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hemoglobin high again
Mar 8, 2002

Dear Dr. Bob Sorry to ask again, but just today i had the results on another cbc and the hemoglobin remains high 18.5, last time i forgot to tell you iam not on any meds yet. I asked the doctor about the concern of having high hemoglobin consistenly and all he says was stop smoking. By the way im writing you from Chile and im kind of getting tired of the general tests non speific, and anything like anti resistance test by the time to start meds etc. By the way th wbc rised to 10.4 and lymph 38. Im thinking seriously to catch a plane and go to the USA to check everything deeply. By the way i just put the cigarettes in the garbage.. Do you see patients ? in case not, where would you recommend to go? For me is the same any place in the USA, of course id like to have the very best specialist taking care (Dr Bob). Anyway i have to travel all the way to the usa Thank you for everything and God bless you always Derek

Response from Dr. Frascino

Hello Derek,

No meds! That makes the problem a bit more difficult to diagnose. Your hemoglobin is greater than 18 consistently. Is your hematocrit greater than 54%? If so, you should check your erythropoietin level. If it's low, you may have polycythemia vera. You should also have an oxygen saturation test. If your oxygen saturation is greater than 92% and your carboxyhemoglobin is elevated, then you could indeed have "smoker's polycythemia." There are other things to consider if your oxygen saturation is less than 92%. These would include certain lung diseases and cardiac shunt problems. Do you live at a high altitude in Chile? That could also be a factor. If you are serious about coming to the USA, I'd be happy to recommend an excellent specialist who could handle both the HIV and hematology problems. The person I'm thinking of is in Los Angeles. Whatever you decide, quitting smoking is an excellent first step! Hopefully, your doctor in Chile can run the tests I described above.

Good luck.

Dr. Bob

From your Canadian neighbour..

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