Update and Question--Red blood cells?

Hey guys! I hope all is well here on the ITP front! I haven't been on in about a month or so. The end of school was hectic and I've been living it up this summer...recharging those batteries! When I say living it up, I mean sleeping past 10 and watching Netflix all day. Quite the exciting life! I believe in my last post I updated you all on my counts. I had been yo-yoing back and forth between numbers after being weaned off of prednisone in November. It was rough at first, but I have been incredibly lucky. After being weaned off, my counts went down from 130 to 90. I told my doctor that I was so sick of prednisone and I refused to treat (go me! First time I've done that!). I told her I wanted to see what would happen and that I wouldn't treat until they got below 50. The next week at my checkup they had dropped down to the 70s. Again, I refused to treat. I'm really proud of myself because the following week they had risen to 110 (no meds). I have sat between 110 and 120 for the past five months. YAY! I went today and my count was 112. I'll certainly take that!

My hematologist says she is fine as long as I am in a safe zone. She prefers above 80. I told her I prefer above 50 before I'll treat. Anyways, I had an appt. today and was ecstatic that my counts are basically the same as last time (last time they were 115, this time 112). My hema was ecstatic, too, saying she was very happy with how they have stabilized and hopefully they will stay this way. Ususally at my appointments I get my number, get examined and leave (blood pressure, stethoscope, temp, bruise check). Before leaving today she snuck in this comment: "Everything looks excellent, but your red blood cells are a little small." I've never heard this comment before. Knowing the neurotic nature of her patient (myself) she quickly said it may be due to some anemia....but that my hemoglobin was great at 15.4. She said I had nothing to worry about and would see me in a month. She didn't act concerned, but she mentioned it, which peaked my interest. If it wasn't something to consider, why even bring it up, you know?

As my buddies on here know, telling Natalie that everything is "excellent....BUT" doesn't work for me. So I've been trying to figure out why my reds are "small." She said the count was normal, size was small. I googled, which I shouldn't do. I'm kicking myself for it. Do any of you know why all of a sudden my red blood cells would be smaller than normal? She didn't say to take an iron supplement, but should I? I need to put this out of my mind, so any information will be helpful. I certainly don't want to stress about this and screw up my platelet count due to my neuroses (sp?). Any response is helpful!

Happy Platelets!

Nice to hear from you, Natalie! You worry too much, girl! Flukey things happen sometimes and it doesn't mean anything is wrong. My CBC's are always out of range and flagged. I don't worry unless someone tells me to. Stop worrying and enjoy your summer. Your Hemo seems a little over-cautious, so I'm sure she'd be on top of it if it looked bad. See what happens next month and don't give it a thought until then.

Funny, one time when I saw a different haematologist because mine was away, she said my reds were small. I did google it and came away no nearer knowing anything. Apart from anaemia which I think we'd know about with the cells also being pale in colour and the haemoglobin being low, there aren't any relevant reasons. Nobody else has said anything to me since so I forgot about it.

Thank you Sandi and Ann! I really appreciate your feedback! Yes, I know I worry entirely too much. I am going to put this out of my mind! I know you are both right---flukey things happen and who's to say it hasn't happened before and they just didn't tell me? Your story is funny Ann because yesterday, I didn't see my actual hematologist. I saw her nurse practitioner----who I also see often, but I'm not sure my hema/onc would have said anything about it, either. She tends to not give as much detail---not because she isn't thorough (she is wonderful), but because she knows how I am and has your philosophy Sandi: I'll tell her if it is imperative she knows. I guess she still remembers me crying and acting like a fool when first diagnosed (and on several other occasions afterwards!!). Your responses are always so helpful and give me clarity and comfort. Thanks for responding! I appreciate it!
Happy platelets!
Natalie

Hi Natalie,

Each hemo has his/her own views, but treatment under 80 seems very anxious.
My hemo starts treatments below 20. Now the disposition to bleed might be different between you and me, but everything above 50 is considered save in my part of the world.

When it comes to red blood cells. I had sooooo many blood tests done over the last years and in a lot of the results there was something unusual, that never came up again.
I would not worry unless it comes up three times in a row.

Good luck
Joerg

My advice would be just keep an eye on your CBC's each month and compare. I have random highs and lows all the time. I had a hema who basically only looked at my platelet count, and since that was stressful enough to me I didn't look at the other counts either. However when I went for my 6 month appt with a specialist he analyzed my hemoglobin levels over the past 6 months and realized I had been low. I was put on iron supplements and was able to bring them up. I'm also feeling a lot better.

The last month or semester of school always hectic! Mine was a killer papers due every couple of days! Congrats on finishing!

Sleep is always a good thing! I do that a lot!

Like Vdeutsch85 said just monitor 1 lab slightly difference isn't something to worry about. So keep monitoring if it continues than let yourself worry and push for answers!