Expert: Chris Larsen - 12/6/2011

Question
QUESTION: I went for a flu shot back in September 2011. My PCP took routine blood tests but I did not hear from her about the test results until today - three months later. She said my hemoglobin was elevated slightly and she wants me to come back in 2012 after the holidays for another blood test. Do I really have to go back? I mean if she did not contact me until three months later and said I dont have to come in immediately and do I have anything to worry about?

ANSWER: Hi Debbie,

Thanks for the question!  First and foremost, your physician has knowledge of your medical history so none of what I tell you is a substitute for what she has to say.  Without having knowledge of your medical history and any medications you may or may not be taking, I'll try and help as best I can.

Hemoglobin is the oxygen transport metalloprotein found in the red blood cells.  Hemoglobin in the blood carries oxygen from the lungs to the rest of the body and then carries the resultant carbon dioxide back to the lungs for exhalation.  Interestingly enough, hemoglobin is the reason that red blood cells appear red.

There are some things that could possibly contribute to an elevated hemoglobin level including living at high altitudes, smoking, and dehydration.  

If I were you, I would most certainly follow her directions and return for a follow up blood test.  I don't say this to cause you any anxiety or concern, but if there is an underlying pathology causing the elevated hemoglobin level then it is best to find the cause and treat it as early as possible.  Of course, this could have just been an anomaly or even a lab error.  So given the fact that the hemoglobin level was slightly elevated, your physician is likely trying to determine if the lab value was actually an anomaly or if the lab value has changed (+/-) since the last blood test.  If your physician felt that this was an immediate concern, I am sure that she would have asked you to return much sooner than after the holidays.

In the meantime, for your long term health, I would try to pursue as healthy a lifestyle as is possible for you.  This includes (with your physician's approval) eating well, exercise, getting enough sleep, reducing stress, etc...

I hope this helps.  And here's wishing you and your family a wonderful holiday season!

Regards,

Chris



---------- FOLLOW-UP ----------

QUESTION: I disagree with you.  FIrst of all she called me three months later about the results. All I did was go for a flu shot. Then she said to me I should come back after the holidays. Didnt say when after the holidays, she did not say please make an appointment.  

Last night my friend Larry called. I told him all about this but he said talk to Leslie (his gf). Leslie works for an insurance company and Leslie told me not to go for the second blood test. Leslie sees this all the time and she said that the doctor just wants to bill the insurance company for blood work and if I really was sick the doctor would not have waited three months and also would not wait until next month which would be the New Year. Leslie said forget the doctor ever called.

Answer
Hi Debbie,

I understand what you are saying and at the end of the day, it's your health.  So ultimately the decision to return for a follow up blood test is yours.  Let me reiterate what I said in my original reply, none of what I tell you is intended to be medical advice and none of what I tell you is a substitute for what your physician has told, or will tell, you.

I don't know why she waited 3 months to give you the results, but I surmise that it was because the lab value was not so far out of the normal range as to elicit an immediate intervention.  Like I said before, my contention is that because the lab value was slightly out of range that the test be redone to eliminate the possibility that there was a lab error or that it was simply an anomaly.  

I wouldn't get hung up on the semantics of what she said about returning and that she didn't ask you to make an appointment.  Many times if the physician wants a repeat test done they will give you a lab request or send one to the lab that you go to giving authorization for the test.  An appointment with the physician is not always necessary prior to having a repeat blood test.  

With respect to your friend's advice, it is entirely up to you as to whether you want to follow it or not.  I would highly doubt that the physician is sending you for another blood test just to bill the insurance company for another blood test; the cost of a CBC (complete blood count) varies depending on the lab and geographic location, but it is very inexpensive (usually less than $30-40).

Like I said before, if I were in your position I would return for a follow up blood test, if not just for your own peace of mind.  

You and your physician are a team working towards your best health.  You have to trust what she is telling you.  If you don't trust your current physician, then perhaps you should look for another one.

Best wishes!

-Chris