Blood and Wine

Dr McCormick replied at 11:41:10 +0100. Reply in green, my next in black.

Hi Doctor

I'm still subconsciously juggling with the purpose of the cytology as its propensity for not finding a positive being high, is not very useful. That it may find a positive may be useful, but I'm not sure about that if there's little or nothing I can envisage doing about it.

However I am getting closer to having the cytology if only for curiosity of the process and outcome.
To that end I think it better to provide a sample where there is clearly a substantial haem count or preferably, well not that I want it, urine that is at least pink. I do a stick test daily and some days are negative so a sample then would be all but useless. Also the more haem there is the more a visual examination will have to study.

Overall things have plateaued out, things are not as 'bad' as when I came to see you, my urine is less often obviously discoloured. I'm not sure if that means any possible tumour is just getting its feet under the table or its being squeezed out of home.

One thing I didn't mention was that when I went to get copies of the U-scan and X-ray I had a shock as when I went for a pee in the hospital my pee was so red I almost fainted. It was so red it was like paint and stained the bowl. I went to A & E and felt very dizzy and out of it. The reason I mention it is that it was extreme and yet the only such time. There were a few times of light pink but most of those were weeks ago. I just wonder what could have been the source of such an amount of blood whereas normally, well, its not like that.

Since we don't know the exact cause of the bleeding it is difficult to draw any conclusions about why you pass more blood on some days than others-this would certainly be not unusual for a tumour.

I thought that was the way, as I had been reading, but it still prompts the query as to why so different. What exactly happens?

In fact, how much and when you pass blood doesn't help us at all , although it does make me worry that you may become anaemic in due course if it continues.

Well luckily the only time was that once, all the other times are no where near the same. I gather that "As little as 1 milliliter (0.03 ounces) of blood will turn the urine red." http://www.urologychannel.com/hematuria/index.shtml so I don't I have any concerns about anaemia at the moment. If I was to bleed a lot I would worry

There is also the possibility that an infection could ensue causing more bleeding-this is unlikely if it goes away again, and if it is not associated with any new symptoms such as pain or fever.

No pain, no fever but I do get a little tired or confused. I'm not sure but my thinking slows down and I can't respond or pat attention to things as well. It happens now and then and is usually followed by either a +++ reading on the sticks or visibly coloured pee.

Back to the cytology option. Is it possible for me to pick up a sample bottle and keep it until I am ready, and then presumably bring it in before 11am one morning, although if it just so happens that I have a pink or red pee at any time maybe I should bring it it immediately. I don't have a fridge to store anything and I imagine that keeping it for any length of time may facilitate degradation of the sample.

I think as regards when you provide the sample-in fact too many red blood cells could make it harder for the cytologist to see any tumour cells, so I think that you should actually avoid a sample on a day when you can see blood.Ideally I would like to send it to the lab the same day but the cells will last a few days before they degrade ,after that it is up to the cytologist when it is screened, so we may not get an answer for several weeks-I don't know as it is not a routine test.

My understanding of the cytology test was that it was looking for a specific type of red blood cell which will define where the blood comes from, no so much looking for cancerous cells. I must read up on that again as otherwise your suggestion makes far more sense. In fact in that case I may go jogging first to loosen up some bit

I will arrange for a pot and a cytology form to be left at Reception for you next week.

Ok that's it for now

Thanks

Roger Lovejoy