GI Referral

[songbird]

Hi friends,
Something weird turned up in my pre-Cytoxan bloodwork this morning. (I had my Cytoxan anyway.)

The nurse told me that I had been "a little anemic" before my last treatment a month ago, but that it was minor and the doctor had ignored it. She went on to say that my current bloodwork showed I was even more anemic. She'd show it to my rheumatologist, who would get back to me. I asked if the birth of my child two months ago could be to blame, but she didn't think it likely.

My rheumy's way of "getting back to me" was to have a gastroenterologist call. I have to go in Monday afternoon with a "suspected GI bleed".

I hadn't been getting any of the ****** stools, coffee grounds look, unusual bruising or anything else I'd attribute to Coumadin--but I have thought of something I may mention to the GI doc. When I was in the hospital at the end of April (and on Coumadin AND Heparin), I got what I thought was my period, but it was much heavier and longer than I would have expected. It cleared up as soon as I was taken off Heparin, and I haven't seen anything unusual since. I mentioned this phenomenon to the nurses in the hospital, but they weren't concerned.

Anybody know what on Earth the GI doc will do to me? I don't feel bad at all.

OK, maybe a little more tired than usual, but I thought that was just because I needed Cytoxan and the lupus was acting up. (Plus, I have a two month old! Is it any suprise that I'm tired?)

I'm so confused.

Songbird

[rriffee@yahoo.com]

hi songbird: Do you have any kidney involvement? this causes low blood count. I have to give myself injections of procrit for this problem. so it might be something like this. a g.i. dr might do an endoscope on you to see it you have any bleeding in the stomach or bowel. hope this helps you. mary jane

[songbird]

<div class='quotetop'>QUOTE(rriffee@yahoo.com @ May 18 2006, 08:53 PM) Quoted post</div><div class='quotemain'>
hi songbird: Do you have any kidney involvement? this causes low blood count. I have to give myself injections of procrit for this problem. so it might be something like this. a g.i. dr might do an endoscope on you to see it you have any bleeding in the stomach or bowel. hope this helps you. mary jane
[/b][/quote]


I haven't had any kidney involvement to this point, just CNS. I have been doing some online research, however (bad idea) and am now very concerned that my kidneys may have started to fail. Before I got pregnant, I was on Norvasc for high blood pressure (long term Prednisone caused it, though I do have a family history of it as well). When I was in the hospital at the end of April, my BP started going way up. I attributed this to the big doses of Solumedrol I was getting, mentioned it to my rheumy when I was discharged. He agreed that BP was too high, put me back on Norvasc.

BP numbers are now perfectly normal.

Should I be preparing myself for my rheumy's "you need dialysis" speech? Should I ask the GI doc to pursue blood tests for kidney function, or will he just think I have medical student's disease?

Thanks,
Song

[rriffee@yahoo.com]

hi songbird: I doubt if you dialysis now. If your bun and creatine (blood workup) were elevated to the point that you needed dialysis you would pretty much know it yourself. You usually become very nauseated. You just need to mention to dr. how you feel around the kidney area. i'm sure he will order the proper tests to check for kidney problems and they have many meds that can help you so you don't get to the point of needing dialysis. so talk to dr. and let me know what happens. keep well mary Jane

[alobreto]

Hi, Songbird! style_emoticons/<#EMO_DIR#>/wink.gif
Congratulations on the new little one! style_emoticons/<#EMO_DIR#>/smile.gif

The reason your doctor is sending you to a GI doc is, I believe, that when someone shows a trend of becoming more anemic over time and there is no obvious blood loss, the MOST COMMON SITE of HIDDEN BLOOD LOSS IS IN THE GUT. That doesn't mean you have blood loss there, but just that it is the most common site, so it is checked out first.

I believe your vaginal blood loss while on heparin is significant and if you can recall how many pads you soaked per day it would go a long way toward providing your doctor with important information.

Try not to count your organ failures before there is any evidence that such is in process. It will do nothing except raise your blood pressure, make you more anxious, and cause you to lose precious sleep that is already interrupted by the wonderful arrival of baby.

That said, it's important that you get the gut checked as it's usually the culprit and is often not too complicated for easy treatment and resolution. It's also important that you tell the doc about the abnormal bleeding you had while in hospital. Your hospital nurses' notes don't go back to the docs and many docs never see them at all even while you're an inpatient.

If it were me, I'd be sure to tell the GI doc AND the rheumatologist.

Hope all goes well at the GI appointment. Most of the tests they do aren't bad and involve having a look around your insides with you sedated. Usually, the worst of it is the laxatives and/or enemas to get the areas clean so they'll be able to see what's going on when they have a look.
Angela style_emoticons/<#EMO_DIR#>/flowers.gif