Blood Work

Kira - -

Many apneic patients have a high RBC and hematocrit pre xPAP treatment. My doc suspected OSA (even though I'm not overweight), but I was fairly sure he was wrong. My bloods were mostly trending in the wrong directions, and my RBCs were well over the line.

After checking online, yes there is a connection between high RBC counts and OSA, so I went through the procedures to get a sleep study, OSA dx, etc.

A blood test a month later showed normal RBCs, and a year later showed better than normal cardio values.

Here's an abstract (a summary) of a scientific study. You don't need to worry about the scientific lingo, but you can easily glean that a big change in RBC normalization happened in only ONE NIGHT of xPAP.

http://tinyurl.com/9gzt8g
Effects of nCPAP therapy on the blood picture in patients with obstructive sleep apnea

Re doc's suspicion of bleeding...you might want to go along with him on that.

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Kiralynx wrote: ......

Can someone post a good recipe for hummus with asparagus and garlic?

Probably not, since I don't use chick peas. However, I've made a dandy one with navy pea beans or split red lentils. Are you wanting the asparagus mashed in as part of the hummus?

....

That's better than chick peas. I would like to mash in the asparagus. Post it please.

Can someone tell me the best wormer medicine for a Rottweiler?

He He ..... happens all the time

The answer may also partly be that blood tests are often not black and white in their interpretation so none of us can really say for sure. Most tests have a normal range and although the cut-offs are statistically calculated using ROC curves ("Receiver Operating Characterisics" - they find the best of these curves and then determine the optimal range). So sometimes a bit above or below means something and sometimes it doesn't. I just went through a whole series of blood tests looking for another autoimmune disorder. I found it interesting to note that it was the *combinations* of results and the strength of some of them that differentiated between various diseases. My head was spinning! The ranges are sometimes different in various labs because it can vary based on the type of equipment. So I leave the interpretation to the docs I trust.

Since obstructive sleep apnea can have all kinds of effects on the body, I imagine it wouldn't be a far stretch to imagine blood work differences. For example, there are various blood tests for inflammatory markers and oxygen desaturation is known to increase inflammation. Thus indirectly the sleep apnea would likely affect inflammatory markers, though there can also be other factors that affect them.

Mindy

Captain_Midnight wrote:Here's an abstract (a summary) of a scientific study. You don't need to worry about the scientific lingo, but you can easily glean that a big change in RBC normalization happened in only ONE NIGHT of xPAP.

http://tinyurl.com/9gzt8g
Effects of nCPAP therapy on the blood picture in patients with obstructive sleep apnea

That's very interesting, and could, potentially, account (in part) for why many new CPAPers feel like a million bucks after their titration, and then spend weeks trying to get back to that point.

Re doc's suspicion of bleeding...you might want to go along with him on that.

Yes. Well. If I weren't in the middle of multiple health issues and still too tired to try breaking in a new PCP, I'd probably change. I research everything he mentions because I no longer trust him.

This, after all, is the doc who missed the sleep apnea when I told him I wasn't sleeping well, that I felt fine when I went to bed, but was being awakened multiple times by severe hip pain... hip pain which is almost gone now that the apnea is being treated. His answer: "Stop stuffing your face, and lose some weight, and it'll all clear up..." skipping over the fact that I've lost 180 pounds.

This is the same doc who dismissed my menstrual-type cramps and post menopausal bleeding with "Stop stuffing your face, and lose some weight, and it'll all clear up..." -- and it was endometrial cancer. If I had not researched, and then taken myself to a gynecologist, I would probably be in deep kimchee at this point.

Now, he may be right about the bleeding issue, but I feel he is wrong to dismiss the effects on the system of losing several units of blood in surgery a few months back. He discounts, if he is even aware, that I had drains in my gut, draiming up to 70cc of plasma twice a day for up to six weeks after the surgery. Many medical people think you can be fully recovered from surgery in six weeks. That's not correct -- in fact, the lymphdema specialist I saw said that for the type of surgery I had, because the body is adjusting to new hormone levels, new methods of circulation (due to the removal of lymph nodes) and other factors, it can take a full year or more to reach a new normal.

Now I've added apnea treatment, and my body has to again recalibrate everything. In point of fact, gut discomfort and the area of numbness in relation to my 24" scar has decreased significantly since effective apnea treatment began.

And then there are my gut issues. Intriguingly, while researching for thoughts for this thread, I ran across the following:

http://tinyurl.com/7mzkch
Conclusions : In patients in whom there is a strong clinical suspicion of coeliac disease, an elevated RDW despite normal haemoglobin concentration may be a reliable predictor of the disease.

I have never been tested for celiac, and I won't be because the current tests require you to eat gluten for 3-4 weeks before the test. I've been gluten-free, starch-free, and refined sugar-free for over 7 years... and I see no reason to make myself deathly ill to satisfy some test. (My niece, who is confirmed celiac, did go back on gluten for the test and was vilely ill.)

I'm primarily curious to see if there are linkages between apnea and RDW or other blood work such as Deerstalker mentioned. It could be a reliable indicator of when to start the testing process -- from blood work, done as part of a normal physical, to oximeter testing, to full polysomnogram. We know there are millions of apnea sufferers out there who aren't getting diagnosed because -- as with my doctor -- the issue isn't even discussed. I knew I wasn't sleeping well because of hip pain. It never occurred to me that not sleeping well could cause the hip pain.

rooster wrote:That's better than chick peas. I would like to mash in the asparagus. Post it please.

Spinach & Feta Hummus

* 1 cup dry navy pea beans, dry baby lima beans or split red lentils
* 1/2 cup fresh spinach
* 3 oz, crumbled feta cheese
* 1/4 cup olive oil
* 3 tablespoons lemon juice
* 2 tablespoons tahini
* 1 teaspoon roasted garlic
* 1/2 teaspoon salt
* 1/4 teaspoon red pepper flakes

Check beans or lentils for debris. Pre-soak beans or lentils for 12-14 hours in enough cold water to cover by 3-4 inches. If the water is particularly cloudy when stirred during soaking, you may wish to drain the beans or lentils and replace the old water with fresh soaking water.

Once soaked, drain, and place the beans or lentils in a large pan with water to cover by 3-4 inches. Bring to a simmer, reduce heat, and cook until tender. Drain and cool.

Combine beans, tahini, spinach, garlic, olice oil and lemon juice in a blender or food processor and blend until smooth. You may also use a hand blender for this. Add the cheese and red better flakes, and blend smooth.

This recipe may be served hot or cold. I serve it with souffle bread or fresh veggies. Non-SCDers can use fresh veggies or pita bread or pita chips. You may wish to adjust salt and red pepper flakes to taste.

Variation: substitute cooked asparagus for the spinach.

Can someone tell me the best wormer medicine for a Rottweiler?

Put them on a bones and raw food diet. Then they won't be unhealthy enough to catch worms!

mindy wrote:He He ..... happens all the time

Oh, aye... after 22 years online, I should be used to it.

The answer may also partly be that blood tests are often not black and white in their interpretation so none of us can really say for sure. Most tests have a normal range and although the cut-offs are statistically calculated using ROC curves ("Receiver Operating Characterisics" - they find the best of these curves and then determine the optimal range). So sometimes a bit above or below means something and sometimes it doesn't. I just went through a whole series of blood tests looking for another autoimmune disorder. I found it interesting to note that it was the *combinations* of results and the strength of some of them that differentiated between various diseases. My head was spinning! The ranges are sometimes different in various labs because it can vary based on the type of equipment. So I leave the interpretation to the docs I trust.

Yes, I always check the lab normals when looking at data. I used to leave interpretation to the docs. But after having had three major medical issues dismissed with "Stop stuffing your face and lose some weight, and it'll all clear up..." I am simply no longer willing to walk into a discussion without having thoroughly researched the issues at hand. Plus, we know from this Forum that while the doctors may have more knowledge than we do about a given topic, they certainly are likely to spend much less time thinking about our particular situation than we do!

Since obstructive sleep apnea can have all kinds of effects on the body, I imagine it wouldn't be a far stretch to imagine blood work differences. For example, there are various blood tests for inflammatory markers and oxygen desaturation is known to increase inflammation. Thus indirectly the sleep apnea would likely affect inflammatory markers, though there can also be other factors that affect them.

Right. I'm just wondering if there's been any research on those areas. As I said above, I know the apnea affects inflammation, because I am having significantly less of it now that my apnea is being treated.

Edited to remove an inadvertent double negative.

Kiralynx wrote:Yes, I always check the lab normals when looking at data. I used to leave interpretation to the docs. But after having had three major medical issues dismissed with "Stop stuffing your face and lose some weight, and it'll all clear up..." I am simply no longer willing not to walk into a discussion without having thoroughly researched the issues at hand. Plus, we know from this Forum that while the doctors may have more knowledge than we do about a given topic, they certainly are likely to spend much less time thinking about our particular situation than we do!

Sorry to hear you've got an insensitive clod for a doc and also one who doesn't sound too swift. I always keep track of my labs (have a folder on my computer with a couple of year's worth) so I can look at trends. I feel very fortunate to currently have a doc who really does listen and pay attention and whom I trust to manage one of my chronic conditions. I've had enough experience with him that I do trust his interpretations. I'm not saying that I trust blindly - it's definitely "trust with verification"

Mindy

mindy wrote:Sorry to hear you've got an insensitive clod for a doc and also one who doesn't sound too swift. I always keep track of my labs (have a folder on my computer with a couple of year's worth) so I can look at trends. I feel very fortunate to currently have a doc who really does listen and pay attention and whom I trust to manage one of my chronic conditions. I've had enough experience with him that I do trust his interpretations. I'm not saying that I trust blindly - it's definitely "trust with verification"

"Trust with verification..." is a good line!

I don't know that he's not intelligent. It's just that he has it fixed in his head that anything that is wrong with me must be because I am fat, and that because I refuse to dive into mind-numbing desperate attempts to lose weight fast, I clearly don't care about my health. He's firmly convinced that weight loss is a strict formula of "calories in less than calories out equals weight loss". And it is not that simple.

I have lost, in the last seven years, 180 pounds. I'm having trouble getting the last 100 off. That I lost as much as I did with untreated apnea ought to say something about my stubbornness. (Note: I was not always that heavy -- it came about because of gut issues created by birth control pills.)

BTW, here's something else of interest -- I should have gone to Pennington first to check for some of this stuff.

http://www.pbrc.edu/News/News_Story.asp?id=74

Molecule in hemoglobin: hidden life as powerful hormone revealed
11/28/07

BATON ROUGE – Scientists have made a surprising discovery this week that the iron containing heme molecule, which is a key part of hemoglobin, does a whole lot more than just help deliver oxygen from lungs to the body’s cells. The iron based heme portion of hemoglobin (pronounced HEEM) leads two lives – one in the bloodstream and one within the body’s cells as a powerful hormone that influences weight gain, the sleep cycle, and meal metabolism in ways that could lead to prevention of serious diseases such as obesity, diabetes, depression, sleep disorders and even breast cancer.

Kiralynx wrote: I don't know that he's not intelligent. It's just that he has it fixed in his head that anything that is wrong with me must be because I am fat, and that because I refuse to dive into mind-numbing desperate attempts to lose weight fast, I clearly don't care about my health. He's firmly convinced that weight loss is a strict formula of "calories in less than calories out equals weight loss". And it is not that simple.

I have lost, in the last seven years, 180 pounds. I'm having trouble getting the last 100 off. That I lost as much as I did with untreated apnea ought to say something about my stubbornness. (Note: I was not always that heavy -- it came about because of gut issues created by birth control pills.)

BTW, here's something else of interest -- I should have gone to Pennington first to check for some of this stuff.

http://www.pbrc.edu/News/News_Story.asp?id=74

Molecule in hemoglobin: hidden life as powerful hormone revealed
11/28/07

BATON ROUGE – Scientists have made a surprising discovery this week that the iron containing heme molecule, which is a key part of hemoglobin, does a whole lot more than just help deliver oxygen from lungs to the body’s cells. The iron based heme portion of hemoglobin (pronounced HEEM) leads two lives – one in the bloodstream and one within the body’s cells as a powerful hormone that influences weight gain, the sleep cycle, and meal metabolism in ways that could lead to prevention of serious diseases such as obesity, diabetes, depression, sleep disorders and even breast cancer.

Wow - congratulations on losing so much weight!!! I used to be thin but gained about 90 lbs (on my 5'2" frame) due mainly to prednisone. I have refused to take it since then. Some of my docs have the same attitude as yours to weight loss and it's a huge struggle for me to lose 10 lbs and then to keep it off. Eveytime they say something like "even losing 10 lbs would be good", I feel like I'm being criticized.

Perhaps when I retire I'll have more time and energy to exercise regularly!

Mindy

mindy wrote:Wow - congratulations on losing so much weight!!! I used to be thin but gained about 90 lbs (on my 5'2" frame) due mainly to prednisone. I have refused to take it since then. Some of my docs have the same attitude as yours to weight loss and it's a huge struggle for me to lose 10 lbs and then to keep it off. Eveytime they say something like "even losing 10 lbs would be good", I feel like I'm being criticized. Perhaps when I retire I'll have more time and energy to exercise regularly!

Mindy,

Trust me, I understand the "being criticized" number! At one time, I had 135 pounds on a 5' 6" frame. Then I developed gut issues, and things went nuts. I battled gut issues and weight for 25 years until I found SCD.

The good thing is that the weight I have lost is staying off. Now if I could just get the rest off. <fingers crossed> that getting the apnea treated will facilitate it!

And now back to blood work... if possible!

Speaking of blood work, I obtained a copy of my work from last year, and from 2004. Didn't have any done in 2005 because of Hurricane Katrina and skipped it in 2006.

Interestingly, the RDW, which is suddenly of such burning concern to the PCP, has been elevated for at least the last four years.

So, if the elevated RDW IS related to the apnea, I've been showing signs in the blood work for at least that long -- and I was having the pain issues for two years before that.

If you run an Advanced Search here in the forum on "red blood," you'll get three pages of hits and some interesting discussions, research links, etc. It's a better search than just "blood" because of our many BP discussions here. Not all of it relates exactly to your question, but there's good info there.

Marsha

Songbird wrote:If you run an Advanced Search here in the forum on "red blood," you'll get three pages of hits and some interesting discussions, research links, etc. It's a better search than just "blood" because of our many BP discussions here. Not all of it relates exactly to your question, but there's good info there.

Thanks, Marsha... I am in the process of reading those threads, though have not yet found anything similar to what am looking for.

Bumping....

Had the colonoscopy 2 January. Results: 100% negative, no sign of diverticulitis, Crohn's, Ulcerative Colitis, or polyps.

So, my PCP was wrong about what caused the RDW -- but he doesn't care about the RDW now that I've had the colonoscopy. What was so gravely worrying is now irrelevant.

So, I still have a drop in hematocrit and a high RDW, and no guesses as to the cause. Guess I'll ask my gynecologist when I see her Friday for my next set of oncology tests.