quick recap, last time I got my period the bleeding was very heavy and I ended up in the ER with a hemoglobin of 77, ferritin of 0 and hgl (or whatever it is) less than 5.

    They were about to transfuse me but they were out of beds and my period was ending so since I'm "young and otherwise healthy" they sent me home with the instructions to rest tons and eat well.

    The problem is, I followed up with my family doctor who admitted and awknowledged that as soon as I got a period again it would likely be a problem. He said I definitely shouldn't go right away because it will take about 12 hours for my hemoglobin to start dropping again (assuming it's come up a bit since I stopped bleeding (about two and a half weeks).

    So I guess what I'm wondering is with having been that low, should I just automatically go back after a day or two or only if my symptoms worsen? I'm starting to adapt to my symptoms (heart racing, freezing cold, tired etc) so I'm not even sure I would notice them worsen...
    Hi Greengal 77

    Do you have any other results of bloods like MCV ?
    Have you ever had your B12 levels and folate checked

    I have to say if you havent ask to get them done specifically

    Folate
    B12 serum
    Hyc
    MMA (the uMMA is more sensitive)
    The last will be elevated with a deficiency even if serum is in the low normal

    High homocysteine(Hyc) levels can account for a racing heart ....
    Do you have any numbness or tingling too?

    has the docs ever looked into the fact that you have heavy periods that seem to be prolonged..........

    Never worrying about returning to the ER if you feel so bad then go

    Look forward to hearing from you
    Cheers
    Rainbows End

     
    Old 10-20-2008, 07:36 AM   #3
    huffle
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    Re: How do I know if I should go back to hospital?

    Part of what they test you for is a "tilt" which is the difference in blood pressure sitting and then standing. If your bleeding that much your blood pressure should go down when you stand thus leading to weakness and light headedness. Next time I would insist on waiting for a bed and get the transfusion. Is there a way your regular doc and set you up for one? Can you go on that birth control pill that allows you to only have like 1 period a year? That would help a lot to not have the monthly blood loss.

    Huffle

     
    Old 10-20-2008, 01:27 PM   #4
    Kiwilily
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    Re: How do I know if I should go back to hospital?

    I think you should go back to the hospital or your doctor's office immediately because they should have done something to help you the first time. It is not your problem that they did not have a bed. It is their problem. You, as a patient, have a right to appropriate care and here they were rationing care, inappropriately.

    I swear, the Canadian health care system is going to pot. My uncle had a heart attack last year, in Ottawa. They did not have a bed for him either. They sent him home with some medicine and told him that he would be placed on a waiting list for the cath lab or open heart surgery within the next year. He dropped dead the next morning, at the age of 56.

    Here in the US, they would have transfused you immediately with 2 units of blood. You then, most likely, still would have needed to have IV iron after that to build up your iron stores. This is exactly what happened to me.

    What did they do to boost your iron stores since your last blood work? Was their only advice to eat healthy foods and rest? What a farce. Were you prescribed iron and folate? Did they order IV iron for you in an infusion center or a doctor's office? IV iron does not need to be given in a hospital Did they at least give you an iron injection? (Canada still does iron injections). What is your doctor's plan?

    Your ferritin is 0 so even if your body is making bunches of red blood cells, these cells contain no iron. You have no iron to give. It takes large amounts of iron to rebuild stores and it generally takes 3-6 months to see even small changes in ferritin. The initial iron that is absorbed gets used to make new red blood cells and it is not available to be turned into stored ferritin. Our body needs to correct the anemia before it can start saving up iron for a rainy day.

    My advice to you is to either go straight to the ER or to your MD's office and don't leave until you get the treatment that you need. If worse comes to worse, call 911 and tell them you passed out. Coming in by ambulance usually fast tracks you to a bed but that is not always the case, in Canada, any longer . It is worth a try though. You let them know that you can not function, period and you need blood now.

    Good luck and I hope that you really get the care that you need.

     
    Old 10-20-2008, 07:20 PM   #5
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    Re: How do I know if I should go back to hospital?

    GG77--Sorry you are having a tough time. I agree with Kiwi. You have to get help before your symptoms get worse, you cannot afford to wait. You have to stop the blood loss or this will continue and never get fixed. When you are anemic with a low ferritin/no ferritin you bleed a lot more. The less blood you have the more you bleed, this is how it works. I did it for a long time and the Hematologist explained this to me. I know it sounds strange, but it also sounds like this may be happening to you. At least you know what your problem is, thats a start. Good luck to you, things will get better. Keep us posted. FLFLOWERGIRL

     
    Old 10-21-2008, 12:19 PM   #6
    GreenGal77
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    Re: How do I know if I should go back to hospital?

    Thanks everyone for your responses. In answer to most of the questions, they didn't give me anything. They gave me a script for iron and folic acid but I used to have an eating disorder and have a really sensitive stomach and I haven't been able to keep the iron down (they know that). So now I'm to concentrate on "diet and rest" It makes no sense.

    My family doc is furious because they are surprised I'm still standing...but at the hospital I get nowhere. I think they are just so busy that they have to pick and choose their battles and I lose because my blood pressure is holding (I don't know, but I think this is probably largely due to the eating disorder...I was quite thin and my body was deprived of nutrients for so long it takes a lot before my blood pressure starts to drop) and also because I have someone who will "watch me".

    So basically my family doctor almost wants me to try and wait as long as possible so that I bleed as long as possible and that way when I do go in I'll (in theory) be even lower and they will have to do something.

    So no IV iron, iron injections or transfusion And I've been bleeding since Sunday. It's slightly lighter than last time but still quite heavy, I started the pill so hopefully it won't be as heavy this time.

     
    Old 10-21-2008, 03:52 PM   #7
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    Re: How do I know if I should go back to hospital?

    GG77--I am unable to take many different kinds of vitamins because they bother my stomach and Ferris Sulfate sent me to the ER. It gave me enteritis for 3 months and caused me a lot of grief. They do make irons for people like us that are extra sensitive to supplements. If it weren't for my GI doc I wouldn't know about this. He prescribed Poly Iron 150mgs elemental high dose iron. It comes with Vitamin C already added to increase the absorption. There is also a Poly Iron150 Forte that also has B-12 in it if that is needed. It in no way causes me any problems. It's hard to believe, but it's true for me. I take it on an empty stomach and never have an upset stomach from it at all. It's worth a try in your situation because you can take up to 3X daily upon the advice of your physician. It is available OTC at the pharmacy, but you have to ask for it and sometimes they will have to order it. It is high dose iron which is what you need. You should ask about it. I feel like it saved me. I was too ill to be given IV iron and my Hgb was not yet low enough to have transfusion at 8.5 Hgb. My doctor said that even if I had a 7 Hgb, he would not recommend me to have a blood transfusion, if I were his wife. I really hope that you get some sort of help. But right now you need to be on high iron supplements, it is crucial to your health. I went through a year of hell and would not wish it on anyone. Keep us posted. FLFLOWERGIRL

     
    Old 10-21-2008, 06:01 PM   #8
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    Re: How do I know if I should go back to hospital?

    Did you try to go back to the ER or to your doctor in the last couple of days? I think that you should be furious with you family doctor. If the ER is not doing anything for you he or she should be. They can give you an iron injection. They could order IV iron. You will not be able to get you counts up quickly enough with oral iron. It will take you a year or more. Your doc can refer you to a hematologist ASAP. You are not getting appropriate care. Bother them until they do something.

     
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