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Dr. Andrew Rynne
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Dr. Andrew Rynne

Family Physician

Exp 50 years

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What causes low CBC count and high sedimentation rate?

Answered by
Dr.
Dr. Bonnie Berger-Durnbaugh

General & Family Physician

Practicing since :1991

Answered : 3129 Questions

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Posted on Mon, 2 May 2016 in General Health
Question: My doctor wants to get me in to a Gastroenterolgist within 3 to 7 days, but they can't get me in till the 29th of this month. Now since the last time I ask a question to you, I have now gotten sick again, probably due to my low wbc and high sedimentation rate. what should I do. Now all of my medical records are being kept at the hospital instead of his practice making it difficult to have them get it to the specialist. What should I do?
doctor
Answered by Dr. Bonnie Berger-Durnbaugh 3 hours later
Brief Answer:
A couple of suggestions:

Detailed Answer:
Hello and welcome,

I read through your last entry as well as this one. I am concerned about you waiting further also.

A couple of suggestions:

Does your doctor know that you can't get in to be seen until February 29, or does just the person scheduling for him know? I suggest you call your doctor and tell his/her nurse the situation again and that you have no appt until Feb 29 and see if they can get you in urgently.

If this doesn't work, consider going in to the ER, where hopefully, they will do some tests and admit you. Once you are admitted to the hospital, you will get a consult with a gastroenterologist as an inpatient, which will usually be the next day.

If you go in to the ER, point out all the things you told us in your last question - the low white count, high sed rate, bruising, chronic diarrhea, and family history.

In addition to another CBC, with a differential (shows which white blood cells are low); they should also draw a liver function panel.

If possible, please let me know how you are doing after you take these actions.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Bonnie Berger-Durnbaugh 9 minutes later
I will let you know. I'm going to try and get my records before work tomorrow and have them sent to the specialist. If I get any worse and they can't see me soon, I will go to the ER which the first Gastro place told me to do if I couldn't get in sooner to the new Gastro that takes my insurance. The Presbyterian group here doesn't take my insurance so that's why they had to refer me out and is causing problems for me to be seen.
doctor
Answered by Dr. Bonnie Berger-Durnbaugh 12 minutes later
Brief Answer:
Ok.

Detailed Answer:
I am sorry for the health care rigamarole you are having to deal with.

With your low white count, do take care to avoid any further infection exposure if possible. Some things you can do, if you aren't already doing them, is don't touch your eyes, nose, or mouth unless you have JUST washed your hands with soap or alcohol gelled them and touched nothing else in between. Alcohol wipe surfaces that others with infections have touched. Wash your hands and face as soon as you come home.

If you have further difficulty getting your records sent (and hopefully that will go smoothly), ask the old Gastroenterologist to just write a consult request letter or a discharge summary to the new one so the new one has some history and your treatment isn't delayed further.


Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Bonnie Berger-Durnbaugh 18 hours later
Thank you Dr. Durnbaugh,

I went down this morning and they are going to fax over my medical records today. It might be the end of the day, but hopefully after seeing my tests and last doctor visit, they can get me in sooner.

I appreciate all of your help. I also wanted to note, that I have a lump around my pelvic area. I am a thin person, so this is very obvious. Many years ago, my gynecologist that really was a substitute for my regular doctor said it was probably just a fat deposit, and I have a small one above my eyebrow that I have had for a couple of years as well. Should this be a concern, or just getting old.

Thank you, XXXXXXX
doctor
Answered by Dr. Bonnie Berger-Durnbaugh 3 hours later
Brief Answer:
About the fatty deposits:

Detailed Answer:
Hi XXXXXXX

If the lump in the pelvic area has never really changed and if it feels as though it is just under the skin in the soft tissue, it is probably a lipoma which is a benign fatty tumor. These are really common and occur in adults at any age. If the lump has grown significantly or changed, then ask your doctor (or even the gasroenterologist if when you see him if it can be felt from the front) to just check it.

The one above the eyebrow is even less likely to be anything concerning.

After the new gastroenterologist gets the faxed records, I strongly recommend calling his office (tomorrow to make sure they got the records) and asking for a call back from his nurse. Then make your case to her and that your doctor wanted you to be seen quickly. Otherwise the records may sit in his inbox for awhile and no urgency will be apparent. Don't worry about being a little pushy - it is important to do right now. Most likely his nurse(s) are the ones who both help get people scheduled earlier as well as try to protect the doctor's schedule.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Bonnie Berger-Durnbaugh 26 hours later
What does this rash look like to you? It's right above my ankle. I don't have any rah diseases, but I'm always itchy all over and this rash is very itchy and nothing helps it stop itching.
doctor
Answered by Dr. Bonnie Berger-Durnbaugh 1 hour later
Brief Answer:
Thoughts:

Detailed Answer:
Looking at the pictures of the skin, it looks like there is a type of bruising or purpura in the lower part and possibly also a fungal skin infection at the upper part of the affected area. I am not entirely sure what is going on. Rashes can be hard to sort out via pictures.

About the purplish colored area, are your Platelet levels normal?

The part that looks like a possible fungal infection - you can try an antifungal cream on it for 2 weeks and see if that helps. It shouldn't hurt anything.

But the more extensive purplish area, I think you should show this to the gastroenterologist. Has your primary doctor looked at it? How long have you had it? Also tell him/her about the chronic generalized itchiness as these are important things to note.

Has any one done a differential count on your white blood count, or a "peripheral smear" on your blood? Given the purple rash and your symptoms, it would be important to see what your lymphocyte levels are.

When is your appointment with the GI doctor?

If you can't get in to see him in the next few days, do try the ER.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Bonnie Berger-Durnbaugh 39 hours later
yes, my doctor ordered blood tests which revealed I have a 2.9 white blood cell count with a high sedimentation rate of 25. my appointment is now on the 16 the of this month. I have tried antifungal and cortisone creams, but nothing helps.
doctor
Answered by Dr. Bonnie Berger-Durnbaugh 9 hours later
Brief Answer:
Need more blood tests.

Detailed Answer:
Hi - sorry for the delay in my responding. I did not have ability to get back to HCM until now.

The white blood count is not the same as the platelet count. I am wondering if your doctor has seen this rash.

I'm glad your appointment with the GI doctor has been moved up. If you are feeling sicker though, don't wait, go to the ER.

I am wondering if this rash may be tied in to the systemic health problems you are having. You might want to go to a dermatologist - hopefully you can get in to see one soon - who might be able to start ordering tests to evaluate.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Bonnie Berger-Durnbaugh 1 hour later
My other symptoms are losing 15 pounds in the last 4 months without trying, night sweats and chills, pain in my chest and underneath my left arm on my rib cage. I have a lump on my left side pelvic area.
I have had diarrhea for over a year and just lost my sister at the age of 48 to colon cancer.
I just want some of guide to let me know what to do. the first Gastro nurse that contacted me said to go to the ER if I got worse. I can't go to them because my insurance doesn't cover them. I finally got the new Gastro to get me in by the 16th instead if the 29th. That's why I'm trying to understand all of this. I ignore a lot 9f any symptoms because I believe they will go away, and I don't address them.
doctor
Answered by Dr. Bonnie Berger-Durnbaugh 13 minutes later
Brief Answer:
About your insurance not covering ER:

Detailed Answer:
I have to say that I am concerned about the constellation of all of your symptoms taken together.

I think in the meantime while you wait for the gastro appt., your primary doctor could be looking into your health decline further - additional tests.

But more importantly, are you sure your insurance will not cover ER (or maybe I read that wrong - maybe you mean your insurance just doesn't cover the previous GI doctor)? There must be some criteria by which your insurance will pay for an ER visit. For example, with the insurance I have, without an obvious emergency, one has to call the doctor on call (if after hours) and be told to go to the ER.

Because I think it would be best to go in now.

Just FYI, I lost my sister to colon cancer when she was 45 yrs old. You must be in considerable emotional pain in addition to everything else.



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