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Dr. Chip
Dr. Chip, Doctor (MD)
Category: Health
Satisfied Customers: 31673
Experience:  Over 20 yrs of Family Practice
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Dr. Chip - In the past year I've had CBC's completed ranging

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Dr. Chip - In the past year I've had CBC's completed ranging from 133,129,122, and lowest at 110 (ref. range starting at 140). No spleen enlargement. No physical symptoms of anything. All other lab values were normal, or very close. This alleviated the doctor's concern of leukemia, lymphoma, etc. In your opinion, is there reason for worry about an early blood dyscrasia (e.g. MDS)? My doctor brought up going to a hematologist when he realized I was freaked out, but was not concerned otherwise. What do you think? THanks
Hi--are you referring to the platelet count? And can you give me the total results of the CBC?
Customer: replied 4 years ago.

Sorry, yes I am referencing platelets. I'm sorry I don't have specific numbers, but I know why wbc was in the middle of perfect. My rbc was the only things a little low (4.36). MCV, MCH, & MCHC were all good.

OK--and no other medical problems and no medications?
Customer: replied 4 years ago.

that's correct - no other problems noted, and no medications other than occasional advil for headaches.

Customer: replied 4 years ago.

my rbc was 3.46, not 4.36, I am sorry. No one brought this up, though.

OK. I don't think there's too much to worry about here. Certainly I don't think MDS is likely. You may have a mild case of idiopathic thrombocytopenia but with a normal spleen even that is unlikely, although a sed rate, if elevated, might indicate it. I think you need to see the hematologist just for peace of mind but I don't think he'll suggest a bone marrow biopsy or any particular treatment for now and the platelet count may very well rise in time.
Customer: replied 4 years ago.

Okay, thank you very much doctor. So as far as MDS or other fatal diseases, this is so unlikely that it's not worth thinking about? What kind of odds are we talking about with this type of diagnosis? Could this be a precursor for things to come in the future, since I am just 25 now?

If I can accept your words and feel comfotable, can I skip on the hematologist? If it's purely for peace of mind? Thanks again

Very unlikely that you'd go on to develop MDS or anything like leukemia or lymphoma and for now your doctor just needs to check things, say, about every three months. If he wants you to see a hematologist, it isn't my place to tell you not to, but I myself wouldn't have made the referral
Customer: replied 4 years ago.

Okay, he actually said they would follow up for a test in 6 months, and it's been 7 without a follow up at this point. I am assuming if he were even slightly worried he would have gotten back in touch. I spoke with the nurse who said the only reason a hematologist was brought up was because I rushed back in for a re-test and he knew I was frightened. I also assume there was a little bit of a liability issue there (which I understand), even though I respect and trust the doctor. I feel like a doctor saying something is "very unlikely" means there is maybe 1% chance or something that minimal? Sorry, I am a numbers guy. I know it's crazy, but if you could gtive me your professional opinion on some sort of % chance this will turn into MDS I'd really appreciate it. With that, I'll say thank you one last time and let you go. Have a good day.

Less than 1% but in medicine you rarely can say absolutely yes or no. And, yes, in this day of medical litigation, patients are often sent to specialists as a CYA maneuver. Let's put it this way, if this were me, I wouldn't be losing any sleep over it. Glad to be of help and call on me any time
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