Looking at lab results... don't understand all of it

[drummerman]

First thing I noticed was my AST and ALT are down to 18,  before tx they were both at 34.  I assume this is good??

Some things I don't really understand...

WBC is 13.1        10.8 is the upper end of the normal range.  Is this bad??  Is it normal for your white blood cells to increase like this?

Red blood count is comfortably in the normal range.

Hemoglobin is 14.8 (normal range)  Is this the measurement that would show if I was anemic??

Neutrophils are 9.1 (normal range = 1.4-7.0)  Is this bad?  Should I be concerned?

Monocytes are 1.5, slightly out of the normal range.  0.9 is the upper limit.
Everything else is in the normal range.... although Bilirubin, Alkaline Phosphatase, are pushing the upper limit.

One last concern ... I know that different labs  have different equipment for measuring viral load.
My lab report say "The quantitative range of the assay is 15 IU/mL to 100 million IU/mL.   Results less than the quantitiative range of the assay will be reported as "HCV RNA detected, less that 15 IU/mL.

Is this the most sensitive viral load test???

ps - the only side effect I am having is anxiousness and a pounding heart at times ( doc  called it palpatations.... also get very winded quite easily.  Super annoying. 

any thoughts, insights would be appreciated.

thanks!
dm

[KimInTheForest]

Hi Drummerman. Those results look good to me! Especially fact that you still have high Red Blood Cells and Hemoglobin at Week 5 with ribavirin. I wish I had been so lucky. Yes, hemoglobin is the one they monitor the most closely to determine your degree of anemia and if it is dropping into danger zone (doctors differ on what exactly constitutes danger).

I unfortunately started treatment with my HGB and RBCs at bottom end of normal, so I had nowhere down to go before I was anemic. The lowest I dropped according to my labs was 9.6 on hemoglobin. But I think I fell lower still in last 3 weeks where I was not tested. At least it sure felt like I fell lower still!

As far as I have seen here, nobody's viral load tests have a LLOQ (lower limit of quantification) below 15 IU/mL. But there might be a fancy machine somewhere that can test and count/quantify even below that. My own labs are based on 15 IU/mL as being the lowest countable limit.

Any drop in AST and ALT is a good thing! Congrats on some good results!.

I too had pounding/racing heart throughout tx, intermittently. Rather unsettling. Shortness of breath is usually part of the riba-anemia package. But it doesn't look like you are anywhere near that stage.

kim

[dragonslayer]

Kim, 

>>As far as I have seen here, nobody's viral load tests have a LLOQ (lower limit of quantification) below 15 IU/mL<<


Many of us have used the Abbott assay which lists 12 as the LLOD and LLOQ!

 https://www.abbottmolecular.com/us/products/infectious-diseases/realtime-pcr/realtime-hcv.html

[KimInTheForest]

Thank you for that info Paul. Good to know.

kim

[drummerman]

Thanks Kim and Paul,

Exactly what I needed to know.

I don't understand the shortness of breath , since I am not anemic.  Weird.

I kind of remember reading about one test being more sensitive then the other and was hoping I had the best one... but they look pretty close to me.

I guess my white blood count is nothing to worry about or doc would have said something?

thanks guys!
dm

[KimInTheForest]

I don't understand the shortness of breath , since I am not anemic.  Weird.

Ribavirin can also cause a dry cough, which in my case was (and still is) accompanied by its own sort of asthmatic shortness of breath that seems to me to be separate from the riba-anemia shortness of breath (which is more about needing to saturate RBCs with more oxygen, not a "throat" issue). Dry cough and wheezy shortness of breath have increased for me post-tx. But the body will sort it out eventually I am sure. (I have no prior history of asthma or allergies.)

kim

[gnatcatcher]

Drummerman, glad you've heard from those who know your treatment. You might also like this web site:
https://labtestsonline.org/understanding/analytes/liver-panel/tab/test/#what
There's a lot of other useful information easily navigated to from links, drop-down menus, etc. For example, on WBC count:
https://labtestsonline.org/understanding/analytes/wbc/tab/sample/
Note especially "When there is an infection or an inflammatory process somewhere in the body, the bone marrow produces more WBCs, releasing them into the blood, and through a complex process, they move to the site of infection or inflammation. As the condition resolves, the production of WBCs by the bone marrow subsides and the number of WBCs drops to normal levels again." The battle between Hep C and the medicine is probably enough for the immune system to call in more WBC troops. I seem to recall my PCP telling me (in other circumstances) that a somewhat elevated WBC meant that my immune system was on the job.

drummerman as in paradiddle, ratamacue, etc?

[drummerman]

Thanks Kim,

I almost forgot... I do have that stupid annoying cough.  It comes and goes and often flairs up in the middle of the night.  I guess this is what they refer to as the riba cough... like the shortness of breath , it is very annoying.

Thanks Gnat for the links .. I will check them out... and the WBC explanation makes total sense.  I was worried I was coming down with pneumonia or something.

dm