human
Scared about abnormal CBC results, history of anorexia25F, 5'0, ~105lbsHistory of anorexia and childhood asthma (used a nebulizer as a little kid, no need for inhaler/treatment now)Abnormal lab results: https://imgur.com/a/Mcg5s0kI see my PCP every couple of months at her request since I have struggled with a restrictive eating disorder since I was 13. As part of my semi-regular appointments she runs what I think are fairly comprehensive labs (I only included pics of abnormal results but she also runs thyroid, estrogen, etc.). My vitamin B12 is also slightly high (1,316 pg/mL).Im mostly concerned that my absolute lymphocyte count has been steadily declining since last year  when I first started seeing my doctor in March 2022 it was 1.26 L and in March 2023 it was 0.79 L. There are a few other results like hematocrit and mean corpuscular volume that are elevated, but those at least seem to be closer to the reference ranges. I know a small elevation/drop can be normal since were not robots, but the decrease in lymphocyte count seems pretty dramatic.My doctor didnt call/comment on my most recent labs, so I sent her a message online asking about the lymphocyte count. Her response was that a slightly lowered lymphocyte count isnt uncommon/could be due to nutrition and we could recheck at my next appointment. However, Ive actually been doing much better with nutrition since around December 2022 and am at a stable weight with normal thyroid/estrogen levels, so Im not sure that malnutrition would be a likely cause.Ive been waking up slightly sweaty/clammy in the middle of the night, usually a few nights per week. Ive experienced this before to a much greater extent in residential treatment for my eating disorder when I was going through refeeding and experiencing hypermetabolism, but that is definitely not the case now as my weight and food intake are adequate (confirmed by RD).I have a small lump on one side of my neck that my PCP ordered an ultrasound for in November 2022  result was normal enlarged lymph node, no biopsy recommended. It hasnt changed/grown, but I recently noticed another small lump on the other side of my neck. The lymph nodes just under my jawbone feel slightly swollen as of this weekend, but Im not sure whether to chalk that up to stress about this whole thing.Does my doctors suggestion to wait a few months until my next appointment to recheck the lymphocyte/other levels sound reasonable? Im worried that it will keep declining, or that it could signal a larger issue in connection with the other signs/symptoms. Thought about seeking a second opinion with a specialist, but Im having trouble figuring out how that will work with my insurance.Thank you for your time and advice.
gpt
This isn't at all concerning. I agree with your doctor.
Pregnant with a pre-existing umbilical hernia. I don't know much yet, and I have questions.Age/sex: 29F | Height: 5ft 0in | Weight: 117 lbs (~105lbs before pregnancy) | Race: whiteI am 16 weeks pregnant with my first child. I live in the US.Yesterday, I had my 16wk OB appointment. We measured baby's HR at 140bpm, woo! But I have also been referred to a surgeon regarding my umbilical hernia, which, to my knowledge and limited understanding, I got in infancy (my mom watched my bellybutton "pop out" during a screaming fit). Yesterday, before the OB measured baby's HR, I told her about my "outtie" belly button and how it's already doubled in size since pregnancy; also about a day last week when I scraped a bathroom stall door against my bellybutton while opening it, which immediately caused sharp, downward shooting pains and overall abdominal discomfort that lasted for the rest of the day. She kind of wrote it off ("bellybuttons sometimes get sensitive during pregnancy"), until I laid down for her to get the heartbeat. She then looked closely at my bellybutton and asked me to do a sit up, then mentioned that she would be referring me to general surgery for an umbilical hernia. I asked her what the medical implications of an umbilical hernia with pregnancy would be, and she just said, "a lot of pain that we can't do anything about."So that was scary, and made me question why even see a surgeon now? Just to confirm it's a hernia? But then I did some googling, and have further confused and worried myself.My consultation with the surgeon isn't for another month, coincidentally the same day as my 20 week ultrasound._________________________________Here's some more info about my experience that might be relevant:-My bellybutton has always been sensitive, even as an adult. It was much bigger as a kid and got smaller as a I grew up, but definitely still an "outtie." When I was a kid, I remember it filling up and getting "hard" when I had gas. I would "pop" it and it would "deflate." That stopped happening by the time I was like 7 y/o.-I have struggled with constipation on and off throughout the years, but I wouldn't say it's generally "severe." I have had occasions when I'd go 4-6 days without a BM where it seemed like nothing helped, but overall, if I pay attention to lifestyle/proper nutrition, I don't go more than 1-2 days without a full BM.-Only today have I noticed a bulging under my bellybutton. And it's only when I lean back far enough so the rest of my belly/organs/fat go down so I can see it. I've never noticed this before, and I assume it's due to the pregnancy.-I've always had a pretty strong core with visible muscle tone and minimal stomach fat._________________________________I would really appreciate any comments/information about what to expect, what possible outcomes are, other experiences, etc. But some of my specific questions are:-Does this pretty much guarantee I'll need a C-section delivery? (to avoid the strain of pushing)-Is it possible to not need surgery at all-- neither during pregnancy nor after?-Will a CT scan be necessary?-Will I inevitably be in a lot of pain?-What would make a surgery necessary while pregnant? (I understand there is also an option of having the hernia surgery at the same time as C-section)-What, if anything, should I look out for before my consultation that would constitute an emergency?________________________________________I think that's all, I'll edit if I think of something else I should add.Thank you so much in advance!
-Does this pretty much guarantee I'll need a C-section delivery? (to avoid the strain of pushing)No, I don't believe so. I'm not ob/gyn but a general surgeon, so I could be wrong on the indications for a c section.-Is it possible to not need surgery at all-- neither during pregnancy nor after?Depends on if you want it fixed, if its causing you pain, etc. Not mandatory in all cases.-Will a CT scan be necessary?No, usually not unless the surgeon is unsure of something, and a CT is contra-indicated in pregnancy.-Will I inevitably be in a lot of pain?No. Some hernias cause pain, others do not.-What would make a surgery necessary while pregnant? (I understand there is also an option of having the hernia surgery at the same time as C-section)Incarceration or strangulation.-What, if anything, should I look out for before my consultation that would constitute an emergency?hard, very painful lump at your belly button that you cannot push back it and it continues to become more and more painful.