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Dr. Andrew Rynne

Family Physician

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What does the following blood test report indicate?

Answered by
Dr. Bonnie Berger-Durnbaugh

General & Family Physician

Practicing since :1991

Answered : 3104 Questions

Posted on Sat, 11 Mar 2017 in General Health
Question: Dr XXXXXXX I did a repeat blood test yesterday, the 15th. In this test the AST came down from 174 to 100.
The ALT came from 267 to 227.
Bilirubin was at 0.8.
Alkaline phosphate was at 184.
A/G Ratio was 1.4
Globulin was at 2.8
GFR >60
RBC Morphology was normal.
WBC came Dow to 14.3. (Slowly come down)
RBC 4.18
Neutrophils 39
Lymphocytes. Coming down slowly 59
Lymphocytes absolute were 8.46
This evening my hepatitis tests came back
And they said they were clear.
My dr is still having me go for abdominal ultrasound at 11:45 AM tomorrow. I am so afraid of what they will find. I just pray everything is clear. I stopped the Tegretol on Monday afternoon and this last test was Wednesday. You are a blessing.
Answered by Dr. Bonnie Berger-Durnbaugh 1 hour later
Brief Answer:

Detailed Answer:

Yay! This is good news!

I am so glad to see these labs (your white blood cells and liver enzymes) moving in the right direction. They should continue to come down to normal over time.

So you have an answer - it was the carbamazepine.

I wouldn't worry much about the abdominal ultrasound. It is unlikely that anything serious will be found since it looks pretty clear that the problem was the carbamazepine. I would expect there might be some inflammation which will decrease over time.

A bit of information about an abdominal ultrasound: You lay on a table next to an ultrasound machine that has a screen. The tech takes an ultrasound probe/transducer and puts gel on it and on your abdomen. He or she will be pushing on your abdomen with this and will spend a good portion of the time with the probe pushing into the area of your liver and gall bladder from various angles, such as under your right rib cage. They will have you hold your breath at times too. You'll feel pressure, but otherwise it isn't too bad. They'll likely check your pancreas and spleen while at it, unless your doctor ordered a "limited" ultrasound. The tech will also be making measurements on the screen of organ sizes, and taking some "still" shots. Don't try to read anything into the tech's reactions. Also, the tech will likely get up and leave the room after the ultrasound is over, to check with the radiologist whether he/she approves the ultrasound (i.e. if it is adequate and good quality). It may take some some time - that doesn't mean there is anything wrong necessarily. Then the tech will come back in and tell you that you can get dressed and that your doctor will be in contact with you. If they want a particular area better imaged, the tech, or the tech and radiologist may come in and do some more. All of this is standard, and no need for worry.

The other day after you wrote your review, the question got closed. I think the process of writing a review closes it. If this happens again, you can ask for me directly.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
Follow up: Dr. Bonnie Berger-Durnbaugh 8 hours later
Thank you. I am very anxious to know all is well. Your reflections on the US process are so helpful. Please pray at 11:45!!! Thank you- thank you!!
Answered by Dr. Bonnie Berger-Durnbaugh 4 hours later
Brief Answer:
Good luck

Detailed Answer:
Saying prayers for you that all goes well with your ultrasound, and you have speedy thorough recovery.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
Follow up: Dr. Bonnie Berger-Durnbaugh 35 hours later
I will send you the report tomorrow. I can't figure out how get my LGHealth to upload. The ultrasound went well. The liver showed some fatty infiltration and no masses or enlargement. Kidneys, spleen and pancreas were all good. I was thinking I could just let you pull up my report. Looks like it was induced by meds. The Tegretol Tylenol and ibuprofen probably. Going off all pain meds has allowed the TN pain to be out of control. I don't want to take any pain meds again!!
I will try to copy these and send them tomorrow. You have been an amazing blessing to me. If I lived close to you all I would probably come to your practice. Your patients are very blessed to have you as their doctor. Thank you again for all your advice which was exactly correct. God bless you. I still have the hematology doctor appointment and the appointment with the oral surgeon to do a 3 D X-ray of my jaw. I guess it will show TMJ along with the Trigeminal Neuralgia if I have it.
God bless you. XXXXXXX
I will keep in touch and let you know what happens. (-:
Answered by Dr. Bonnie Berger-Durnbaugh 36 minutes later
Brief Answer:

Detailed Answer:

That is good news about the ultrasound.

As you would like to be off pain medications, you might want to consider trying acupuncture. That can help for neuromuscular problems. If you do consider this route, here are some recommendations:

- find a practitioner that was actually trained in China (i.e. they will likely be Chinese) and who has been in practice for some time. I think their training is better than how Traditional Chinese Medicine students are trained in the US.

- you should start to notice some improvement in 3 sessions. If there is no improvement in that time, none at all, then it probably is not going to work. Don't let the same practitioner keep you going for long periods if it isn't working.

- have 3 sessions over the course of 1 1/2 - 2 weeks at first so that it has more chance to work.

- you don't necessarily need the pre-made Chinese herbals and supplements. Just go for the acupuncture itself.

Good luck to you.

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

The User accepted the expert's answer

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