New Test Results - Good News!
    The test results have been posted for draw date 8/8/03. Almost everything looks good. Her RDW is high, which I need to look into, and her protein/ urine/random came back positive (it should be negative), which was a mentioned concern of Mom's hematologist. I'm wondering about her low IgG, but he didn't mention it and I didn't have the lab results to actually look at until he spirited out of the office. Over all, he pronounced Mom as no longer suffering from anemia, was very pleased with her progress, was torn about whether to "cut [Mom] loose" or have her come back but finally decided to write her PCP a note about the positive protein/urine/random result and have us come back on February 17, 2004 at 1100. I'm writing that for my own reference and to help paste it into my conscious brain.
    Her weight was stable at 150 (although, it looked to me like 149 but the nurse couldn't decide and went for 150). Her blood pressure was "a little low," said the nurse, at 102/62. Her pulse was 80 and her ear temperature was 97. I took it this morning because she felt so warm but her warmness was a result of snugness in her bed and I measured it orally at 97.1. Seems a little low to me but no one mentioned it.
    The hematologist greeted Mom by mentioning that he was pleased to see her "big smile" and Mom responded, "I saved it for you."
    He smiled back and said, "I'm blessed!"
    Later he mentioned Mom's smile and I teased him (and her) and said, "It's her secret weapon." He agreed.
    There were two changes I noticed in Reference Range numbers since 1/23/03 (the last time this particular battery was ordered on Mom). The upper calcium range was changed from 10.2 to 10.4. Curiously, on her 1/23/03 test, Mom registered "high" at 10.4. Today, she registered "normal" at 10.4. As well, the potassium/serum Reference Range was changed from an upper cutoff of 5.1 to 5.2. This is bizarre. I'm going to call MCS, let her in on the good news and ask her whether this changing of reference ranges is typical.
    I checked WebMD for information on high RDW (Red Cell Distribution Width). This is what I found, with the portion underlined, by me, that appears to apply to my mother (except for the fact that her hematologist seemed not to take note of it and pronounced her "no longer anemic", anyway):

One commonly used method for classifying anemia is to categorize the anemia by the size of the red blood cell as measured by the mean corpuscular volume (MCV). Microcytic anemias are associated with an MCV less than or equal to 79 femtoliters (fl) and include iron-deficiency anemia, thalassemia, and anemia of chronic disease. Macrocytic anemias are associated with an MCV greater than 101 fl and include anemias related to vitamin B12 or folate deficiency, myelodysplasia, and liver disease. Most anemias are normocytic, meaning that the MCV is in the normal range. This category includes myelophthisic anemia (anemia due to neoplastic replacement of the bone marrow), most chemotherapy- related anemias, anemia due to renal or hepatic dysfunction, hemolytic anemia, and aplastic anemia. However, a mixed red blood cell population consisting of both microcytic and macrocytic cells (anisocytosis) may indicate a combined etiology, for example chronic blood loss (microcytic) with resultant reticulocytosis (macrocytic). In this situation, the MCV may be in the normal range, but the red cell size distribution width (RDW) would be elevated."

    One more mystery to be solved.
    I'll be back later...to ruminate on the plight of caregivers being responsible not only for taking care of their charges but themselves as well.
- posted by gail rae @ 14:32   email...this post