Everywhere I go, I bring a sweater. Despite the fact that in the Outer Rings of Hell (a.k.a Arizona), it can get up to 115 degrees.
Inside, I’m always cold. The grocery store, the mall, the movie theater, a restaurant, my job, our apartment (he likes to keep it at 71 degrees year round and I hate it). Laugh at me all you want for wearing a sweater, but I’ll be the one laughing at you when your huggin’ yourself when we’re having lunch somewhere. But I digress. I never thought anything of being cold because my mom and my older sister get cold, too.
But over the past four years, I’ve been experiencing moments of dizziness. I didn’t think anything of it because 1) I wasn’t incapacitated and 2) it was only happening occasionally. I was also feeling fatigued, like I could totally sleep longer on the weekends but would force myself to get up at 9:30am. I just attributed that to the fact that “Hello, my name is Cece and I’m a Night Owl.” I have, on more than one occasion, been known to stay up until 2am reading.
On a weeknight.
Where I would have to get up at 7am the following morning for work.
I get it. That’s no bueno. But if you’re a bookworm like I am, you know it’s impossible to put down a really good romance book.
I would feel even more fatigued when I was on my period, but thought that was normal.
Yeah. That’s not normal.
Last year, I decided to make an appointment with my primary (naturopathic) doctor when, after bending down to do a task (like cleaning out the litter box), my heart felt like it was trying to beat itself out of my chest when I stood back up. And when the swelling in my ankles wasn’t going away after my period ended.
My previous doctor had left the group practice and I had been reassigned to Dr. G. Since I was a new patient for her, she wanted a full physical done on me. I was completely okay with that because I wanted to find out what the hell was going on with me.
“You’re severely anemic”
When I met with Dr. G in July, she immediately got down to business. You know it’s bad when they pull up a chair next to you instead of across from you.
“Have you passed out at all?” she asked me.
“Uhhh…no. Why?” I said.
Unless you count that one time in the bathtub.* But I didn’t mention that. More on that later.
“I think it’s a miracle that you haven’t because you’re severely anemic,” she announced. “Like, you-need-a-transfusion anemic.”
Then she showed me the test results.
I have to say that even I was a bit shocked. Once she explained everything.
How bad, you ask? I’m gonna break it down for you in a minute.
But first, ya’ll are about to get schooled. Medically. If you’re not familiar with anemia, per the Mayo Clinic:
Anemia is a condition in which you don’t have enough healthy red blood cells to carry adequate oxygen to the body’s tissues. Having anemia may make you feel tired and weak.
There are many forms of anemia, each with its own cause. Anemia can be temporary or long term, and it can range from mild to severe. Treatments for anemia range from taking supplements to undergoing medical procedures. You may be able to prevent some types of anemia by eating a healthy, varied diet.
Anemia signs and symptoms vary depending on the cause of your anemia. They may include:
- Pale or yellowish skin
- Irregular heartbeats
- Shortness of breath
- Dizziness or light-headedness
- Chest pain
- Cold hands and feet
My symptoms highlighted in yellow.
At first anemia can be so mild that it goes unnoticed. But symptoms worsen as anemia worsens. Some anemias, such as iron deficiency anemia or vitamin B-12 deficiency, are common.
Anemia occurs when your blood doesn’t have enough red blood cells. This can happen if:
- Your body doesn’t make enough red blood cells
- Bleeding causes you to lose red blood cells more quickly than they can be replaced
- Your body destroys red blood cells
What red blood cells do
Your body makes three types of blood cells — white blood cells to fight infection, platelets to help your blood clot and red blood cells to carry oxygen throughout your body.
Red blood cells contain hemoglobin — an iron-rich protein that gives blood its red color. Hemoglobin enables red blood cells to carry oxygen from your lungs to all parts of your body and to carry carbon dioxide from other parts of the body to your lungs so that it can be exhaled.
Most blood cells, including red blood cells, are produced regularly in your bone marrow — a spongy material found within the cavities of many of your large bones. To produce hemoglobin and red blood cells, your body needs iron, vitamin B-12, folate and other nutrients from the foods you eat.
Causes of anemia
Different types of anemia and their causes include:
Iron deficiency anemia. This is the most common type of anemia worldwide. Iron deficiency anemia is caused by a shortage of iron in your body. Your bone marrow needs iron to make hemoglobin. Without adequate iron, your body can’t produce enough hemoglobin for red blood cells.
Without iron supplementation, this type of anemia occurs in many pregnant women. It is also caused by blood loss, such as from heavy menstrual bleeding, an ulcer, cancer and regular use of some over-the-counter pain relievers, especially aspirin.
Vitamin deficiency anemia. In addition to iron, your body needs folate and vitamin B-12 to produce enough healthy red blood cells. A diet lacking in these and other key nutrients can cause decreased red blood cell production.
Additionally, some people may consume enough B-12, but their bodies aren’t able to process the vitamin. This can lead to vitamin deficiency anemia, also known as pernicious anemia.
Anemia of chronic disease. Certain diseases — such as cancer, HIV/AIDS, rheumatoid arthritis, kidney disease, Crohn’s disease and other chronic inflammatory diseases — can interfere with the production of red blood cells.
Aplastic anemia. This rare, life-threatening anemia occurs when your body doesn’t produce enough red blood cells. Causes of aplastic anemia include infections, certain medicines, autoimmune diseases and exposure to toxic chemicals.
Anemias associated with bone marrow disease. A variety of diseases, such as leukemia and myelofibrosis, can cause anemia by affecting blood production in your bone marrow. The effects of these types of cancer and cancer-like disorders vary from mild to life-threatening.
Hemolytic anemias. This group of anemias develops when red blood cells are destroyed faster than bone marrow can replace them. Certain blood diseases increase red blood cell destruction. You can inherit a hemolytic anemia, or you can develop it later in life.
Sickle cell anemia. This inherited and sometimes serious condition is an inherited hemolytic anemia. It’s caused by a defective form of hemoglobin that forces red blood cells to assume an abnormal crescent (sickle) shape. These irregular blood cells die prematurely, resulting in a chronic shortage of red blood cells.
Other anemias. There are several other forms of anemia, such as thalassemia and malarial anemia.
These factors place you at increased risk of anemia:
A diet lacking in certain vitamins. Having a diet that is consistently low in iron, vitamin B-12 and folate increases your risk of anemia.
Intestinal disorders. Having an intestinal disorder that affects the absorption of nutrients in your small intestine — such as Crohn’s disease and celiac disease — puts you at risk of anemia.
Menstruation. In general, women who haven’t experienced menopause have a greater risk of iron deficiency anemia than do men and postmenopausal women. That’s because menstruation causes the loss of red blood cells.
Pregnancy. If you’re pregnant and aren’t taking a multivitamin with folic acid, you’re at an increased risk of anemia.
Chronic conditions. If you have cancer, kidney failure or another chronic condition, you may be at risk of anemia of chronic disease. These conditions can lead to a shortage of red blood cells.
Slow, chronic blood loss from an ulcer or other source within your body can deplete your body’s store of iron, leading to iron deficiency anemia.
Family history. If your family has a history of an inherited anemia, such as sickle cell anemia, you also may be at increased risk of the condition.
Other factors. A history of certain infections, blood diseases and autoimmune disorders, alcoholism, exposure to toxic chemicals, and the use of some medications can affect red blood cell production and lead to anemia.
Age. People over age 65 are at increased risk of anemia.
Left untreated, anemia can cause many health problems, such as:
Severe fatigue. When anemia is severe enough, you may be so tired that you can’t complete everyday tasks.
Pregnancy complications. Pregnant women with folate deficiency anemia may be more likely to experience complications, such as premature birth.
Heart problems. Anemia can lead to a rapid or irregular heartbeat (arrhythmia). When you’re anemic your heart must pump more blood to compensate for the lack of oxygen in the blood. This can lead to an enlarged heart or heart failure.
Death. Some inherited anemias, such as sickle cell anemia, can be serious and lead to life-threatening complications. Losing a lot of blood quickly results in acute, severe anemia and can be fatal.
So, how severely anemic was I? Above, you read about what red blood cells do, right? Shit’s about to get real, peoples.
My Hemoglobin levels were at 6.5 g/dL grams per deciliter (g/dL). The normal range is 11.5 to 16.
My Hematocrit levels (this test determines the percentage of red blood cells in the blood.) were at 23.8% Normal range for and adult female should be 38%-46%. The reference range for my test was 35-48%.
My MCV levels (mean corpuscular volume – the size of red blood cells) was 60.3 fl (femtolitre). Average levels for an adult is between 80 to 100. The reference range for my test was 78-100.
My MCH levels (mean corpuscular hemoglobin – the average amount of hemoglobin found in the red blood cells) were at 16.5 pg (picograms). Normal MCH levels are around 27 to 33 picograms (pg) per cell in adults. The reference range for my test was 27-34 pg.
My MCHC Levels (mean corpuscular hemoglobin concentration – the measurement of how much hemoglobin is inside one red blood cell) was at 27.3 g/dl. A normal MCHC level for an adult is 31-37 g/dL.
Due to the above craptastic results, the lab was unable to provide accurate results for twelve other tests. I’m still not sure how important those other results would’ve been.
But wait, there’s more…
My Ferritin levels (a protein that stores iron, releasing it when your body needs it) were at 5 ng/mL. Typical ranges are 20 to 200 nanograms per milliliter in women. The reference range for my test was 9-162 ng/ML.
I’m not done. In addition to being severely anemic, I was also:
1) Pre-Diabetic. My Hemoglobin A1c levels (average blood sugar level for the past two to three months) were at 5.7%. Normal range for non-diabetics is 4%-5.6%.
2) Slightly Vitamin D deficient. My Vitamin D levels were at 19.5 ng/mL. A level of 20 nanograms/milliliter to 50 ng/mL is considered adequate for healthy people.
3) Sporting a heart murmur.
So, what was Dr. G’s plan, you ask?
Come back next month to find out.
*Bathtub Incident – remember earlier when I mentioned that I’d passed out in the tub? Well, here’s what happened. A couple of years ago, I got sick (from Babendude, no doubt) and I decided to do what he did to get rid of it: draw an Epsom salt bath. I only soaked for 15 minutes and thought I did my best to stay hydrated.
When I was done, I stood up and turned on the shower for a cool rinse. The next thing I know, Babendude is sharply calling my name and I come to. When I had stood up, he’d momentarily left the bathroom. He came back in when he heard a loud splash.
“Are you all right? Did you bump your head?” he asked.
Surprisingly, I didn’t.
My Chaka Khan hairdo cushioned the blow. LOL
Note to self: Drink a gallon of water while you’re taking an Epsom salt bath. And stand up slowly.