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I am looking for advice on lab work and how to address my Dr about it
I have had labs done every year since 2022 and every year my Anion Gap has been low. The last 2 years I have had my labs done 2x a year due to high cholesterol, triglycerides and low calcium & sodium.
After medication and diet change my numbers have slightly lowered on the high test and my sodium and calcium are within normal range. What my concern is happens to be the abnormal test the dr never discusses, my anion gap. In 2022 it was an 8 "normal range" however since my hysterectomy in 2022 it has been dropping and is now at a 3 for last 3 sets of labs. My albium is normal as well as creatines and all other test on that panel until most recent labs which noted a high level of chloride. My concern is reading on line it tends to note kidney disease and cancer yet my Dr has not even addressed these numbers. Should I be concerned and should I schedule an appointment to ask questions or should I seek a specialist to review the existing labs?
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Delicate area. My ENT friend, not PCP, gets furious when patients ask questions based on their reading of their charts and Google MD.
You are right to be concerned. My charts and research also shows stuff out of whack, but not talked about. I wait for my Hemo/Onc to tell me. If he doesn't I might inquire or leave it alone for awhile. Some docs are happy to share, others are too sterile (or angry) to address it.
Also, for CYA they may send you for more tests.
Maybe write a letter?
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1 ReactionWrite down your questions and ask away...
My anemia was watched for 1.5+ and wish I would have pushed sooner to dig a bit deeper not that the outcome would have changed anything. PCP are very busy and see patient after patient. Luckily my PCP, PA and Oncologist are all very supportive and will happily answer any questions I have. 🙏🏻
Hope you can get all your questions answered. 😊👍🏻
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2 ReactionsAfter being diagnosed with ALL, then T-Cell large granular LL. I wondered by my platelets went up. I then had a bone marrow test and was diagnosed with Essential Thrombocythemia by another lab. Platelets before test always hovered around 435 to 465. Two years ago I was tested for JAK2 and all other mutations and tests were negative. White blood cell count changes from high and average. I have not seen the tests results for the bone marrow biopsy. But was immediately placed on Hydroxyurea and baby aspirin. Doctor did not explain why other than giving the new diagnoses. His nurse came in and handed me my prescription. I had to ask her to write down the new diagnoses for me. She came back with a print out. Is this standard operating procedure. I feel like I've bee left out in the cold.
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2 ReactionsWelcome to Connect @marygantt Oh gosh, there’s nothing like feeling left out in the cold by your doctor! When you get a new diagnosis you’d like to know as much as you can about what it entails, what can be done for treatments and how this will impact your life!
Quite frankly, I’d urge you to get a 2nd opinion. You’d like confirmation of your diagnoses and you’d also like to feel that your doctor and their team have your back.
You have a right to know the results of the bone marrow biopsy and why you’ve been given a medication to treat ET (having too many platelets) but not addressing the ALL or T-cell large granular LL. These are both forms of leukemia.
Were you undergoing treatment for ALL or T-cell large granular LL?
Do you have access to a larger teaching hospital or another hematologist oncologist?
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5 ReactionsI would ask your current physician for a referral to another physician and why. That way it will gve him the opportunity to answer your questions and then still ask for a referral or do a self-referral to a larger Medical Center. He has a job to do and is not doing it in the best interest of the patient - you! If he feels to busy or pressured he needs to seek employment elsewhere. If you do not get the answers that you need then report him to the Risk Management Department, the Hospital CEO, and the local Chapter for the AMA.I am so tired of the entitled, self-import attitude of the physicians that I am coming in contact with and the new docs that are being turned out are even worse!
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1 ReactionHi @marygantt,
I totally relate to feeling confused by doctor’s recommendations! I was diagnosed with ET 1/2025 and then my O/H changed that to primary myelofibrosis 2/2025. I do have high platelets and CALR1, no chromosome mutations. First she told me not to take baby aspirin, just high dose Hydrea which I have never taken and then she changed that to ok to take baby aspirin. I asked for bone marrow biopsy and I have unusual megakarocytes. My risk analysis came back very low and low for primary myelofibrosis. Then she referred me to bone marrow transplant specialist so I will keep my appointment for early August there. I recently had pelvis CT scan she ordered which showed normal spleen and everything else including no clots anywhere. The only unusual finding was mild liver enlargement. I feel totally fine and just finished climbing to the top of the Vernal Falls Waterfall in Yosemite a few days ago while on family trip with friends. I will continue to take low dose aspirin daily and living me normal busy life as usual like I always have.
Stay positive and advocate for yourself!