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Sir WBC Level Again Increased In One Month From 79000

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Posted on Thu, 4 Jun 2020
Question: sir
WBC level again increased in one month from 79000 to 95000 but Platlates and RBC &Haemoglobin is ok .Again LDH increased from 390 to 450.
No fever ;No weight loss No other symptoms.
DR telling treatment can start but it is up to you
Not immediate but required
What your opinion?
Whether I wait more
Up to what level WBC increased I will not worried if other parameters ok
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Follow up: Dr. Indranil Ghosh (0 minute later)
sir
WBC level again increased in one month from 79000 to 95000 but Platlates and RBC &Haemoglobin is ok .Again LDH increased from 390 to 450.
No fever ;No weight loss No other symptoms.
DR telling treatment can start but it is up to you
Not immediate but required
What your opinion?
Whether I wait more
Up to what level WBC increased I will not worried if other parameters ok
doctor
Answered by Dr. Indranil Ghosh (9 hours later)
Brief Answer:
Treatment can wait

Detailed Answer:
Hi
Thanks for following up.

I understand that wbc has risen again. But I am not sure if this much rise in 1 month is correct or not. But even then, it's not mandatory to start treatment right now.

You may repeat another count in 1 month and see. As your doctor has correctly said, it's not absolutely necessary to start treatment now. But yes, we will need it in near future. Unfortunately there's no criteria of WBC count to start treatment so I can't answer that.

Hope this helps.
Regards
Above answer was peer-reviewed by : Dr. Raju A.T
doctor
doctor
Answered by Dr. Indranil Ghosh (0 minute later)
Brief Answer:
Treatment can wait

Detailed Answer:
Hi
Thanks for following up.

I understand that wbc has risen again. But I am not sure if this much rise in 1 month is correct or not. But even then, it's not mandatory to start treatment right now.

You may repeat another count in 1 month and see. As your doctor has correctly said, it's not absolutely necessary to start treatment now. But yes, we will need it in near future. Unfortunately there's no criteria of WBC count to start treatment so I can't answer that.

Hope this helps.
Regards
Above answer was peer-reviewed by : Dr. Raju A.T
doctor
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Follow up: Dr. Indranil Ghosh (10 hours later)
Sir
Thanks lot
I understand there is no way except chemotherapy. I want also delay because once the treatment start life may horrible due to mainly side effect and other complication.
My only pray to avoid chemotherapy as possible.
But what precautions I should take not to increase level rapidly .How to stop infections .I do not know what is inside going on.
Nowadays I am facing dry mouth problem.
Whether I will do ESR test and CRP .
So many queries and doubt arises in mind
If possible please suggest.
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Follow up: Dr. Indranil Ghosh (0 minute later)
Sir
Thanks lot
I understand there is no way except chemotherapy. I want also delay because once the treatment start life may horrible due to mainly side effect and other complication.
My only pray to avoid chemotherapy as possible.
But what precautions I should take not to increase level rapidly .How to stop infections .I do not know what is inside going on.
Nowadays I am facing dry mouth problem.
Whether I will do ESR test and CRP .
So many queries and doubt arises in mind
If possible please suggest.
doctor
Answered by Dr. Indranil Ghosh (4 hours later)
Brief Answer:
ESR and CRP won't help

Detailed Answer:
Dry mouth is also likely unrelated to this problem.

There is no such precaution to limit the increase in WBC. At this stage yu don't need preventive medicines to stop infections. You can consult your doctor regarding influenza and pneumonia vaccination as those are helpful in this scenario.

Regards
Above answer was peer-reviewed by : Dr. Kampana
doctor
doctor
Answered by Dr. Indranil Ghosh (0 minute later)
Brief Answer:
ESR and CRP won't help

Detailed Answer:
Dry mouth is also likely unrelated to this problem.

There is no such precaution to limit the increase in WBC. At this stage yu don't need preventive medicines to stop infections. You can consult your doctor regarding influenza and pneumonia vaccination as those are helpful in this scenario.

Regards
Above answer was peer-reviewed by : Dr. Kampana
doctor
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Follow up: Dr. Indranil Ghosh (2 days later)
local dr suggested to carried out FISH for Cyclin & uric acid.After report he will suggest.I do not understand why this test required again as FISH test already carried out which comes negative. He worried about high level of WBC AND told treatment may be required.
PLEASE SEND YOUR VALUABLE ADVICE.
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Follow up: Dr. Indranil Ghosh (0 minute later)
local dr suggested to carried out FISH for Cyclin & uric acid.After report he will suggest.I do not understand why this test required again as FISH test already carried out which comes negative. He worried about high level of WBC AND told treatment may be required.
PLEASE SEND YOUR VALUABLE ADVICE.
doctor
Answered by Dr. Indranil Ghosh (6 hours later)
Brief Answer:
If cyclin D1 negative no need to do it again

Detailed Answer:
WBC count is worrisome, but as I said no criteria to start treatment on its basis. I personally do not start treatment if absolutely no symptoms.
Above answer was peer-reviewed by : Dr. Yogesh D
doctor
doctor
Answered by Dr. Indranil Ghosh (0 minute later)
Brief Answer:
If cyclin D1 negative no need to do it again

Detailed Answer:
WBC count is worrisome, but as I said no criteria to start treatment on its basis. I personally do not start treatment if absolutely no symptoms.
Above answer was peer-reviewed by : Dr. Yogesh D
doctor
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Follow up: Dr. Indranil Ghosh (27 hours later)
As per prescription of Dr dated 16_03_2020 what test Dr suggested? . Already pdf file loaded.
Blood collection wala told me that FISH cyclin D1 test will be done by block. I have to arrange from where biopsy has done before 3 years
I totally confused what he want to say
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Follow up: Dr. Indranil Ghosh (0 minute later)
As per prescription of Dr dated 16_03_2020 what test Dr suggested? . Already pdf file loaded.
Blood collection wala told me that FISH cyclin D1 test will be done by block. I have to arrange from where biopsy has done before 3 years
I totally confused what he want to say
doctor
Answered by Dr. Indranil Ghosh (8 hours later)
Brief Answer:
Yes fish have done on a block

Detailed Answer:
He has advised uric acid in blood and FISH for cyclin D1 on the block.

For that, you need original biopsy block. But if it's done already then I think there's no need. Maybe you can share the results with him.

Regards


Above answer was peer-reviewed by : Dr. Arnab Banerjee
doctor
doctor
Answered by Dr. Indranil Ghosh (0 minute later)
Brief Answer:
Yes fish have done on a block

Detailed Answer:
He has advised uric acid in blood and FISH for cyclin D1 on the block.

For that, you need original biopsy block. But if it's done already then I think there's no need. Maybe you can share the results with him.

Regards


Above answer was peer-reviewed by : Dr. Arnab Banerjee
doctor
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Follow up: Dr. Indranil Ghosh (12 days later)
Sir
I attached 4 numbers FISH reports . Two reports at the time of biopsy and two are current .Is earlier two reports on 06 12 2017 FISH for cyclin D1 on the block.
Currently I checked my weight reduced two kg within 15 days. NO fever No nausea . Appetite ok .
Due to lockdown I can not go anywhere .Can you suggest how weight will increase.Any protein supplementary ? .Please advice some protein supplementary .
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Follow up: Dr. Indranil Ghosh (0 minute later)
Sir
I attached 4 numbers FISH reports . Two reports at the time of biopsy and two are current .Is earlier two reports on 06 12 2017 FISH for cyclin D1 on the block.
Currently I checked my weight reduced two kg within 15 days. NO fever No nausea . Appetite ok .
Due to lockdown I can not go anywhere .Can you suggest how weight will increase.Any protein supplementary ? .Please advice some protein supplementary .
doctor
Answered by Dr. Indranil Ghosh (6 hours later)
Brief Answer:
after lockdown lifted you can start the treatment

Detailed Answer:
Hi
Weight loss is not too much but most probably this indicates need for treatment. After corona situation improves you can start it.

The first FISH was done on bone marrow while second one on blood. That is adequate. I don't think any further FISH is required.

We give supplements to many. For diabetic patients sometimes we give Ensure diabetes.

Hope this helps.
regards
Above answer was peer-reviewed by : Dr. Yogesh D
doctor
doctor
Answered by Dr. Indranil Ghosh (0 minute later)
Brief Answer:
after lockdown lifted you can start the treatment

Detailed Answer:
Hi
Weight loss is not too much but most probably this indicates need for treatment. After corona situation improves you can start it.

The first FISH was done on bone marrow while second one on blood. That is adequate. I don't think any further FISH is required.

We give supplements to many. For diabetic patients sometimes we give Ensure diabetes.

Hope this helps.
regards
Above answer was peer-reviewed by : Dr. Yogesh D
doctor
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Follow up: Dr. Indranil Ghosh (2 days later)
Thanks sir
After going through your valuable answer few queries and tension in my mind.
. 1. How much I can delay treatment . Immediate after lock down or 1st week of May or later on. How much emergency.
2. If treatment required from where I will start . Whether in XXXXXXX or in XXXXXXX as presently I am in XXXXXXX .
3. If the chemo is required once in month then I can take in XXXXXXX from any big hospital and come back to XXXXXXX after 2-3 days .
4. OR it is better to take chemo in XXXXXXX itself so that any complications arises due to side effects then immediate rush to Dr.
5. What will be the dose of BR chemo .
6 What are the precautions I will take before and after chemo.
7. So many confusions and fear
sir I am taking Ensure diabetic care once in day.
sir waiting for your valuable advice
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Follow up: Dr. Indranil Ghosh (0 minute later)
Thanks sir
After going through your valuable answer few queries and tension in my mind.
. 1. How much I can delay treatment . Immediate after lock down or 1st week of May or later on. How much emergency.
2. If treatment required from where I will start . Whether in XXXXXXX or in XXXXXXX as presently I am in XXXXXXX .
3. If the chemo is required once in month then I can take in XXXXXXX from any big hospital and come back to XXXXXXX after 2-3 days .
4. OR it is better to take chemo in XXXXXXX itself so that any complications arises due to side effects then immediate rush to Dr.
5. What will be the dose of BR chemo .
6 What are the precautions I will take before and after chemo.
7. So many confusions and fear
sir I am taking Ensure diabetic care once in day.
sir waiting for your valuable advice
doctor
Answered by Dr. Indranil Ghosh (9 hours later)
Brief Answer:
Can be delayed by a month

Detailed Answer:
Hi,
Thanks for following up.

Surely it can be delayed by a month or so. Better to take in XXXXXXX as travel should be avoided in these times.

Dose can't be specified without examining the patient in-person. Your treating Oncologist should be able to fix it. General precautions are to avoid contact with other persons, maintain personal and food hygiene. In case of any complications, it's advisable to notify the treating oncologist urgently.

I am sure you will do well with treatment.
Best Regards




Above answer was peer-reviewed by : Dr. Arnab Banerjee
doctor
doctor
Answered by Dr. Indranil Ghosh (0 minute later)
Brief Answer:
Can be delayed by a month

Detailed Answer:
Hi,
Thanks for following up.

Surely it can be delayed by a month or so. Better to take in XXXXXXX as travel should be avoided in these times.

Dose can't be specified without examining the patient in-person. Your treating Oncologist should be able to fix it. General precautions are to avoid contact with other persons, maintain personal and food hygiene. In case of any complications, it's advisable to notify the treating oncologist urgently.

I am sure you will do well with treatment.
Best Regards




Above answer was peer-reviewed by : Dr. Arnab Banerjee
doctor
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Follow up: Dr. Indranil Ghosh (4 days later)
Thanks sir for moral support
In XXXXXXX I know one dr only Mr G biswas in sparsh hospital. For others I have no idea and limitations also like critical testing and medicine crisis also.
Actually I am waiting for lockdown lifting so that I can go. At present no OPD
Thanks sir for giving valuable advice since two years.
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Follow up: Dr. Indranil Ghosh (0 minute later)
Thanks sir for moral support
In XXXXXXX I know one dr only Mr G biswas in sparsh hospital. For others I have no idea and limitations also like critical testing and medicine crisis also.
Actually I am waiting for lockdown lifting so that I can go. At present no OPD
Thanks sir for giving valuable advice since two years.
doctor
Answered by Dr. Indranil Ghosh (18 hours later)
Brief Answer:
testing and medicines are available at hospitals

Detailed Answer:
So far, there is no crisis of anticancer medicines. All major hospitals are operating their labs as well.
Lockdown in Bhuwaneswar has been extended to April 30th. You may try to meet the doctor before that.

Regards
Above answer was peer-reviewed by : Dr. Vaishalee Punj
doctor
doctor
Answered by Dr. Indranil Ghosh (0 minute later)
Brief Answer:
testing and medicines are available at hospitals

Detailed Answer:
So far, there is no crisis of anticancer medicines. All major hospitals are operating their labs as well.
Lockdown in Bhuwaneswar has been extended to April 30th. You may try to meet the doctor before that.

Regards
Above answer was peer-reviewed by : Dr. Vaishalee Punj
doctor
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Follow up: Dr. Indranil Ghosh (7 days later)
Sir
As per your advice Today I could visit local Dr. Dr suggested to take following medicine as lockdown going on and further test not possible now so start oral therapy
1.cap Ibrunat 140 mg x 3 cap once a day
2. Liquid Alkasol 10 ml thrice
3. Liquid Ranidom _O
4. Cap SanQ 10 forte
Advice some more test after taking medicine
II could not ask in details due to emergency call for Dr
Now my question whether anticancer medicine have side effects
If yes what will be and for that what medicine prescribed.
Weight loss 2 kg within one month observed
I am facing weakness and both legs cramping
Please advice
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Follow up: Dr. Indranil Ghosh (0 minute later)
Sir
As per your advice Today I could visit local Dr. Dr suggested to take following medicine as lockdown going on and further test not possible now so start oral therapy
1.cap Ibrunat 140 mg x 3 cap once a day
2. Liquid Alkasol 10 ml thrice
3. Liquid Ranidom _O
4. Cap SanQ 10 forte
Advice some more test after taking medicine
II could not ask in details due to emergency call for Dr
Now my question whether anticancer medicine have side effects
If yes what will be and for that what medicine prescribed.
Weight loss 2 kg within one month observed
I am facing weakness and both legs cramping
Please advice
doctor
Answered by Dr. Indranil Ghosh (5 hours later)
Brief Answer:
Ok to start ibrutinib

Detailed Answer:
Ibrutinib is a good drug considering present situation.

It's common to have side effects like nausea, diarrhoea, low blood counts with ibrutinib.. Mostly manageable..If serious problem, doctor may reduce the dose.

Nothing to worry regarding muscle cramps. Drink plenty of fluids.

Hope for the best results
Regards
Above answer was peer-reviewed by : Dr. Prasad
doctor
doctor
Answered by Dr. Indranil Ghosh (0 minute later)
Brief Answer:
Ok to start ibrutinib

Detailed Answer:
Ibrutinib is a good drug considering present situation.

It's common to have side effects like nausea, diarrhoea, low blood counts with ibrutinib.. Mostly manageable..If serious problem, doctor may reduce the dose.

Nothing to worry regarding muscle cramps. Drink plenty of fluids.

Hope for the best results
Regards
Above answer was peer-reviewed by : Dr. Prasad
doctor
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Follow up: Dr. Indranil Ghosh (2 days later)
Sir
Many many thanks
From starting you are giving moral support and valuable advice. Once You have check me in XXXXXXX appolo.
Sir except nonveg any other food items restricted with this medicine.
I don't know what will be the good effects on my health and worried for side effects.
Sir you are my moral booster
Thanks sir again. Remotely you are doing lot of help.
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Follow up: Dr. Indranil Ghosh (0 minute later)
Sir
Many many thanks
From starting you are giving moral support and valuable advice. Once You have check me in XXXXXXX appolo.
Sir except nonveg any other food items restricted with this medicine.
I don't know what will be the good effects on my health and worried for side effects.
Sir you are my moral booster
Thanks sir again. Remotely you are doing lot of help.
doctor
Answered by Dr. Indranil Ghosh (1 hour later)
Brief Answer:
No food is restricted

Detailed Answer:
It has no interaction with any food, including non veg.

don't worry about side effects too much. If something unusual happens, do contact your doctor.
Above answer was peer-reviewed by : Dr. Prasad
doctor
doctor
Answered by Dr. Indranil Ghosh (0 minute later)
Brief Answer:
No food is restricted

Detailed Answer:
It has no interaction with any food, including non veg.

don't worry about side effects too much. If something unusual happens, do contact your doctor.
Above answer was peer-reviewed by : Dr. Prasad
doctor
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Follow up: Dr. Indranil Ghosh (3 days later)
Sir
6 days over. Going on ok tilldate.
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Follow up: Dr. Indranil Ghosh (0 minute later)
Sir
6 days over. Going on ok tilldate.
doctor
Answered by Dr. Indranil Ghosh (3 hours later)
Brief Answer:
That's great

Detailed Answer:
I am sure you will do well with treatment.

Regards
Above answer was peer-reviewed by : Dr. Kampana
doctor
doctor
Answered by Dr. Indranil Ghosh (0 minute later)
Brief Answer:
That's great

Detailed Answer:
I am sure you will do well with treatment.

Regards
Above answer was peer-reviewed by : Dr. Kampana
doctor
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Follow up: Dr. Indranil Ghosh (21 hours later)
Sir Good morning
Today my body temperature was low at 5am.Pulse rate was 63 as per Oxymeter and spo2 98%..Temperature measure found 95.7..Body skin feel cool. Other things ok.
At 1130 am. BP was 130/80pulse rate 70 temperature 96.7
Little worried.
Medicine Ibrunat taken as per prescription.
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Follow up: Dr. Indranil Ghosh (0 minute later)
Sir Good morning
Today my body temperature was low at 5am.Pulse rate was 63 as per Oxymeter and spo2 98%..Temperature measure found 95.7..Body skin feel cool. Other things ok.
At 1130 am. BP was 130/80pulse rate 70 temperature 96.7
Little worried.
Medicine Ibrunat taken as per prescription.
doctor
Answered by Dr. Indranil Ghosh (3 hours later)
Brief Answer:
Unlikely to be XXXXXXX to ibrutinib

Detailed Answer:
Temp was bit low but ibrutinib doesn't cause it. So I don't think it was due to ibrutinib.

Monitor temp regularly. Get warm sunlight. Most likely it will improve soon. If problem persists then you may need to visit the hospital.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
doctor
Answered by Dr. Indranil Ghosh (0 minute later)
Brief Answer:
Unlikely to be XXXXXXX to ibrutinib

Detailed Answer:
Temp was bit low but ibrutinib doesn't cause it. So I don't think it was due to ibrutinib.

Monitor temp regularly. Get warm sunlight. Most likely it will improve soon. If problem persists then you may need to visit the hospital.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Indranil Ghosh (11 days later)
Sir
attached new reports .
WBC LEVEL INCREASED
Hgb and PLT reduced
Capsule IBRUNAT taken 19 days
Observation-
Before medicine
WBC--83900
Hgb--13.6
PLT-1.43 LAC
RBC-5.08
After medicine
WBC--99500
Hgb--11.8
PLT-86000
RBC-4.51
Problems observed
Body temperature always remain in between 95to 96.6
PR remain in between 65 TO 68
PRESSURE--115/72
QUERIES
1.WHATS THE REPORT INDICATING?
2. Will parameters will increased initially and then reduced due to capsule IBRUNATE characters
3. How long IBRUNAT(Targeted Therapy Drugs) WILL TAKE or medicine required to change.
4. Why body temp and PR remains low ( Thyroid test ok )
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Follow up: Dr. Indranil Ghosh (0 minute later)
Sir
attached new reports .
WBC LEVEL INCREASED
Hgb and PLT reduced
Capsule IBRUNAT taken 19 days
Observation-
Before medicine
WBC--83900
Hgb--13.6
PLT-1.43 LAC
RBC-5.08
After medicine
WBC--99500
Hgb--11.8
PLT-86000
RBC-4.51
Problems observed
Body temperature always remain in between 95to 96.6
PR remain in between 65 TO 68
PRESSURE--115/72
QUERIES
1.WHATS THE REPORT INDICATING?
2. Will parameters will increased initially and then reduced due to capsule IBRUNATE characters
3. How long IBRUNAT(Targeted Therapy Drugs) WILL TAKE or medicine required to change.
4. Why body temp and PR remains low ( Thyroid test ok )
doctor
Answered by Dr. Indranil Ghosh (7 hours later)
Brief Answer:
Nothing much to worry

Detailed Answer:
As I can see that WBC was 101000 on 14.3.20 also, so it has not increased. Some variation may be there between labs so the value of 83000 can be explained by that. It may take some time to act. At least 2 months should be given to see the effect. If still no effect, can think of chemo.

Platelet count is low because of ibrutinib. If it falls below 50000 we may have to stop.

Body temp can't be explained by ibrutinib or the disease. I think this is normal for you. Heart rate is also acceptable. You can do one ECG just to make sure everything is normal.

Overall, there is nothing much to worry at this time, as WBC count is stable and not increasing as fast as before.
Above answer was peer-reviewed by : Dr. Prasad
doctor
doctor
Answered by Dr. Indranil Ghosh (0 minute later)
Brief Answer:
Nothing much to worry

Detailed Answer:
As I can see that WBC was 101000 on 14.3.20 also, so it has not increased. Some variation may be there between labs so the value of 83000 can be explained by that. It may take some time to act. At least 2 months should be given to see the effect. If still no effect, can think of chemo.

Platelet count is low because of ibrutinib. If it falls below 50000 we may have to stop.

Body temp can't be explained by ibrutinib or the disease. I think this is normal for you. Heart rate is also acceptable. You can do one ECG just to make sure everything is normal.

Overall, there is nothing much to worry at this time, as WBC count is stable and not increasing as fast as before.
Above answer was peer-reviewed by : Dr. Prasad
doctor
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Follow up: Dr. Indranil Ghosh (20 hours later)
Thanks sir
Yesterday I COULD not upload all reports.Today uploaded all reports.
Observation-
1.Before taking medicine-
Hgb-13.6,TLC-83900,PLT-1.43 LAC,RBC-5.08,Neutrophil-18,Lymphocytes-66
2.After taking medicine 18 days
Hgb-11.8,TLC-99500,PLT-0.86 LAC,RBC4.51,Neutrophil-10,Lymphocytes-90
3. CT SCAN REPORT
Multiple enlarged retroperitoneal lymphnodes
Few enlarged pelvic lymphnodes
4. CT THORAX REPORT
Tinny calcification in right middle lobe of lung
Few mlildly enlarged lymphnodes
5. 2D ECHO WITH DOPPLER
ALL NORMAL
6. ECG REPORT
Low T WAVE (V5,V6)
Abnormal Q WAVE (III,VI)
PROLONGED P WAVE
7. Weight--63 kg ,slightly increased
8. Body temperature --95 to 97F
9. PULSE RATE--63 TO 68
10. ( THYROID TEST NORMAL)

11. LFT & LIPID PROFILE NORMAL
12. SUGER UNDER CONTROL
PROBLEMS
1. BODY FEEL COOL ( THYROID TEST NORMAL)
2. MOUTH AND LIPS DRYNESS
QUERIES
1. WHAT THE REPORTS INDICATE? Specially CT SCAN
2. Whether this target tharephy drugs will continue? --I got answer perhaps
3. Why some times body skin feels cool?
4. Is ultimately BR treatment required which I don't want in present COVID situation .
5. your valuable advice overall.


As per local dr prescription continued medicine till FISH Cyclin D1 test result on blood comes out.Next review 15th May
Thanks & regard
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Follow up: Dr. Indranil Ghosh (0 minute later)
Thanks sir
Yesterday I COULD not upload all reports.Today uploaded all reports.
Observation-
1.Before taking medicine-
Hgb-13.6,TLC-83900,PLT-1.43 LAC,RBC-5.08,Neutrophil-18,Lymphocytes-66
2.After taking medicine 18 days
Hgb-11.8,TLC-99500,PLT-0.86 LAC,RBC4.51,Neutrophil-10,Lymphocytes-90
3. CT SCAN REPORT
Multiple enlarged retroperitoneal lymphnodes
Few enlarged pelvic lymphnodes
4. CT THORAX REPORT
Tinny calcification in right middle lobe of lung
Few mlildly enlarged lymphnodes
5. 2D ECHO WITH DOPPLER
ALL NORMAL
6. ECG REPORT
Low T WAVE (V5,V6)
Abnormal Q WAVE (III,VI)
PROLONGED P WAVE
7. Weight--63 kg ,slightly increased
8. Body temperature --95 to 97F
9. PULSE RATE--63 TO 68
10. ( THYROID TEST NORMAL)

11. LFT & LIPID PROFILE NORMAL
12. SUGER UNDER CONTROL
PROBLEMS
1. BODY FEEL COOL ( THYROID TEST NORMAL)
2. MOUTH AND LIPS DRYNESS
QUERIES
1. WHAT THE REPORTS INDICATE? Specially CT SCAN
2. Whether this target tharephy drugs will continue? --I got answer perhaps
3. Why some times body skin feels cool?
4. Is ultimately BR treatment required which I don't want in present COVID situation .
5. your valuable advice overall.


As per local dr prescription continued medicine till FISH Cyclin D1 test result on blood comes out.Next review 15th May
Thanks & regard
doctor
Answered by Dr. Indranil Ghosh (6 hours later)
Brief Answer:
CT is as expected

Detailed Answer:
CT scan shows few lymph nodes which is very much expected. echocardiogram totally normal though ecg showed some changes. Better to consult a cardiologist. Surely ibrutinib to continue for now. If ibrutinib fails then BR.

Best wishes
Above answer was peer-reviewed by : Dr. Prasad
doctor
doctor
Answered by Dr. Indranil Ghosh (0 minute later)
Brief Answer:
CT is as expected

Detailed Answer:
CT scan shows few lymph nodes which is very much expected. echocardiogram totally normal though ecg showed some changes. Better to consult a cardiologist. Surely ibrutinib to continue for now. If ibrutinib fails then BR.

Best wishes
Above answer was peer-reviewed by : Dr. Prasad
doctor
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Follow up: Dr. Indranil Ghosh (3 days later)
Sir
Many many thanks for your evergreen advice.
I am worried about chemotherapy which I don't want immediately due to current situation but local Dr told that all will depends upon the results of FISH cycling D1 test.
Sir will drug Ibrunat give some positive results in future. What's your experience telling.
Before starting this drugs I could manage to contact with Dr M B Agrawal. Asper him need not hurry to start chemotherapy so you can continue this target therapy drugs till no side effects.
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Follow up: Dr. Indranil Ghosh (0 minute later)
Sir
Many many thanks for your evergreen advice.
I am worried about chemotherapy which I don't want immediately due to current situation but local Dr told that all will depends upon the results of FISH cycling D1 test.
Sir will drug Ibrunat give some positive results in future. What's your experience telling.
Before starting this drugs I could manage to contact with Dr M B Agrawal. Asper him need not hurry to start chemotherapy so you can continue this target therapy drugs till no side effects.
doctor
Answered by Dr. Indranil Ghosh (15 hours later)
Brief Answer:
yes there is no hurry

Detailed Answer:
As I said, ibrutinib takes time to act, so it's not the time to judge its efficacy. It can very well give good results.

So at present ibrutinib can continue.

Regards
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
doctor
Answered by Dr. Indranil Ghosh (0 minute later)
Brief Answer:
yes there is no hurry

Detailed Answer:
As I said, ibrutinib takes time to act, so it's not the time to judge its efficacy. It can very well give good results.

So at present ibrutinib can continue.

Regards
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Indranil Ghosh (3 days later)
What's report telling of FISH just upload
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Follow up: Dr. Indranil Ghosh (0 minute later)
What's report telling of FISH just upload
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Answered by Dr. Indranil Ghosh (16 hours later)
Brief Answer:
It's negative

Detailed Answer:
FISH is negative for cyclin D1 translocation. So it's a good result. Nothing to worry.
Above answer was peer-reviewed by : Dr. Vaishalee Punj
doctor
doctor
Answered by Dr. Indranil Ghosh (0 minute later)
Brief Answer:
It's negative

Detailed Answer:
FISH is negative for cyclin D1 translocation. So it's a good result. Nothing to worry.
Note: For further queries related to kidney problems Click here.

Above answer was peer-reviewed by : Dr. Vaishalee Punj
doctor
Answered by
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Dr. Indranil Ghosh

Oncologist

Practicing since :2004

Answered : 1711 Questions

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