Anaemic after Transplant

Well, What is Anaemia, that’s the first questions. In greek it means lack of Blood. Well it is reduction in number of Red Blood Cells or Hemoglobin in you blood. Well hemoglobin found in Red Blood cells carries oxygen from the lungs to the tissues of your body. Lack of hemoglobin means, lack of oxygen to your tissues and hence this could lead to serious consequences over a period of time.

“This article has little technical information and more practical experience and knowledge after discussing with  other fellow patients. I am patient and learning from all such problems arising”

This has been a common problem with a lot of people and with Dialysis and Transplant patients it is quite common. But there is a level below which it can even cause death. Some thing like this, that as hemoglobin is low, enough oxygen is not being provided to your tissues. And Red blood cells count goes low, it would say, blood loses its power and enough red blood cells are not being generated. This starts damaging the body rapidly.

Red Blood Cells & Hemoglobin

Symptoms

So what are the symptoms?  Generally

1) Feeling Tired

2)Looking Pale- check you nails, they start looking whitish or yellowish as if they don’t have the glow in them

3) feeling breathless after little exercise, even walking

4) a rapid pulse of palpitations (you will be able to hear your heartbeat or feel it pumping ).There are more symptoms specific to the cause of Anaemia, but  these common ones which patients have discussed.

Normal Levels

Normal Levels for Hemoglobin

Children – 11 -13 gm/dl

Adults  – 12 – 17 g,/dl

Depending on your condition (if you have Kidney failure or any other problem) lower levels sometimes are accepted since you are being treated for certain conditions. Certain countries follow different range for normal hemoglobin levels.

Causes

There are many causes for anaemia. 1) Loss of Blood being one of them. You might have bled externally and need blood, or it could be internal which could be dangerous. 2) You body is not making enough Red Blood Cells or Heamoglobin. There are many reasons for this, like iron deficiency, B12 deficiency, lack of ixygen in the body, lack of certain vitamins (related to your diet). 3) It is also related to Bone Marrow Disorder such as Leukaemia or Aplastic Anaemia( a rare condition where bone marrow fails to produce blood cells properly) 4) Any chronic disease (Commonly in Kidney Patients is Chronic Kidney Failure) 5) Sometime it is high dosage of certain tablets that are regularly taken by patients (Like immunosuppressants for Kidney Patients) which slow down the production of Red Blood Cells in order to Treat your Kidney.

Benefits of Vitamin B12

Tests you may have to Undergo

There are a  few test that you have to undergo in order to understand the case of being anaemic and getting the right treatment.

1) Blood Film Tests, here they test the blood under the microscope

2) Lots more blood tests, especially for B12 levels

3) Gastroscopy, procedure where they insert the camera from the anus and look inside for bleeding. This test is troublesome, with some people they give you powder mixed with 1 litre of water and you keep drinking to clear your stomach. Normally 3-4 packets of such medium sized pouches are given to patients to clear the waste completely, so that the tets can be conducted without obstructions. Well, who may to sit near the toilet for almost a day and a half and not eat anything.  This tests generally lasts for 30 mins,and you are given a sedative so you dont know what is happening. One surpising thing about the sedative they give is that, after the test you dont tend to remember anything. What happened ? God Knows? Or the nurses and the doctor. It happend and Idont remember a thing.

4) Colonoscopy, a better version of Gastroscopy, as the camera is inserted from your mouth to check for bleeding . Not very painful as they spray your throat mkaing it numb so thhat the camera does not hurt. The process is uncomfortable, but lasts for up to 5 mins generally. After that within 30 mins you can drink. But before the test you should be empty stomach for a good few hours.  I had this as well, and problem I developed later after a few days was acidity in my throat, whatever I eat, was like stuck in my throat, could not go down. It was quite acidic and painful but gradually disappeared.

5) Stool Test, I gues that should be simple, Dont want to elaborate on that.

6) Bone Marrow Biopsy – A Sample of your bone marrow is taken, They take it generally from your Hip Bone, giving local anaesthesia, since you have to sit in a particular position. I dont know about General Anesthesia, as different Hospitals or Countries have different rules. All I know is that this leaves a bruise and it is painful

Treatment

Treatments are various kinds and will dpeend on the cause and your body condition.

Diet – Helps in increasing Hemoglobin or prevent it from going Low.

1) Iron is one of the main sources that increases red blood cells. Foods that are high in iron are Apple, Liver, Green Vegetables, Dried Fruits, Pulses (Lentils, Chick Peas), Certain Breatfast Cereals and Bread. There are Iron tablets or liquid available, but it is better to consult your doctor before you consume them.

2) Vitamin B12 – Found in Meat, Cheese, Eggs, Milk, and certain prepared or processed foods where iron is added later.

3) Folate – Again found in liver, red meat, yeast extract, green vegtables and oranges

Foods High in B12

Well Green vegetables are a very good source or iron and also dried fruits. I have staterted with a balanced diet of Meat and Greens since they help in iron levels and over are beneficial.

Please consult your doctor or dietician, since a lot of people have alergy and are unable to consume certain foods. For vegetarins, greens are good or you could also ask your doctor for supplements.

I am facing this problem, since quite a few years. Initially the symptoms I was getting, I did not have a clue that this was due to hemoglobin. It thought it was over exertion or maybe something not known. But it was low count of hemoglobin. I was peritoneal dialysis then and health over all was fine, hence i used to have clinic appoints once every 3 months. And due to this, no bloods were taken and overall health and pd probelms were attended to. I had report to my dialysis clinic and they found that the hemoglobin level was 6. This was much below than normal and this could lead to death. A Bit scared initially, but I was given immediate transufsion and thing got better. Since then I have had this problem now and then, generally within a period of 6 months. But after moving from Peritoneal Dialsysis to Hemodialsysi, It became a frequent thing. I was given transufions every other month and started with EPO Injections. I have to come to know that the problem of being Anaemic is quite common with Kidney Failure Patients.

Red Blood Cells Level When Anaemic

After my transplant i have got this problem again after 6 months and have done loads of test (Like Endoscopy, Colonoscopy, Kidney Biopsy, Various Kinds of Blood Tests). Proposed tests are Bone Marrow tests which are very painful and leave a bruise in you hip bone. I hope I dont have to undergo that test. Currenctly my hemoglobin is under control. Ofcourse due to certain medicines being stopped and precaustions takem, Also I have changed my diet so that I can each Iron rich foods and help myself to overcome this problem. I belive, if things can be controlled naturally, taking extra medicines, transfusions or undergoing tests, is just damaging your body.

Well, Good luck, if you have such a problem, it is controllable, provided detected and treated and the right time. If you have even a small sympton, dont take a risk.