grandmother's abnormal blood results

[amimi55]

Hi hoping i can get some answers. My gran is 87 and very ill with persistant utis, chest infections, dementia-like symptoms, fluid build up in arms (water just seeps from her skin), body pain, a hard mass on her left side below ribcage. In last three months (during which her symptoms and discomfort has increased), her haemoglobin, rbc and wbc have been consistently decreasing so haemoglobin come down from 11.2 to 9, rbc is now 2,520,000 (down from 3,500,000) and wbc is 3,500 (down from 5,200). The dr who ordered the tests says her wbc is very good (she currently has two infections incl uti), and whilst she is mildly anaemic, she just needs to increase her intake of protein (even tho we have been giving supplements and high protein foods for three months). Given the blood results are below normal range, and that her health is deteriorating, how is it possible for her dr to say everything is fine and there is no need for any other tests?

[John Irlam, DO, FASCP]

Hi there,
Thanks for the post.  I'm not quite sure how to approach this.  I would start by saying that even if the numbers are low that they need to be taken into context in the overall health of your grandmother.  These numbers would be very worrisome in someone in their 30's with no other health problems but with someone in their late 80's with multiple other medical problems these numbers might just reflect her overall health but not be indicative of any one problem (at least nothing that I can relate them to).  Unfortunately it sounds as though her health is poor.  What is the cause of her edema?  What is the mass that you've referred to?  Is there some reason why she gets repeat UTI's and chest infections?  I'm sorry I couldn't be of more help.  Please let me know if you receive any additional information.
Thanks,
John

[amimi55]

Thank you so much for your response, really appreciate it. We do have some further information - she has had an abdominal ultrasonography done. The only things showing up on that scan are a fatty liver and excessive ascitis. Extensive blood results have show slight level of infection (eg CRP is16.80), albumin has gone down to 1.9 which is probably contributing to her skin condition (she has bullous pemphigoid and it is worsening - she has literally got water pouring out of her arms, so we have had to reduce her water intake to 1200ml). Most worrying of all is her Ca-125 cancer test which shows an elevation of 272.40 u/ml. But our problem is that to confirm whether she has cancer or evenabdominal tb (she has tb of the lungs in past), we would have to hospitalise her and my whole family is against putting her through that. But we cannot get her a prescription of morphine without a definitive diagnosis. Meanwhile she is miserable, suffering and without morphine her pain is going to increase. Any suggestion would be so welcome. I am in india with her and without family's consent my hands seem to be tied...