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Hi Carol, I can feel your anxiety growing…so I hope you don’t mind but I’m going to suggest to avoid reading your blood work or at least ‘reading too much into your blood work’ and wait for your doctor’s interpretation. Often it’s so easy to take things out of context and fear the worst.
I know you’re concerned about seeing smudged cells and enlarged platelets. Smudged cells are basically cells that collapse and ‘smear or smudge’ while being prepped for a look-see under the microscope. The cells have weakened outer membranes and from my understanding, are very common in patients with CLL. Enlarged platelets, again from my understanding of seeing this in my own blood work, aren’t always of concern unless they are all large. Finding a few enlarged platelets in blood work can be a related to a variety of reasons. I remember being alarmed but they were of no consequence.
I think what will be important is the cytology report to see how well the treatment is working for you. Rituxin is one of the first line treatments for SLL/CLL. Because it’s an anti-inflammatory medication it might also help with the PG so that is likely why your doctor suggested the treatment. I was on Rituxin for a month and it was a life saver for me.
It doesn’t sound as though you have a great communication level between you and your oncologist. Not that she’s dismissive but she sure doesn’t sound like she’s willing to dig more deeply into your co-conditions or help you find answers to your questions That’s incredibly frustrating.
Is this a hematologist oncologist, a doctor who specializes in blood cancers? Are you able to find another provider for a 2nd opinion?
Replies to "Hi Carol, I can feel your anxiety growing…so I hope you don’t mind but I’m going..."
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She is a hematologist oncologist. She is moving many states away and her last day at the hospital is this week. She will be doing telehealth and then flying back to town every. 3 months to see patients. She is probably overloaded with packing. children, selling and buying a new home, schools for her children. So patient care has probably slid down her list of priorities. There is another hematologist oncologist I want to switch to and will do so after my next telehealth visit with the current doctor. The factor worrying me most is her doubt in my condition. Trying to educate her seems a waste.
From my understanding smudge cells are due to low protein in the membrane that surrounds the lymphocyte. I can look at test results going back at least 5 years and it was not an issue until recent months.
I understand added medications such as the steroid and Rituxin will have an effect on many elements of our blood. The enlarged platelets are a concern because they can slow clotting which I noticed a few nights ago and also because I have already had a small stroke. I am facing possible major back surgery and no doctor in his right mind would do that if clotting is an issue.
Yes, I am a nervous Nellie and I was so spoiled by my previous oncologist who taught all over the US but he had the audacity to retire.
Doctors are human beings and have every day worries just like the rest of us. But a lack of understanding of a diagnosis and personal distraction don't inspire a sense of confidence. It doesn't feel right that I have to justify and explain my medical condition to my doctor.
Thank you for your words of encouragement. I think you understand much better than most doctors .
Have a happy 4th and a relaxing extended weekend!