Low Hemoglobin

[Grahame]

I had a TURP and TURBT procedure done at the same time this past October. Prior to the surgery my hemoglobin was at a normal level but it dropped significantly after the surgery. It dropped again a few weeks later and I was told by my family doctor to go to the emergency department to get an iron infusion. Several weeks have now gone by since receiving the iron and my hemoglobin level has started to rise but only very slightly. My doctor is not sure why the low level is persisting and wants to refer me to a GI specialist. I think the low hemoglobin was caused by blood loss during the surgery and by the BCG treatments I have been receiving for non-invasive BC. Anyone else had a similar experience?

[marysue]

Hi Grahame:

I’m not a doctor so my following comments are only personal speculation not firm facts.  I think that there is some merit to what you say about the surgery and BCG treatments causing low hemoglobin.  You may have lost considerable blood prior to and during surgery.  The tumours bleed out prior to being detected and removed.  Sometimes that bleeding is visible and sometimes not.  So, I’m speculating that if you had the tumours for a while before they were detected you may have been losing blood at a steady rate even if it wasn’t visible.

I bled out pretty heavily one day and that sent me running to my GP to find out what was going on. Tests revealed multiple tumours in my bladder and it went from there with a TURBT and follow up BCG treatments.  I had been feeling really tired for several months prior to the bleed out so in my case I suspect that I may have been bleeding out for a while and just not been able to see it.  Cancer does cause fatigue and in some cases low blood counts.  Then of course we lose blood when we have the TURBT surgery and in your case the TURP as well.  For you that was a double whammy.

As for the BCG causing low hemoglobin, I don’t know for sure,  but my uro had me do several blood tests while doing BCG.  I’m pretty sure he was monitoring my hemoglobin.  I never did think to ask him about that. I was never told that I was anemic but I certainly felt like it.  I became anemic before and after my hysterectomy surgery in 2002 due to serious blood loss and ended up on iron.  Since I was feeling the same way after BCG treatments I started myself on a naturally sourced iron supplement after my BCG treatments were finished and it helped.

The BCG treatments did inflame my digestive tract and I did bleed a bit for a while when I had a bowel movement.  My doctor at the time blamed my hemmoroids which also got inflamed during treatment but I suspect that I had developed at least a temporary version of irritable bowel syndrome.   I’m fine now.  Things cleared  up a few months after treatments were finished.

I think your situation bears investigating and I strongly recommend that you followup with a GI specialist as per your GP, to see if you are bleeding from the GI tract.  The two things I suggest focusing on are; 1) Are you bleeding somewhere internally and that blood loss is causing the anemia or 2) Do you have some other as yet undetected condition that is contributing to anemia?

Best wishes gong forward.  (((HUGS))))

[Donald123]

I went to my family doctor 18 months after having a large amount of blood in my urine.  She sent me for a CT Scan and then a urologist who confirmed a large muscle-invasive tumour.  I also had low hemoglobin following that.  Prior to a RC a few weeks later I had an iron infusion.  For the following six to eight months, my hemoglobin remained low, and I tired easily.  It felt that I was constantly starving for oxygen.  Lots of test but no findings.  Iron pills raised my iron level but not the hemoglobin.  I stopped taking them after two months.  Finally I’ve started feeling more myself.  A lot more energy and less fatigue.

Hopefully you will have similar results….. Don

 

 

[marysue]

Hi Donald123:

I also found eating food items that were rich in iron and B vitamins helped as well.  It takes time for your body to rebuild after surgery.  With the TURBTS I know that I had blood loss and also from the tumours bleeding out.  It took about a month for me to recover from the TURBTs and feel like myself.

My worst blood loss as mentioned was during the hysterectomy surgery and that took almost a year to recover from. I was as weak as water even though I had a blood transfusion during surgery.  I remember that even watering my houseplants was so taxing in the first 6 weeks post op that I’d need a nap afterwards.  At about 7-8 weeks post op, I tried to go swimming thinking that it would help build up my muscles and help me get my strength back.  I couldn’t even swim one length of the pool without stopping several times.  I normally can do 3-4 lengths without stopping.  I went home and slept for the whole afternoon.  After that I just realized that I must still be anemic even though test results said that my hemoglobin was normal and that I needed more time to recover.  I have since discovered that the low end of normal hemoglobin readings are an anemic state for me. That was when I upped my diet and stayed on my natural iron supplements for another 3 months.  I had the surgery in the middle of March.  By the end of August I was starting to feel some better.  Even today my multi vitamin has a small amount of iron in it.  I feel better when I take it.

Hopefully you and  Grahame will feel better as time goes on.  ((((HUGS))))

[Tana]

Hi Grahame;

Thankyou for your posting for I have learnt about the difference in my situation and my blood levels  between hemoglobin and ferritin. I felt low energy lately again and because I was  anemic years ago with heavy blood loss I was concerned to get a blood test. I was going by ferritin levels with the anemia I was minus 1 when they caught it and last year I was 87. Last week it showed 43. That alarmed me. My doctor appointment finally arrived and she said but what is your hemoglobin count. That is 122. She said ferritin is stored iron and hemoglobin is the iron rich blood cells now as I heard her( a phone call appointment) – please correct me if I’m wrong –

So she said let’s do a fecal test to rule out blood in stools but that the ferritin can be low as a result of diet ( which indeed I have reduced red meat by 90% or more last two years and less chicken also ( 50% less). I was hoping to go vegetarian and eat rich in leafy greens- a protein drink with pea protein and spinach and broccoli . Though I can’t digest beans. The Naturopath said I was low in protein and also upped B12 supplements. The Naturopath I see said the fatigue for me was the adrenal exhaustion ( my doings of staying in a draining relationship and employment that I have taken measures to change). The body sure is an amazing creation that I learn about.

So my family doctor said yes good ahead and supplement to get more iron that it wouldn’t hurt me. That cancer and BCG treatments can be a factor of lowering iron in me.

Thanks Grahame – I like to learn- I hope you got your hemoglobin low iron checked by the specialist for your help. I know what a Turbt is ( I’ve had two) but what is a Turp?

Take Care – All the best in your treatments- Tana

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