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27F immunocompromised and sick for two weeks. Getting worse. Rheumatologist is out of town and ER doctor sent me home pending blood test results that are still processing. Insight?Demographics: 27 female. Height 5ft 6in, weight 190lbs. Married.Conditions: rheumatoid arthritis and lupus; SVT.Meds: 2000mg sulfasalazine, 400mg plaquenil, 200mg Cimzia injection every two weeks.Non-smoker, no alcohol, no caffeine.Duration of complaint: 2weeksI have four doses of pfizer covid vaccine.Currently negative for covid.Two weeks ago before my scheduled Cimzia injection I spiked a low-grade fever. It was about 37.8c. Since then, my temperatures have been 37.5c to 38.5c. Acetaminophen will not bring my temperature down. It initially started with fatigue and headache and fever.Last week I began to get a sore throat, sweating, clamminess, chills, mild sinus pressure, confusion, shortness of breath, and a slight cough.I went in for monthly rheumatology bloodwork on 7/28. Ill attach the results. Mildly decreased WBC and Neutrophils.On 7/29 I went to the emergency room as my primary doctor instructed me to because I was not improving. Many cultures were taken. WBC further decreased and neutrophils were more than half of the previous day. There is a WBC Morphology pending pathologist review.Sepsis cultures have not shown any growth over the day.X-ray of chest showed no abnormality.Im confused as to what could be causing this. The ER doctor also said he was confused and it could be a medication or a nasty virus (was not tested for these) and that I have neutropenia and I am quite immune compromised but left it at that.Today, 7/30, I have had more difficulty breathing, particularly with movement or talking. Im coughing green/yellow thick mucus. More fatigue. My lungs feel heavy.Im thinking of heading back to the ER tomorrow if symptoms get worse, but Im not sure it will do any good for me or provide me with more.Is there any insights?Ive reached out to my rheumatologists receptionist as well as my primary doctor. However, Monday here is a holiday so the offices are closed. The earliest I could see my primary is on Tuesday, and Im not sure how much further it will progress by then.here is the link to my imgur albumI understand that some of the blood work with the hematology panel is still pending.Also, what does it mean with the WBC morphology Reviewed by technologist Sent to Pathologist for review?
gpt
I wouldn't wait a day more. Go to the ER. In my opinion you should be started on broad spectrum antibiotics asap, while waiting for results.
Worsening Breath hunger with normal blood panel resultsMy doctor doesnt seem to think theres a problem here. Does anyone have an idea why I find it so hard to breath? Walking up the stairs is becoming more and more difficult. Im 33/f (I hope this makes sense, its translated from German)Material submitted: Whole blood or supplement, EDTA blood, GlucoExactinvestigationresultDimension reference areagraphicprevious valueCLINICAL CHEMICAL TESTSglucose10560-100The multiplication of the measurement result by a factor of 1.16 required for the GlucoExact tube was already 60-100 mg/dl (3.3-5.6 mmol) normal fasting glucose: 100-125 mg/dl (5.6-6.9 mmol) abnormal fasting glucose: >126 mmol/l) Diabetes mellitus (guidelines of the DDG from 10/2004, confirmed in Diabetologie 2010; 5: 109-112)performed.mg/dl (>7.0GOT (ASAT) GT29160.7<0.9Creatinine (Jaff)GFR (calculated, according to CKD-EPI)11460min/1.73m2COFIRON BUDGETferritin13-150LIPOS METABOLISM/ATHEROSCLEROSIS RISK DIAGNOSTICS45-23075cholesterol134triglycerides62mg/day20-150HDL cholesterol51mg/day48-83LDL cholesterolmg/day10-155LDL target values according to the ESC/EAS guideline: Diagnosis and therapy of dyslipidemia (2019 version): In the case of a low cardiovascular risk, an LDL cholesterol target value of <116 mg/dl (<3.0 mmol) should be set, and in the case of a moderately increased cardiovascular risk of <100 mg/dl (<2.6 mmol/l) should be aimed for. If the cardiovascular risk is high, the LDL. Cholesterol maintained at less than 50% of baseline and at least <70 mg/dl (<1.8 mmol/l) and very highcardiovascular to be sustained to less than 50% of baseline and at least to <55 mg/dL (<1.4 mmol/L).non-HDL8314-185Secondary non-HDL target values according to the ESC/EAS guideline: Diagnosis and therapy of dyslipidemia (2019 version): with a moderately increased cardiovascular risk <130 mg/dl (<3.4 mmol/l), with a high cardiovascular risk <100 mg/dl dl (<2.6 mmol). at very high cardiovascular risk <85 mg/dl (<2.2 mmol).VITAMIN DIAGNOSTICSVitamin B12197-771 1.8-9.0folic acidTHYROID DIAGNOSTICS TSH basal value1.250.4-4.0TSH in the reference range as an indication of a euthyroid SD functional position (assuming an intact HVL axis). Please note the changed reference range.Page 1/2amedes MVZ 1. Laboratory. and Microbiology Leipziger Chaussee 1911 06112 Halle/Saale Tel.:0345/44507-100 FAX:44507210amedeswithdrawal inputSurnamePIKE EMMAborn05/20/1989 (933 years)Payer checkout investigationYour number 7014147367 barcode number701414736707/26/2022 07/26/2022final resultlab noYPWG26 5414resultDimension reference areagraphicprevious valueHEMATOLOGICAL DIAGNOSTICSSMALL BLOOD COUNT5.44.0-9.0leukocyteserythrocyte hemoglobin4.2TA39-5313.0120-16.0hematocrit MCV3836-4789.880-9630.728-32MCHC34.230-36platelets150-400Commentary on findings: [1] Please note the changed reference range.This finding was medically validated by Dr. Biro, F for Laboratory Medicine
While your blood tests are normal, there isnt much of any investigation for shortness of breath (aside from demonstrating that youre not anemic). A typical workup for shortness of breath will include chest imaging (usually starting with a chest x-ray) and pulmonary function testing (breathing tests). If you doctor isnt comfortable working up your symptoms its always reasonable to ask about a referral to a pulmonologist.