Why doesn't a Mayo Wellness Checkup Include a Blood Test?

Perhaps your doctor first reviewed your past medical record to see if your routine labs were current. If your labs are recent, up-to-date and of normal values they may rely on those rather than ordering new labs. But once you say you have symptoms, a doctor will often order many labs, imaging, etc. to determine a possible cause. There's little point in a doctor ordering a bunch of labs if you don't have any signs or symptoms. I always say if you give a doctor a reason to dig deeper and pay them enough money, they will likely find something wrong with a person.

Hi @fortunateoldman, you have quite a jaded view of the medical system. The doctors that I know, and I have a huge team behind me at this point, don’t order extra tests in the hope if they dig deep enough they’ll find something wrong, just to pad their pockets. I’m sorry if you’ve had that happen. Was this in conjunction with your CLL diagnosis?

Lori:

My reply was somewhat in jest, but not entirely. But, yes, for several years I would have my annual Medicare exam with blood tests including CBC, CMP, thyroid, lipids, PSA and a few others. Those labs were all relatively normal and every year my doc would say “see you next year”. But yet, I didn’t feel good with low energy, night sweats, itching to name a few.

I always found it interesting that my previous internist never ran an automated or manual differential along with the CBC each year. I then bought a direct-to-consumer CBC panel but with a differential and went to Quest Diagnostics to have it done. When the results came back my lymphocytes were extremely elevated, near 11,000 as I recall, although the CBC overall was reasonably normal.

Then I sent the Quest results to my new internist on MyChart and asked what could be causing my lymphocytosis. His PA called me back immediately and asked if I could come in the next morning. Of course I did and he then ran a myriad of additional tests and referred me to a hematologist/oncologist who ran another battery of blood, imaging, genetic, immune, biopsy, etc. testing. I’m sure you know the drill. It turned out I did have blood cancer like some of my other family members have.

So if I had taken my previous internist's word that I was fine, I never would have discovered I had SLL. It’s definitely worth it to be one’s own advocate.

Absolutely, I firmly believe we have to be our own advocates for healthcare. I know from experience, too, that a CBC without differential doesn’t necessarily paint the entire picture. So I’m glad you were able to finally get the diagnosis for SLL with a little more sleuthing. Your symptoms should have warranted more research with that first appointment. Fortunatly SLL is generally very slow to develop.
So you have other members in your family with SLL? That is one of the few forms of leukemia that may have a genetic link. Are you or any of the family members in treatment?

Lori:

I have one sister with a CLL diagnosis who is in the watch and wait mode. She may actually have SLL but refuses to have a lymph node biopsy performed.

Another sister died from Acute Lymphoblastic Lymphoma many years ago prior to effective treatments. That form of lymphoma is extremely aggressive and hard to treat to this day.

Why are people so stubborn to get diagnosed. It’s just better to find out so it can be treated. Le sigh…
SLL and CLL are identical under a microscope. The only difference is where the cells are primarily located. CLL in the blood, SLL in the lymph nodes. They’re treated same way and are one of the more responsive forms of leukemia. I hope your sister doesn’t wait too long…

And I’m sorry your other sister passed away from ALL. In children there’s a good chance of a cure. But it tends to be lower for adults so I’m sorry that your sister was a victim. I lost my brother to Hodgkin’s Lymphoma when he was 27. That was in 1969. Now it has a cure rate of 95%. Let’s hope for a future where all cancers can be either prevented or cured, right?

Lori:

My reply was somewhat in jest, but not entirely. But, yes, for several years I would have my annual Medicare exam with blood tests including CBC, CMP, thyroid, lipids, PSA and a few others. Those labs were all relatively normal and every year my doc would say “see you next year”. But yet, I didn’t feel good with low energy, night sweats, itching to name a few.

I always found it interesting that my previous internist never ran an automated or manual differential along with the CBC each year. I then bought a direct-to-consumer CBC panel but with a differential and went to Quest Diagnostics to have it done. When the results came back my lymphocytes were extremely elevated, near 11,000 as I recall, although the CBC overall was reasonably normal.

Then I sent the Quest results to my new internist on MyChart and asked what could be causing my lymphocytosis. His PA called me back immediately and asked if I could come in the next morning. Of course I did and he then ran a myriad of additional tests and referred me to a hematologist/oncologist who ran another battery of blood, imaging, genetic, immune, biopsy, etc. testing. I’m sure you know the drill. It turned out I did have blood cancer like some of my other family members have.

So if I had taken my previous internist's word that I was fine, I never would have discovered I had SLL. It’s definitely worth it to be one’s own advocate.