Thursday, August 20, 2015

Testing Testing 1 - 2 - 3

Last week I shuffled off to my scheduled battery of blood tests to try to get some help with how crappy I have been feeling.  I have now processed and can put into layman's terms the conversations I had with my doctors, and I thought I would share these results here so as to shed some light on the mysterious "blood work" I often mention.  

Commonplace in western medicine is to draw blood and analyze the particles within to learn valuable information about a patient.  Anyone with a disease or health issues being monitored by a medical professional is familiar with The Lab Visit.   Even when doctored by a Naturopath there are quite often blood tests recommended or requested to help determine health dilemmas, and that blood work is done in the mainstream hospital or laboratory as well.   


<---  That's me.  When I register for my bloodwork at Odette(Sunnybrook) I get a baggie of vials to hang onto until it's my turn.  Those vials are special for the trial and are in addition to the usual seven more vials chosen in the lab.  My record is 23 vials of blood drawn at one visit!


As a stage IIIB cancer patient I have blood taken at MINIMUM every six weeks, to monitor my health but also as stipulated by the clinical trial to treat melanoma in which I am participating.  They check for many different things including general information such as pregnancy, HIV, anemia, high blood sugar, bad cholesterol - all of which I consistently test negative for thank you very much.  They also watch closely many other factors including electrolytes, liver profile, cortisol, hormone stuff, and a bunch of things ending in "-cytes."

For the post-thyroidectomy papillary thyroid cancer side of my journey, I also have blood tests every three months plus at random times if needed, based on my feeling of "general well-being."  They check my TSH, Free T4, and Thyroglobulin, which apparently indicate whether or not I am taking an appropriate dose of that thyroid hormone replacement medication every morning an HOUR BEFORE my morning coffee.  Based on that and my general yuck feeling and weight gain, we decided last week to increase my thyroid hormone replacement pill.  Because I had two of four parathyroid removed they also have to watch my calcium levels so they check calcium and albumin regularly, to check on my calcium supplement intake.  

One nice thing about these tests is that I can see them all and understand where I am with them.  Sunnybrook posts them all on my online chart thingy I can log into, and my family physician explains them to me as well and shows me cool graphs of my results.  These tools help paint more of the picture of where I am at, how my history has been, and how I may expect to feel if any of these things change in the future.  

Who wants to know all of this stuff if they are not a doctor?  Some do, some don't.... I do, when it comes to feeling ill and/or fatigued.  I can watch trends and learn about how my body functions. Or doesn't.  

I want to detail some of my results for those who may experience the same things but without the benefit of the amazing doctors I have the privilege of working with.  In all of my charts of results it shows what my blood value is, and it shows the optimal range of where it should be.  Here are some of my favourites:
  • Ca (Calcium)  - mine is at 2.11, optimal range is 2.10 - 2.55 mmol/L
  • Albumin - mine is at 43, optimal range is 35 - 50 g/L
If calcium is too low (hypocalcemia) then there is risk of seizures, muscle spasms and paresthaesia.  When I get cramps and tingling pins and needles in my hands then I hurry up and take an extra dose of calcium and the accompanying fancy vitamin D thingy I receive by prescription. 
  • Fe (Iron) - mine is at 29, optimal range is 7.5 - 32.2 umol/L  
This one is unrelated to my cancer, but I find it interesting because for years after a period of vegetarianism I struggled with low iron, to the point that I was unable to donate blood. I took iron supplements and BBQ'd lots of steak and I am now happy to report this is one that I don't have to worry about.  
  • Platelets - 177, optimal 150 - 400 x10E9/L
  • White Blood Count - 4.6, optimal 4.0 - 11.0 x10E9/L
  • Auto Lymphocytes Abs 0.9 (LOW), optimal 1.5 - 4.0 x10E9/L
I'm unclear as to the details of these results, they are on the low side, but I am told this is normal for someone receiving the type of immunotherapy treatment that I am. Doesn't directly relate to how I am feeling, just internal mumbo-jumbo.
  • Free T4 (Partial) - Thyroxine, Free - mine is at 15.4, optimal range 7.5 - 21.1 pmol/L
  • Thyroglobulin, mine is undetectable, which is a good thing.   
Thyroid levels seem to be okay, we have increased my daily dose and will check again in September to see how I am feeling, but otherwise we await the thyroid ultrasound in October to check for recurrence.  Sadly there is not a blood test for that.  Nor for melanoma, check for recurrence is by CT scan.

Well if you're still with me after all that, thank you. LOL  If you found that interesting in any way then thank you also, bravo!  

To me it is strange how it all works - sometimes I feel like a guinea pig, sometimes like a science experiment, and sometimes like a sick person who doesn't care about these details I just want my life back.  Regardless, we press on, doing what we can to figure out whatever we can, and we use tools such as these blood tests to make educated guesses about what decisions to make in my health care.   

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