Carter had an appt yesterday. His last visit was good so they decided to give his body about a month to do whatever it was going to do. At that time his hemoglobin was a 8.4 (the highest since transfusion) and his retic was still in the 4's. He seemed to be continuously improving and they didn't feel the need to keep sticking him every week. I was a little anxious about this appt because I wanted to know how he was doing.
The appt was originally scheduled for last Thursday with Dr. Bradfield but got cancelled and moved to yesterday with Dr. Gauger. I totally believe this was the Lord. There are 6 different oncology/hematology doctors and I was told they like to keep patients between 2 doctors. Carter had seen Dr. Pitel and who I thought was Dr. Gauger. Then, because neither of these doctors were available during a week when Carter needed to be seen, we saw Dr. Bradfield. Yesterday, when Dr. Gauger walked in and introduced herself, it completely through me off guard. I had never seen her before. I found out that who I thought was Dr. Gauger originally was really Dr. Bansal. This means I had seen 4 of the 6 doctors in practice. Not good. He didn't have a good following by any of them because he had jumped around so much.
Now, all the doctors are good but the real Dr. Gauger was exceptional! She was very good and she will be the doctor I request from here forward. She sat across from me and put Carter's file on the desk. We discussed Carter's history and went over a chart that had every reading on it since he started getting blood work. The good news is that his hemoglobin went up to a 10.7 (we're getting close to the normal low). She said she wanted to determine what Carter's baseline hemoglobin was so we know what is normal for him. I'm not sure yet how that will be determined. The concerning news is that the size of his red blood cells are too large. She said if the retic was high it would give some explanation but the retic had dropped to a 1.7. She wants to know why. Why are they so big? Per the chart, the size of his red cells have not been normal for some time and the numbers are increasing each blood draw. She feels a bone marrow biopsy needs to be the next step. Each Monday morning all 6 doctors have a meeting. She said Carter will be discussed at their meeting and she will go over her concerns with the other 3 doctors who have seen him. After this meeting, Carter's nurse will call with what's next. So, as for now, a bone marrow biospsy has not been scheduled. If it does get scheduled, it will probably take place within the next 2 weeks. Dr. Gauger also requested the blood from the lab so she could look at it herself. I really feel good about his care under her.
There are only a handful of things that could be causing the red blood cells to be too large. Most you cannot even pronounce without some practice much less spell. I didn't write down the possibilities because I didn't want to worry myself unnecessarily.
Thanks for your prayers. I will update when I know more.
107.6 MCV, retic 1.7, white count 3.81, platelets good
