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Re: Blood work
Apr 19, 2016
coff73ee, have you had lab results like this before? You were already dx'ed with lupus, correct?

Anyhow... I read about several possible causes for low neutrophils coupled with high lymphocytes: viral infections; autoimmune diseases (cited specifically were Felty's syndrome which can be seen with RA, and also SLE); lymphomas and leukemias; something called adult-onset neutropenia; etc.

What I have no clue about: how abnormal your neutrophil and lymphocyte readings are, and how doctors judge "absolute values" vs. percents. Also, whether you have symptoms that seemingly accompany changes in these two particular tests. So if your family doctor hasn't sat you down to explain such things, I'd try my rheumatologist; and if still no good answers, I'd ask to see a hematologist. In short, I truly don't know whether one should worry about these two test results or not & think your doctors need to explain your results to YOUR satisfaction. Please let us know what you learn. I'll keep my fingers crossed that you get answers that aren't worrisome!
Re: Blood work
Apr 19, 2016
Thank you for your reply. Just super frustrated with doctors right now .

Bear with me this is a long and complicated story. Back in February I started to have issues with my kidneys again. I went in to my family doc, he sent me for a emergency ct scan and blood work. The scan showed I have kidney stones, gallbladder stones, partially collapsed left lung and a calcified and destroyed spleen . The blood work showed I had a kidney infection. He prescribed me antibiotics for my infection and sent me on my way.

Fast forward a week from then. Not only did I have a scheduled appointment with my kidney doc but also with my rheumatologist. The kidney doc placed me on potassium citrate to help with the stones. Both kidneys are full of stones again. And sent me on my way with another appointment in a year.

When I seen my rheumatologist for my lupus she was at a loss for words when I asked her about the ct scan. She actually told me to come back and 12 weeks that she needed more time to go over my files . But she did start me on cymabalta for my fibromyalgia . Also asked me to have blood work done when the kidney infection was cleared up.

I started on both new medications and had lab work done for both doctors. After starting on the cymbalta I started to have shortness of breath, bad headaches and fluttering in my chest . I stopped the cymalta and emailed my rheumatologist informing her of this.

On the fourth of this month I was back in to my family doctor due to the fact even after I stopped the medication I was still having the fluttering feeling. He did a ekg that showed left axis deviation. After the ekg results he wanted me to wear a 24 hour heart Monitor. Started the monitor on the 4th into the 5th of this month. He said he would call me with the results as soon as he had them.

Now hear I sit the 19th with no Communication from any doctors. Only reason I even have the results of some of my blood work was from me seeing the results online.

Just would really like to get to the bottom of all this. Sorry so long and confusing .

As far as the labs above yea this is normal for me. Guess it's time I stop being so passive about test results. Not once ever have my rheumatologist explained my results to me .
Re: Blood work
Apr 19, 2016
Now *I'm* starting to get annoyed with your family doctor without ever having met him!!! Your kidney & gallstones ALONE are recipes for misery. (I've had stones, total blockage & massive infection.)

In [B]GENERAL[/B]. When you don't hear from your doctors within the promised timeframe, do you call their offices & ask to speak with doctor (not nurse or other staffer)?

Re [B]STONES[/B]. Was it was AFTER your nephrologist told you to return in a year that you your family dr. sent your to the ER & prescribed an antibiotic, and that you then learned you had many (presumably new) stones? Did this update even get passed to your nephrologist? Did the nephrologist even OK the med? i.e., is your family doc even coordinating with your nephrologist?

Based on my own experience with stones & with seeing a teaching hospital urologist, I'd want to know if I'd had all appropriate tests, for example, 24-hour urine collection, followed by analysis by a lab truly *expert* in stones. (My urologist had me send my collection to Litholink, a Midwest specialty lab. My results made me laugh because they "outed" my diet, which had gone haywire when I was nursing a broken arm, e.g., peanut butter, gallons of iced tea, spinach salads, all high-oxylate.) Anyway, my result was simple: calcium oxylate stones, almost always correctable by dietary changes and increased water intake. But had my result been something other than simple, her next step would have been to look for deeper causes for stones, like hyperparathyroidism as one example. For that review, she'd have sent me to a nephrologist, then I might have also needed an endocrinologist.

If above thinking doesn't look familiar, then in your shoes I'd want to make sure the nephrologist had review your latest findings (all those kidney stones plus the gallstones)---and I'd certainly switch specialists if still at an impasse.

re [B]Gallstones[/B]. Did any doctor say whether surgical removal might be needed? I'd ask that ASAP, like today. You do not want a gallbladder attack: they can mimic a massive heart attack, and can cause severe vomiting & blow-out pain. While chasing down this question, you could also read up on foods that can trigger gallbladder attacks, then avoid them like the plague. (My sister was done in by peanut butter right after her son was born. My parents were alive then and got her off her LR floor and to the ER.)

Another thought: who in your stable of doctors do you trust, any of them? If any, I'd ask that doctor how I might line up a better team & achieve better coordination among them. It just doesn't seem to me as though they are acting as a team, and you really need one! I hurt just reading your post & so hope you can make something happen PDQ. Sending hugs, Vee

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