EPOCRIT and Anemia

[Whamo]

My labs were good, too good, as they stopped my Epocrit.  Now it's Saturday, and I'm anemic again, all because my number was 12 and the limit is 11.  Or was it 13? 

[Joe]

They do that to me all the time. I take my Epo as directed and my Hemo count goes to 14, so the tell me to stop and we start labs every week. So far, my Hemo count is down to 13. Will have to see what I'm down to at clinic this week. I'm feeling kind of puny, so I'm thinking it's low. I'd love to get it all balanced out.

[cassandra]

I don't know how they prescribe Epo at yours, but I just receive the prescription the Neph prescribed (say 3 x 5000 a week, and if I see that my Hb is 10,9 (I start clotting above 11) I take it maybe 1 time a week, till I get my next labs. It's usually 12 by then, so I just keep doing the reduced amount, and could end up with a fridge full of Epo if I wouldn't conveniently forget to pick up the order.

It works for me like that, and keep my Hb between 10,9-12 without having big drops or spikes.

good luck Cas

[Joe]

I have 7 vials in my fridge Cas. I think they have me on record as taking 10000 units a week which would be 1/2 a vial. Just haven't taken any in 3 weeks. We'll see what the numbers look like at clinic next week.

[Rerun]

Epo is delicately balanced.  Too much you can have a heart attack or clot your access and too little and you feel puny but you are not going to die from being a little low.  Back in the old days before Epo we got down to 9 before we got a blood transfusion.  Now that is puny.

[Joe]

I do PD, so clotting an access isn't an issue. And yes, if I get down below 10, I feel pretty puny.

[Whamo]

I've just recently switched from Hemo to PD.  Before I got my epocrit like clockwork.  My nurse explained that the insurance company and/or state audit would go crazy if they gave me more epocrit when I'm at my current level.  I guess I'll just have to tough it out.