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Anemia, bone marrow
Apr 17, 2005

Hi Doc I have been l on meds since 1993. I have had mixed results - never undectable - but I am still alive and kicking. I am very adherant to the dosing programs and also get the key tests done - phenotype, etc. My current T's are 65 and my Vl is 180K. I am trying to get enrolled in an integrase stufy combined with T-20 and a new PI. That is a seperate challenge.

I feel like that last several months have seen me on a downward spiral. First I had to come off viread due to renal viral problems. I am back on now and being monitored regularly. I also had a nasty viral thing that contributed to me losing about 25lbs,

Now, my Dr tells me today that he wants me to see a hematologist. He is worried that some of my absolute counts WBC and RBC as well as hemaglobin and platelet counts are continuing to decline in a rather linear manner. My latest platle count was 68 that . I think he feels that my bone marrow is pooped out - or more dauntingly that I could have some infection in my bone marrow of that it might be due to drug toxicity

So.. do you think a visit to this blood guy is worthwhile. (I should mention that my regular DR is starting me on a six week course of procrit and neulasta shots.

I feel frustrated and anxious.

Thanks Neal

Response from Dr. Frascino

Hi Neal,

Yes, if your blood counts are consistently drifting down, a trip to the hematologist is definitely warranted. It is possible you have an opportunistic infection, such as MAC, which could be driving your counts down. Other opportunistic processes are possible as well. Drug suppression or toxicity is another possibility. Most likely the hematologist will want to perform a bone marrow biopsy to help determine what's going on. The sooner you know, the sooner you'll be able to do something about it!

I think the Procrit and Neulasta injections are a good idea. Procrit simulates the production of new red blood cells while Neulasta stimulates production of white blood cells. By the way, your blood counts need to be at a certain level to qualify for most clinical trials.

You're "still alive and kicking," I suggest you try to kick the anxiety and frustration while focus on being alive.

I'm here if you need me, Neal. Let's get through this together, OK?

Dr. Bob


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