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routine bloodwork - HCT and RBC high

so your suggestion would be to check iron/ferritine before trying to get a phlebotomy?
What i also have is MCH and MCHC value that are both slightly under the range
(MCH 26pg, MCHC 30.1 g/dl).
for HB i rechecked. 17,1 was not correct, it is 16,4
not sure how to interpret the MCH and MCHC value?
My hematologist checks my iron levels 2x per year to make sure it doesn't get too low. I get a CBC every 3 months to check on my hemoglobin level. He does a phlebotomy on me if mine gets up close to 16. I have a history of blood clots though and a clotting disorder, so my case is different than yours.
 
no i am not taking aspirin or any blood thinners.
I do take:
3AM + 2PM torsemide 5mg
25mg eplerenone AM
10mg Jardiance AM
8,75mg Nebivolol AM
and i should take the maximum dosage of entresto 2x daily but ive swapped entresto to candesartan because i feel worse when i am on entresto
so right now 16mg AM 8mg PM candesartan

would you suggest 1-2 baby aspirin daily? i should have a pack somewhere from old ECA days

yeah, i also hope the sleep study will bring results and i get additional help..
just incase i get blood drawn this week:
what os "tibc"?
ferritin and iron are known.
thanks for your help buddy!!
Should also keep an eye on you platelet count too.
 
Might need a CPAP. I once tried doing a sleep study but because I'm such a picky sleeper, I couldn't sleep well in their bed. You also have to wear a lot of apparatuses that make it hard to sleep. My study was inconusive, but they offered to prescribe a CPAP. I didn't get one.
why did you get it?
i assume it would also help in your case by a mail since sleep apnea is very critical for the cardiovascular system.
inconclusive doesnt mean you dont have it, or am i wrong?
 
How is your heart rhythm now? You dont take any amioderone or mexiletine like me, so it must be ok.

Your EF is back up over 35 or 40 now? You dont have the life vest defibrillator any more, right?
 
My hematologist checks my iron levels 2x per year to make sure it doesn't get too low. I get a CBC every 3 months to check on my hemoglobin level. He does a phlebotomy on me if mine gets up close to 16. I have a history of blood clots though and a clotting disorder, so my case is different than yours.
Have you been tested for JAK2 mutation? Antiphospholipid syndrome panel?
 
Have you been tested for JAK2 mutation? Antiphospholipid syndrome panel?
I'm pretty sure I was tested for both by my hematologist. He even did a bone marrow biopsy.

Seems I just have the factor 2 clotting disorder (prothrombin) and what looks like secondary polycythmia caused by the TRT. It might also be a bit high because of my heart failure.
 
How is your heart rhythm now? You dont take any amioderone or mexiletine like me, so it must be ok.

Your EF is back up over 35 or 40 now? You dont have the life vest defibrillator any more, right?
according to my last test it should be around 36.
but tbh, i would say ive felt better when they told me i was around 25 xD.
I think the sheer amount of medication also does havoc on my body. early octobre ive added entreso back in after switching to candesartan because doc told me
i should try again and since then, ive feeling quite worse in regrds to shortness of breath and energy level.
then yesterday ive switched back again to candesartan and hope the shortness of breath and low energy etc gets better now..
i think entresto is not for everyone..
 
It sounds like your body is compensating for your SOB by producing more RBCs to transport more oxygen to your body.
Sometimes the older drugs work better than the new ones. I think once they correct the heart failure your body will normalize. My only concern is if you remove blood that will make you anemic making the cardiac output higher and increasing demand for oxygen exchange.
 
according to my last test it should be around 36.
but tbh, i would say ive felt better when they told me i was around 25 xD.
I think the sheer amount of medication also does havoc on my body. early octobre ive added entreso back in after switching to candesartan because doc told me
i should try again and since then, ive feeling quite worse in regrds to shortness of breath and energy level.
then yesterday ive switched back again to candesartan and hope the shortness of breath and low energy etc gets better now..
i think entresto is not for everyone..
I won't touch that shit entresto. I took it for a month and didn't feel a thing from it. Stopped it when I discovered the risk of developing Alzhiemers and macular degeneration.

My cardiologist also wants me to take Jardiance too, I said no on that also. I don't have any diabetes and don't want to to go on any more meds.

My EF is now up to 30 to 35% because of my new pacemaker, and I'm feeling better. Like you, I felt better back in 2008 after my heart attack and my EF was only 25%. Years later mine got down to about 15% after an ablation surgery and I felt like I was going to die.
 
It sounds like your body is compensating for your SOB by producing more RBCs to transport more oxygen to your body.
Sometimes the older drugs work better than the new ones. I think once they correct the heart failure your body will normalize. My only concern is if you remove blood that will make you anemic making the cardiac output higher and increasing demand for oxygen exchange.
With me, doing a therapeutic phlebotomy while having heart failure didn't cause me any trouble. I've been doing it now for about 13 years too.

Once he had me do one when my hemoglobin was around 15 and I felt some mild symptoms for about 1 month until I built back up again. Now he doesn't do one unless I'm getting up around 16. So that's working for me. Last year I had 2 phlebotomies the whole year.
 
It sounds like your body is compensating for your SOB by producing more RBCs to transport more oxygen to your body.
Sometimes the older drugs work better than the new ones. I think once they correct the heart failure your body will normalize. My only concern is if you remove blood that will make you anemic making the cardiac output higher and increasing demand for oxygen exchange.
Yeah i assume that too.
I think i will hold off giving blood until after my appointment at the pneumologist and the sleep study.
i hope that switching back to entresto gives some relief to my symtpoms (like it did last time when ive dropped it for candesartan) and then in 2 weeks i get help regarding the oxygen saturation
@maldorf:
yeah, if it gets better now after dropping entresto again then it will be the last time i try it, even if my cardiologist asks 100 times..
for jardiance, i feel like it removes more carbs from my body which in turn is bad for sports. I feel almost no pump in the muscles since ive added it.
Not sure how exactly it works in regards to what you pee out and what you store in regards to the glycogen you "eat"..

good to hear it is also like that for you with the feeling opposed to heart function, haha^^
last appointment i felt like crap and hoped that the EF didnt drop. then he tells me its the biggest jump right now. around 7% in 6 weeks..
i couldnt believe it so ive asked the nurse at the desk to print me the letter he wrote, lol^^
 
Yeah around 16 for patients with prior clots or coag. disorders... my only concern is causing anemia with his microcytic, hypochromic RBCs. I would check ferritin,iron,tibc. I think you might be iron deficiency anemic already, I think the erythrocytosis is reactive to the underlying pathology.
 
Yeah around 16 for patients with prior clots or coag. disorders... my only concern is causing anemia with his microcytic, hypochromic RBCs. I would check ferritin,iron,tibc. I think you might be iron deficiency anemic already, I think the erythrocytosis is reactive to the underlying pathology.
okay ill try to get a fast appointment for blood work
can you tell me what tibc is? never heard of it before.
 
Total iron binding capacity
If you're high you're likely iron deficiency
If you're low most likely iron overload
 
Yeah around 16 for patients with prior clots or coag. disorders... my only concern is causing anemia with his microcytic, hypochromic RBCs. I would check ferritin,iron,tibc. I think you might be iron deficiency anemic already, I think the erythrocytosis is reactive to the underlying pathology.
My ferritin is usually on the low end of normal, but nonetheless in the normal range. That was back when I was getting phlebotomies 6x a year or more too. Now it's even higher. I never had any sides except a couple times when we did a phlebotomy at a hgb of 15, hence letting it get higher now.

My oxygen saturation has always been good though, mid to upper normal.
 
Yeah i assume that too.
I think i will hold off giving blood until after my appointment at the pneumologist and the sleep study.
i hope that switching back to entresto gives some relief to my symtpoms (like it did last time when ive dropped it for candesartan) and then in 2 weeks i get help regarding the oxygen saturation
@maldorf:
yeah, if it gets better now after dropping entresto again then it will be the last time i try it, even if my cardiologist asks 100 times..
for jardiance, i feel like it removes more carbs from my body which in turn is bad for sports. I feel almost no pump in the muscles since ive added it.
Not sure how exactly it works in regards to what you pee out and what you store in regards to the glycogen you "eat"..

good to hear it is also like that for you with the feeling opposed to heart function, haha^^
last appointment i felt like crap and hoped that the EF didnt drop. then he tells me its the biggest jump right now. around 7% in 6 weeks..
i couldnt believe it so ive asked the nurse at the desk to print me the letter he wrote, lol^^
Yes, no rush in getting a phlebotomy at the hgb you have now. You don't have a clotting disorder either, right? You had no clot though? Did they ever test you for clotting disorders? I'm guessing no because you never had a clot.

You're in Germany, right? Sounds like the healthcare system is quite different than here in the US.. I was shocked at how long it took for you to get test results and how they took your vest from you when your ef was down around 30%.

Are you exercising fairly vigorously now, or holding back like I do? Be careful.
 
it will take about a month in my experience to start to see a drop. but I imagine you could get a drop quicker if you really stepped up your hydration/electrolyte protocol.

Good luck.

55% isn't terrible though. I am regularly 53-55% and I function just fine with BP, HR, etc.
yea mine was either 51 or 53 just slightly outside normal and im pretty gassed the fuck up and feel great and my BP, HR are good, theybare a lil high for me but still normal, that said all my life up until i broke 250 my HR was still in the 50s and BP was like 105/65 now its in “normal range” but im 5’7 280 so fuck it im cool, i do a good bit of cardio and drink oceans of water- not by force either, i crave 2 plus gallons a day. That said why not donate and just lie, with all your meds theyre prolly gonna trash it anyway once they test it.
 
Yes, no rush in getting a phlebotomy at the hgb you have now. You don't have a clotting disorder either, right? You had no clot though? Did they ever test you for clotting disorders? I'm guessing no because you never had a clot.

You're in Germany, right? Sounds like the healthcare system is quite different than here in the US.. I was shocked at how long it took for you to get test results and how they took your vest from you when your ef was down around 30%.

Are you exercising fairly vigorously now, or holding back like I do? Be careful.
yeah, no blood clots and according to them, i am at no risk for a blood clot issue. I think i was tested for factor 5 or something like that.
well, in germany you have the public healthcare and private healthcare. Public ones (like i am) suck for special appointments like cardiologists etc. They dont give a fuck about you if they can only charge the bare minimum.

i still excersise but i hold back.
I usually have 2 45 min walks a week, 1 liss cardio session 40-60min and 3-4 gym days. Gym days are always 20-30min LISS/MISS first (i try to get my pulse to high 120's which takes quite a bit of effort on my dose of beta blocker) and then 50-60mins of whatever i want to do (no heavy lifting that requires valsa manoveur or whatever its called, i dont do free excersises anymore)
every 3-4 weeks i do some days off in a row to give my whole system a break (most of the time monday-thursday off, so 4 days in a row)

@marssel:
same here. BP is on the lower end, often below 100/60s and hr during the day is high 60s.
but still the damn shortness of breath. So you also were gassed out and had a harder time to catch your breath when your hct was high?
 

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