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1st follow up/labs

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Hello,

Yesterday was my 1st follow up since dx.Here is a copy of my 1st

set of labs and now the results from yesterday finger prick..New ones

are on the right side..

This is what my lab says..

> Auto Diff

> Gran # 12.2 High normal 2.0-7.8 new---- 3.5

> Lymph # 3.4 normal 0.0-6.0 new---------2.8

> MO# 0.7 High normal 0.1- 0.6 new----0.3

> GRAN % 74 normal 49-74 new -----51.3

> lymph % 21 low normal 23-47 new------43.5

> mo% 5 normal 3-6 new---------5.2

>

> WBC 19.8 EXTRA HIGH 4-11 new------6.6

> SEGS 61 50-75

> BANDS 5 0-5

> METAMYELOCYTES 3 HIGH 0-0.1

> MYELOCYTES 3 HIGH 0-0.1

> LYMPHS 26 20-44

> MONOCYTES 0 0-10

> EOSINOPHILES 1 1-7

> BASOPHILES 1 0-2

> RBC 4.20 3.80-.10

> HEMOGLOBIN 12.7 11.3-15.5 new--------12.6

> HEMATOCRIT 40.6 35.5-47 new--------38.7

> MCV 97 81-102 new-----98

> MCH 30.3 27-35 new-----31.9

> MCHC 31.4 31-37 new-----32.7

> RDW 16.2 HIGH 11.5-14.5 new----15.0

> PLATELET COUNT 755 EXTRA HIGH 150-450 new------254

So as you can see blood levels are coming down.Dr. wants to keep the

same course of Gleevec 100mg 4 times daily.He is going to start

monitoring the blood weekly now instead of every 3 weeks.I found out

he is not a CML specialist.He is a Hemo/Onc.He has alot of patients

with CML and has treated many over the years.

I asked the DR about a BMB he said we didn't need to do one unless

the acute stage is suspected.He said something about he checks the

BCR/BML and if that was normal and showed no abnormalities then he

would do a BMB but we already know the cells are abnormal so not a

real need.Hope I understood him correctly and wrote this right.

He will do weekly finger pricks to monitor and at 3 months will do

BCR.Hope I am understanding this all correctly.I asked about my

spleen pain and he said something about stretching of the capsules

and unless it was 3times enlarged he wouldn't notice it but it felt

ok yesterday based on that description.I asked about the Fatigue he

said it should be getting better now that my levels are returning to

normal.(it has gotten worse since starting meds)I asked about the

water gain he said if it continues at the next visit he will

perscribe something.I asked about the itching he said that was due to

the CML itself not the meds as well as my excessive bruising(not

platlet related).Dr. says the Gleevec is working...

So does it sound like he is doing the correct things or do I need

to look for a specialist in another city? I don't know if his

comments to my questions are the correct response or not..Any info or

further advise is welcome..Thanks for reading all this..

SharonS

>

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Hi Sharon,

Your blood looks great so that's a good thing. I would really

question his logic on not doing a BMB though. All of the experts

would do them on diagnosis and later to confirm CCR, after that it's

a controversial topic but I don't know any doctors who don't do any

BMB's at all, ever.

The test he was referring to is probably the PCR. Some people call

it a BCR/ABL test because that's what it looks for. The BCR/ABL gene

is what causes the Philadelphia chromosome so it's a good test to see

how the CML is doing however it tells you nothing about your other

chromosomes which is what the BMB would do.

Did he do an ultrasound to look at your spleen? If he's only relying

on palpating it, again that raises a red flag especially if you're

complaining of pain in the area.

It doesn't sound like he addressed the bruising issue either. Did he

do an INR or Prothrombin Time test? That would measure how long it

takes for you to stop bleeding. It could be that you have enough

platelets but the ones you have aren't working well for some reason.

I'm glad he's doing a CBC every week now but he should never have let

you go 3 weeks without doing one when you began treatment. Also, it

doesn't look like he's testing your liver, kidneys or electrolytes

unless maybe you just didn't report those numbers? Those are all

important things to watch in the early days and periodically later on.

The good news though is that your numbers are coming down. Now what

you want to watch is how low will they go.

Take care,

Tracey

>

> Hello,

> Yesterday was my 1st follow up since dx.Here is a copy of my 1st

> set of labs and now the results from yesterday finger prick..New

ones

> are on the right side..

>

> This is what my lab says..

> > Auto Diff

> > Gran # 12.2 High normal 2.0-7.8 new---- 3.5

> > Lymph # 3.4 normal 0.0-6.0 new---------2.8

> > MO# 0.7 High normal 0.1- 0.6 new----0.3

> > GRAN % 74 normal 49-74 new -----51.3

> > lymph % 21 low normal 23-47 new------43.5

> > mo% 5 normal 3-6 new---------5.2

> >

> > WBC 19.8 EXTRA HIGH 4-11 new------6.6

> > SEGS 61 50-75

> > BANDS 5 0-5

> > METAMYELOCYTES 3 HIGH 0-0.1

> > MYELOCYTES 3 HIGH 0-0.1

> > LYMPHS 26 20-44

> > MONOCYTES 0 0-10

> > EOSINOPHILES 1 1-7

> > BASOPHILES 1 0-2

> > RBC 4.20 3.80-.10

> > HEMOGLOBIN 12.7 11.3-15.5 new--------12.6

> > HEMATOCRIT 40.6 35.5-47 new--------38.7

> > MCV 97 81-102 new-----98

> > MCH 30.3 27-35 new-----31.9

> > MCHC 31.4 31-37 new-----32.7

> > RDW 16.2 HIGH 11.5-14.5 new----15.0

> > PLATELET COUNT 755 EXTRA HIGH 150-450 new------254

>

> So as you can see blood levels are coming down.Dr. wants to keep

the

> same course of Gleevec 100mg 4 times daily.He is going to start

> monitoring the blood weekly now instead of every 3 weeks.I found

out

> he is not a CML specialist.He is a Hemo/Onc.He has alot of patients

> with CML and has treated many over the years.

> I asked the DR about a BMB he said we didn't need to do one

unless

> the acute stage is suspected.He said something about he checks the

> BCR/BML and if that was normal and showed no abnormalities then he

> would do a BMB but we already know the cells are abnormal so not a

> real need.Hope I understood him correctly and wrote this right.

>

> He will do weekly finger pricks to monitor and at 3 months will

do

> BCR.Hope I am understanding this all correctly.I asked about my

> spleen pain and he said something about stretching of the capsules

> and unless it was 3times enlarged he wouldn't notice it but it felt

> ok yesterday based on that description.I asked about the Fatigue he

> said it should be getting better now that my levels are returning

to

> normal.(it has gotten worse since starting meds)I asked about the

> water gain he said if it continues at the next visit he will

> perscribe something.I asked about the itching he said that was due

to

> the CML itself not the meds as well as my excessive bruising(not

> platlet related).Dr. says the Gleevec is working...

> So does it sound like he is doing the correct things or do I need

> to look for a specialist in another city? I don't know if his

> comments to my questions are the correct response or not..Any info

or

> further advise is welcome..Thanks for reading all this..

>

> SharonS

> >

>

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