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My uncle had what I guess some would call an assisted fall last week. The doctor thought it was related to a UTI. My cousin just showed me the blood tests and it looks like my uncle is anemic. He hasn't had a CBC done in over a year so there's nothing to compare it to. He had one the day he went to the ER and then the following day. It looks like it's worsening. He did lose a bit of blood from a cut, but I would think his numbers would've improved not worsened.


I'm concerned about this. I only know about animals, but if this were my dog my veterinarian would've definitely expressed concern. I guess this could be related to his UTI. Or I'm worried he could have internal bleeding or something else may be going on. I also don't know if it's regenerative.


MCV is 85, Normal is 82-98


HCT is 31.0 and falling, Normal is 35.8-47.9


RBC is 3.67 and falling, Normal is 4.01-4.90


WBC is 7.8 and falling (was 10.6, but this may be good since he has a UTI), Normal is 3.7-11.0


Any opinions? I'm not sure why doctors are never concerned with anemia. I've learned from my pets that it's something to be taken seriously, especially if it's non-regenerative. This could also explain why he's so tired all the time and is weak. I wish I knew when this started, it could've been months ago and could've contributed to not being able to support his weight and the assisted fall. Doctors! Ugh! Overworked, I guess.

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Has your cousin asked your uncle's doctors to comment? I should start there.
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KateH2 Dec 2019
He has an appointment tomorrow (Wednesday) morning, but wanted to educate himself beforehand. Around here you have to go in armed with knowledge to get good care from a doctor. It's very sad.
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Kate, yes, it is definitely something over which to be concerned.   It can affect energy levels, and thus his healing ability, and even attitude toward healing and life in general.   So it could affect both physical ability and mental attitude.

I wouldn't agree that doctors "are never concerned with anemia."   Mine were, to the point that when I had an emergency appendectomy the surgeon wanted me to have a transfusion.    I've had to be aware of this since I recall being anemic several decades ago, and when I eat iron rich foods, I feel more energetic.  (That's just a simple explanation).

Sometimes doctors default to providing limited information if the patient/family don't inquire.   So the best thing you and your family can do is educate yourself so you can communicate on a level that reveals your concern and understanding.   If you don't get answers then, and the doctor isn't inclined to be more informative,  you need to find another physician.

That happened to us once when I asked a cardiologist specific questions about my mother's health.   He made it clear that he was the doctor, and in a roundabout way that he didn't need to discuss details with us.   After that he was no longer my mother's cardiologist; I found a much more personal and communicative one.

There's a web site that interprets values of blood draw results, but I can't which one it is now.    However, it seems you're already aware of the significance.   What you can do is some online research on each of the low values so you can discuss it in more detail with the doctor tomorrow.

I think you understand enough to know the questions that need to be asked, but you can start generally with expressions of concerns about the low levels you cited, i.e., potential causes, affects, and remedies.  I always go for the natural remedies first, meds second, for myself, but with my father, I was willing to use meds since he was older and more fragile and I didn't want to gamble.  However, all our doctors knew that I preferred viable natural solutions first.

Another issue to consider for an "assisted fall" is whether this occurred as he was trying to stand up.   If so, orthostatic hypotension might be involved.    This occurs when rising.    

You might approach this with the doctor as what are the potential causes of the "assisted fall" (including syncope), then proceed from there.   Don't be afraid to so state if you don't understand, even asking the doctor what specific areas you should research for a good understanding of the factors in play.
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Nothing here is dangerously low, but it is low. It cannot be accounted for in a cut. Does he have any occult (hidden) blood in his stool; are they black. How is his diet. The doctor may put him on supplements of iron and recheck him; he may do other tests to see if there is a source he can easily identify. I suspect doctor will ask him to improve his diet if able, and will then recheck him, see if these numbers are improving or getting worse. You do not mention age. It may be time to think of what illnesses he would want to treat and how many tests he would be willing to undergo. For instance, would he want a colonoscopy? Would he treat any blood disease given the difficulties of some treatments, and etc. But I would wait and see what a recheck shows. Let your doctor guide you here.
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My mother was anemic the last several years of her life, and the doctors were concerned. It may have been related to decrease kidney function (although if your uncle had bloodwork I assumed they tested kidney function as well). My mother had several sources for the problem in addition to kidney disease. She had gut bleeds due to ulcers, extremely bad bleeding hemorrhoids, and finally some sort of leukemia or lymphoma (which ultimately killed her, but she also had extremely high and rising white cell counts, which your uncle doesn't have). It could be a lot of different things. My mother had a few transfusions, a lot of IV iron infusions, and took iron supplements. They kept her going, for a while at least.

The fact that he's not feeling well make the issue concerning in his case. It's important that his doctor be aware of that. Good luck!
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I agree with Alvadear; his values are low but not critical. Uncle can be iron deficient, have kidney disease (kidneys produce a substance called erythropoietin that stimulates the bone marrow to produce red blood cells), GI bleed or any number of ailments that would affect his HCT. They may order uncle B12 shots as elderly folk tend to get pernicious anemia due to age and B12 deficiency.
I’d bring it to the doctor’s attention and if this persists see a hematologist.
The Doctors I work with are VERY concerned with anemia. But your uncle’s numbers aren’t that bad. These days doctors won’t transfuse blood unless Hgb is < 6.0 or 7.0. (Which is too low if you ask me).
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