Reference #s

I've had some requests that we clarify the numbers we're watching on Max's blood and urine markers.

These are the normal range for CBC (complete blood count):
WBC white blood cells 4.0-12.0
HGB hemoglobin 11.5-14.5
PLT platelet 140-440
ANC absolute neutrophil count 1500-5000
LDH 470-900

These are about normal for Max:
WBC 1.0-2.5
HGB 8.0-11.0
PLT 50-150
ANC 500-1200
LDH 600-700 (we watch this as it can indicate NB activity)

In order for Max to begin a chemo round his blood counts need to be:
PLT 50
ANC 500
These numbers were 75 &750 in the past, but we've had lower them in order to keep Max on treatment. When Max goes below ANC 500 he in considered at risk of getting an infection (neutropenic). If he were to get a fever of 101.5+ he would need to be checked into the hospital to receive IV antibiotics for up to 10 days.

Urine markers we watch are called cathecholamines, aka HVA/VMA:
HVA <9.0
VMA <8.5

Max's fluctuate between:
HVA 12-20
VMA 10-18
Andy keeps a graph charting the points to watch for any steady rise in the numbers which would indicate NB activity.

Andy referred to Max's LDH spiking this past week which gave us a huge scare in conjunction with the HVA/VMA numbers being higher than usual. It turned out that because Max had a red blood transfusion on Tuesday it artifically increased his LDH in his CBC (complete blood count) on Wednesday. When you receive a transfusion there are LDH in the red blood and they can increase the longer the blood sits on the shelf waiting to be used. Which translated into Max's LDH being twice what we normally see and which put Andy & I into orbit until Dr. Roberts soothed our fears (and the LDH #s dropped as he said they would).

I hope this helps!


Anonymous said...

Thanks for helping me get through my day again Max you are a genious!! Melis thanks for the info!
Best to you all. I am traveling this week so I'll try to catch up next week. WoW thats MoM upsidedown Max you can do it with your fingers its funny.

Later Leo

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