Okay!!!

He just came back from Dr. Fred. He got the results of his latest blood work. Dr. Fred gave him the results.

His Platelet count was 130 (which was in the Low column on the paper)

Normal platelet count is 140-400

Tryglicerides are 202.
His cholesterol is 234. His HDL is 32. His LDL is 162. His cholesterol/HDL/Ratio is 7.3.

His iron was normal at 72. His TIBC was 232 (this has always had an odd number). His Transferrin Saturation is 31. His TSH -3rd generation is 2.98. His T4, FREE is 1.1. So I gather this is fine.


Dr. Fred said his high cholesterol might be due to lack of exercise. (can't go because of Foot Ulcer).

Now Alan LOVES bars. Dr. Fred said "as long as the bars don't contain cholesterol, that's no problem."

Dr. Fred put him on Crestor. 10 mgs.

Alan has been (since his stent), on plavix and aspirin therapy.

We DO eat healthy, but Alan is a sugar junkie. All the bars have sugar. He has a coffee roll at Dunkin every morning. He loves the coffee roll (he has officially had his last coffee roll (his words). He eats about 4 bars a day. He likes the cereal bars. He told Dr. Fred about the cereal bars and Dr. Fred said "they are okay, as long as they don't have cholesterol". I checked, they don't.

Now I eat way more fish than he does. He eats chicken, whole wheat spaghetti with turkey meatballs.

But he literally LOVES these bars, and might that have contributed to the odd numbers (the platelet and the cholesterol)??.

Or could the fact that he takes aspirin and plavix every day, lead to low platelet count?

All of the other blood work was normal.

Dr. Fred said "we'll re-do this test next month". "I want to see if the platelets go UP or DOWN, or if it's a true reading. Then we'll figure out if it's the medication or what" Dr. Fred also said: "This could also be a false reading"

So I would REALLY appreciate someone explaining the Platelet count.
Under CBC, (including DIFF/PLT), his WBC is 6.4. His RBC is 5.21, Hemogloin is 15.0, Hematocrit is 43.3. MCV is 83.1. MCH is 28.7. RDW is 15.0 and everything else in the CBC thing is all normal. Only the Platelet number was off.

To say that my mind is spinning is putting it mildly.

Thanks to ANYONE who can explain this. Alan did not want to pin Dr. Fred down by asking him a million questions.

Thank god I wasn't there, because we would have never left until I had more answers.

P.S. I just got this off of the internet. I googled Side Effects of Plavix

What is thrombotic thrombocytopenic purpura?
Thrombotic thrombocytopenic purpura (TTP) is a rare blood condition in which small clots thrombi) begin to develop within the blood circulation, resulting in the consumption of platelets and thus a low platelet count (thrombocytopenia). Characteristics of the blood disorder are low red blood cell counts, low platelet counts, abnormalities in kidney function, and neurological (nervous system) abnormalities.

Huh? Ya had me going for a minute, there Mel!

The most toxic statin.... never ceases to amaze me.
Crestor for a PN patient....

http://www.medicationsense.com/artic...es_053005.html

here is a link about platelets:

http://www.merck.com/pubs/mmanual_ha...h49/ch49c.html

Severe platelet abnormalities may show up as bruising and bleeding gums.

Good luck!

Okay, I just replied to you but I deleted what I wrote.

I took the bull by the horns, and I actually got Alan's doctor on the phone (no small accomplishment).

I said "You gave him Crestor, it's got a really bad rep, what do you think about it?" I also said "I have read up on this drug and it's really the strongest of all the statins". He said "I'll be honest, of all the meds, this is the one that really reduces the plaque and I want to give it a shot". I then said "what side effects should we look for? and he said "muscle pain, muscle weakness", and if that happens just call me".

Then I asked him "what about the low platelet count", he said "Don't worry, it's not that low, I'm running another blood test next month". I then said: 'do you think it could be attributed to the Plavix and Aspirin?" and he said "it could be, but I want to run another test next month and we'll act on that'.

I thanked him. (Actually it's so hard to get this guy on the phone BECAUSE EVERYBODY CALLS HIM AFTER 4 P.M. AND THAT'S WHEN HE RETURNS CALLS, ETC.

I was lucky to get him on the first try.

So, having no power to tell the doctor 'ALAN IS NOT TAKING THIS", I honestly don't know what to do.

I believe I've done all I can do at this point. I really don't know what else I can do except to wait and watch.

melody

may be caused by Plavix.

http://www.webmd.com/drugs/drug-5869...l&pagenumber=6

There are papers on PubMed stating that Plavix causes platelets to fall in some people. Exact reason is not understood at this time.

--for a guy as big as he is, I don't think that Alan's cholesterol numbers are in very dangerous territory. Not yet, anyway. And probably not enough to go on a statin--I would think exercise (when he can), diet (do I hear oat bran?) and Niacin would be better options to try first, especially since he has documented neuropathy.

Would it be possible to explain the above to the physician? Do you think he'd be receptive?

I suspect that the automatic "statin" response is due to Alan's heart/circulatory history. And those triglycerides need to be lowered, which may have factored into that decision. But, as indicators of potential cardiac problems, inasmuch as he is on Plavix and aspirin (which very well could be affecting his platelet numbers, BTW--and the numbers are not that low, yet, and may also be related to Alan's autoimmunity situation), I'd be more interested in his C-reactive protein level (did they do those tests?). This is a better predictor of possible cardiac vessel problems than mere cholesterol readins--one needs inflammation to form clogging plaques, not just high cholesterol levels (and the very reason Alan is on aspirin and Plavix, I'm assuming, is to keep inflammatory factors reduced).

"Would it be possible to explain the above to the physician? Do you think he'd be receptive?"

From the way the conversation went today, I don't think so. Maybe I can run this by him next month WHEN I WILL DEFINITELY GO WITH ALAN TO HIS APPOINTMENT.

Is a C-reactive protein a special test. I can't remember if he ever had this.

I have the blood test results right in front of me. Can't find it on the test.

Oh, his PSA was 2.73 (it went down), all that tomato sauce I guess

And is B-12 serum was 607. And mine was 2000 lol

But I do think it's the plavix and aspirin.

We'll find out more next month.

Two of my friends are on Crestor by the way.

I do thank all of you for all this good info.

I really don't know what I would do without you people.

Melody

Hi,

I am a sales rep that works in diagnostics. From what I've seen platelet counts of 130 are relatively normal. They may fall out of the "normal" reference range for the cell counter used but I suspect this isn't a cause for concern.

Just my two cents knowing how these measurements are taken and calculated from the technology side. If you ran the same sample 10 times you may have some results fall below 140 and some above. Peoples platelet counts remain pretty consistent over time so this is probably normal for him.

I doubt that ASA or Plavix is causing his platelet count to be lower. It is extremely important for stent patients to take these medications-please don't consider stopping the meds unless your physician directs you otherwise.

Again, I'm just a rep and not an MD...not even close. Just my two cents from somebody who works around labs.

People with autoimmune disorders can have spleens that eat up
platelets. This happened with a friend of mine whose husband became
Diabetic type I after a severe bout of flu.

Unbeknownst to him his spleen was damaged too. They discovered it
when he had angina attacks and they found he needed a quintuple bypass..
they could not do the operation, too risky. So they removed the spleen.
His platelets were lower than Alan's and incompatible with life. He survived both procedures.

What is at issue here are the lipids.
All that honey that Alan eats has got to go.Sugars are bad for triglycerides.
Also his HDLs are low...and that can be changed too.
Fish oil will fix both of those, and improve the cholesterol ratio.
There is an RX one called Lovasa which may be covered on your insurance.
Otherwise you pay over the counter. Fish oil does not help LDLs much, but keeping them from oxidizing helps too. Antioxidants would be called for.

The stents have a bad prognosis... this procedure is not working out in the long run. So doctor's are worried they will clog up.
That is why Alan's doctor is pushing the Crestor. Besides, Crestor and Lipitor are going neck and neck and the sales force will reflect that race.

It is a tough decision to make.

Mrs. D.

Alan has had his last bit of honey. I do thank you for that. He puts it on everything. He has an impulse problem (all formerly obese people still possess the traits that got them obese in the first place).

It's all about replacing bad habits with good habits. I told him "you are not bringing another cereal bar in this house".

Fresh fruits and veggies from now on. Maybe on the weekend, he can have one of my brownies. That's a guilty pleasure, that we all need, and if we don't indulge, then we MIGHT INDULGE EVERY DAY.

That's how I lost my 100 lbs. I'm still losing. Very slowly, but I'll lose.

About stents. I dont' understand this. If they are no good, then why are doctors still doing it.

Oh, I have a question about diabetes. I don't eat after 7 p.m. That's how I've been able to lose weight. Slowly, but I'm 60, and better slow and steady, than to take off 10 lbs and put it right back on.

So here's my question. Sometimes I get up and my sugar is 130. Sometimes 127. ( I can live with his, because it used to be over 265). My a1c is 6.5. They are happy with this.

But why, sometimes is my sugar 160, or 154?? I dont' get this. I eat fish, I eat my veggies. I don't juice fruit (like I do with Alan).

I once did a test. I ate something at 8 p.m. (a small apple)., The next morning my sugar was 118.

Why the heck would it not have gone up.

Does not eating after 7 p.m. make my pancreas work harder and that's why my sugar is over 120 (sometimes).

And if I do my walking for one hour, every day, then the next day my sugar is better. So I understand that exercise is key in this.

I am on 22 of the Lantus. I go to Cornell on May 30th.

During my last visit, (because Alan's nurse had told me never to go to bed without eating something, well, I listened, and at 10 p.m., I would eat a bit of something). Well, that didn't work, and my sugar went up. I went to Cornell and they said "why on earth are you eating at 10 p.m. ? I said 'because someone told me that my sugar will go DOWN at 4 a.m. and I should prevent this by eating a bit of something before bedtime"

They replied: 'You are not that type of diabetic, stop eating at 10 pm.".

I listened, and my sugar got better. I have done this 'not eating after 7 p.m." for two years now, and got my a1c down to 6.5 (from 9.0) when I first began the Cornell Protocol.

I just want to understand why, sometimes, if I don't eat after 7 p.m, my sugar might read 154, and sometimes, if I eat an apple at 8 p.m, my sugar will be 118 the next morning.

I really don't understand this diabetes thing.

I don't eat white stuff. I do occasionally eat one brownie after dinner with a cup of coffee (only on weekends).

Would having a brownie at 6 p.m. with a cup of coffee significantly impact my sugar reading at 8 am. the next morning.

That's a lot of hourse to go without any food in my body. I don't miss it. I don't need it. My sugar does not drop in the middle of the night. I feel fine.

This means I go over 10 hours without eating. Shouldn't my sugar be 100 or so the next morning??

One would think I would by hypoglycemic, but this is not the case.

I tested this theory more than once. I ate the way I normally eat. Protein, veggies, no refined carbs. I ate my dinner (usually broiled salmon or turbot fillet). I then ate something at 8 p.m. (a small apple, some 100 calorie snack thingees).

The next morning my sugar was fine.

Then, I would do the same thing, without the 8 a.m. snack. and bam, the next morning my sugar is 150 or so.

I am not taking the chromium picolinate (I ran out), going to get some today.

This whole diabetes thing is quite confusing.

And don't get me wrong. I know plenty of people who wish they could get their diabetes down to 200 in the morning. They are on insulin, oral meds, they eat fine, and sometimes they go to 400. I know I am not that type of diabetic.

And I do test during the day.

sometimes it's 115.

I wonder, if I changed to taking Lantus at night (like some people I know), would that make a difference??

Thanks if you can make heads or tails about of my diabetes question.

I just want to get up in the morning and see a sugar reading of less than 110.

And I don't want to up my insulin.

I'm thinking. As I continue to lose, (they say if you lose even 10 lbs), your sugar reading gets better)

Oh, and the Methyl B-12 is still WORKING JUST FINE!!!!