Hi All:

I've been following the thread above about Diana's dad and his elevated counts. I'd like to offer a note of clarification on a couple of points discussed above by Gary.

First off, I would be cautious about directing someone to ask if receiving a transfusion is a "marginal issue". It is really hard to make a call about that without seeing a specific patient's panel of blood results over time. Sometimes, with oncology patients who are in for a long haul, there are expected drops in counts, call nadir points, which occur at predictable intervals. If a downward trend in counts in seen, a transfusion may be recommended prophylactically to rally the counts before they bottom out. In any case, it is appropriate to ask the provider to show you a copy of the trends and interpret the results so you can make an informed choice.

On the issue of the blood cultures, let me offer further clarification. A complete blood count measures predominantly the amount of red blood cells (RBC's) and blood volume (hematocrit) as well as the oxygen carrying capacity of the blood (hemoglobin). It also measures the white blood cell count (wbc) and can detect the presence of bacteria outside of a normal range and on an upward trend which may indicate a local or sytemic infection with an organism which is a bacteria ONLY.

A blood culture, often done when systemic infection is suspected, is a different type of test where the blood taken from the patient is planted on an agar plate to see if organisms grow that are present systemically in the person. It screens for organisms that are bacterial but ALSO picks up those that are protozoal and fungal in nature among others. People who are immunosupressed from chemo often pick up funky organisms that the general public have immunity against if they are healthy.
So,a blood culture is an ADJUNCT to the diagnostic process when a simple CBC may not capture all of the caustive agents that could be responsible for infection.

Gary-my intent is not to offend you in any way. I just think we need to be careful about posting information that is not technically correct because people here often take what is posted as hard fact and I would hate for you or any of us to unintentionally mislead someone undergoing treatment who is making decisions.Being a health care provider myself, I am especially sensitive to making sure the posts that offer medical explanations are accurate.

Thanks for listening,

Kim