What Is Causing My Blood Work To Change?

I went for a diabetic check-up recently. I asked for this as I wasn’t convinced I was giving my injectable medication properly. It is a once a week non-insulin drug. Along with that drug, I take one other pill daily for my diabetes. I just wasn’t seeing the results I hoped for. Was it my diet? Was it the meds? I would get the support at the diabetic education center.

When I saw the nurse to discuss the meds I’m on, I found out they are considered the last chance before insulin. On one hand, it was a punch to the gut. I guess I kinda knew that but I didn’t want to hear it at that moment. I just wanted to make sure I was giving the med properly. I learned two things. First, the injectable is not seen much at this diabetic education center but that I could trust the way I was injecting the med. Second, I wasn’t rotating my sites enough. That surprised me since I only inject once a week. I should not be injecting in the same area within a month. This was all good information. I was happy with the information I received.

Increase of red blood cell count

My philosophy has always been ‘no insulin before my time.’ Not ‘no insulin’, just no insulin if there were things within my power I could do to keep my diabetes in line. Paying attention to my diet was certainly part of that. There were things I could still fix. Lately, I was coming to the conclusion that I may need insulin but not for the reason I thought. I may need to come off both meds because of something that showed up in my blood work.

Over the last few times, the results were showing my red blood cells were increasing. The endocrinologist volleyed that to my family doctor when it first showed up. However, I wasn’t happy with my current family doc. She shrugged off the result. I found a new family doctor. He did not shrug it off but he did talk to me about how at this time, there was no reason to worry, it is not uncommon. After 2 more lab tests, 3 months apart my red blood cell count was still slowly creeping up with no explanation. My doctor told me he wanted to speak to a hematologist that he trusted to verbally consult but that the hematologist would likely just say it was all ok and to monitor. Sure, I support that. Long story short, the hematologist wants to see me.

Causes of increase to red blood cell count

As I sit here waiting for the date of the appointment my mind is going to all kinds of dark places.

Dehydration

One cause of the rise can be dehydration but that is usually from illness. I have been chronically dehydrated for years but not from illness. I travel for work and do not have access to clean washrooms so I tend not to drink a lot during the day. To add to that, the two meds I need for diabetes can cause dehydration. This is why I have been coming to the realization that I may need to come off the meds I’m on to go on insulin. However, this is a guess on my part.

Polycythemia vera

A second cause is something called polycythemia vera (PV). It is a blood cancer. It is one explanation for the rise in red blood cells. PV happens slowly over a long period of time. I have some of the other signs but they are vague and may be attributed to other causes. It is more common in men than in women but that didn’t give me much comfort considering my alarm bells rang when the hematologist decided he wanted to see me. I can’t imagine the hematologist would be thinking it’s dehydration. Wouldn’t that be in the endocrinologist’s purview if he was the one prescribing the meds?

Unknown

A third cause may be unknown. Sometimes we have to admit that the medical community doesn’t know why some things happen. This could also be the case. According to my family doctor, there is no glaring reason why my red blood cell count is rising.

All of these scenarios potentially fit my picture. Right now I am a jumble of nerves. I am quite frankly terrified. I hope I get some answers soon. My mental health depends on it.