HGB question for maldorf

[turbobusa]

Hello I had a recent blood panel for a surgical repair of umbilical hernia.
My rbc was 19.9. They would not clear me for surgery.
I figured it was from a bit of A50 then eq after the 50.
I went off and did pct and that went well.
I got checked again and was down to 18.1
The hemo doc said I would need about 5 phlebotomies
and it would take 3-4 months to get my rbc in line.
I find it odd that my ins allowed 5 appts with the hemo doc and
he felt I needed that many bleeds.
Can't they just take the red cells and replace the
plasma to speed things along.Sorry so long winded.
I know you are very knowledgeable in this topic.
Thanks, T..
Ps I asked the doc that question and he got kind of pissed.

 

[alpha6164]

Hello I had a recent blood panel for a surgical repair of umbilical hernia.
My rbc was 19.9. They would not clear me for surgery.
I figured it was from a bit of A50 then eq after the 50.
I went off and did pct and that went well.
I got checked again and was down to 18.1
The hemo doc said I would need about 5 phlebotomies
and it would take 3-4 months to get my rbc in line.
I find it odd that my ins allowed 5 appts with the hemo doc and
he felt I needed that many bleeds.
Can't they just take the red cells and replace the
plasma to speed things along.Sorry so long winded.
I know you are very knowledgeable in this topic.
Thanks, T..
Ps I asked the doc that question and he got kind of pissed.

I know that this question is posted for Maldorf, but i will reply. No you can just take our red cells and replace with plasma. We do a exchange transfusions for patients that have sickle cell anemia but it costs thousands of dollars and has significant risks for embolic events. Your only choice to reduce RBC is give a unit of blood every two week for a total of 4 units over 2 months. Your body over the next three or four months will stabilize and you will end up in the 15-16 range. Hope that helps.

 

[maldorf]

I know that this question is posted for Maldorf, but i will reply. No you can just take our red cells and replace with plasma. We do a exchange transfusions for patients that have sickle cell anemia but it costs thousands of dollars and has significant risks for embolic events. Your only choice to reduce RBC is give a unit of blood every two week for a total of 4 units over 2 months. Your body over the next three or four months will stabilize and you will end up in the 15-16 range. Hope that helps.

Yep. if youre hemoglobin is that high it is going to take a long time to SAFELY get it down. I now have a 500 ml phlebotomy once a month at my hematologist/oncologist office. One phlebotomy brings my hemoglobin down about 1 to .5 after that 1 month wait. It is a slow process. Something is going on with me because I continuoulsy make too many RBCs. After all the tests and nothing turned up positive the only thing we can blame it on is the HRT that I am on (100 mg/week).

Once every 2 weeks I think is the most aggressive that they get.

 

[turbobusa]

Thanks guys, I really appreciate the insight. I am getting a blood draw in the morning to see where the count is. Hopefully it has decreased.
T

 

[maldorf]

Thanks guys, I really appreciate the insight. I am getting a blood draw in the morning to see where the count is. Hopefully it has decreased.
T

The main thing for you is to get off of all AAS and let that number come down. Being that high youre at much more risk of a clot(heart attack or stroke) anyways and you shouldnt let it get that high. I think its a blessing that you had that surgery scheduled because you wouldnt have know it was that high otherwise. As you can see you dont feel any different when your hemoglobin/hematocrit is high. My hemoglobin was up to 20 once and I felt ok.

I once had 3 hernias repaired, one was umbilical, and I got off all steroids for 2 months prior to the surgery and my tests came back normal.

 

[turbobusa]

Thanks Maldorf. I will get my results from todays blood draw soon. Hope it is down. I have been off for about 6-7 weeks. I am anxious to get this surgery done. They did warn me of clot/stroke etc problems with that high of rbc. Also told me endurance actually decreases at those levels as the blood moves too slow for good 02 cos exchange.

 

[turbobusa]

Got my latest blood test results. RBC is at 17.6.
I looked up normal ranges in men and the high end of normal
was 17.2. I hope that is right so maybe I am closer to surgical clearance than I thought.
Thanks, T

 

[maldorf]

Thanks Maldorf. I will get my results from todays blood draw soon. Hope it is down. I have been off for about 6-7 weeks. I am anxious to get this surgery done. They did warn me of clot/stroke etc problems with that high of rbc. Also told me endurance actually decreases at those levels as the blood moves too slow for good 02 cos exchange.

Mine got as high as 20 and I never felt too much decrease in cardio really, so I dont know how much you really feel it. It makes sense logically though how it would reduce your endurance. It also makes your heart work harder to push that heavy sludge around! Good way to enduce some cardiomyopathy I would bet it if persists for a long period of time.