Bloodwork and PCP. Any suggestions?

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My 88-year-old Mom (one month post-partial hip replacement) saw her PCP last week and he did bloodwork to check a few things like low hemoglobin level. His office called and said all was within normal range. When I was finally able to check the results online through the patient portal, I was shocked! Most of the red blood cell numbers were out of whack including hemoglobin which was 10 and her potassium level was a sky-high 5.9! At the hospital her potassium was not even that high and they made her drink that stuff that binds to the potassium and is excreted in stool. I know from past experience with my Dad, a high potassium level is dangerous and could lead to a heart attack. I called the PCP's office but, of course, he left early since it was Friday. His nurse ASSURED me that someone would get back to me TODAY. Right. Didn't happen. Supposedly the doctor on call would review the numbers and let me know what should be done. I am mad enough right now to spit fire and certainly angry enough to change to a different primary care doctor. Did her PCP not even look at the test results? How could he say a 5.9 potassium level is normal??! Not sure what to do about this. Mom has been lethargic and has no appetite to speak of. I'm trying to encourage her to drink water but am at a loss as to what to do now. Any suggestions?

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Shane, they checked her eGFR last week before they administered contrast for a lung CT and it was 57. Strange that her PCP never addresses any bloodwork results including eGFR or hemoglobin or all the red blood cell stuff that shows up "abnormal" in her test results. And, the urine specimen came back with "multiple bacteria" with a note that the specimen was most likely "contaminated" but he never suggested doing the urine test again. Yet he wants her to have a bone density test! What could a bone density test possibly show on an 88-year-old woman who has broken a fibula and a hip in the same month?? Osteoporosis? DUH! Think it is time to start looking for a new PCP!
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Reply to texasrdr22
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Glad they are going to repeat it. What stage CKD does she have?
Good work checking out the mg of potassium in her Centrum. Also avoid salt substitutes as they often are high in potassium as well.
I immediately thought she had chronic kidney disease (CKD), curious to know what her eGfr is? Glad you got them to recheck. 
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Reply to Shane1124
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One of the Home Health nurses called back and said they did not have standing orders to draw Mom's blood so all she could do was tell me to watch for symptoms like chest pain, shortness of breath and muscle cramping. Not sure why her potassium level is so high. She is not on an ACE inhibitor but her GFR is not what it should be for her kidney function. I did look at the label on the Centrum Silver multi-vitamin I had started her on and it did have 80mg of potassium included. So, I took her off that.

The PCP's office called this morning (Monday) and said he wanted her to come in to check the level again. Wait a minute......he was NOT concerned when he "supposedly" reviewed the results but now wants a re-draw?? I told the person who called that I was still waiting for a callback from their office that I was promised would come last Friday afternoon! Crickets chirping on the other end of the line. I will take her back today to get another blood draw. Bless her heart! She must be feeling like a pin cushion by now.
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Reply to texasrdr22
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I’m curious, has your mom had to take the kayexelate ( the potassium binding med) before this episode? 5.9 is high but not necessarily that high (range is 3.5-5.5) but you’ve mentioned the medicine that binds potassium in the gut for excretion). If she has has high potassium issues in the past, her body could get tolerant of a high potassium ( I have seen this specifically in kidney disease patients on dialysis). I’ve seen a few patients with a potassium of 8! And no cardiac arrest. 

Why is her potassium elevated? Does she have kidney disease or taking an ace inhibitor? Some people get a high potassium from an ace inhibitor as well. 

Ask them to repeat the potassium level. Sometimes the way the specimen is drawn and if not spun or refrigerated soon enough a process called hemolysis occurs causing  the red blood cells to burst & increase the potassium level and the result would be a false (can’t remember if it would make the potassium result higher or lower).  Often the lab will note this on the result sheet as “incomplete separation of serum and cells”. 
A HGB at 10 post op is not too low meaning they won’t transfuse her. What was it before surgery? Red blood cells are made in large bone marrow (especially the femur) and the femur is manipulated during hip surgery as well.
Make sure too that she avoids high  potassium foods like tomatoes, OJ, oranges, potatoes and bananas. 
Keep us posted. 
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Reply to Shane1124
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Tex, did you call back the doctor's service to tell them no one had called you?
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Reply to BarbBrooklyn
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Barb's suggestion of calling a nurse might also be possible if a local hospital has that option. One in my area has what's known as a "nurse navigator". There might be other troubleshooting services atbother hospitals, but hopefully the hospital with which your doctor is affiliated.

There's an excellent source for interpreting lab results, of any nature. I'll see if I can find it. I used it to check out my results whenever blood work was done.

Another thing - do you have the lab report, and if so does it indicate which results are not within the normal parameters?
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Reply to GardenArtist
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BarbBrooklyn, great idea! I will check out that option. Thanks!
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Does mom's insurance have a nurse line you can call? That is often a good option.
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Reply to BarbBrooklyn
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I was researching online (yes, I know. Dr. Google, right?!) and one source, Mayo clinic I think, said 6 was an extremely critical level. 5.9 is not that far from 6! I have found that speaking with any medical personnel on the weekend is not an easy task to accomplish. I have placed a call to one of the nursing services who came to see Mom when she was first released from rehab and for whom Medicare is paying. Let's see if anyone returns my call.
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Reply to texasrdr22
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Texasrdr, I just checked some paperwork and the range for potassium is 3.5 to 5.2, so 5.9 isn't that far off. That's probably why the doctor isn't worried.

But I can fully understand why you would want to speak with the doctor to help clarify that chart readings.
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