Category: Medical Definitions

Understanding the Comprehensive Metabolic Panel

Ah. The Comprehensive Metabolic Panel. Or the Comp Metabolic Panel. Or the CMP.

 

I knew that if you had managed to make it through the CBC post, you’d be waiting with bated breath for this one. I hate to disappoint, so here we go!

 

What is it? Basically it is a measure of your metabolism. When most people think metabolism, they think of it speeding up or slowing down, but for a doctor, it’s more a look at how your patient is functioning. Are their kidneys and liver okay? Are they having any sort of imbalances in their system? Is their blood sugar normal?

 

The components of the CMP include:

 

Total Protein - Means: This measures all the proteins in serum. Simply put, serum is what is left after your blood clots. It’s not a blood cell. - Range: 6.4-8.9

 

Albumin - Means: A wee protein that’s made in the liver. - Range: 3.5-5.7

 

Globulin - Means: Proteins that are made in the liver. They are pretty important. They are involved in the functioning of the liver, but also are important in blood clotting and fighting infection. The scariest thing during cancer treatment? Infections. - Range - 23-35

 

A/G Ratio - Albumin/Globulin Ratio. Means: The ratio of albumin to globulin. It’s helping to track liver or kidney stuff.

 

ALT - Stands for: Alanine Aminotrans. - Means: An enzyme found in the liver and kidneys. This is used to test for liver damage. The worst possible side effect seen on my clinical trial was someone who died from liver failure, although it is uncertain if the drug caused it or if there was some underlying cause. Anyway, I’m not drinking while on it. No problem! - Range - 7-52

 

AST - Stands for: Aspartate Aminotransferase. - Means: An enzyme in the heart and liver. Also good for detecting liver damage. - Range: 13-39

 

Alkaline Phosphatase - Means: Another one of those liver enzymes. If it’s high, though, it can be liver function issues *or* something is up with your bones. This is important because one of the rare side effects is acute myeloid leukemia. This is a cancer of the blood and bone marrow. Want to avoid that, methinks. - Range - 34-104

 

Total Bilirubin - Means: This is a waste product created by the liver as it breaks down - and recycles! - cells. Good to know our bodies are environmentally conscious. - Range - 0.3-1.0

 

Urea Nitrogen - Means: This is a measurement of nitrogen in the blood that comes from urea, a waste product. I’m often impressed by the naming of these things. How creative! Anyway, this is testing for damage to the liver. We want it to be normal. - Range: 7-25

 

Creatinine - Means: - A waste product from muscles. The kidneys filter it, so it helps measure kidney function. Range: 0.6-1.3

 

BUN/Creatinine Ratio - Stands for: Blood Urea Nitrogen/Creatinine Ratio - Means: The ratio  BUN to creatinine in the blood. Yep. If it’s too high, it could mean dehydration or congestive heart failure. These things are bad. - Range: 8.0-20.0

 

Glucose - Means: Your body’s energy source. This should be pretty stable. Not too high. Not too low. Just right! - Range: 70-105

 

Sodium - Means: It’s an electrolyte that helps balance water inside and around cells. Too much or too little is bad. - Range: 136-145

 

Potassium - Means: It’s a mineral! It helps your body keep the fluid balance spot on while also helping with contracting muscles and nerve signalling. It’s important because it helps you retain the right amount of water and can keep your blood pressure down. Get enough and you can avoid exciting things like strokes and kidney stones! Range: 3.5-5.1

 

Chloride - Means: It’s an electrolyte that helps with regulation of fluid in the body. - Range: 98-107

 

Carbon Dioxide - Means: It’s a byproduct of, oh, breathing. It does help maintain balance in your body. Too much is bad. Too little and you’re probably in a higher altitude or at an oxygen bar. - Range: 21.0-31.0

 

Calcium - Means: An important mineral. You know? Drink your milk! I don’t drink milk, but you can get calcium from other sources, such as cheese! It’s important for, oh, muscles, heart (hint: the heart is a muscle), bones. That kind of thing. - Range: 8.6-10.3

 

GFR Estimate - Stands for: Glomerular Filtration Rate. Means: An estimate of your kidney function. Pretty important. - Range: 90-120

Note: This test must be adjusted for race. If a person is African-American, the estimated GFR must be multiplied by a factor of 1.21 per a note on my chart. Mine is not adjusted as I am near-translucent white, especially in the winter.

 

My AST was low on the most recent test, and before that, my ALT as well. But overall everything has been in the normal range, so that is good. Please do keep in mind that depending on which doctor you are seeing, the ranges I’ve outlined above may be slightly different. My body doesn’t appear to know that it’s got cancer. That is why my type of cancer could have been an even worse problem if I had not been getting tests regularly due to family history. If it had been evident through physical examination or showing up in blood tests, I’d probably be stage 3 or later. Stage 3 is where the cancer has started to metastasize, or spread, throughout the body.

 

See? I. Am. Lucky.

Filed under: Medical Definitions

Understanding the CBC

If you or someone you know has ever had cancer or any other illness that requires careful monitoring, you’re probably thinking: How do I have any blood left???

Purple and white daisies and some yellow marigolds all with dew on them.
Daisy family photo

They take blood when you first go in, and then they just take and take and take more! No wonder your counts are low. They took it all in little vials to run tests.

 

But truly, the blood panels are important. There are two tests that I have had repeatedly already, and so I think it is a good idea to understand what on earth they’re testing for. The first is the CBC, or complete blood count, and differential with platelets. The second is the CMP or comprehensive metabolic panel.

 

Today we will focus on the CBC and diff w/platelets.

 

What is it? It’s what is sounds like, actually. It’s a test to determine information about your blood cells and platelets. The following is a list of what’s included in it and the ranges from my treatment facility. The ranges may vary slightly depending on where you are being treated unless it is something that all doctors agree on.

 

The components of the CBC include:

 

WBC - Stands for: White Blood Cells - Means: The measurement of the amount of the cells that are part of your immune system. Infections and some drugs can make your number of white blood cells go down. If they are too low, you are more at risk for infections and have a harder time fighting against infections. - Range: 4.2-10

 

RBC - Stands for: Red Blood Cells - Means: Cells that carry oxygen around your body and take carbon dioxide out of your body. They’re important. If you have too few, it is called anemia. Anemia can make you feel tired and weak. It is caused when you have low iron, which is directly related to the amount of hemoglobin in your red blood cells. - Range: 4.20-5.40

 

Hgb - Stands for: Hemoglobin - Means: The measurement of a protein that is produced in your bone marrow that is stored in red blood cells. It’s what helps you transport oxygen and carbon dioxide around your body and is the reason the cells are red. - Range: 12.0-16.0

 

HCT - Stands for: Hematocrit - Means: This is the measurement of how much of your blood is made up of red blood cells. If this goes too low, it could mean that you have low iron, which can lead to less red blood cells, leading to anemia. See how these things are related? - Range: 36.0-48.0

 

MCV - Stands for: Mean Corpuscular Volume - Means: The measurement of the actual size of the red blood cells. Measured in femtoliters per cell. Femtoliters are a metric unit of volume = to 10 to the -15 litres. If your red blood cells are too small, it could mean that you have... anemia. Or another deficiency. But basically anemia is what I care about. - Range: 81.0-101.0

 

MCH - Stands for: Mean Corpuscular Hemoglobin - Means: The measurement of the average mass of hemoglobin per red blood cell. It will be lower if you have - wait for it! - anemia. - Range: 27.0-34.0

 

MCHC - Stands for:  Mean Corpuscular Hemoglobin Concentration - Means: The measurement of the average concentration of hemoglobin in a single red blood cell. To get this one, you can divide the hemoglobin by the hematocrit. Assumption: If it’s low? ANEMIA. - Range: 31.5-36.0

 

RDW - Stands for: Red blood cell Distribution Width - Means: This measures range of size of the red blood cells. If this one goes low? You’ll never guess what that could mean. Anemia - Range: 11.5-14.5

 

Platelet Count - Stands for: Uhm. Platelet Count. I’ll change that for the rest... - Means: The measurement of the number of platelets in the blood. Platelets are little helpers that help clot your blood. If you cut yourself, and your platelet count is low and you are anemic, you will bleed more. Good side effect: I won’t have to shave for the next six months! Bad side effect: I’ll lose all my hair anyway. Can’t win ‘em all. - Range: 140-440

 

Mean Platelet Volume - Means: The measurement of the average size of the platelets found in the blood. If they’re too small, indicates anemia. - Range: 7.0-12.0

 

Neutrophils - Means: A type of white blood cell that offers protection from infections and does other stuff too. But we care about infections. They are the first responders to a bacterial infection. They are heroes. - Range: 37.-73.0

 

Lymphocytes - Means: They are cells in the immune system that fight infection. Their home base in the lymph nodes, but they can range all over the body.  - Range: 20.0-53.0

 

Monocytes - Means: They are leukocytes. Those are a white blood cells. They are the largest type and help in adaptive immunity.  - Range: 2.5-12.0

 

Eosinophils - Means: Disease-fighting white blood cells. Think, like, ninja cells. They tend to congregate around an infection, allergic reaction, or cancer. Obviously, if you have this count high, you’d prefer it’s not the third option. I’m glad mine have been in the normal range so far. - Range: 0.5-10.0

 

Basophils - Means: White blood cells that are produced in the bone marrow and are part of your immune system. Low? Possible allergic reaction. High?  Chronic inflammation or something bad. Bad being the medical term for “Something you don’t want to get.” - Range: 0.0-3.0

 

ABS Neutrophils - Stands for: Absolute Neutrophil Count. Means: A measure of the number of neutrophils in the blood, basically. I found them called neutrophil granulocytes or polymorphonuclear cells - we’ll just stick with the counting part. - Range: 1.40-6.50

 

ABS Lymphocytes - Means: A measure of the number of lymphocytes helping to fight disease in the body. - Range: 1.2-3.4

 

ABS Monocytes - Means: A measure of the number of monocytes. This one is interesting to me because it can be linked to lymphomas or leukemias. One of the very rare possible side effects is that Talazoparib, the drug I’ll be taking, can cause myeloid leukemia. That is a cancer of the blood and blood marrow. Best to avoid that if we can. - Range: 0.0-0.8

 

ABS Eosinophils - Means: The measure of the eosinophils in the blood.  - Range: 0.0-0.7

 

ABS Basophils - Means: The measure of the number of basophils in the blood. - Range: 0.0-0.2

 

Currently all my numbers are within the normal ranges, but I haven’t started treatment yet.

 

Information above brought to you by many Google searches and several days because it was a lot to look up. I don’t want to give out bad information if I can avoid it.

Filed under: Medical Definitions

One Test in the Clear!

My positron emission tomography scan, or PET scan, showed no additional areas of concern beyond the areas we know about already. I am relieved. Husband is relieved. Friends and family are relieved. Dogs are napping.

The person who brought me in and prepped me for the scan did a great job describing it. You are not to eat for 7-8 hours before you get scanned. Before that time, you should avoid sweets and carbs. I ate some chicken and a salad I made with lettuce from our garden. I didn’t eat any tomatoes out of abundance of caution. I put homemade Italian dressing on and some feta cheese. And then I had a snack later in the evening of smoked pork. Then I went to bed.

On the way in to the office I saw an employee walking down the hallway carrying cupcakes. I briefly toyed with the idea of tackling him, but decided that would be frowned upon.

The prep once you are there. They check your blood sugar to ensure you are not out of whack because the delivery system for the radioactive drug, or tracer, uses glucose to move throughout the body. In my quick research, it appears that the tracer can be swallowed, injected, or inhaled. Depends on what they’re testing for. In my case, it was an injection. 

When the radioactive glucose (not what they call it, that’s what I call it – not a medically correct term!) is initially injected into your body, it goes through your bloodstream and if they were to scan you right then, your scan would be gray. This is because you have been fasting and everywhere wants some of that yummy glucose. 

Your brain and heart, of course, do not rest. I was told they would appear yellow on the imaging. Areas of concern would also show up in a similar way because the cancer cells are greedy and keep a hold of the radioactive glucose long after the rest of the body has had its fill. Therefore, they show up on the scan.

They’ve conducted all the studies, of course, and determined that 45-60 minutes after the radioactive glucose is introduced is the best time to run the scan. In that 45-60 minutes, you rest. I saw in a recliner in a room with subdued lighting and a warm blanket over me and dozed off. It was 7:15am when I went there. We’d had to get up at 5am to make this appointment. I was tired.

After this time, they come and get you and then you have to take a wee. I’d read that online before I went, so I was prepared when they wouldn’t let me go any further without a pit stop. Done. Then on to the room. This particular room was very relaxing. Subdued lighting during the actual test, and a color-changing ceiling with little points of light to resemble stars.

That helps you keep calm and to not think too much about your arms behind your head and hands maybe trying to fall asleep. I was face-up on a table with my head between two squishy things and then slid into a tube. It’s open on both ends, so unless you are super claustrophobic it’s not too bad.

First they did a computerized tomography (CT) scan. It’s a fancy X-ray that provides much more information than a normal X-ray. I was told they would overlay the PET scan on the CT scan, so try not to move. No problem. That was the short part.

Then the PET scan. The actual imaging surface is not very wide, so I was slowly moved into the machine as they started around mid-thigh with my imaging. I moved bit by bit and was as still as I could be during the whole process because I wanted good pictures on the first try.

They wanted to be sure there was no cancer anywhere else. This is the best scan they have for that. They didn’t see anything beyond what we know already. I am pleased. Still mad at cancer, of course, but glad that we caught it so early due to screening.

Apparently after I was escorted out of the waiting room they started handing out shakes! No fair… (they were meds for screening, so I was only jealous because I was hungry)

Filed under: Medical Definitions