Thoughts on My CBC Blood Test Results

I am frustrated.

I have fluctuating feelings about how I am being treated by the doctor. I wonder if I am being hypercritical in my assessment of my relationship with him. I have been trying to put it all into words, cohesive and clear. But my flaky thought processes get in the way. I'm not down on myself when I say flaky. It is what it is... perhaps distracted might be the better description.

Needless to say on my recent visit, I walked away feeling dissatisfied.

Doctor did not release the blood result records to me until after the visit. When he brought them up on his computer he barely showed them to me. I told him I wanted a copy. He went and got a paper copy and waved it in front of my face declaring that my blood results were "normal". While doing so, he acted all happy and excited. I only saw a flash of the paper and didn't get the chance to examine it. But, I did see those warning red marks indicating somethings were not normal.

In the meantime, he says, "I thought you would be more excited about this. Jumping up and down for joy. I'm very happy about this. Why aren't you?"

I told him, "I feel numb. It doesn't seem real to me. Maybe I have been in denial since the beginning. Since my results were so low in the first place, this doesn't seem like a major thing. Plus, there are so many patients who have CML much worse than me. I'm a member of a CML support group and when people are writing back and forth sharing their challenges. Also, I read articles from PubMed and I see the challenging results of others. I feel like a baby if I complain."

I would have said more but he cut me off. "You shouldn't pay attention to what you read in blogs on the internet"

I felt like laughing that he didn't know the difference between a support group and a blog. But, didn't bother to explain it to him. What I did say is, "The PubMed articles I read are from a reputable source, the National Institute of Health Library. These are peer reviewed legitimate articles I am reading."

Getting back to the CBC results. I fail to see how they are considered normal. Granted some of the numbers are very close to normal. But, some are not. And what does that mean in terms of recovery? In particular Lymphocyte result is still less than half of the low normal.

When I asked the doctor why that was so, and what it meant, he said he didn't know. He's a Hemetologist, a blood oncologist. Shouldn't he know?

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I took the photograph of a part of downtown Santa Cruz, CA at the beginning of Pacific Ave and Front St.

If it's Normal, Why Continue With Chemo?

Each time I visit my oncologist, I will be asked to have my blood tested. All people with CML have to do this regularly. What caused me to be referred to the oncologist in the first place was my high white cell count.

These blood tests are to monitor the disease and ensure that treatment is working effectively.

Art Glass from Monterey Bay Aquarium
photo taken by Elizabeth Munroz

My blood tests have returned to normal already as I mentioned in yesterday's post. I had a blood test in June which was normal.  It was not indicating the possibility of leukemia. August 24th the same test was done, a CBC, which made the doctor suspicious of Leukemia. In September the test was run again, and still it indicated the same.
That is when I was told I have leukemia. After that, the bone marrow biopsy was done and it verified that I have CML for sure.

Before I started the chemo pill, my blood test was run again. This time the white cells had quickly raised up to 51,000. Alarming to say the least.

I've been taking the chemo pill daily for a few weeks. Now I have what is called hematological response which shows how well the treatment is normalizing my white blood cell count. Complete hematologic response is normal white blood cell and platelet counts, no blasts in the peripheral blood, and less than 5% myelocytes and metamyelocytes in the blood.

It is now my understanding that a cytogenetic response is the next thing to be looked for to verify there is a response inside the bone marrow. But, I wont have that information until  I get my next bone marrow biopsy. I was told that would happen in about six months. Just because the blood looks normal doesn't mean it's normal deeper within.

CBC Blood Test Results

Went to the oncologist on Tuesday. These are my blood results. Everything is back to normal except Lymphocytes. They've been low for a very long time even way before the diagnosis of CML.

I called his office today to ask if I should be continuing to take the Chemo pill. I am concerned that it might push my blood values to below normal. I had to leave a message with the person who answered the phone. She said she would pass the message on to his nurse. I asked if I could speak to the nurse. I was told she was busy. I asked if I could have the nurse call me back so I could talk to her about this. I was told no, the doctor has to make the decision.

Then, why the heck is the message to be passed on to the nurse?

I told the woman who answered the phone that I didn't want to have the same thing happen as last time when I called just before a weekend. And then no one called me back on that day, and then no one called me back until late on the following Monday leaving me a message on my phone to call back the next day. I didn't want to go through the weekend without having an answer.

So, today, I did get a phone call... from the nurse. Dr. Wong is too busy to talk to me. He says must continue to take the medicine. When I asked her if the medicine was going to continue to push my blood results below normal, she didn't know the answer.

I know there are other patients who are in much worse condition than I am. I have the "easy" cancer, the chronic cancer, which is now much more controllable than in the past. So naturally, the doctor is going to be more involved with the others. But, I wish I could get my questions answered even if they are stupid questions. I am not finding the answers myself.

Forgot to mention that my eyes are infected. When I saw Dr. Wong on Tuesday, I went to Urgent Care and was seen by a doctor there, who ordered antibiotic eye drops for me. They sting! but at least my eyes are not so gunky and red!

Wednesday I went to the dermatologist because the rash has gotten much worse, especially on my face. Dr. South ordered two prescriptions for me. I hope they work. He told me to put ice packs on my face to treat the burning of my cheeks.

I need to accept that I have a doctor who needs to apply himself to the patients who have more serious problems. I really shouldn't be complaining. I am very fortunate that things are not worse than they are.

Below is my almost perfect blood test results.

Component	Your Value	Standard Range	Units	Flag
White Blood Cell Count	8.3	4.0 - 11.0	K/uL
Red Blood Cell Count	4.00	3.90 - 5.40	M/uL
Hemoglobin	12.7	12.0 - 15.5	g/dL
Hematocrit	39.7	35.0 - 47.0	%
MCV	99	80 - 100	fL
MCH	31.8	27.0 - 33.0	pg
MCHC	32.0	31.0 - 36.0	g/dL
RDW	13.6	<16.4 -	%
Platelet Count	317	150 - 400	K/uL
Differential Type	Automated
Neutrophil %	73	49.0 - 74.0	%
Lymphocyte %	16	26.0 - 46.0	%	L
Monocyte %	6	2.0 - 12.0	%
Eosinophil %	3	0.0 - 5.0	%
Basophil %	2	0.0 - 2.0	%
Abs. Neutrophil	6.1	2.0 - 8.0	K/uL
Abs. Lymphocyte	1.4	1.0 - 5.1	K/uL
Abs. Monocyte	0.5	0.0 - 0.8	K/uL
Abs. Eosinophil	0.2	0.0 - 0.5	K/uL
Abs. Basophil	0.2	0.0 - 0.2	K/uL

CBC Blood Test Results

Component Results

Component	Your Value	Standard Range	Units	Flag
White Blood Cell Count	54.7	4.0 - 11.0	K/uL	HH
Red Blood Cell Count	4.73	3.90 - 5.40	M/uL
Hemoglobin	14.9	12.0 - 15.5	g/dL
Hematocrit	47.7	35.0 - 47.0	%	H
MCV	101	80 - 100	fL	H
MCH	31.5	27.0 - 33.0	pg
MCHC	31.2	31.0 - 36.0	g/dL
RDW	14.9	<16.4 -	%
Platelet Count	395	150 - 400	K/uL
Neutrophil	65	49 - 64	%	H
Neutrophil Bands	15	0.0 - 10.0	%	H
Lymphocyte	5	26 - 46	%	L
Atyp. Lymph	2	0 -	%	H
Monocyte	6	0 - 12	%
Basophil	3	0 - 2	%	H
Metamyelocyte	4	0 -	%	H
Abs. Neutrophil	35.6	2.0 - 8.0	K/uL	H
Abs. Band	8.2	0.0 - 1.4	K/uL	H
Abs. Lymphocyte	2.7	1.0 - 5.1	K/uL
Abs. Atyp. Lymph	1.1	0 -	K/uL	H
Abs. Monocyte	3.3	0.0 - 0.95	K/uL	H
Abs. Basophil	1.6	0.0 - 0.2	K/uL	H
Abs. Metamyelocyte	2.2	0 -	K/uL	H