Thalassemia Patients and Friends

Discussion Forums => Thalassemia Major => Topic started by: Zaini on May 30, 2008, 06:03:51 AM

Title: Annual check up!!
Post by: Zaini on May 30, 2008, 06:03:51 AM
Hi Everyone,

Zainab is due for her annual tests,her doctor suggested following tests,

1-CBC
2-ferritin (done every three months )
3-hepatitus c antibodies
4-urine detailed report
5-creatinine
6-liver function test
7-alkaline phosphate
8-calcium,magnesium,phosphorus
9-TSH

Along with an eye check up and echo,and as MRI is quite expensive,i am planning to do an ultrasound just to know the size of her spleen.Do you think anything else can be added?
Does that make any difference if these tests are done when her hb is low,i mean when we go for cross matching,do you think it would effect the results in anyway?

Thanks for your time,

ZAINI.
Title: Re: Annual check up!!
Post by: §ãJ¡Ð ساجد on May 30, 2008, 06:47:47 AM
Hi Zaini,

These tests are regardless of Hb. These are the usual test that are prescribed as a routine check up.

Well, I had also been prescribed T4 Hormone test. Maybe that is not required for Zainab's age and TSH should be enough.
Title: Re: Annual check up!!
Post by: Andy Battaglia on May 31, 2008, 04:30:56 AM
Hi Zaini,

Most of the standard tests are represented here, but as Sajid mentioned, T4 is often done, as is PTH (Parathyroid Hormone). Vitamin D, zinc, copper, and selenium are also routinely tested. In our documents section you will find a couple very relevant documents pertaining to comprehensive care and what is included. I would suggest all parents and patients read these documents and if possible, make sure your doctor has a copy.

http://www.thalassemiapatientsandfriends.com/index.php?topic=1762.0

http://www.thalassemiapatientsandfriends.com/index.php?topic=1587.0

We have Dr Vichinsky to thank for developing these guidelines.

Title: Re: Annual check up!!
Post by: §ãJ¡Ð ساجد on May 31, 2008, 03:26:39 PM
:doh

PTH was also included. Sorry I missed it out.

Thanks Andy :thumbsup
Title: Re: Annual check up!!
Post by: Zaini on May 31, 2008, 03:56:57 PM
Thanks Andy and Sajid,

For your input,we did these tests yesterday and i'll post the results here tomorrow hopefully,regarding other tests,i think i'll wait a month or so as tests are very costly. i hope everything comes back normal.

ZAINI.
Title: Re: Annual check up!!
Post by: Zaini on June 01, 2008, 12:51:50 PM
Hello everyone,

Well, here are the results of Zainab's blood tests mentioned above,

TEST               RESULT                    NORMAL RANGES

TSH                5.73ulU/ml                  0.6------6.3    (for 4 months to 15 years)
Ferritin             1232 ng/ml
Hepatitus C
Antibody           non reactive (0.13)

Magnesium         2.2 mg/dl                  1.9-2.5
Calcium              9.5 mg/dl                  8.6-10.5
Phosphorus        5.4 mg/dl                  4.0-6.3

Serum creatinine  0.3 mg/dl                 0.65-1.1

LFT
S.Total bilirubin   0.9 mg/dl                  0.0-1.0
S.Direct bilirubin  0.1 mg/dl                  0-0.15
S.Indirect bilirubin 0.8 mg/dl                0.1-0.95
GAMMA GT          19IU/L                    1-37
SGPT(ALT)          20IU/L                    3-33
Alkaline phosphatase 158 I.U/L             97-278

Now i think every thing seems to be normal Alhumdulillah,now we'll go for echo and eye checkup,hope everything will be ok there too.

ZAINI.
   
Title: Re: Annual check up!!
Post by: Andy Battaglia on June 01, 2008, 01:39:34 PM
Hi Zaini,

Zainab is doing quite well and it's nice to see her ferritin low. I like to think IP6 has made some difference supplementing her chelation. Zaini, you're doing great keeping her healthy.  :thumbsup
Title: Re: Annual check up!!
Post by: §ãJ¡Ð ساجد on June 01, 2008, 02:08:03 PM
:agree

Don't worry about the echo and eye. Insha Allah they will be normal as well :thumbsup
Title: Re: Annual check up!!
Post by: Canadian_Family on June 01, 2008, 09:01:01 PM
You are doing a good job Zaini.

Title: Re: Annual check up!!
Post by: Sharmin on June 01, 2008, 09:12:06 PM
Zaini,

The results look great (thank god) - you are doing a wonderful job Zaini.  The rest of the results will be great too.  Best of luck.

Sharmin
Title: Re: Annual check up!!
Post by: Zaini on June 02, 2008, 03:01:34 PM
Thanks pals, :hugfriend

For your encouraging words,it's all by the grace of ALLAH Almighty,HE gave me the courage to fight it.

And also i give a lot of credit to you friends,especially Andy,i believe IP6 and wheat grass are working inside her body making her stay well. :hugfriend

ZAINI.

 
Title: Re: Annual check up!!
Post by: sah on June 03, 2008, 05:25:42 PM
Zaini,
It is nice to see Zainab's results.I wish her all the best for the future. :)
Sah.
Title: Re: Annual check up!!
Post by: Manal on June 03, 2008, 05:54:48 PM
Zaini, you are doing an excellent job :wink

manal
Title: Re: Annual check up!!
Post by: Zaini on June 04, 2008, 02:58:08 PM
Thanks sah and Manal  :hugfriend :hugfriend

ZAINI.
Title: Re: Annual check up!!
Post by: jade on June 08, 2008, 03:48:26 AM
hi Zaini,

I found this from an article.  It is about the check up to be made.  I hope this is helpful:

For individuals with thalassemia major, follow-up to monitor the effectiveness of transfusion therapy and chelation therapy and their side effects includes the following:

    *

      Physical examination every month by a physician familiar with the affected individual and the disease
    *

      Assessment of liver function tests (serum concentration of ALT) every two months
    *

      Determination of serum ferritin concentration every three months
    *

      Assessment of growth and development every six months
    *

      Annual
          o

            Ophthalmologic and audiologic examinations
          o

            Complete cardiac evaluation, and evaluation of thyroid, endocrine pancreas, parathyroid, adrenal, and pituitary function
          o

            Liver ultrasound evaluation and determination of serum alpha-fetoprotein concentration in adults with hepatitis C and iron overload for early detection of hepatocarcinoma
          o

            Bone densitometry to assess for osteoporosis in the adult
    *

      Regular gallbladder echography for early detection of cholelithiasis [Galanello et al 2001], particularly in individuals with the Gilbert syndrome genotype [i.e., presence of the (TA)7/(TA)7 motif in the promoter of the UGT1A gene]
Title: Re: Annual check up!!
Post by: Zaini on June 08, 2008, 10:35:27 AM
Thanks a lot Jade,

It will definitely help.

ZAINI.
Title: Re: Annual check up!!
Post by: Zaini on June 17, 2008, 11:27:32 AM
Hello everyone,

We went for echo yesterday and i just wanted to share the results.

STRUCTURAL INTERPRETATION

Normal sized LV with normal function
No segmental wall motion abnormality seen
Normal mitral and aortic valves
Normal sized RV.No P.S
No ASD,No VSD
No LV clot or pericardial effussion seen

DOPPLER

No flow abnormality seen.

Pressure Gradient (mm hg)

Diastolic flow velocity across mitral valve Ewave=0.98,Awave=0.72

Estimated RV/MPA Pressure (mm hg)

25 mmHg

Final Echo Dx

Normal sized LV with normal function.
Normal valve.

Apart from the world normal i don't understand much  :biggrin but the echo cardiographer and zainab's hemo both said that her heart is doing fine right now.

I asked Zainab's hemo about dexa scan ,but she said that it's not necessary as Zainab's calcium and alkaline phosphatase levels are normal.

It's been 4 years zainab started transfusing,so i asked her hemo that should we go for MRI,to know the condition of her liver ,but she was like "what else would you do,her ferritin is already going down? "

I didn't get her really,what's wrong with being on the safe side.

ZAINI.
Title: Re: Annual check up!!
Post by: §ãJ¡Ð ساجد on June 17, 2008, 11:46:12 AM
Hi,

I'm glad that her echo came out normal. :clap

About the MRI, well, I guess your doctor is right. Zainab "IS" very young to have complications. Organ damage occurs slowly and that too when there is no or little compliance in treatment.

You're doing a great job. Just keep up the good work that you're doing already. :thumbsup
Title: Re: Annual check up!!
Post by: Zaini on June 18, 2008, 05:50:28 PM
Thanx Sajid  :hugfriend

ZAINI.