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What Does This Blood Report Indicate?

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Posted on Fri, 3 Feb 2017
Question: fiollowup to my previous counsultations. I would like to send you my lab results from my last blood test December 19th. let me know how I can do that.
Frequent urination and gas have passed. All I am left with is slight pain on left abdomen from under rib cage to slightly belwo and weakness when I try to push myself or do any exercise. I do nto feel like it. Still have strong appetite, normal blood pressure and sleep well albeit more tired than usual. any ideas what this could be ?

I have attached my results
doctor
Answered by Dr. Bonnie Berger-Durnbaugh (5 hours later)
Brief Answer:
Information

Detailed Answer:
Hello,

Thanks for attaching the lab results. I looked at the lymphocyte count and it was only very mildly elevated. Lymphocytes sometimes increase mildly when there is a viral infection. Given that you had had some nose stuffiness and some gastrointestinal symptoms, it might have been related to that.

I wanted to see your lymphocyte count to make sure it was not in a very markedly elevated range which could go with more serious problems. They are not in a concerning range so that is good.

Regarding the continued pain under and below the left rib cage, this may be from stomach irritation or reflux, if you notice it more when doing movements that involve bending over. If this is the case, you might try taking an H2 blocker such as ranitidine (Zantac) 150 mg twice a day for 3 days and see if it makes a difference. Zantac is sold without prescription in the US (over the counter) and is a safe acid reducer. It could also be related to gas in the left splenic flexure of the colon although you have noted that gas problem has gone away.

If, however, the pain occurs more with touching the area you described, or when you move the chest wall/abdominal wall, it could be a muscular-tendon strain that is resolving.

Does any of this seem consistent with what you are experiencing?
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Bonnie Berger-Durnbaugh (52 minutes later)
Thanks for the prompt reply Doctor Berger.

I feel general weakness...Cannot even think of exercising get through my days and just want to crash. Certainly not use to being so low energy. it reminds of when i had mono + the left abdominal tingling and burning sensation. the tingling and burning subsides if i do not do exercise but feel tightness specially when i get up in the morning. no pain when i touch the area, just the ongoign burning/tingling sensation made worse by high intensity exercise (or at least 50% or what i am used to as intensity)

i have had heartburn issues before but have resolved this with diet. Eat proteins (Chicken, meat, fish) lots of cruciferous vegetables, fruits. alternate Vega Vegetable protein powder now and then with Whey isolate protein when i fee hungry or post workout. Mornings are whole grain oats with blueberries.

Eat 6 meals a day small but filling hard boiled eggs, bananas, Toast with avocado. Religious about what i eat and take care of my health

Will try to relax and see how things go over next two weeks. If symptoms get better or worse and will go in for renewed blood test. the results you see are from December 19th and i feel much weaker than then ( at least back then i could exercise).

Worried hypocondriac here :) I am so used to feeling top shape that anything that is not right always warrants my full attention to resolve especially when it goes on for such a prolonged time.

Thanks for your patience and understanding.

Regards,
XXXXXXX XXXX
doctor
Answered by Dr. Bonnie Berger-Durnbaugh (30 minutes later)
Brief Answer:
Thoughts on this.

Detailed Answer:
I'm thinking on this and trying to put pieces together. So the pain in the left abdomen feels like it did when you had mono? With mono, there can be enlargement of the liver and spleen and perhaps some spleen involvement was what you felt when you had mono.

The spleen can be involved in mono because the Epstein Barr Virus (cause of mono) affects lymph nodes and so it can affect (temporarily) the spleen.

Do you have any lymph node tenderness or enlargements in your neck or anywhere else?

Did your doctor try to palpate your spleen?

Sometimes other viruses can cause an ongoing fatigue. One that does is CMV (cytomegalovirus).

Your doctor can test your blood specifically for these (mono and CMV). And should examine your abdomen for size of your spleen. Often it is hard to feel the spleen except in children or unless it is enlarged or if a patient is quite slender.

If that pain or pressure continues, then the next thing to do would be an ultrasound (sonography). If an ultrasound doesn't provide a good indication, then the next step is an MRI or CT.

I don't think you are a hypochondriac. Your concern of persistent fatigue and pain that feels like mono should be looked into. Since you feel weaker now than before, I think you should go in to be seen now.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Bonnie Berger-Durnbaugh (1 hour later)
Back in December had no swollen lymph nodes. I remember my lymph nodes when i had mono and they were a lot more swollen than now. Had doctor feel for my spleen but they said nothing was abnormal...but did not have a convinced look by doctor that they knew what they were looking for or even cared at that point

Thanks Will keep you posted on symptom evolution, Tests and results.

It sucks getting older and sick :))))
doctor
Answered by Dr. Bonnie Berger-Durnbaugh (3 hours later)
Brief Answer:
Yes, please let me know how you are doing.

Detailed Answer:
Yes, I will appreciate hearing back after further testing.

You are not so old, and you have been taking good care of yourself. So this may not be a matter of getting sick related to age.

And it may be a virus that is hanging on too long and will pass. In college I developed extreme fatigue for 2-3 months but tested negative for mono. We never figured out what it was, but it did pass. Also, I have seen in patients after flu-like viruses an occasional post-viral syndrome that lasts a few weeks up to 3 months. Still, with the unexplained pain you are having, I would pursue imaging studies.
Note: For further follow up on related General & Family Physician Click here.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Bonnie Berger-Durnbaugh

General & Family Physician

Practicing since :1991

Answered : 3133 Questions

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What Does This Blood Report Indicate?

Brief Answer: Information Detailed Answer: Hello, Thanks for attaching the lab results. I looked at the lymphocyte count and it was only very mildly elevated. Lymphocytes sometimes increase mildly when there is a viral infection. Given that you had had some nose stuffiness and some gastrointestinal symptoms, it might have been related to that. I wanted to see your lymphocyte count to make sure it was not in a very markedly elevated range which could go with more serious problems. They are not in a concerning range so that is good. Regarding the continued pain under and below the left rib cage, this may be from stomach irritation or reflux, if you notice it more when doing movements that involve bending over. If this is the case, you might try taking an H2 blocker such as ranitidine (Zantac) 150 mg twice a day for 3 days and see if it makes a difference. Zantac is sold without prescription in the US (over the counter) and is a safe acid reducer. It could also be related to gas in the left splenic flexure of the colon although you have noted that gas problem has gone away. If, however, the pain occurs more with touching the area you described, or when you move the chest wall/abdominal wall, it could be a muscular-tendon strain that is resolving. Does any of this seem consistent with what you are experiencing?