Hematology, Part II

November 15, 2019

Multiple appointments today. (This is how most of my days off would become.) I started off with the consult for the endoscopy/colonoscopy. I met with a nurse practitioner, and we both agreed that in light of the kidney issues (which was unknown at the time this consult was placed), an endoscopy was no longer needed. It was very unlikely that the anemia was due to internal bleeding but was instead due to the low-functioning kidneys. The colonoscopy was still on, however, just as a routine screening due to my age. (We have no history of colon cancer in my family.) It was scheduled for January 20, 2020.

I asked her (begged her?) for the low volume prep stuff for the colonoscopy. I know myself—there is NO way I could choke down a gallon of that nasty stuff. It’s not the aftermath I feared, it was just drinking all that crap. Just thinking about it makes me gag, and I knew I would throw it up. I had read many articles that stated the low volume prep was just as effective as the full amount of Drano; it was just more expensive. I was definitely willing to pay the extra for it! She agreed to write the prescription for the new stuff.

I saw the hematologist that afternoon. She was aghast that the PA didn’t take me seriously and that she blamed this issue on my age. I was glad to have the confirmation that I wasn’t overreacting to that appointment.

She said that the blood work indicated that I did NOT have iron-deficient anemia. I’m probably going to get a lot of this wrong, but this is how I understood it: My long-term iron levels were normal, as measured by my lab results (ferritin and TIBC). But my access to that iron was poor, because of the poor kidney function. Because they are only functioning at about 1/3 of their capacity, they can’t “push” the iron-containing red blood cells out to the rest of my system. Again, this is probably only partially correct but that’s how I understood it. This wasn’t the news I wanted to hear because I was hopeful it was the anemia causing the low kidney function and not the other way around. An anemia problem seemed like it would be a lot easier to fix than a kidney problem. I was certainly right about that. At this point, I just needed to wait to see the nephrologist. Once again, I had high hopes for that appointment.

Hemoglobin (November 2019): 8.2

Playa Flamingo sunset

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