Column: Anemia and how to fix it

My health care provider, a physician assistant I’d met only that morning, was casual, nonchalant delivering the news.
“You’re anemic, and it’s been getting progressively worse,” she said. She’d read the results of my lab work over the past few weeks.
Anemia, caused by not having enough healthy red blood cells, is another side effect of chemotherapy. Bone marrow produces red blood cells that carry oxygen throughout the body. From what I understand, chemotherapy suppresses the bone marrow and causes it to make fewer red blood cells. The timing of my weekly treatments make it difficult for my bone marrow to rebound and start producing more red blood cells before the next treatment.
People with anemia can experience dizziness, lightheadedness, heart palpitations and shortness of breath. Severe anemia can even cause organ damage.
Despite the weekly lab work I have before my chemotherapy treatments, this is the first time anyone one has mentioned to me that I’m anemic. It seems like this would be good information to have. I start to wonder if this has anything to do with me feeling light-headed or getting sick and after I have blood drawn for lab work. Is this why I’m sometimes out of breath when I take the stairs to the second floor of the Cancer Center?
I later find out that my hemoglobin (a part of red blood cells) level started at a 12 before treatment and now I’m at a 7.
The nurse who administers my chemotherapy has even worse news for me. If the anemia gets any worse, if my number goes below a 7, I’ll have to have a blood transfusion.
Let me just say: My rational self knows a blood transfusion is probably not a big deal. I’ve been told that cancer patients typically have to have at least one blood transfusion during the course of chemotherapy. And I know that there are all kinds of safety screenings in place to make sure the blood I would get won’t cause me any harm. After I wrote about this on my blog, two people reached out to me and said they’d had blood transfusions before and they felt so much better after having them. My rational self fully expects that to be the case for me, too.
But the irrational part of me, the part of me that fears needles and hates the sight of blood, hates this idea. That part of me is still cringing from the news.
“I can’t even think about that,” I tell the nurse while making a disgusted face. “That’s so gross.” He just smiles and tells me it sounds like a bigger deal than it is.
Besides the transfusion, there’s nothing I can do to bring up my red blood cell count, I’m told. If it were caused by an iron deficiency, I could eat more spinach and red meat. But my anemia is caused by chemotherapy. If they were to hold off treatment, my numbers would probably rebound. But I’d like to get through with my treatments as quickly as possible.
Over the weekend after my treatment, I grow either more anemic or more paranoid. I’m certain that I’m feeling more and more shortness of breath when I’m walking. My appetite is all but gone. I get lightheaded when I stand up. I spend most of my time in bed or on my couch. Exercise, I reason, might cause organ damage.
Long story short, I end up back in my doctor’s office on Tuesday so the same physician assistant can explain anemia and the blood transfusion process again. I come away with the message that my symptoms would probably be worse if there were something immediate to worry about. Peace of mind for a $40 co-pay.
I’ll have to wait until my next treatment to find out whether I need a blood transfusion.

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