Do bloodwork numbers reflect minor cold or something more?
Question: For the second time in two years, I’ve had bloodwork done due to massive headache, general tiredness and body pains. Both times, I also had very minor signs of a cold (post-nasal drip). My recent test shows elevated neutrophils of 89 percent (normal range is 40-80 percent), with high normal absolute neutrophils. My lymphocytes are more concerning, at 4 percent lymphocytes (range 20-40 percent), with absolute lymphocytes of 272 (range 1,000-3,000).
I’m having recurrent low-grade fevers (99.6100.3) that seem to last only a few hours; night sweats; and am generally exhausted all the time. I am currently in a tropical country, and am concerned at times about the care I receive here.
Wha t follow-up care, if any, should I request, and with what kind of doctor?Iamconc erned about lymphoma, as both my mom and brother have hadit.—M .H.
Answer: It is difficult to evaluate your blood counts, as both t imesyou had it done, you were sick.Acompleteblood count (CBC) in a person whoissick with an acute infection often shows elevated neutrophils and low lymphocytes, so I would recommend evaluation during a time when you are well, if possible. A hematologist is the expert in reviewing results of white blood cell (as well as red blood cell and platelet) abnormalities.
Lymphoma can cause fevers and fatigue, so it is a diagnosis that is worth considering. However, being in a tropical country, you are at risk for many different infections, which may have very similar symptoms and are far more likely. You might consider an expert in infectious diseases to help evaluate your current situation.
Q: I recently had a cataract removed in my left eye and lens-replacement surgery in both eyes. Upon completion and before the first two-week follow-up appointm ent,I noticed visual abnormalities — quite different in each eye — which were subsequently diagnosed as macular puckers, neither of which had been present during presurgical screening. Since t hereisahistory of macular degeneration in my family, this outc omewass aid to be an “age-related” phenomenon unrelated to the surgery. Vitrectomy has been recommended for both eyes.
Would you please explain the mechanics or relationship of how cataract and lens-replacement surgery can lead to the condition of macular puckers? —J.W.
Answer: Macular pucker, also called epiretinal membrane, is essentially a scar over the macula, the very center of the retina, where our vision is sharpest. It is not related to macular degeneration, and it probably had nothing to do with the cataract surgery. Rather, it is more l ikelythatremovalofthe cataract made it possible for your ophthalmologisttosee the macula clearly enough to make the diagnosis. The surgery, vitrectomy, usually restores about half of the lost vision.