How anemic are you?

[Des]

HB between 10 and 12. I use Cosmopher (iron)

[tyefly]

     to ajusting Lab results......   

[RightSide]

Today  my clinic informed me that we have a new protocol for EPO......  and that their range is now 10-12.... and until I go down to below 10 I am not to take anymore EPO...... Its the new bundle program.....  and they dont get paid for that anymore...so  now it time to cut back....to earn more profits....  at the exspense of the patients... 

It's not just a matter of "profits." 

Epogen and Aranesp have been found to have dangerous side effects. This is the new FDA warning:

WARNINGS

INCREASED MORTALITY, SERIOUS CARDIOVASCULAR EVENTS, THROMBOEMBOLIC EVENTS, STROKE and INCREASED RISK OF TUMOR PROGRESSION OR RECURRENCE

Chronic Renal Failure:

    * In clinical studies, patients experienced greater risks for death, serious cardiovascular events, and stroke when administered erythropoiesis-stimulating agents (ESAs) to target hemoglobin levels of 13 g/dL and above.
    * Individualize dosing to achieve and maintain hemoglobin levels within the range of 10 to 12 g/dL.

Cancer:

    * ESAs shortened overall survival and/or increased the risk of tumor progression or recurrence in some clinical studies in patients with breast, non-small cell lung, head and neck, lymphoid, and cervical cancers (see WARNINGS: Table 1).
    * To decrease these risks, as well as the risk of serious cardio- and thrombovascular events, use the lowest dose needed to avoid red blood cell transfusion.
    * Because of these risks, prescribers and hospitals must enroll in and comply with the ESA APPRISE Oncology Program to prescribe and/or dispense EPOGEN® to patients with cancer. To enroll in the ESA APPRISE Oncology Program, visit www.esa-apprise.com or call 1-866-284-8089 for further assistance.
    * Use ESAs only for treatment of anemia due to concomitant myelosuppressive chemotherapy.
    * ESAs are not indicated for patients receiving myelosuppressive therapy when the anticipated outcome is cure.
    * Discontinue following the completion of a chemotherapy course.

Perisurgery: EPOGEN® increased the rate of deep venous thromboses in patients not receiving prophylactic anticoagulation. Consider deep venous thrombosis prophylaxis.

http://tinyurl.com/4rxjxwe

[peleroja]

Last blood test mine was 9.5, but then again I am still recovering from my 2 week bout in the hospital.  Doc said he would raise my Epo.  Kaiser likes us to be somewhere between 10 and 12, and raise or lower the Epo accordingly.

[dyann]

I have been severely anemic for a long time  my court is usually between 7-9 and my saturations as low as 4 I was called today to be told that they were 9 on this last blood draw. they give me I.V Iron and I take 20 of epo 3 times a week but as soon as the iron stops I drop right back down.  I am always tired with no energy and latley find myself very depressed my Dr. is working on it so no complaints there but just tired of it all.

[galvo]

I have the same problems, dyann and am also sick and tired of it.

[natnnnat]

interesting and useful discussion.  Gregory's haemoglobin is at 88 (8.8 US) and they want him back on aranesp.  I gave him a shot tonight, we had a left over dose of it in the fridge.  And came here looking for this thread, as I knew there was some discussion of the recommended range.  Thanks for calming my worries.

[Cordelia]

I don't get aranesp anymore. I haven't for awhile now, a few months. I seem to be doing good. My hemoglobin is around 113.

Sometimes I get liquid iron and I hate that. I get so darned constipated from it   

[galvo]

My haemoglobins dropped to 79 and have now recovered to 125. Docs don't know why they went down or why they went back up. Am having another colonoscopy and gastroscopy to-day and am booking in for a camera gastroscopy. We'll see what they find.

[jbeany]

I've been running at 13/14 since my transplant.  At least until last month.  Mine bottomed out with the surgery and the complications, and of course the not really eating anything for a month.
I'm tired of puffing whenever I so much as do the laundry.

Wonder if I can beg my doc for a single dose of Aranesp?!

[brandi1leigh]

I am EPO resistant so I take wild swings in my Hemoglobin levels. I was hospitalized last month when I dropped to 6.7, but usually manage to hold steady between 9 and 10. My doctor, the nurses and clinic manager are all very concerned about it. I've seen a hematologist and had a host of tests done, but I just don't respond well to EPO. Most people don't realize how different you feel when you are 9 compared to above a 10.

[jagermiester]

I have had problems with being anemic since I was 12 years old.  The first time there was any indication that something might be wrong was when I had just finished PE and my pulse was racing pretty fast and I didn't feel good.  I was sent to the nurses office and she decided to let me lay down to let my heart rate go down since I just had PE.  Well, it didn't go down so she called my mom and advised to take me to the doctor.  Well, we lived in London at that time, which was in 1970, and our doctor would not let us come to his office for some reason and always made a house call when we needed to see him.  He diagnosed me as being anemic and had prescribed these HORRIBLE huge iron pills that made everything I ate taste like iron. 

When I complained about it, he said that I could do what they use to do in the olden days to treat anemia...............   eat raw liver     I took the iron pills