Something’s off inside

My family doctor wanted to see me today to follow up on my latest blood work.  He isn’t happy about it.  My red blood cell count is off, in amounts varying from slightly to significantly, depending on which measure you look at.  To translate it from Lab into English, I have too many red cells, they’re too small, their hemoglobin content is low, and they’re pale and washed-out looking.  This worries him because (1) I’m not female, therefore (2) I don’t have periods to screw up my blood work; hence (3) he doesn’t have a convenient explanation for it.  My serum iron level came back well within range, but the rest of it clearly suggests to him that while I may have enough serum iron in my blood, I’m not taking it up.  At the end of the visit he handed me an order for three or four different labs to be done, to rule out this and that offbeat condition.  At the same time I mentioned that my gastric specialist, whom I saw last week, wants me to go off for even more labs to test me for antibodies to sprue—which, now I’ve read a bit about it, is well within the range of possible causes.  I hope that’s not it, though I fear that’s what it may be.  When I mentioned the sprue antibody test, I saw a small “Aha!” light go on over his head, so I’m sure he’s going to be very interested in the result of those labs.  In passing he asked whether I was a regular blood donor, and when I said I was he hinted I might have to give that up until my blood work looks better, because regular drawdowns can aggravate iron-deficiency anemias, especially when another disease process is involved at the same time  Like a number of other conditions I have, sprue is chronic and once you have it, you have it for the rest of your life, and the only way to manage it is to stop eating and drinking an awful lot of things—and many of them, frankly, I ain’t willing to give up at this point.

Other than the sprue part, the GI guy said he was fairly well pleased with the results of the ’scopes he did on me last fall.  He removed one benign polyp from my stomach and saw nothing else interesting there, indicating I’ve got my reflux under good control.  He did mention seeing a few patches of epithelial cells in my lower gut he wants to keep an eye on in the long term, but again nothing seemed to cause him any immediate concern.