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crazy bloodwork

SnapDragon2's picture
SnapDragon2
Posts: 260
Joined: Nov 2019

Bloodwork showed elevation with alt, ast, chloride, glucose and sodium.  What the heck!  Does folfox cause all of this?

SnapDragon2's picture
SnapDragon2
Posts: 260
Joined: Nov 2019

OH...AND CEA is up to 12!

Tom M.
Posts: 109
Joined: May 2019

My ALT & AST are always elevated on chemo. Chemo will mess with your blood work. The 3 things that they look at most when on chemo are WBC, RBC, and Hemaglobin. They want those 3 to stay in the safe zone. Please stay calm. I know it's hard at times but it is important to stay positive. From what I read on this forum I know your family is behind you as is everyone here. I guess you can say everyone here is like family. Be strong, as always you are in my prayers. I pray for all of us here every night. Take care,    Tom

SnapDragon2's picture
SnapDragon2
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Hi Tom,  Thank you so much!  Those 3 markers are in the safe zone.  Lord knows I try really hard to stay calm but last few times flipped me out about the panel results.

Yes, my family is wonderful.  From what I'd read yours is too.  We are blessed for sure.

Stay Safe! 

Kazenmax's picture
Kazenmax
Posts: 413
Joined: Feb 2016

I understand how scary that sounds but it could also mean you are dehydrated. I recall having these kinds of bad counts during chemo. My onc never does CEA. He said that it was a poor indicator for rectal cancer.

Im not a doctor but I think that the chemo can cause these numbers. What did your doc say?

i hope theres a simple explanation. Good luck.

k

SnapDragon2's picture
SnapDragon2
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Joined: Nov 2019

It worries me for sure.  Yes, you are probably right.  I did some research last night and found a few papers that stated chloride and sodium generally go hand in hand and can point to dehydration.  My onc has never mentioned it as a concern and those two have been high for 2 months, smh.  I wish he was an agressive onc.  He always just says "your #s look good."  Uhm, no they don't!  So anyway, drinking gatorade for next 9 days until I go back for chemo, so we'll see what those 2 #s are like then.  Its so frustrating.

abita's picture
abita
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Joined: Dec 2017

DId yuo talk to the oncology nutritionist yet? If your hospital has one, they maybe could help you know if you are needing to adjust your nutrional intake. 

SnapDragon2's picture
SnapDragon2
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Joined: Nov 2019

No, they don't have one.  I went to one for a consultation right before start of folfox.  Found out I am gluten sensitive and thyroid levels were off because of it.  Onc was mad I went to a nutritionalist and said there is no such thing as gluten sensitivity, you either have celiac disease or you don't.  I took advice of nutritionalist and cut out gluten.  The thyroid level went from a high of 218 to 1.3 in 5 weeks.  Normal level is <6.  Emailed nutritionalist my bloodwork yesterday.  So hopefully he will have some insight and advice.

SandiaBuddy's picture
SandiaBuddy
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I started on Gatorade (actually Powerade Strawberry Lemondade) during chemo, and have stayed drinking it until now (I probably do not need the extra sugar anymore).  I also supplement with potasium gluconate, which seems to help me.  Chemo wreaks havoc with your body and the way it reacts is unpredicatable.  But if the numbers do not worry the oncologist, it is probably ok.  I had some weird numbers, but they never mentioned them, so I just disregarded them.

SandiaBuddy's picture
SandiaBuddy
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I am in the dark on all of this, but I do know that chemo throws everything off. . .  I hope your oncologist provides information and things continue in the right direction for you.

SnapDragon2's picture
SnapDragon2
Posts: 260
Joined: Nov 2019

You are so right.  It does and worries me when the #s are way up or way down.  If there is an easy/preventive fix so you don't wind up with organ damage due to chemo then I need to know about it.  My onc is to conservative and offers nothing.

abita's picture
abita
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Joined: Dec 2017

How much elevation? And did it go up? There are some that are a bit high on my bloodwork, and he always tells me my bloodwork is good. I think unfortunately, chemo is poison. There is also the possibilty that the tumors cause the bad bloodwork. Does your hospital portal have a messaging system? I would send a quick note and ask if you should be concerned about those specific issues.  They don't talk about it, but they defiinitely closely monitor any indicators of damage to organs. My doctor once said something in response to my question as to whether I could have a glass of wine at my reunion that made it very clear that he was not treating just my tumors that it is his job to keep me alive and with a good quality of life. So, my whole point in saying that is I know how scary seeing high numbers can be, but that a good oncologist is watching all that as well as they want to keep us as good as they can in addition to killing the tumors. You should definitely ask, hey, I see the numbers are high, should I be concerned?

Unlike Kazenmax, my CEA count was a good indicator of my tumors. Not as much with the recurrence though. It stays in the good range, but gets larger when the tumors do and smaller when they are shrinking. To be fair, my original liver tumors were gigantic so of course the numbr was high.

I agree about the water. But no scientific basis or professional telling me. In my own head, which is not a good source, I feel like chemo is a poison, so I should drink water according to guidelines to help my kidneys and liver.

I am a vegan. When I was due for surgeries, my surgeon and the hospital nutritionist had me eat lots of protein for healing. I curtailed that, but recently a nurse told me I should still make sure to get enough protein so I heal from the chemo. Again, I have no basis as to whether that is good advice or not. 

SnapDragon2's picture
SnapDragon2
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Joined: Nov 2019

chloride was highest on 24th bloodwork at 111

sodium was 147

 

alt up to 19 from 14

ast up to 28 from 14 ( alt should be equal to ast or higher then ast from what I read)

monocytes up to 13.3 (need to research this one.  I have no idea what monocytes do)

lymphocytes up to 10.5 (a super good thing.  been eating lots of orange foods to get that up.)

abita's picture
abita
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Chloride normal range is up to 109, so you are out of normal range, but not by much

Sodium is 143, so agian, high, but not crazy high

My lab report has your AST and ALT to be in normal range. How far over normal range does yours have it as? I wonder if we are on different scales. 

SnapDragon2's picture
SnapDragon2
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alt 2-38

ast 9-33

My worry is they have always been 14 and 14, then now a jump apart.

Tueffel
Posts: 65
Joined: Feb 2020

What I understand is that you have questions but the doctor never has the time or does not care to explain why certain things are out of range or not normal. You are going now through scary times, so you do have more questions. 

I would say first of all that I can only explain to you what it could mean but that does not mean that it will be the case for you. The numbers could be close to normal or always like that during a chemo for you or even before.

Glucose: I assume you were not 8 hours of fasting when they took your blood. If you were it depends again how high the number was to consider if someone is prediabetic or has diabetes. 

ALT and AST: normally these are liver and bile system enzymes. They indicate damage of cells. They can be elevated due to drugs. I dont know if you have liver mets and if they do release normal enzymes when they are damaged. 

Sodium: water loss is a possibility. Maybe you should check the gatorade you are drinking. I know that drinks mention how high their sodium content is. If you drink a lot of ot and it has a lot of sodium it could be this cause. 

Still at this point I can only do assumptions about your case. 

SnapDragon2's picture
SnapDragon2
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Haven't drank any gatorade yet but planning to starting today.

NewHere's picture
NewHere
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Joined: Feb 2015

Most of the time it is better to cut Gatorade with water.  Or make your own drink.  It really should be limited to exercise at a high level or if you are experiencing a need for it - like you are about to dehydrate.  Even then, we cut it with water when we suspect heat exertion etc.  If you have a nutristionist, may be a good idea to speak with them.

 

As to the blood work in general, there can be occasional spikes/changes. Of course spikes should be looked at, but the trend is also important.  I had one bloodwork test done where the numbers were way off and they redid them right away - they thought there was an issue/contaiminaiton.  Numbers came back to normal.  Get answers from your doc about it.  And make sure you feel comfortable with the answers (fully understand the how and why as compared to getting an answer "There is nothing to worry about" if you want more than that.)

SnapDragon2's picture
SnapDragon2
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Funny story: He told me 3 weeks ago when I asked for details of the highs and lows of #'s that for me not to worry about it.  He hasn't lost a patient yet on chemo.  Just Wow!!!  A nurse did tell me they have a few patients that get hydration fluid before or after chemo.  If I can avoid any side effects then that is what I need to do.  I don't want to wait until its bad enough to have to have fluids or bad enough to where I have to have a stint or whatever in my liver, ya know!

Thank you for info on gatorade with water.  Thats what I will do.  I have the lower sugar.  Store was out of zero sugar.

abita's picture
abita
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I don't know that might make me look for new doctor. I was hospitalized when diagnosed, and my surgeon came in the day after they saw the tumor, a Saturday, to tell me all I needed to k ow and to give me hope.

SnapDragon2's picture
SnapDragon2
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Joined: Nov 2019

Right now I think I'm better off staying put.  I have you all to help me fill in the blanks :) and so grateful for it!

Ruthmomto4's picture
Ruthmomto4
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My husband has two metal and one plastic, they keep him alive and not jaundice which I can tell you is much worse than a stent. I replied below with more information. I think you are fine with those results. :)

Trubrit's picture
Trubrit
Posts: 5114
Joined: Jan 2013

My Oncologist never ordered a CEA on me during treatment because he said that ithe chemo makes it fluctuate, so it is not accurate.  I'm fine. Sometimes ignorance is bliss. 

Tru

SnapDragon2's picture
SnapDragon2
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He did tell me CEA fluctuates in some patients.  Mine was high (7) before chemo and keeps climbing so it does worry me.

Ruthmomto4's picture
Ruthmomto4
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Will be effected by chemo those are very tiny elevations I would not even give them a second though.  Still in normal range and yes it's fine your liver will fix those after chemo is over. All those things you are watching will fluctuate from chemo. I have my husband's liver values memorized from ages back and he has liver damage from surgeries and a bile duct tumor. His ast & alt have gine into the 200-300 range to rebound back to normal. Don't lose a second of time worrying on these numbers it's fine! 

SnapDragon2's picture
SnapDragon2
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Thank you for your reply.  I knew someone here was a liver expert.  Yes, it is spelled stent.  I'm still learning.  I worry which is a natural thing and need to verify everything so I don't slip thru the cracks with my cancer.  

Ruthmomto4's picture
Ruthmomto4
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Joined: May 2013

If you thought I was being nasty or snarky in my replies I wasn't. I just have been through so much with my husbands liver enyzemes. The first time they went sky high I flipped! It was so scary, his alp was in the 1,000s. I didn't know it could go that high lol I was just trying to make you feel better that was my only intention. 

SnapDragon2's picture
SnapDragon2
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Goodness, of course I didn't think that.  I am truly grateful that you responded.  You have put me at ease a little, so Thank You!  I know I would flip out and pass out probably if I saw those #s.  Thank God for modern medicine/technology to combat when things go wrong.  You all keep going and fighting this horrible disease!

Tom M.
Posts: 109
Joined: May 2019

Snap, don't panic with the CEA being elevated. It will rise a bit with the begining of treatment. It will most likly drop as you go on. Stay positive my friend.  Tom

SnapDragon2's picture
SnapDragon2
Posts: 260
Joined: Nov 2019

Thank you, Tom!  It has been steady at 12 for rounds 3 & 4.  So next Monday it should go down or something is going on?  Idk but don't get much info from onc, smh...I have been researching on my own about trends.

Tueffel
Posts: 65
Joined: Feb 2020

I am reading now a little bit of CEA as well because I got the bloodwork from my dad. It is called flare when CEA rises at the beginning of chemo and then decreases. Apparently it is a good prognostic value. 

I think fluctuations can always occur. How high was it before? 12 is according to the parameters I have not high. My dads CEA dropöed from 61 to 13, his Ca 19-9 from 411 to 95. 

Thing is with this parameters: just google non cancer diseases that can elevate it. I think even something like gall bladder inflammation  can cause an elevated CEA. 

I think at the end it all depends how much it changes. A little bit of fluctuations can always be possible. Sometimes it is just more important how the trend is and yes how much it changes. 

SnapDragon2's picture
SnapDragon2
Posts: 260
Joined: Nov 2019

Normal is <5.  Mine was 24 before surgery.  5.9 after surgery.  Then increased to 7 day of/before first folfox infusion.  Climbed to 10 then 12 and 12.  My worry is it was still above normal after surgery even though clear margins.  Makes me think cancer is camping out somewhere.  I haven't had the CA 19-9 marker.  It is on my list to get it started along with a few more.  I will do this on my own since my onc is a standard kind of doc (one size fits all).

Your dad is responding well to treatment.  Those numbers are coming down really good!!!! He might benefit from cimitedine and IV vitC since you know for sure both his CEA and CA19-9 were/are high.  Research it for met prevention.

SnapDragon2's picture
SnapDragon2
Posts: 260
Joined: Nov 2019

Liver counts keep going up.  So, having spinach for supper and more leafy greens the next 2 weeks.  On the lab report they took off the normal range ref for them, smh!  Like I don't already know...things like that make me think WHY??? Leads to mistrust like they are trying to hide it from me.

abita's picture
abita
Posts: 776
Joined: Dec 2017

which enzymes are those?

SnapDragon2's picture
SnapDragon2
Posts: 260
Joined: Nov 2019

ast and alt

Tueffel
Posts: 65
Joined: Feb 2020

Actually my dad kind of has the same case. 2 of his liver enzymes are also elevated. They were normal the whole time but the last 2 times one of them before they started chemo were extremely high. I was wondering that they continued his chemo. 

I would just say that you write down all your questions and ask your doctor. He should know why it is elevated, if it is expected during chemo or not, when it will get lower.. 

SnapDragon2's picture
SnapDragon2
Posts: 260
Joined: Nov 2019

Onc was out today, just the nurse.  But he always says bloodwork is normal.  Ruth commented on this thread and told me not to worry.  I take her word for it but still it keeps going up.  ast is now at 38. alt is 30.  I'm only on 5th round so trying to keep it tamped down.

SnapDragon2's picture
SnapDragon2
Posts: 260
Joined: Nov 2019

which ones of your dads are up?

Tueffel
Posts: 65
Joined: Feb 2020

GOT and GPT are up. Before I read them I did not even know that they exist... And it is really difficult to find these two in the internet. His bilirubin is also increased but that was the whole time that way. This did not worry much until I had class about this. I am anxious now cause dads CT is soon to check if the tumor responded to the chemo. 

 

EDIT Apparently GOT is the same as AST and GPT is the same as ALT. That they need to rename things is terrible

SnapDragon2's picture
SnapDragon2
Posts: 260
Joined: Nov 2019

Yes, on my lab report it has in parenthesis (SGOT) (SGPT)

I hope your dad has a good scan!

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