Anemia found on bloodwork: When to see a hematologist?

Posted by doreenseal @doreenseal, Feb 27, 2023

My sis went to dr for annual exam and dr dx her with a-fib. From multiple blood draws they have come back with the following diagnosis.

Microscopic Pathological Diagnosis: Peripheral Blood Smear - Normochromic Normocytic Anemia with Rouleaux Tendency

Her dr hasn’t called her yet but our family is concerned what this may mean. My sis had her thyroid removed 10+ years ago and is a 5+ year survivor of colo-rectal cancer. I think her a-fib dx is a byproduct of of issues. Don’t you think she should insist on seeing a hemotologist dr to help speed this process up? Thank you.

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doreensel @doreenseal- Just googled
1.) Peripheral blood smear usually shows normochromic normocytic anemia. Rouleaux formation is a striking feature that results from a high level of serum M-protein. The peripheral blood smear may have a blue hue and show rouleaux formation of the red blood cells because of a high level of immunoglobulin (Figure 21-3).
2.) A Peripheral Smear permits interpretation of diagnostically significant red blood cell (RBC) findings. These include assessment of RBC shape, size, color, inclusions, and arrangement. Abnormalities of RBC shape and other RBC features can provide key information in establishing a differential diagnosis.
YES! I would; 30 days in hospital 2020 and (team) missed Polycythemia Vera - 2 years later again with hospitalized with Cellulitis/sepsis & hired a hemotologist: diagnosed with cancer at the hospital Sept 2022.

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@doreenseal, any update on your sister? Did she decide to consult a hematologist? How is her a-fib being managed?

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@colleenyoung

@doreenseal, any update on your sister? Did she decide to consult a hematologist? How is her a-fib being managed?

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She has a PET scan on 3/23, a hematologist appt on 3/28 and a cardio appt on 3/31. So, she is meeting with right people soon. With her previous colorectal cancer we are happy they have a PET scan scheduled sooner than later. Hopefully she will get some answers. She did get an Apple Watch and she has had many recorded episodes of ‘Afib’ so this will give the cardio doctor some good info to start with. Unfortunately her insurance isn’t picking up much if the Eliquis cost so it’s very expensive for her. We are trying to help her find a way to get it more reasonable until she has her appt with her doctor and he can give her advice. Thank you for reaching out for an update.

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contact the company that manufacture Eliquis and they may cover the cost

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@doreenseal

She has a PET scan on 3/23, a hematologist appt on 3/28 and a cardio appt on 3/31. So, she is meeting with right people soon. With her previous colorectal cancer we are happy they have a PET scan scheduled sooner than later. Hopefully she will get some answers. She did get an Apple Watch and she has had many recorded episodes of ‘Afib’ so this will give the cardio doctor some good info to start with. Unfortunately her insurance isn’t picking up much if the Eliquis cost so it’s very expensive for her. We are trying to help her find a way to get it more reasonable until she has her appt with her doctor and he can give her advice. Thank you for reaching out for an update.

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@doreenseal, good to hear that she has appointments lined up with the right specialists in the coming days. I agree with @cctoo. Many pharmaceutical companies have financial assistance programs for their drugs. Here's information from the makers of Eliquis https://www.bms.com/patient-and-caregivers/get-help-paying-for-your-medicines.html

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Thank you Colleen. I appreciate your help & comments. She hasn’t received her PET scan results. She’ll probably hear more on Tuesday when she has her hermatologist appointment. Thanks again.

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@doreenseal

She has a PET scan on 3/23, a hematologist appt on 3/28 and a cardio appt on 3/31. So, she is meeting with right people soon. With her previous colorectal cancer we are happy they have a PET scan scheduled sooner than later. Hopefully she will get some answers. She did get an Apple Watch and she has had many recorded episodes of ‘Afib’ so this will give the cardio doctor some good info to start with. Unfortunately her insurance isn’t picking up much if the Eliquis cost so it’s very expensive for her. We are trying to help her find a way to get it more reasonable until she has her appt with her doctor and he can give her advice. Thank you for reaching out for an update.

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You can get a cuooon for Eliquis for a few months free as long as you are not on aPart D prescription program. I got 3 months free two years ago. Some people keep renewing. I am picking up my script tonight from express scripts and with my very good union plan it is $138 a month.

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@doreenseal

She has a PET scan on 3/23, a hematologist appt on 3/28 and a cardio appt on 3/31. So, she is meeting with right people soon. With her previous colorectal cancer we are happy they have a PET scan scheduled sooner than later. Hopefully she will get some answers. She did get an Apple Watch and she has had many recorded episodes of ‘Afib’ so this will give the cardio doctor some good info to start with. Unfortunately her insurance isn’t picking up much if the Eliquis cost so it’s very expensive for her. We are trying to help her find a way to get it more reasonable until she has her appt with her doctor and he can give her advice. Thank you for reaching out for an update.

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Latest update on my sis. The PET scan came back clear so that was wonderful news. But, the dr said she may have a smoldering multiple myeloma. She is scheduled for a 24 hr urine test, more blood draws and a bone marrow biopsy. These will all be occurring in the next 4-6 weeks. I hope the add’l tests will provide a more definitive answer. They will continue to monitor her MM. I know 2 ppl that had MM. 1 of them lived a few years with it being monitored and then it reared it’s ugly head and she was gone in 8 months. The other person wasn’t that lucky. She battled it fiercely from the beginning and died within a year too. It’s a tough disease.

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@doreenseal

Latest update on my sis. The PET scan came back clear so that was wonderful news. But, the dr said she may have a smoldering multiple myeloma. She is scheduled for a 24 hr urine test, more blood draws and a bone marrow biopsy. These will all be occurring in the next 4-6 weeks. I hope the add’l tests will provide a more definitive answer. They will continue to monitor her MM. I know 2 ppl that had MM. 1 of them lived a few years with it being monitored and then it reared it’s ugly head and she was gone in 8 months. The other person wasn’t that lucky. She battled it fiercely from the beginning and died within a year too. It’s a tough disease.

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@doreenseal, keep us posted as your sister learns more through the next weeks of testing. How is she doing? How are you doing?

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@colleenyoung

@doreenseal, keep us posted as your sister learns more through the next weeks of testing. How is she doing? How are you doing?

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Besides the MM diagnosis my sister is dealing with afib. Yesterday, 4/11 she had a cardio conversion done which appears to be successful. I am sure they will be watching it this first month to ensure a sinus heart rhythm. She is scheduled for a bone biopsy on 4/18. I have not heard the results of her 24-hour urine test. But, I am sure between the biopsy and the urine test they'll be able to give her a more definitive answer as the MM progression. She has a wonderful support system in her church so that is great. Our family is supporting her from afar. My sister that is 13 mos. younger that the ill one is going out to be with her for the biopsy. Thanks again for reaching out. This is a wonderful service that Mayo provides (MayoConnect).

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