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Need some help interpreting lab results for BBB

 
 
Reply Fri 31 Aug, 2012 12:43 pm
First, I'll copy a post from another thread to explain what is going on...
Butrflynet wrote:

By the way, I had to take BBB to the ER on Wednesday and they've kept her there a couple days for observation. She has been having numerous instances of dizzy, weakness and chest pressure -- 7 in 24 hours.

So far, with all the tests run, they haven't found anything that indicates a problem with her heart, brain or any other bio systems.

It is possible she will be coming home today, depending on how she does after some physical therapy this morning.


URL: http://able2know.org/topic/196704-2#post-5093324


I've been looking at her blood work and reading the test explanations on a lab tests online site. When I go pick her up this afternoon, I will try to get the doctor to talk to me about my questions. In the meantime, here's what caught my attention.


Test:

D-Dimer, Quantitative

BBB's value is 1.58. The standard range is 0.00 - 0.50.

The D-dimer is used to detect pulmonary embolus (blood clots). I also read that an elevated D-dimer can be a result of surgery, liver disease, trauma, infection, DIC, etc.

So, the question is...is this indicating her past history with blood clots in her leg and lung (3 years ago) or is it just an indication that it is still soon after her recent hip replacement surgery on May 7th? None of the other lab work indicates there is an infection. Is that result abnormally high or is it just an indication that her body is still healing itself after her surgery and subsequent avulsion fracture?


The ER did a cat scan of her chest to be sure there were no blood clots there. It was clear. Should I put in a request to her GP doctor to have a full doppler scan done of her entire body to rule out blood clots anywhere else?


Test:

PRO-BNP N-Terminal

NT Pro BNP - BBB's is 646. Standard range is 0 - 450.

I understand that this test is to help detect and evaluate severity of heart failure. I understand that higher than normal results suggest a person has some degree of heart failure and the level of BNP is relative to its severity.

The ER doctors and cardiac specialists say all their tests show there are no problems with BBB's heart. Isn't this lab test result saying something else?

They say there is no indication she should be monitored by a cardiologist. I'm thinking that she should at least be referred to one who can then get baseline test results for later comparison and become familiar with these events she is having in increasing frequency.

Test:
CBC with Differential

All are in the normal range except 3 items related to white blood cells.

Neutrophils - hers is 84, standard range is 40-76.

Lymphocytes - hers is 12, standard range is 16-47

Abs. Neutrophil - hers is 7.8, standard range is 1.8 - 7.0.


The ER and cardiology doctors think these recent problems of hers are a result of her not being able to tolerate a recent dosage increase in the Aricept she is taking for dementia. About 10 days ago her dose was increased from 5 to 10 mg.

I understand that these white blood cell indicators can sometimes rise due to drug reaction.

She's been on the 5 mg of Aricept for about 6 months now and none of the similar CBC tests that were done before, during and after her May 7th hip replacement surgery had these white blood cell indicators flagged.
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Type: Question • Score: 3 • Views: 1,815 • Replies: 6
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Butrflynet
 
  1  
Reply Fri 31 Aug, 2012 12:49 pm
@Butrflynet,
I have to leave to get to the hospital for her catscan. Won't be able to respond to questions until I get back.
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Frank Apisa
 
  2  
Reply Fri 31 Aug, 2012 02:38 pm
@Butrflynet,
I have absolutely nothing to give you regarding the test results and measures...

...but I do want to extend my wishes that BBB has a decent a speedy recovery.

BBB posts some of the most interesting information available on A2K.

Get well soon, BBB!
0 Replies
 
JPB
 
  2  
Reply Fri 31 Aug, 2012 03:30 pm
@Butrflynet,
Quote:
The ER and cardiology doctors think these recent problems of hers are a result of her not being able to tolerate a recent dosage increase in the Aricept she is taking for dementia. About 10 days ago her dose was increased from 5 to 10 mg.

I understand that these white blood cell indicators can sometimes rise due to drug reaction.

She's been on the 5 mg of Aricept for about 6 months now and none of the similar CBC tests that were done before, during and after her May 7th hip replacement surgery had these white blood cell indicators flagged.


The change in dosage makes sense re her symptoms and timing. From PubMed:
Some side effects can be serious. If you experience any of these symptoms, call your doctor immediately:

fainting

slow heartbeat

chest pain

black or tarry stools

red blood in stools

bloody vomit

vomit that looks like coffee grounds

inability to control urination

difficulty urinating or pain when urinating

lower back pain

fever

seizures

The d dimer test has a 93-96% sensitivity (elevated in the presence of a blood clot about 95% of the time) but it also has a 50% specificity (elevated when there's no blood clot about 50% of the time). An elevate d dimer isn't anything to get too excited about, but she does have a history of clots so it isn't something to ignore either. Is she still taking blood thinners of any kind?

I'm sure they'll rule out CHF and clots before releasing her. Her nt pbnp is elevated but not that far outside the 95% of the upper limit of normal for someone her age

Quote:
Females < 45 yrs 180[3]
45-54 yrs 190[3]
55-64 yrs 230[3]
65-74 yrs 350[3]
> 75 yrs 620[3] Source


her cbc is fine. Hopefully you got full explanations from her dr.
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Butrflynet
 
  1  
Reply Fri 31 Aug, 2012 07:47 pm
Thanks for the info, JPB. That is pretty much what the discharge nurse had to say.

BBB is home now. I'll post details in the morning about what the discharge diagnosis is.
ossobuco
 
  1  
Reply Fri 31 Aug, 2012 07:48 pm
@Butrflynet,
I missed the first part of all this, that you linked to.
Hang in there, y'all.
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BumbleBeeBoogie
 
  2  
Reply Sat 1 Sep, 2012 12:04 pm
@Butrflynet,
Wednesday at noon, I suddenly started starting having tremors in my chest area, lasting 8 events. My doctor's nurse said I should get to the emergency room in our hospital. When I went to the entrance, I told the entry staff that I thought the medicine my doctor orders for me to take was causing my illness. I told them my doctor had doubled the size of the medicine prescription a week before. When they put me in the emergency room, I repeated to them again about my opinion being the medicine size increase. I spent nine hours in the emergency room taking all kinds of treatments from medicine to devices. Then they moved me into my hospital room.

After a few more tests in the morning, the physician arrived to tell me that she believes the illness I had was caused by my physician's doubling my prescription is the cause of my pain. I (and she) laughed that I was right about my original opinion of the cause. They kept me another day to get the results of the previous tests and to do two more.

They released me so I could get my exam for permitting the surgery to repair my weakness in my abdominal wall. The big tester will advise us if we are a go for repairing my hernia. If I'm approved, I will be back in the hospital in about two weeks. I hope it will only take one day, but my old age may take a little longer.

I discovered I lost five pounds during the three days to 159, not too bad for 5-6/5 inches tall for an 83 year old woman . Wish I could loose weight that easy all of the time. Wouldn't hurt to loose another 20 pounds to get back to my younger days.

Poor Butrflynet and Stugotz are really worried about their mom. Me---I just want to be able to get in my car and drive it soon---and to end my kids fear for their mom.

Dolly and Madison doggies want everybody to be well so they can play all the time.

BBB



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