Postby mpbser » Tue May 23, 2017 3:23 pm
Hi LPL, "Did your DH get blood transfusions during/after this surgery? Was his hemoglobin very low before surgery?
You/he mentioned earlier that his hemoglobin was ranging from 7 to 9 and that he had had 6 transfusions before, the last one 4/12/17. How is his doctor thinking regarding this?"
No transfusions since 4/12/17 but his Hg was improving even since that day. Here are the specifics:
Results Value Reference Range Status Flag Date
red blood cell distribution width 20.00% 11.5-14.5 completed H 5/23/2017
platelet count 337 10*3/mm3 150-600 completed N 5/23/2017
mean corpuscular volume, RBC 70.2 fL 80.0-94.0 completed L 5/23/2017
mean corpuscular hemoglobin, RBC 20.8 pg 27.0-31.0 completed L 5/23/2017
mean corpuscular hemoglobin concentration, RBC 29.6 G/DL 32.0-37.5 completed L 5/23/2017
leukocyte count, blood 8.86 10*3/mm3 4.0-11.0 completed N 5/23/2017
hemoglobin, blood 7.6 g/dL 14.0-18.0 completed LL 5/23/2017
hematocrit, blood 25.70% 40.0-54.0 completed L 5/23/2017
erythrocyte (RBC) count 3.66 XMILL/UL 4.6-6.2 completed L 5/23/2017
red blood cell distribution width 20.00% 11.5-14.5 completed H 5/22/2017
platelet count 345 10*3/mm3 150-600 completed N 5/22/2017
mean corpuscular volume, RBC 70.4 fL 80.0-94.0 completed L 5/22/2017
mean corpuscular hemoglobin, RBC 20.1 pg 27.0-31.0 completed L 5/22/2017
mean corpuscular hemoglobin concentration, RBC 28.6 G/DL 32.0-37.5 completed L 5/22/2017
leukocyte count, blood 10.43 10*3/mm3 4.0-11.0 completed N 5/22/2017
hemoglobin, blood 8.1 g/dL 14.0-18.0 completed L 5/22/2017
hematocrit, blood 28.30% 40.0-54.0 completed L 5/22/2017
erythrocyte (RBC) count 4.02 XMILL/UL 4.6-6.2 completed L 5/22/2017
red blood cell distribution width 20.20% 11.5-14.5 completed H 5/21/2017
platelet count 346 10*3/mm3 150-600 completed N 5/21/2017
mean corpuscular volume, RBC 70.4 fL 80.0-94.0 completed L 5/21/2017
mean corpuscular hemoglobin, RBC 20.9 pg 27.0-31.0 completed L 5/21/2017
mean corpuscular hemoglobin concentration, RBC 29.7 G/DL 32.0-37.5 completed L 5/21/2017
leukocyte count, blood 12.50 10*3/mm3 4.0-11.0 completed H 5/21/2017
hemoglobin, blood 8.7 g/dL 14.0-18.0 completed L 5/21/2017
hematocrit, blood 29.30% 40.0-54.0 completed L 5/21/2017
erythrocyte (RBC) count 4.16 XMILL/UL 4.6-6.2 completed L 5/21/2017
SURGERY DATE 5/19/2017
red blood cell distribution width 20.80% 11.5-14.5 completed H 5/18/2017
mean corpuscular volume, RBC 70.3 fL 80.0-94.0 completed L 5/18/2017
mean corpuscular hemoglobin, RBC 20.6 pg 27.0-31.0 completed L 5/18/2017
mean corpuscular hemoglobin concentration, RBC 29.3 G/DL 32.0-37.5 completed L 5/18/2017
hemoglobin, blood 9.5 g/dL 14.0-18.0 completed L 5/18/2017
hematocrit, blood 32.40% 40.0-54.0 completed L 5/18/2017
erythrocyte (RBC) count 4.61 XMILL/UL 4.6-6.2 completed N 5/18/2017
red blood cell distribution width 21.50% 11.5-14.5 completed H 5/2/2017
mean corpuscular volume, RBC 69.4 fL 80.0-94.0 completed L 5/2/2017
mean corpuscular hemoglobin, RBC 20.3 pg 27.0-31.0 completed L 5/2/2017
mean corpuscular hemoglobin concentration, RBC 29.2 G/DL 32.0-37.5 completed L 5/2/2017
hemoglobin, blood 9.3 g/dL 14.0-18.0 completed L 5/2/2017
hematocrit, blood 31.80% 40.0-54.0 completed L 5/2/2017
erythrocyte (RBC) count 4.58 XMILL/UL 4.6-6.2 completed L 5/2/2017
red blood cell distribution width 20.60% 11.5-14.5 completed H 4/12/2017
mean corpuscular volume, RBC 66.8 fL 80.0-94.0 completed L 4/12/2017
mean corpuscular hemoglobin, RBC 18.5 pg 27.0-31.0 completed L 4/12/2017
mean corpuscular hemoglobin concentration, RBC 27.7 G/DL 32.0-37.5 completed L 4/12/2017
hemoglobin, blood 7.3 g/dL 14.0-18.0 completed LL 4/12/2017
hematocrit, blood 26.40% 40.0-54.0 completed L 4/12/2017
erythrocyte (RBC) count 3.95 XMILL/UL 4.6-6.2 completed L 4/12/2017
His doctor was mildly concerned and wasn't very clear to use in explaining what might be going on. He decided against transfusion at this time because of its immunosuppressive effect. We get regular second opinions from a surgeon friend of ours in NYC (residency at Mt. Sinai) who told me this morning: If all the other numbers are normal, or trending better, then it's generally not an issue until it gets under 6. So, if he is feeling good, peeing, eating, and all other tests are normal (which they are or at least very close to), or improving from where they were, then no worries. Another thing is that if there is internal bleeding post surgery, his belly would be getting more tender, his BP would be dropping, pulse increasing, and blood in the toilet. For Hg to drop by 1, there is a blood loss of about 300 ml which is larger than a can of soda volume. That's either coming out, or staying in the belly causing pain, distention, nausea, fever, malaise, and other changes in vitals."
That information made me and husband feel a whole lot better. He came home this afternoon but doesn't want to come to this forum for now.
Wife 4/17 Dx age 45
5/17 LAR
Adenocarcinoma
low grade
1st primary T3 N2b M1a
Stage IVA
8/17 Sub-total colectomy
2nd primary 5.5 cm T1 N0
9 of 96 nodes
CEA: < 2.9
MSS
Lynch no; KRAS wild
Immunohistochemsistry Normal
Fall 2017 FOLFOX shrank the 1 met in liver
1/18 Liver left hepatectomy seg 4
5/18 CT clear
12/18 MRI 1 liver met
3/7/19 Resection & HAI
4/1/19 Folfiri & FUDR
5/13/19 HAI pump catheter dislodge, nearly bled to death
6-7 '19 5FU 4 cycles
NED