Re: Sara's Blood Work

[Guest guest]

Katrina,

Do you have high blood pressure, high heart rate...is that how you keep Q

up? about every night, especially, I do have to get up and pace around as I

feel like I need to do that to breathe...I have positional problems,

breathing now...What is Ischemic Reperfussion Injury?...

Oh, I could not find what you were talking about...to find in Archives?

Amelia

[Guest guest]

Hi Evan,

I'd suggested C-Reactive Protein. It's another that can go with heart disease.

It would not rule it in or out, tho. Technically, it means inflammation,

indicating some disease process.

Mine was high for at least a couple of years, and has normalized since I've been

on Dr. Cheney's protocol for me. He found I have Diastolic Heart Dysfunction in

2005. I am one of his patients " living on adrenaline " which keeps cardiac output

( " Q " ) up better, but risks for Ischemia Reperfusion Injury to all organs.

There are also some immune panels that used to always be done with CFS,

Imbalance of CD4, 8, that sort of thing.-- Mine were really off, but Dr, Cheney

just glanced. Don't know if that's cause it was familiar, or he just focused on

my heart. They're not hard to get...Klimas might have these listed somewhere?

or Dallas/Ft Worth CFIDS Support Group site?

Others know about TH1, TH2 shift...more complex, lab.

Fibrin is another that can be high with heart/CFS. Mine was.

Did you guys print out Cheney Cardiac post from " DFW " ? Pretty packed with info.

Take care,

Katrina

In , Evan <evan@...> wrote:

>

> When Sara went off for her cardio work up last Monday (done at the

> local emergency room), they did a bunch of blood work. I've spent

> the afternoon on Google trying to figure out what it all means, and

> thought I'd ask y'all for your opinions.

>

> CBC

> WBC 7.6 4.0 - 11.0 /L

> RBC 4.34 3.80 - 5.20 /L

> Hemoglobin 131 115 - 155 g/L

> Hematocrit 0.39 0.35 - 0.45 L/L

> MCV 90 82 - 98 fL

> MCHC 334 300 - 370 g/L

> RDW-CV 12.9 11.0 - 15.0 %

> Platelet Count 264 150 - 400 /L

> MPV 10.4 7.5 - 10.5 fL

> Neutrophils 4.36 2.0 - 8.0 /L

> Lymphocytes 2.19 1.2 - 3.5 /L

> Monocytes 0.56 0.2 - 1.0 /L

> Eosinophils 0.47 0.0 - 0.7 /L

>

> INR 1.0 0.8 - 1.2

> PTT 29 23 - 37 seconds

>

> CHEM 7

> Random Glucose 7.3 3.9 - 11.0 mmol/L

> Urea 4.4 2.0 - 9.0 mmol/L

> Creatinine 75 30 - 105 umol/L

> Sodium 141 135 - 150 mmol/L

> Potassium 4.0 3.5 - 5.0 mmol/L

> Chloride 103 96 - 106 mmol/L

> Bicarbonate 29* 21 - 29 mmol/L

> Anion Gap 9 3 - 16 mmol/L

>

> CHEM ABDOMEN

> Total Bilirubin 6 0-18 umol/L

> AST 21 10 - 38 U/L

> ALT 38 20 - 65 U/L

> LD 169 90 - 250 U/L

> Alk Phos 71 50 - 200 U/L

> GGT 66 H* 10 - 55 U/L

> Amylase 40 35 - 90 U/L

>

> CHEST PAIN PANEL

> Troponin T <0.01 <0.01 ug/L

> CK 70 <70 U/L

>

> D-Dimer Negative

>

>

> I note that there are two values at the edge of or outside the

> " normal " range: Bicarbonate (at 29 the top edge of normal) and GGT

> (at 66 outside the normal 10 - 55 range). I'm not clear on what the

> Bicarbonate might mean, but the GGT jumps out as being involved in

> glutathione metabolism. Allrefer.com says that high levels of GGT

> may indicate liver disease or congestive heart failure. None of the

> other indicators of liver disease (AST, LD, Alk Phos) are elevated,

> though.

>

> Considering Sara's family history of Congestive Heart Failure I would

> have liked to see a BNP test. Diastolic issues aside (we're trying

> to arrange impedance and echo tests) what else would have pointed to/

> ruled out CHF?

>

> Evan

> --

> Engines of Mischief Consulting <http://

> www.enginesofmischief.com>

> Mischievous Ramblings <http://www.enginesofmischief.com/blogs/

> ramblings>

> Photo Gallery <http://www.enginesofmischief.com/

> gallery>

>

> Programming today is a race between Software Engineers

> striving to build bigger and better idiot-proof programs,

> and the Universe trying to produce bigger and better idiots.

> So far, the Universe is winning.

> -- Rich Cook

>

>

>

>

[Guest guest]

On Jul 23, 2006, at 8:17 PM, kattemayo wrote:

>

> Hi Evan,

>

> I'd suggested C-Reactive Protein. It's another that can go with

> heart disease. It would not rule it in or out, tho. Technically, it

> means inflammation, indicating some disease process.

>

> Mine was high for at least a couple of years, and has normalized

> since I've been on Dr. Cheney's protocol for me. He found I have

> Diastolic Heart Dysfunction in 2005. I am one of his patients

> " living on adrenaline " which keeps cardiac output ( " Q " ) up better,

> but risks for Ischemia Reperfusion Injury to all organs.

>

> There are also some immune panels that used to always be done with

> CFS, Imbalance of CD4, 8, that sort of thing.-- Mine were really

> off, but Dr, Cheney just glanced. Don't know if that's cause it was

> familiar, or he just focused on my heart. They're not hard to

> get...Klimas might have these listed somewhere?

> or Dallas/Ft Worth CFIDS Support Group site?

> Others know about TH1, TH2 shift...more complex, lab.

>

> Fibrin is another that can be high with heart/CFS. Mine was.

That's the " INR " entry below. My fibrins were slightly over the line

at FFC last summer, but large doses of bromelian and etc. seem to

have done their job bringing them back into line.

ly, I was amazed to find myself in the dead center of almost all

of these, except the couple Evan noted.

>

> Did you guys print out Cheney Cardiac post from " DFW " ? Pretty

> packed with info.

We've got that, plus all the source studies he cites, plus Lerner,

plus Peckerman, plus....it's starting to be quite a collection.

My follow-up with the doc is tomorrow morning, which is why we're

gathering info today. The gist is: Look, we've eliminated systolic

issues. But I still feel like warmed-over shit (have spent the entire

week off my feet, mostly semi-horizontal, and bloating). Can we

PLEASE talk about diastolic and other issues now?

I also followed Rich's advice and tried to track down the ECG and

impedance equipment. There may be one impedance machine at the

province's main teaching hospital, 45 minutes away. The GE rep knew

of not a single Vivid 7 machine anywhere in the province; for that,

I'll probably have to go to the States and pay out of pocket -- he's

trying to find me one not too far south of the border.

The immune panels are a whole other issue, which will probably be

discussed a whole other day.

But, as you see, I've now got a partner on the job. I finally just

ran out of energy and fight to deal with doctors any more on my own.

I'm soooo tired of being told that there's nothing wrong with me, or

having my serious concerns deflected. I can't even bear to make the

doctors' appointments any more, let alone show up for them.

From here on out, they're going to have to deal with a big, deep-

voiced six-foot bossman with his full mental faculties. He's

organized, a quick study, and a whole lot harder to say " no " to.

Sara

[Guest guest]

>>>>> Do you have high blood pressure,

.....is that how you keep Q

> up? <<<<<

No, I have low BP. That's why I've done a number of things, healthy and not, to

stay upright and get BP to...da,da,da...90s over 60s.

Has varied Over the years:

Salt

Fluids

Gookinaid

Florinef

Pacing, figeting

Ice Cold Drinks

Caffeine(moderate)

Smoking

Dr. Cheney (confirmed the above), says some patients " will kill for Florinef "

and do better smoking...I know...horrifying...but true...heard that from Dr.

Klimas too.

Others are " living on adrenaline " by body's own methods.

The problems....this means I am now not only " maldistributing low blood volume " ,

but include drop, then rushes (corrections) of blood flow, causing IRI....hits

of free radicals to " every cell " .

What's a girl to do? No caregivers anymore while I languish on couch (I was near

paralysis, so I really mean forced there, like many are)

Florinef was main vertical-enabler, then the others.

Now a few are turning on me, and it's an even finer more precise balance. But

also improvements from my heart protocol...hopefully not too late.

>>>>high heart rate<<<<

usually normal, but stress does scary things...I take...a little cortef, and

manage stimuli/stress better...or not.

My neighbor returned home, is blasting music, probably meaning a few

drinkers...heart is beating faster. Abnormal, over-resoponse to everything.

Katrina

P.S. Was it about NMH, POTS? THere is a group with great archives. I think it's

called ME-Orthostatic. Will check later...have to leave awhile. Technically, I'm

the Co-moderator, but rarely there...it's quiet. Wish it were here.

K.

>

> Katrina,

>

> Do you have high blood pressure, high heart rate...is that how you keep Q

> up? about every night, especially, I do have to get up and pace around as

I

> feel like I need to do that to breathe...I have positional problems,

> breathing now...What is Ischemic Reperfussion Injury?...

>

> Oh, I could not find what you were talking about...to find in Archives?

>

> Amelia

>

>

>

[Guest guest]

Forgot..very crucial..

feet up (Raise Q by 1 litre per minute)

or moving ( 2 litres perminute)

at all times!

Your need to pace *now*, not to faint, is classic for orthostatic stuff. ANd,

correct

>

> Katrina,

>

> Do you have high blood pressure, high heart rate...is that how you keep Q

> up? about every night, especially, I do have to get up and pace around as

I

> feel like I need to do that to breathe...I have positional problems,

> breathing now...What is Ischemic Reperfussion Injury?...

>

> Oh, I could not find what you were talking about...to find in Archives?

>

> Amelia

>

>

>

[Guest guest]

Hi, Evan.

I think there are a couple of hints of cardiac issues in these test

results, but since they aren't jumping right out, the doctor

probably didn't believe that they mean anything.

First, the creatine kinase (CK). That's right on the upper limit of

normal. There are several isotypes of creatine kinase, and the

folks at the hospital just measured the total of all of them in

Sara's case, so one can't definitively narrow this specifically to

the heart muscle, but it is true that one of the possible causes of

elevated creatine kinase is inflammation of the heart muscle

(myocarditis). One of my suspects in Sara's case is a viral

infection in the heart muscle, and elevated CK would be consistent

with that. But as you can see, it's right at the upper limit of

normal, we don't know the isotype of CK that's somewhat elevated,

and there are other possible reasons that CK in general can be

elevated, so this would probably not be very convincing to the docs.

Second, GGT is definitely elevated. It's true that gamma glutamyl

transpeptidase is involved in glutathione metabolism, but its

elevation in the blood is not involved with that. The idea is that

this enzyme is normally found abundantly on cell membranes of cells

in the liver and the bile tract. It's also found on the kidney

cells. But when it shows up elevated in the blood, what it's saying

is that cells in the liver are dying off faster than normal. When

they die, this is one of the enzymes that is released to the blood

stream, and its the most sensitive indicator of elevated die-off

rate of cells in the liver. Cardiac insufficiency (low cardiac

output) is a possible cause for this elevation, because the blood

flow to the liver is diminished somewhat, and this is thought to

cause more rapid cell die-off there. So basically, it can be an

indicator of liver damage secondary to cardiac insufficiency.

Again, this is not highly definitive, because there are other things

that can cause die-off of liver cells and elevate GGT as well (such

as a gall bladder problem). So, as I say, I think there's a hint

here of a cardiac issue, but I think this alone would probably not

be convincing to the docs.

I'm happy to hear that you are pursuing the impedance cardiography.

I saw Sara's post about the possibility of their being such a

machine near you. I'm sorry to hear that a G.E. vivid 7 is not

available there. I wish I knew more about echocardiography, but I

believe that there are competing machines that can characterize

diastolic dysfunction. For example, I think that Siemans makes such

as machine, and there may be others. Perhaps if you get to the

cardiologist who uses the impedance cardiograph, he will be up to

speed on diastolic cardiomyopathy as well, and have an

echocardiograph that will do the job, even if it isn't the G.E.

machine. There were three papers on diastolic dysfunction in a

recent issue of the New England Journal of Medicine, and my

impression is that the cardiologists are rapidly getting up to speed

on this, since they have found that about half the people who die of

heart failure did not have a decreased ejection fraction, meaning

that they did not have a systolic heart problem, and now that the

technology has come along, they are in a position to analyze the

other big cause of heart failure, i.e. diastolic dysfunction.

Sara's bicarbonate is on the high end of normal, as you noted. The

books will tell you that high bicarbonate occurs in respiratory

acidosis and in metabolic alkalosis. We don't have a blood pH

measurement for Sara, so we can't definitively say which she is

tending toward. However, we have encountered this in the past on

this list in PWCs, going back to 2001, and in those cases the pH was

elevated, so that it would be classified as tending toward a

metabolic alkalosis. I don't know yet what causes this in CFS, but

it may be what's called a contraction alkalosis. This occurs when a

person loses a lot of fluid that is low in bicarbonate, so that the

remaining blood becomes more concentrated in bicarbonate. Perhaps

the large volumes of dilute urine excreted because of the diabetes

insipidus that occurs in many cases of CFS would fill the bill. I'm

not sure about this. But we have seen elevated bicarbonate in other

PWCs. As far as I know, it doesn't say anything directly about the

condition of the heart, though.

I hope this is helpful. I'd really like to see Sara get her health

back.

Rich

>

> When Sara went off for her cardio work up last Monday (done at

the

> local emergency room), they did a bunch of blood work. I've

spent

> the afternoon on Google trying to figure out what it all means,

and

> thought I'd ask y'all for your opinions.

>

> CBC

> WBC 7.6 4.0 - 11.0 /L

> RBC 4.34 3.80 - 5.20 /L

> Hemoglobin 131 115 - 155 g/L

> Hematocrit 0.39 0.35 - 0.45 L/L

> MCV 90 82 - 98 fL

> MCHC 334 300 - 370 g/L

> RDW-CV 12.9 11.0 - 15.0 %

> Platelet Count 264 150 - 400 /L

> MPV 10.4 7.5 - 10.5 fL

> Neutrophils 4.36 2.0 - 8.0 /L

> Lymphocytes 2.19 1.2 - 3.5 /L

> Monocytes 0.56 0.2 - 1.0 /L

> Eosinophils 0.47 0.0 - 0.7 /L

>

> INR 1.0 0.8 - 1.2

> PTT 29 23 - 37 seconds

>

> CHEM 7

> Random Glucose 7.3 3.9 - 11.0 mmol/L

> Urea 4.4 2.0 - 9.0

mmol/L

> Creatinine 75 30 - 105 umol/L

> Sodium 141 135 - 150 mmol/L

> Potassium 4.0 3.5 - 5.0 mmol/L

> Chloride 103 96 - 106

mmol/L

> Bicarbonate 29* 21 - 29 mmol/L

> Anion Gap 9 3 - 16 mmol/L

>

> CHEM ABDOMEN

> Total Bilirubin 6 0-18 umol/L

> AST 21 10 - 38 U/L

> ALT 38 20 - 65 U/L

> LD 169 90 - 250 U/L

> Alk Phos 71 50 - 200 U/L

> GGT 66 H* 10 - 55 U/L

> Amylase 40 35 - 90 U/L

>

> CHEST PAIN PANEL

> Troponin T <0.01 <0.01 ug/L

> CK 70 <70 U/L

>

> D-Dimer Negative

>

>

> I note that there are two values at the edge of or outside the

> " normal " range: Bicarbonate (at 29 the top edge of normal) and

GGT

> (at 66 outside the normal 10 - 55 range). I'm not clear on what

the

> Bicarbonate might mean, but the GGT jumps out as being involved

in

> glutathione metabolism. Allrefer.com says that high levels of

GGT

> may indicate liver disease or congestive heart failure. None of

the

> other indicators of liver disease (AST, LD, Alk Phos) are

elevated,

> though.

>

> Considering Sara's family history of Congestive Heart Failure I

would

> have liked to see a BNP test. Diastolic issues aside (we're

trying

> to arrange impedance and echo tests) what else would have pointed

to/

> ruled out CHF?

>

> Evan

> --

> Engines of Mischief Consulting <http://

> www.enginesofmischief.com>

> Mischievous Ramblings <http://www.enginesofmischief.com/blogs/

> ramblings>

> Photo Gallery

<http://www.enginesofmischief.com/

> gallery>

>

> Programming today is a race between Software Engineers

> striving to build bigger and better idiot-proof programs,

> and the Universe trying to produce bigger and better idiots.

> So far, the Universe is winning.

> -- Rich Cook

>

>

>

>

[Guest guest]

Ok, I will check that out!

[Guest guest]

Sorry, my bad.

Typo in the " normal " value, which should be 170

On 2006.07.23, at 5:27 PM, Evan wrote:

> CHEST PAIN PANEL

> Troponin T <0.01 <0.01 ug/L

> CK 70 <70 U/L

CK 70 <170 U/L

--

Engines of Mischief Consulting <http://

www.enginesofmischief.com>

Mischievous Ramblings <http://www.enginesofmischief.com/blogs/

ramblings>

Photo Gallery <http://www.enginesofmischief.com/

gallery>

Do not stand at my grave and weep. I am not there. I do not sleep.

I am a thousand winds that blow. I am the diamond glints on snow.

I am the sunlight on ripened grain. I am the gentle autumn rain.

When you awaken in the morning's hush, I am the swift uplifting rush

of quiet birds in circling flight. I am the soft star that shines at

night.

Do not stand at my grave and cry. I am not there. I did not die.

[Guest guest]

O.K., Evan.

Scratch that one!

Rich

>

> > CHEST PAIN PANEL

> > Troponin T <0.01 <0.01 ug/L

> > CK 70 <70 U/L

>

> CK 70 <170 U/L

> --

> Engines of Mischief Consulting <http://

> www.enginesofmischief.com>

> Mischievous Ramblings <http://www.enginesofmischief.com/blogs/

> ramblings>

> Photo Gallery

<http://www.enginesofmischief.com/

> gallery>

>

> Do not stand at my grave and weep. I am not there. I do not

sleep.

> I am a thousand winds that blow. I am the diamond glints on snow.

> I am the sunlight on ripened grain. I am the gentle autumn rain.

> When you awaken in the morning's hush, I am the swift uplifting

rush

> of quiet birds in circling flight. I am the soft star that shines

at

> night.

> Do not stand at my grave and cry. I am not there. I did not die.

>

>

>

>

>