View Full Version : Low white blood cells....what?
Eurodriver
04-29-14, 16:34
Just got back from a routine annual checkup (did a fasting lab w/ blood and urine last week) Doctor told me I have low white blood cells and immediately sent me to the lab for more blood work including an HIV test and set me up with a hemotologist.
I'm not too concerned with HIV, as I'm not having sex with men or doing IV drugs, nor am I having sex with women that have sex with other men that do those things...but it's still a little scary.
My doctor kind of pissed me off. After I left I realized that she literally told me nothing other than my WBC was "half a point low" and then rattled off a ton of scary diseases like cancer and HIV. Now I'm sitting here sweating the results.
Can anyone shed some light on this? Is this precautionary? All of the info I've read online has been "Low WBC is caused by - " and then it lists a bunch of diseases. Do some people just have lower WBC? Does it vary among individuals and I was just caught on a "low" day? I'm totally healthy (haven't even had a cold for at least a few months), in my 20s, with a normal BMI.
It can vary by individual and on any given day. One single low white count value is not necessarily of significance. I don't know what "half a point low" means.
It's unfortunate that your interaction with her left you with questions and anxiety. In my opinion, that means that she didn't do her job properly.
Just got back from a routine annual checkup (did a fasting lab w/ blood and urine last week) Doctor told me I have low white blood cells and immediately sent me to the lab for more blood work including an HIV test and set me up with a hemotologist.
I'm not too concerned with HIV, as I'm not having sex with men or doing IV drugs, nor am I having sex with women that have sex with other men that do those things...but it's still a little scary.
My doctor kind of pissed me off. After I left I realized that she literally told me nothing other than my WBC was "half a point low" and then rattled off a ton of scary diseases like cancer and HIV. Now I'm sitting here sweating the results.
Can anyone shed some light on this? Is this precautionary? All of the info I've read online has been "Low WBC is caused by - " and then it lists a bunch of diseases. Do some people just have lower WBC? Does it vary among individuals and I was just caught on a "low" day? I'm totally healthy (haven't even had a cold for at least a few months), in my 20s, with a normal BMI.
What doc Hmac said. It sounds like your doc was not terribly concerned by it, but obviously didn't do a great job of conveying that to you. Did she want you to return for further testing?
Did she want you to return for further testing?
She sent him for additional lab work and a hematology appointment. Seems maybe a bit of an overreaction based on a single CBC. ED, what were the actual values, differential and platelet count?
Eurodriver
04-29-14, 21:24
She told me absolutely nothing except that my cholesterol is 3 points higher from last time (134, was 131) and then she said "There's another thing I noticed, your white blood cell count is half a point low. It's probably nothing, but if it's cancer or HIV I'd like to catch it now rather than later. I'll set you up with a hematologist and I'm requesting an HIV test and additional bloodwork." She didn't give me specific numbers, she didn't compare it to last year's numbers, nothing.
While my brain finished processing what she had just said, she basically kicked me out of the examination room and said we were all done. It wasn't until I was getting my blood drawn later on that I did a double take like...cancer...HIV...what?
montanadave
04-29-14, 21:45
That's a piss poor way to discuss a patient's lab results. Don't get all wrapped around the axle based on one lab value that falls a tad out of the "normal" range. Let 'em repeat the lab work and see what gives. Nine times out of ten a little blip like you describe is just a transient fluctuation.
About twenty-five years ago, I took a health insurance physical and got flagged. Insurance agent couldn't tell me anything beyond "there was an abnormality in your lab work and you've been declined." Then the insurance company refused to release the lab results to me; they'd only provide them to my physician, which I did not have. It took about two weeks to get releases signed, faxed, appointment made with a doc, and the lab results forwarded before I finally got an answer.
And all the time I'm thinking I've got AIDS or cancer or some such shit. I get in with the doc, he quickly tells me to chill out and that I'm not dying, then asks what's going on. I tell him my wife just walked out on me, I'm broke and probably going to lose my house, and I'm drinking like a fish every night. "Bingo," he says, "that explains that." Turns out my liver enzymes were slightly elevated.
I can't stand health providers that cause patients undue anxiety or, conversely, can't bring themselves to be straight with people when there's bad news.
That's a piss poor way to discuss a patient's lab results. Don't get all wrapped around the axle based on one lab value that falls a tad out of the "normal" range. Let 'em repeat the lab work and see what gives. Nine times out of ten a little blip like you describe is just a transient fluctuation.
I can't stand health providers that cause patients undue anxiety or, conversely, can't bring themselves to be straight with people when there's bad news.
I must agree on all counts.
No offense, but sounds like a lousy physician in terms of patient interaction. However, given the current state of general practice, I'm not surprised that your appointment seemed rushed.
Do you happen to have the lab results?
Eurodriver
05-02-14, 06:03
I just called and got some more info:
HIV was negative.
Leukocytes were 3.5 K/ul. The "normal reference range" is 4.0-10.6
Also neutrophils were 1.65 K/uL with a normal reference range of 2.2-7.4
In Sept 2013 my Leukocytes were 3.9 and my neutrophils were 1.79.
montanadave
05-02-14, 06:17
I did not get anything.
Pretty much "coulda, woulda, shoulda" at this point, but going forward always request a copy of your lab results, blood work, diagnostic tests, etc. It just makes sense to keep a personal file of your medical records.
And, as is obvious in hindsight, it allows a person to obtain additional counsel or a second opinion.
montanadave
05-02-14, 06:27
I just called and got some more info:
HIV was negative.
Leukocytes were 3.5 K/ul. The "normal reference range" is 4.0-10.6
Also neutrophils were 1.65 K/uL with a normal reference range of 2.2-7.4
In Sept 2013 my Leukocytes were 3.9 and my neutrophils were 1.79.
Sounds like you have a history of lower white cell counts. Certainly worth monitoring but, in the absence of any significant health problems, most likely idiopathic and not anything to be alarmed about. Probably wouldn't hurt to talk to a hematologist just to get an expert's assessment and provide you some additional information about possible causes, potential for complications, and future monitoring.
One of the docs will likely chime in with a "curbside consult."
Sounds like you have a history of lower white cell counts. Certainly worth monitoring but, in the absence of any significant health problems, most likely idiopathic and not anything to be alarmed about. Probably wouldn't hurt to talk to a hematologist just to get an expert's assessment and provide you some additional information about possible causes, potential for complications, and future monitoring.
One of the docs will likely chime in with a "curbside consult."
I agree with your assessment above.
My Wife had the same thing happen recently, hers were very low, to the point they talked of doing a transfusion.
She had a chronic bronchial infection and loe Iron levels. 2 weeks of strong AB meds, and iron supplement she's 100%
Hematologist thought she might have bone cancer, I 'm like how about doing some more tests before even saying that to someone.
Eurodriver
05-18-14, 17:02
I got a second opinion and brought my medical records from the USMC dating back to '06.
I've always had a WBC under 3.7. Doc said it was normal for my ethnicity.
Dumbass VA doctor.
Had a similar event a while back. Went for a physical for a job, was told it was going to be the standard, but no bloodwork. Show up, the standard bullshit, turn head and cough twice, ect, ect, ect. Anyway, they decide to do bloodwork out of the blue. I go, "Um, wasn't told that beforehand and on the way here I chugged a Coke and had a chicken biscuit with hasbrowns." I was told by the pinhead there that it wouldn't affect the results. :blink: Um... bullshit?
Anyway, they take blood and the next day I get a call from them freaking the hell out. My cholesterol was off the charts and they were telling me that I needed to go to the ER, that I was a walking heart attack, and that I need emergency this and take and bypass, ect, ect, ect. the whole sky is falling by the numbers. I ended up just hanging up because I couldn't get a word in edgewise. They called my primary care physician that I go to and tell him, send him the records ect. Get a call from his secretary to come in, set a date for a few days down the road. Go to see him and he is a little concerned since it isn't even close to the results from prior bloodwork, until I tell him I wasn't told that they were going to be doing bloodwork and had eaten on the way to the physical. At that point he threw the paperwork up in the air since the results were less than useless and told me thanks for coming in.
And that isn't even the first or last time something like that occurred.
Moral of the story, always get a second opinion before freaking out.
Had a similar event a while back. Went for a physical for a job, was told it was going to be the standard, but no bloodwork. Show up, the standard bullshit, turn head and cough twice, ect, ect, ect. Anyway, they decide to do bloodwork out of the blue. I go, "Um, wasn't told that beforehand and on the way here I chugged a Coke and had a chicken biscuit with hasbrowns." I was told by the pinhead there that it wouldn't affect the results. :blink: Um... bullshit?
Moral of the story, always get a second opinion before freaking out.
I don't necessarily disagree with the concept of a second opinion if you're uncomfortable with the first, but how do you know that the second guy is right and the first one is wrong?
In your case, your opinion that you have to be fasting in order to get an accurate lipid profile isn't quite as sure a thing as you seem to think it is.
http://www.healthnewsreview.org/2012/11/not-so-fast-on-fasting-for-cholesterol-tests/
http://www.webmd.com/cholesterol-management/news/20121108/fasting-may-not-be-needed-before-cholesterol-test
http://www.ncbi.nlm.nih.gov/pubmed/23147400
Conclusion: Fasting times showed little association with lipid subclass levels in a community-based population, which suggests that fasting for routine lipid levels is largely unnecessary.
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