Dear Ask The Doctor: I am waiting for a referral to a hematologist and worried about my blood work. My ferritin has been low for months, now it is 8.4 and my platelet count was slightly elevated last month and up another 100 this month to 529. My RDW is 16.3 and my MCH is 26.8. Possible factors may be that I have had most of my pancreas and all of my spleen removed due to a cyst that was growing on those and my stomach. (I am four years sober). I am on medicaid and not a priority patient so would really like to know if there is something I can be doing to stay safe and healthy until I am seen by the specialist. I am also still menstruating and have incredibly heavy periods. Recent procedures show internal hemorrhoids and a slow emptying stomach. Also my stomach is basically open at the top but apparently not a pressing need for surgery. I will have a hysterectomy in the middle of August if this problem does not prohibit surgery. Thanks in advance for your time. Robin
Dear Patient: The increased blood loss during menstruation is the underlying cause. The low ferritin levels indicate depletion of iron stores and the raised RDW reflects an increased variability in the size of red blood cells in order to compensate for the loss of RBCs. The raised platelet count is usually associated with severe iron deficiency anemia. You may need iron supplements along with iron rich diet to make up for the deficiency. You may discuss with your gynecologist (if possible) for some medications to reduce or stop the heavy bleeding, who may also suggest a suitable iron supplement in your case (given your medical history to avoid any side effects like stomach upset, diarrhea or constipation etc.). You may include raisin, spinach, beans, figs, dates, prunes, broccoli, beet, other green leafy vegetables, cereals, meat, liver etc.