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Suggest Treatment For Rheumatic Fever And Anemia

Posted on Wed, 30 Sep 2015

Question: 5 weeks ago, a routine CBC turned up low HGB (9) Followed with serum ferritin (5.6) I was sent to GP for anemia eval. The eval amounted to her showing me the labs I had in my lap. She did not listen when I said I have taken omeprazole 20 2xday for 15 years. She said she is 100% certain I have a bleed and have had it for at least a year or two. Prescribed 3xday iron w 2xcolace. I did not know her. I saw Hematologist 4 was ago. He suggested iron pill 1x day with OJ on empty stomach for 3 mos. then recheck blood. I am 68 yr old female. Seldom ill. Had rheumatic fever with existing tricuspid reguritation. I am experience so much fear and anxiety because first doctors said cancer about 20 times, heart failure, heart attack, etc. Help.

Answered by Dr. Hardik Sanghvi (1 hour later)

Brief Answer:
You may have some GI bleeding.

Detailed Answer:
Hi, dear
I have gone through your question. I can understand your concern.
You have low hemoglobin. Your ferritine level is also low. It suggest iron deficiency anemia.
You should take iron supplements treatment. Take iron rich food like dates, green leafy vegetables, dry fruits, jeggary etc. Oral iron supplements like ferrous sulphate or ferrous fumarate can be taken.

you may have some bleeding which leads to loss of iron. You should go for examination. Go for ultrasound abdomen and endoscopy if required. Its not cancer always. There are many causes of gastrointestinal bleeding like ulcer, piles, fissure etc.

Go for investigation. Don't worry about cancer.

Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using health care magic. Wish you a very good health.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Hardik Sanghvi (23 minutes later)

I was hoping to wait until iron supplements have been taken for 8-12 weeks, then redo blood work. If not substantial improvement, then see doctor for endoscopy. I believe in my heart that it is an absorption issue because of 15 years omeprazole use. The hematologist I saw in XXXXXXX indicated re-check is not urgent. Do you think that it is ok to wait until the 12 week window? Thank you. XXXX

Answered by Dr. Hardik Sanghvi (2 hours later)

Brief Answer:
You can wait. There is no urgency.

Detailed Answer:
Hi, dear
I have gone through your question. I can understand your concern.
Your hemoglobin is low but it is not too low. You can wait with iron supplements usage. If your hemoglobin is improving then its ok. Otherwise you need further investigation to search the cause of low hemoglobin.

Nothing urgent and you can wait. Just be relaxed.
Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using health care magic. Wish you a very good health.

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Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar