Hi Billye,

I haven't posted in a couple of years and saw your post regarding low HGB. I do check this site from time to time though. My husband John is the one who ended up with PN from his treatment for Severe Aplastic Anemia. One of the side effects from having low red cells/hemaglobin is that your body likes to maintain a certain level of fluid volume in your circulatory system. So when you're down a couple of pints like you are, your body compensates by holding on to more fluids to fill the void. This can result in water retention throughout your system. John's HGB is at 10.9 also and he too is carrying extra fluid.

If you have your CBC records, look for where you're counts were when you did not present with the fatigue and fluid retention. This will give you an indication as to what level your body would like to be at. So if you normally had a HGB of 14, then dropping to 10.9, you will feel it even though the docs say it's mild anemia.

There are a couple of thing we keep an eye on. We focus on trends...looking at the CBC over time. The key components we track are White Blood count, Absolute Neutrophil count (also known as granulocytes), Hemaglobin, Hematocrit and platelets. You want to monitor all of these to see if other lines, that are still in a normal range, are trending down/up. When it comes to your red cell line, you should ask them what your Absolute Reticulocyte count is. This is the actual number of new red blood cell circulating in your blood. It's not unusual for the RWD to be high when you are anemic. Large red blood cells are usually a result of many new red blood cells being produced to make for the deficit.

There is a hormone, EPO, ((erythopoein (sp)) produced by the kidneys which stimulates the production of red cells. You may want to ask them to check your EPO levels at some time.

This about all that comes to mind right now. Hope it's helpful. I will look for a link that explains blood production and post it later. I think it will be helpful in understanding how blood is produced.

Wishing you the best,
Marlene