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  #18  
Old Sat Oct 7, 2017, 04:16 PM
zent1000 zent1000 is offline
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Join Date: Sep 2016
Posts: 11
Hello,

Thanks again for all your answers over the course of a year regarding my father's abnormal values on the CBC report. Your advice has been invaluable!!

Background:
My father is 80 and lives alone in India. His see his primary care physician every 3/6 months. A CBC has been done every time he sees his PCP since 2014. He started seeing a Hematologist in May 2016 as his MCV was elevated during two consecutive CBC's. My father has no symptoms so far and is able to do his daily activities : morning and evening walks, exercise bike and participate in social events. He is 5 ft 3 inches in height and weighs 119 lbs with a waist size of 35.5 inches.

The Hematolgist orders a CBC before each visit. He will be seeing my father tomorrow. A CBC was done yesterday and the following values were abnormal (in bold):

RBC (Reference Range : 4.5 - 6.5):
January 2017 : 4.35
July 2017 : 4.24
October 2017 : 4.00

Hemoglobin (Reference Range : 14-18)
January 2017 : 14.41
July 2017 : 14
October 2017 : 13.4

MCV (Reference Range : 80-96)
January 2017 : 99.9
July 2017 : 94.55
October 2017 : 100.5

MCH (Reference Range : 27-31)
January 2017 : 33.11
July 2017 : 33.03
October 2017 : 33.3

Packed Cell Volume (Reference Range - 42-54)
January 2017 : 43.16
July 2017 : 40.09
October 2017 : 40.2

The rest of his values in his CBC are normal.

His RBC of 4.0 and Hemoglobin of 13.4 are the lowest values in his 4 years of CBC testing. His Hematologist has always told me that even if my father has elevated MCV (97-103) and low RBC (4.25-4.5), he will not order a bone marrow test if my father's Hemoglobin is normal (equal or more than 14). My father's Vitamin B12 and Folic acid were normal when measured in July as mentioned in my previous post #15). His Iron (and Ferritin) were never measured.

Questions:
1) All the reasons for his low Hemoglobin seem to be pointing towards MDS at this time. Your comments?

2) His primary care physician recommended my father ask for a peripheral blood smear with his Hematologist before a bone marrow test is used to confirm MDS. Your comments?

3) Any other advice or questions my father should be asking his Hematologist when he sees him tomorrow? I will update you after the visit.

Thank you again,
Zent
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