CLL - Referral to CLL Specialist

Posted by pebbles @pebbles, Dec 31, 2018

Thank you for this resource.

I have found substantial information about the treatment plans after diagnosis, criteria for diagnosis but not the protocol for referral to a specialist. I learned that CLL is typically found as a result of a workup for another health issue or wellness visit.

My main question is after the first blood test that showed elevated levels how long did it take for your provider to refer you to a specialist? Did your provider repeat the test before referral? If so, how much time elapsed between first results and repeat testing?

Finally, if you didn’t get a referral after the first test did you feel that time was wasted? I understand that CLL is mostly not fast acting and treatment is delayed until significant symptoms, so some period of delay is likely not something to be concerned about.

My story:

My CBC done by my primary care doc in mid-december reported elevated absolute lymphocytes (4400/ul), WBCs (11,300/ul) and alkaline phosphatase (122 IU/L). CBC is done every 6 months because of long term medication use with possible liver effects.

This is the first time there were any unusual anomalies. For about 2 months prior to the blood test I was recovering from oral surgery complication that removed a failed dental implant, bone graft and oral pain from a titanium film that was removed a week before the blood test.

I experience significant fatigue and intermittent shortness of breath that I did not mention to PCP at last appointment since I’ve always felt tired consistent with other health issues, my weight and denial.

The lab provides patients with access to results after the doctor reviews them. After consulting Dr. Google (extensive research) I called primary care and asked if doctor saw results, if I should come in before my scheduled appointment 6 months away, etc. The gatekeeper said that if Dr. Was concerned the nurse would have called. The nurse hasn’t called.

Being a former caregiver and advocate for my late husband who experienced too many missteps in early diagnosis of several disorders I am on heightened alert when I read lab reports that indicate out of normal range results. And for some reason I am more hesitant to be the dogged advocate for myself than for others. Your experiences would help me put things in perspective and/or motivate me to get past the gatekeeper and see my doctor before my next scheduled appointment in 6 months.

Thanks in advance for any guidance and sharing your experience.

Interested in more discussions like this? Go to the Blood Cancers & Disorders Support Group.

@pebbles

I decided not to pursue at that time because the lab results weren’t that much out of range plus I went into plain old denial with respect to the symptoms. Today I had blood drawn as part of my 6 month PCP wellness visit. I’ll decide if I need to take any steps once I see those results.

I greatly appreciate your concern.

When I was seeking info on CLL I found this on-line resource that sends daily emails listing questions and community answers about CLL. Perhaps you are aware of it but maybe not. I hope this is helpful.

Send posts in PLAIN TEXT to CLL@listserv.acor.org
Contact list managers at cll-request@listserv.acor.org
Search archives at http://listserv.acor.org/archives/cll.html
CLL Doctor List at https://sites.google.com/site/acorclldoctorlist/
CLL List Help pages at https://sites.google.com/site/clllisthelp/home

Jump to this post

Hello @pebbles

I'm glad that you shared some websites for CLL. In your first post, you mentioned fatigue connected with another health problem. Is this check-up going to check on the status of that problem as well?

Are you being seen at a multidisciplinary health center like a university medical center or a Mayo facility?

REPLY
@hopeful33250

Hello @pebbles

I'm glad that you shared some websites for CLL. In your first post, you mentioned fatigue connected with another health problem. Is this check-up going to check on the status of that problem as well?

Are you being seen at a multidisciplinary health center like a university medical center or a Mayo facility?

Jump to this post

Some new info. Last week I had a blood test during semiannual pcp visit. The alkaline phosphatase is still elevated. I don’t know the level yet. Doctor has requested I go for a bone scan. I did not mention my suspicions from 6 months ago. Hopefully I can get in quickly for the test.

REPLY

Hi @pebbles

I appreciate the update. Is the elevated alkaline phosphatase an indicator of CLL? I do hope you are able to get the bone scan done soon.
Will you post again?

REPLY
@pebbles

Some new info. Last week I had a blood test during semiannual pcp visit. The alkaline phosphatase is still elevated. I don’t know the level yet. Doctor has requested I go for a bone scan. I did not mention my suspicions from 6 months ago. Hopefully I can get in quickly for the test.

Jump to this post

Hi @pebbles,

I hope you are doing well. As it has been a few months since you last posted about a possible bone scan, I was just wondering how you were doing. Were you able to get the bone scan scheduled yet?

REPLY

Howdy folks. I would not wait for anything when it comes to diagnosing an illness. Especially if it could something as serious as cancer. I went to a Dr for a few years prior to being diagnosed. I was on meds at the time I noticed something was not right with me. All he did was either increase my meds’s strength or change them altogether. Finally my wife said I should change Dr’s. Which I did. After a lot of diff tests I was diagnosed with a blood cancer. It was either CLL or another one. Slips me which one right now but the treatment was the same. My wife came with me to see the Oncologist and when he said I had cancer, i felt like Homer Simpson. Everything was blah blah blah. Thank god she was there with me. Because it took so long to diagnose this, my CLL will never be cured. However after 12 bags of Chem and 6 bags of Rituximab, i’m 100% in remission. Its been a real hard grind but at least I’m on this side of the grass!!!!!! I only have to go for bloodwork every 4 months and so far so good. Listen to what your body tells you folks and sometimes a second opinion might just save your life!!!!!!

REPLY

You are so right, I had a VA NP that it looks like she just did not know how to read a CBC, I check my own blood work and changed Doctors at the VA and I did not Central Vestibular Vertigo, on my first visit I told him I think I have cancer and it turned out I did have Essential Thrombocythemia, it now looks like it is under control. I hope you do as well.

REPLY
Please sign in or register to post a reply.