Hematologist
Finally had this appointment today. CBC/Iron studies have not been terrible but have been bouncing around at various levels of "not great' since before surgery. I've tried all the forms of iron under the sun, from poly to carbonyl to chelates to proferrin. Nothing works.
The doc is Anne Greist at St. Vincent's in Indy. I liked her and the staff. They all seem to know what they are doing and I was glad to her Dr. Griest talk about how even though some of the numbers are within range, they are not trending well. Much better than hearing "Oh your numbers are in range, you're doing great, go home and be happy!"
I had a bunch of labwork from various pre- and post-op stages for them to look at, but they are waffling a little bit on whether this is actually iron deficiency anemia or something else. Some of the numbers fit that profile and others don't. So, they drew some more blood to look at and run a few tests. Based on that, the plan is to
1. Rule out things like bone marrow issues/cancer and make sure this really is iron deficiency.
2. Possibly do an iron absorption study where I drink oral iron and they draw blood before and after to see how much is absorbed. Given that we know I malabsorb iron, we are likely to skip this step, but I was anemic pre-op so there is more going on than just surgical malabsorption here.
3. Infusion. Most likely I will it will come to this and sooner rather than later. Assuming we end up here, they would have me try the infusion and no additional supplementation, and see how the numbers hold up after a matter of weeks & months.
If it ends up at the infusion, and my numbers hold up, I may never need another one. Or, if my numbers start to trail off, they might do periodic infusions or I could try oral supplements again. If the numbers tank quickly, they would suspect that I am losing blood and I'd have to head off to someone else to get that figured out.
I'm pretty sure I was told they prefer to do Infed; the reasoning was that they can do the whole dose at once rather than in several smaller doses, and that sounds good to me. I really wanted to avoid infusions if possible, but at this point it looks like possible outcomes are to be anemic and get infusions, or find out I have leukemia and need something much more drastic. I'll take the anemia and infusions, I guess.
At this point I'm just waiting to hear from them. Should be Friday.
The doc is Anne Greist at St. Vincent's in Indy. I liked her and the staff. They all seem to know what they are doing and I was glad to her Dr. Griest talk about how even though some of the numbers are within range, they are not trending well. Much better than hearing "Oh your numbers are in range, you're doing great, go home and be happy!"
I had a bunch of labwork from various pre- and post-op stages for them to look at, but they are waffling a little bit on whether this is actually iron deficiency anemia or something else. Some of the numbers fit that profile and others don't. So, they drew some more blood to look at and run a few tests. Based on that, the plan is to
1. Rule out things like bone marrow issues/cancer and make sure this really is iron deficiency.
2. Possibly do an iron absorption study where I drink oral iron and they draw blood before and after to see how much is absorbed. Given that we know I malabsorb iron, we are likely to skip this step, but I was anemic pre-op so there is more going on than just surgical malabsorption here.
3. Infusion. Most likely I will it will come to this and sooner rather than later. Assuming we end up here, they would have me try the infusion and no additional supplementation, and see how the numbers hold up after a matter of weeks & months.
If it ends up at the infusion, and my numbers hold up, I may never need another one. Or, if my numbers start to trail off, they might do periodic infusions or I could try oral supplements again. If the numbers tank quickly, they would suspect that I am losing blood and I'd have to head off to someone else to get that figured out.
I'm pretty sure I was told they prefer to do Infed; the reasoning was that they can do the whole dose at once rather than in several smaller doses, and that sounds good to me. I really wanted to avoid infusions if possible, but at this point it looks like possible outcomes are to be anemic and get infusions, or find out I have leukemia and need something much more drastic. I'll take the anemia and infusions, I guess.
At this point I'm just waiting to hear from them. Should be Friday.
How have you been feeling?
Infusions aren't the end of the world, but talk to some of the vets here who get them regularly for helpful hints if it comes to that for you.
I hope they come to a definitive conclusion and get all this sorted out soon. I'll be looking to see the outcome. And in the meantime am swingin' what I got for ya.
~Becky
Infusions aren't the end of the world, but talk to some of the vets here who get them regularly for helpful hints if it comes to that for you.
I hope they come to a definitive conclusion and get all this sorted out soon. I'll be looking to see the outcome. And in the meantime am swingin' what I got for ya.
~Becky
Hi Chad-I am 10 years out and had my first iron infusion of Dextran a month ago. Took about 4 hrs to drip, no side effects and will get follow-up blood work done at 6 wks. Depending on what they say will determine if I need another one, or that one did the trick. Hematologist said it wasn't anemia, had ferritin count of 8. Haven't noticed any changes, but I didn't slow down before I numbers tanked.
I want your hematologist! I had to practically do a sales pitch to have mine consider that it's anything but that I'm not absorbing my iron (yet my ferritin is high). I still think my dr should have done your 1.
I'm glad to hear that you finally found a good one! All the hematologists in my entire city work in the same office here, I just don't feel like I have a lot of choices at this point. I had to wait 5 weeks to get the appt in the first place!
I'm glad to hear that you finally found a good one! All the hematologists in my entire city work in the same office here, I just don't feel like I have a lot of choices at this point. I had to wait 5 weeks to get the appt in the first place!
HW / SW / CW / GW 299 / 287 / 160 / 140 Feb '09 / Mar '09 / Dec '13 /Aug '10
Appendicitis/Bowel Obstruction Surgery 8/21/10
Beat Hodgkin's Lymphoma! 7/15/2011 - 1/26/2012 
Ran Half-Marathon 10/14/2012
First Pregnancy, Due 8/12/14 I LOVE MY DS!!!
Infed is a brand name for iron dextran, an intravenous, or IV form, of supplemental iron.
Infed is infused slowly through a tube directly into a vein, usually in the arm. The total dose of Infed required to correct anemia and replace iron stores is often given as a series of infusions. For example, a typical total dose of 1000 mg may be divided into five weekly infusions of 200 mg.
Alternatively, the total dose of Infed can be given as a single infusion over four to six hours. Injection into a muscle is not recommended because it is painful and iron is poorly absorbed.
I received 1200 mg-the hematologist ordered it according to my height!
The number of newly produced red blood cells, called reticulocytes, increases four or five days after an Infed infusion. The hemoglobin level rises within seven to 14 days, reaching a normal value by six to eight weeks. It increases more rapidly after a single total dose infusion than when the same dose is divided into multiple infusions. Approximately 50 percent of the infused iron is incorporated into hemoglobin within three to four weeks. The rest is stored in a protein called ferritin, available for future use. Symptoms of anemia such as fatigue and weakness often improve during the first week, even before correction of anemia.
Advantages
Infed reverses iron deficiency anemia more rapidly than oral iron supplements. Intravenous iron is a more reliable treatment since the full dose is delivered directly to the bone marrow, bypassing the need for intestinal absorption.
Because I was scheduled for a major surgery a week after the initial infusion, he wanted a big boost to try and make sure I would not need a transfusion during surgery. Must have worked--he said if this dose doesn't keep me boosted, he would order another round.
Infed is infused slowly through a tube directly into a vein, usually in the arm. The total dose of Infed required to correct anemia and replace iron stores is often given as a series of infusions. For example, a typical total dose of 1000 mg may be divided into five weekly infusions of 200 mg.
Alternatively, the total dose of Infed can be given as a single infusion over four to six hours. Injection into a muscle is not recommended because it is painful and iron is poorly absorbed.
I received 1200 mg-the hematologist ordered it according to my height!
The number of newly produced red blood cells, called reticulocytes, increases four or five days after an Infed infusion. The hemoglobin level rises within seven to 14 days, reaching a normal value by six to eight weeks. It increases more rapidly after a single total dose infusion than when the same dose is divided into multiple infusions. Approximately 50 percent of the infused iron is incorporated into hemoglobin within three to four weeks. The rest is stored in a protein called ferritin, available for future use. Symptoms of anemia such as fatigue and weakness often improve during the first week, even before correction of anemia.
Advantages
Infed reverses iron deficiency anemia more rapidly than oral iron supplements. Intravenous iron is a more reliable treatment since the full dose is delivered directly to the bone marrow, bypassing the need for intestinal absorption.
Because I was scheduled for a major surgery a week after the initial infusion, he wanted a big boost to try and make sure I would not need a transfusion during surgery. Must have worked--he said if this dose doesn't keep me boosted, he would order another round.
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