Iron deficiency

[Naive]

Hi, I have an iron deficiency. I've required a couple of blood transfusions in the last couple of months. Lowest Hb was 54.

I just received a copy of my blood test taken before my first transfusion. The doctor didn't discuss these results with me and I didn't look at them until I got home.

I have some concerns. The results say

Pancytopaenia.

Leucoerythroblastic blood picture with rare myelocyte and nucleated RBC seen.

Red cell morphology shows anistocytosis, hypo chromic and micro cystic cells and stomatocytes.

Eosinophils show dysplastic changes.

WCC 1.9 L
Hb 54 L
Plat 130 L
HCT 0.2 L
RCC 2.96 L
MCV 69.1 L
MCH 19.8 L
MCHC 286 L
RDW 18.7 H
Neuts 0.9 L
Lymph 0.6 L
Mono 0.25 N
Eos 0.5 N
Baso 0.01 N
Reticent 55 N
Retic% 1.9 N

The recommendation was to correlate symptoms with the blood results and consider a bone marrow biopsy.

I feel fine since I've had my last transfusion but the only counts that have improved are my Hb and RCC.

After Dr Google my main questions are....are stomatocytes indicative of anything nasty and the dysplastic eosinophils...I don't like the sound of that even though the count is normal.

Any suggestions for questions to ask the haematologist would be appreciated.

As an incidental finding I also have a chromosome deletion (small) that is related to Autism.

[bailie]

I think a bone marrow biopsy should be done soon, but I am not a doctor. I have had 17 of them and for me they haven't been a problem. I hope you are feeling better. It is good that you are doing your research.

[Fana]

Totally agree with bailie, get the bone marrow biopsy done Soon.good luck

[Cheryl C]

I agree you need to follow up on this and have a biopsy.

[Naive]

Thanks for your answers. I'm more than willing to have a bone marrow biopsy to sort this out but my doctor hasn't suggested it even though the blood report mentions it.

How to ask about having one without seeming pushy or questioning his competence?

[Neil Cuadra]

Originally Posted by Naive

Thanks for your answers. I'm more than willing to have a bone marrow biopsy to sort this out but my doctor hasn't suggested it even though the blood report mentions it.

How to ask about having one without seeming pushy or questioning his competence?

Naive,

I suggesting being straightforward. For example, you can say "My test results recommend a bone marrow biopsy. From what I've read, that makes sense because of my unexplained low counts. Is that right?"

Keep in mind that doctors who take offense at patient questions aren't the best doctors. If, instead, your doctor appreciates a sensible question that shows you want to learn about your condition and you are participating in the decision-making process, that's a good sign.

[Naive]

Thanks Neil, I went to see my GP and he looked at the report and said it was suspicious for cancer but I need to have more investigations. I'm seeing the haematologist again in two weeks.