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Suggest Treatment For Shortness Of Breath And Dizziness

Posted on Thu, 7 Jul 2016

Question: I recently went to ER for symptoms of Vertigo:
shortness of breath (gasping for air), regurgitation, little diahrrea, and dizziness (room spinning).

All blood work came back fine with the exception of my Giobulin was 3.8H and Albumn/Globulin Ration 0.9L.

What does this mean? Shd I get further testing for liver/kidney or infection.

Red Blood count 3.91L ??

Answered by Dr. Shuba hariprasad (2 hours later)

Brief Answer:
Nothing to panic based on these results alone

Detailed Answer:
Hello,
Thank you for your query.
I'm Dr. Shuba Hariprasad and will be answering your query today.

Would you please clarify a few things for me?
- did they tell you why you had the gasping/breathing difficulty. Was your physical exam normal except for the vertigo?

- did they do any test for checking your heart function? Like an electrocardiogram or echocardiogram?

-did you have any other tests like a urine analysis or a chest x-ray?

- Have you had similar episodes before?

- do you have any other medical conditions or take any medications?

- any recent illness like a throat infection or sinusitis, pneumonia, diarrheal disease etc?

- any family history of significant medical disease, including cancer?

- do you have any urinary symptoms? (increased frequency, frothing of the urine, pain or burning while passing urine)

- any other symptoms which is of a recent onsetonset? Weight loss, fatigue, for instance?

Your level of globulins are slightly raised, although the A/G ratio falls within the lower part of the normal range.
Elevated globulin levels could signify autoimmune disease or certain other medical conditions but this value alone does not diagnose any condition.

The value is just above normal and could be due to a heightened immune response to a recent infection.
A low RBC count also needs to be correlated with other blood indices to arrive a probable diagnosis.

If you could send me all the reports of your tests, I could help you better.

Please Do not panic. These values are not too high and there is nothing to worry based on this alone.

Please get back to with the clarifications and reports.
I would be happy to help you with any other questions you may have

Wish you well
Regards,
Dr. Shuba Hariprasad

Above answer was peer-reviewed by : Dr. Yogesh D

Follow up: Dr. Shuba hariprasad (1 hour later)

I submitted answer to your questions and my blood work results; please let me know if you receive my response.

Thank you.

Answered by Dr. Shuba hariprasad (4 minutes later)

Brief Answer:
Did not receive or see any responses or attached reports

Detailed Answer:
Hello,
Sorry but did not receive any reports or answers yet.
Please try sending them again.
Regards,
Dr. Shuba Hariprasad

Above answer was peer-reviewed by : Dr. Prasad

Follow up: Dr. Shuba hariprasad (1 hour later)

Do you have a number that I can fax my results too?

My scanner is not working properly.

Response to your questions:
the doc at the hospital didn't address my breathing problem; by the time I was seen my him, it had sopped. However, the paramedics did give me an oxygen mask and increased volume to number2.

I don't drink or smoke and I am not on any meds.

A urine test was not performed.

No sister had ovarian cancer a few years ago. No other family history.

No urinary problems. No weight loss or fatigue.

I was diagnosed in 2014 with gastritis. However, I don't have any symptoms.

Answered by Dr. Shuba hariprasad (44 minutes later)

Brief Answer:
Clinically all sounds good but a physician consult would be better

Detailed Answer:
Hello,
Thank you for the follow up and clarifications.

Based on these, I favor the possibility of everything being just fine.
A sister with ovarian cancer would lead me to keep a close eye on you as well. An ultrasound and or blood test (CA 125) to screen for signs and markers of ovarian cancer.
A pap smear every year to catch a cervical cancer is also recommended. However if these are normal it can be retested after a 2-3years.

I am sorry but I do not have a fax number. If you have a XXXXXXX phone or a camera you can take snaps of the report and upload it here. Alternatively if its possible to type out the results here? At least the albumin levels, liver enzymes (alt/ast or sgpt/sgot), Creatinine levels, hemoglobin, Hematocrit, MCHC (mean corpus clarify hemoglobin concentration), potassium & sodium levels.

I still recommend a physician consult with the tests I mentioned earlier to see if anything is out of place.

Hope to hear from you.

Wish you good health
Regards,
Dr. Shuba Hariprasad

Above answer was peer-reviewed by : Dr. Prasad

Follow up: Dr. Shuba hariprasad (2 hours later)

Below are my blood levels:
WBC 6.0 - k/cmm
RBC 3.91L
Hemoglobin 12.0 - gm/dl
Hematocrit 36.9 %
Mean Corpuscular Volume 94 FL
Mean Corpuscular Hemoglobin 31 pg
Mean Corpuscular Hemoglobin Concent 33 G/DL
RDW Coefficient of Variation 13.6%
Platelet Count 209 - K/cmm
Neutrophils (%) Auto 69 %
Lymphocytes % Auto 22 %
Monocytes (%) Auto 8 %
Eosinophils % Auto 1
Basophils % Auto 1 %
Neutrophils # Auto 4.1 K/CMM
Lymphocytes # Auto 1.3 k/cmm
Monocytes # Auto 0.5 K/cmm
Eosinophils # Auto 0.0# Auto 0.0 K/cmm
Neutrophils # Auto 1.3 k/cmm
Basophils # Auto 0.0 K/cmm
Sodium Level 142
Potassium Level 3.6 MMOL/L
Chloride Level 110 MMOL/L
Carbon Dioxide Level 26 MMOL/L
Anon Gap 10 MMOL/L
Blood Urea Nitrogen 13 Mg/DL
Creatinine 0.82
Glucose level 90 MG/DL
Calcium 90MG/DL
Calcium Level 8.8 MG/DL
Total Bilirubin 0.2 MG/DL
AST/SGOT 11 u/l
ALT/SGPT 18 U/L
Alkaline Phosphatase 87 U/L
Total Protein 7.3 G/DL
Albumin 3.5 G/DL
Globulin 3.8 H G/DL
Albumin/Globulin Ratio 0.9 L

Answered by Dr. Shuba hariprasad (10 hours later)

Brief Answer:
All except globulin are normal.

Detailed Answer:
Hello,
Thank you for the follow up.
I've gone through your reports.
Albumin is normal. And so are you red blood cell indices.
Only your chloride level is a little high but that could be due to your hyperventilation as you went to the ER.

Or else all your reports do not indicate anything abnormal except for slightly raised globulin levels.

I recommend seeing your physician if you develop any new symptoms (joint pains /swelling, altered bowel habits, back pain for or after 3 months to recheck your globulin & albumin levels, whichever is earlier.

If at the same level or higher, a blood test to check for individual immunoglobulin levels, CRP and ESR (c Reactive protein & erythrocyte sedimentation rate) and to check for any auto immune disease.

If A/G ratio or Albumin is lower, a urine test and blood test to check kidney function should be done.

Hope this helps.
Please let me know if there is anything else I can help you with.
Wish you the best.

Regards,
Dr. Shuba Hariprasad

Above answer was peer-reviewed by : Dr. Sonia Raina