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Developing the habit of brushing your teeth regularly is one of the advices of dentists but this does not mean overzealously brushing your gums and teeth.
If vigorous brushing is not good for your oral health then improper flossing will not do you any good as well.
There are several reasons why you should quit smoking and one of this is bleeding gums and oral problems. Oral contraceptives, nasal sprays, anti-depressants and anti-coagulants are researched to cause bleeding gums in patients. This condition is rarely experienced by man but those who are infected with this disorder like Rheumatoid Arthritis, Hashimoto’s Thyroiditis and Systemic Lupus Erythematosus are researched to be prone to bleeding gums. Those who are diagnosed with this illness have bleeding gums as one of its prevalent characteristics. Hormonal imbalance or shift during puberty, pregnancy, menopause or menstruation may also trigger bleeding gums.
The symptoms of diabetes, on skin are mostly curable, especially, if they are detected early. Due to diabetes, the smaller blood vessels supplying blood and oxygen to the skin get damaged. The diabetes leads to damaging of the blood vessels and this damage is visible in the form of different skin conditions. Other than diabetic dermopathy, damage in blood vessels can also cause Necrobiosis lipoidica diabeticorum or NLD, where large and shiny scaly patches develop over the skin. The diabetics have high sugar level in their blood, providing a perfect medium for the growth of fungus and other pathogens. This fungus mostly develops in moist and warm areas regions of the skin, like, around the fingernails, between toes, in armpits, in groin area, under foreskin of male genitalia, and also in corners of the mouth. Other fungal infections that may be found in the skin of diabetic patients, include, athlete’s foot, jock itch and ring worm.
Bacterial infections are also very prominent, on the skin of diabetic patients, due to high blood sugar levels. The most common bacterial infections found in the skin of diabetic patients, include, boils, infection of glands present in the eyelids, inflammation of a certain region of skin and tissues below it also called as carbuncles, folliculitis (infection in the hair follicles) and inflammation around the nails. Blisters are not a regular sight in the diabetic patients, but, some patients may develop blisters in their forearms, feet, toes, hands and fingers. This condition is mainly found in the patients suffering from type 1 diabetes and can be controlled by normalizing blood sugar levels. This condition of the skin is mainly found, in the males of younger age group, suffering from type 1 diabetes.
Due to high glucose levels, the fluid from the skin cells evaporates, leaving the skin dry. Diabetic patients need to take special care of their skin, and keep on sanitizing and moisturizing it, to prevent it from drying. Atherosclerosis is the thickening of arteries, and a common occurrence in diabetic patients. Contact with latex items, such as latex gloves, may cause rashes in those with a latex allergy. A skin rash from an allergic reaction is usually localized to the spot where the allergen made contact. A rash appearing anywhere on the skin is the body’s way of telling us that something is wrong. For the past four months, I've been getting a rash that can be like all bumps or welts -- anywhere there has been pressure on skin.
When my son eats, the area around his eyes will turn red like a rash and then the rash will go away.
My boyfriend keeps getting a rash on his fingers and hand, but we can't figure out what it is. If you get bumps when you're hot you may have Cholinergic urticaria which are red splotches with bumps in the middle and they itch like crazy.
Don't forget about heat rash - I used to get that when I was a kid on really hot days and my mom would have to wipe my arms and legs with rubbing alcohol to cool me down. At the center of the hemoglobin molecule is a heme group, with an iron atom at the center of it.
As it goes through the body, hemoglobin gives up its oxygen to the various cells it comes in contact with.
When this wonderful oxygen transport from your lungs, through your heart to the rest of your body is messed up for some reason, you have anemia. I used one of my own prior CBC reports to illustrate white blood cell counts in my last article. If I were a CLL patient with red blood cell issues, RBC can be much lower than these healthy reference ranges. Anemia is easy to diagnose but not as easy to explain since it can be caused by many different things. Once again, I cannot over emphasize the importance of not getting fixated on any one number but looking for overall trends. MCHC is the average hemoglobin concentration of packed red cells expressed as a percentage.
In CLL patients with sharply lower RBC – perhaps because of AIHA or some of the other reasons discussed below, the bone marrow will register this fact and try to compensate by producing more red blood cells to replace the ones being lost.
There are specific reasons for anemia in CLL, over and above the general reasons (poor diet, physical blood loss etc) discussed above. When the problem is too few red blood cells, patients are transfused with “packed red cells” – not whole blood.
The risk of infection using standard issue packed red cells is trace levels of viruses (hepatitis is one of the biggest risk factors) that can hide out in the donor white blood cells. Irradiated and leukoreduced blood products are a tad more expensive than the garden variety blood products, but not prohibitively so, and definitely not as expensive as the complications patients can run into if the wrong products are used. As with most things, too frequent red blood cell transfusions carry the risk of iron overload. You are right that poikilocytosis is the term given to somewhat mis-shapen red blood cells.
There are many different reasons why red blood cells can be misshapen, not all of them well understood. I listed Vitamin B1 deficiency in the table under reasons for low hemoglobin, therefore anemia.
About two weeks ago my Hemoglobin went rapidly down to 7, so I needed a transfusion to get a better one. I read that erythrocyte concentrates are the better the newer they are and that older ones are from a poorer quality and in so far bad for hosts.
Blood banks have very strict guidelines on how long they can keep blood products before they are past their shelf life, so I would not worry about it.


LynnS: My maternal grandfather died, like your mother, of complications of aplastic anemia after 6 years or so of blood transfusions.
Both my primary care and Oncologist recommended low dose asprin therapy for me as a preventative step to future cardiac events.
Low dose aspirin is likely a good thing to do except for those with aspirin allergy, very low platelet counts or problematic coagulopathies such as Von Willebrands disease, hemophilia, etc.
I would love to know more about the spleen and liver and how it copes with a huge mount of lymphocytes eg: 200K. You do a great service in guiding us in the art of knowing when to panic and when to wait out the lower or higher than normal numbers on our blood work and what it all means.
CLL Topics Updates does not provide medical advice and its contents are for information only. Individual who experience any of the signs of bleeding gums should immediately consult this matter with their dentist because it may already be a signal for more serious and complicated dental problem like gingivitis and periodontal diseases. If you experience any one of these over a long period of time then better set-up an appointment with your dentist immediately. You should be careful in flossing the side of your teeth’s natural curves and be certain not to force the floss into it because it may leave cuts on the surfaces of your gums. Studies show that smokers are more likely to develop tartar on their teeth compared to non-smokers. So if you experience bleeding gums after taking in medications then it would be better to report this matter to your physician so he or she can change your prescription.
The sudden increase in the level of hormones of the body causes an increased blood flow towards your gums which makes them appear red, tended and swollen. This increase in blood glucose can be either because of inefficiency of the body to produce insulin, or due to inefficiency of the body cells to respond to insulin. In fact, it has been observed in studies that as much as 33% of the total population, in the world, suffering from diabetes, has to suffer from different types of skin disorders. So, anyone having a diabetic condition should take these symptoms seriously and get them cured, as early as possible.
This is caused due to hyper pigmentation and occurs mainly in the places, where the skins meet, like, neck, armpits, groin, and under the breasts. This results into the formation of small scaly patches of reddish to brown or light brown color, over the skin. Poor circulation of blood due to damage of blood vessels also leads to itchiness and numbness of skin. These fungal infections are characterized by the present of sore spots and rashes, which are surrounded by small blisters on all sides.
Patients having any of these symptoms of fungal infection, need to immediately rush to the doctor and get proper medications. These infections are mostly characterized by inflammation of the affected tissue, which is red in color and very painful.
These blister resemble those blisters that are developed due to burns and can be of any size, from small to large.
This condition is known as digital sclerosis, and it makes the joints of affected body parts (mostly fingers) stiff and incapable of normal movement. This dryness is also caused due to infection of pathogens, like, fungus, bacteria and virus.
These factors include different types of infections, dryness of the skin, and also allergies. This condition affects the legs of the patients and results into hairless, shiny, thin and cold skin. But, thankfully, you can control these skin conditions, by using proper medication and remedies.
I have worked for the TSA for five years and never had a problem with the blue latex gloves. I am getting red, small, itchy dots on my arms, legs and on my stomach only in the evenings.I went to a general physician, he gave me some antihistamines and a lotion to apply. Due to the severe pain, I had to double up and it started causing me similar itching problems, so I compensated by taking double doses of Benadryl.
Since anemia is a common side effect of CLL and causes significant loss of quality of life, we need to learn about it.
Over the years I have seen many thousands of patient CBC reports, people seem to like sending me stuff and ask me to read the tea-leaves. Take out all the water in the red blood cells and pretty much the only thing left is hemoglobin. We said if you take a tube of fresh blood and spin it around fast in a centrifuge, the red blood cells will settle to the bottom and that this layer is just under half the volume of blood in the tube. There is a range of sizes in red blood cells, not all of them are exact copies of each other. It is a derived number, you can calculate MCH by dividing the total amount of hemoglobin by the number of RBC, then multiply by ten to make the units work. You can calculate it by dividing the total amount of hemoglobin by the hematocrit, multiply by 100 to get percentage. Many of the chemotherapy drugs used to treat CLL are “myelosuppressive” – meaning they damage or reduce the production capacity of stem cells to produce more myeloid cells – red blood cells are part of the myeloid line. The only choices at that point are stem cell transplant with healthy stem cells from a willing donor, or a lifetime of blood transfusion dependency. These are chemical messengers that alert the bone marrow to low RBC; marching orders as it were, that tell the marrow to gear up and increase production. One of the most common autoimmune diseases in CLL is AIHA (autoimmune hemolytic anemia), where perfectly good red blood cells are targeted and destroyed by the body’s own immune system gone berserk. The red blood cells are separated from blood plasma and from the other cells such as platelets, white blood cells etc by simple process of centrifugation. So, most blood banks recommend using irradiated and leukoreduced blood products for transplant patients as well as patients with any level of immune dysfunction.
I had reason to learn all about this while my husband was going through his stem cell transplant and needed frequent transfusions. Each of those healthy new red blood cells coming into the body carries its own iron atom, and too many transfusions can cause too much accumulation of iron in the body of the patient. The reason for this low Hemoglobin is not yet identified but some reasons like bone marrow infiltration with CLL or autoimmune disease ore some viruses could be excluded. I am in W&W but this seems counter intuitive as asprin thins the blood and would seem to impact platlets. I have been anemic and you explanation of causes and the meanings of the CBC has been very helpful. Moreover, cigarette and tobacco contains hazardous chemicals and substances which reduces the effectiveness of the mouth’s immune system.


When this happens, then plaque and tartar formation will rampantly spread on the surface of your teeth and gums causing gum inflammation which will eventually lead to bleeding and swelling. The skin related symptoms of diabetes may also act as warning signals, to help patients become aware of their fluctuating blood sugar levels.
These blisters are mostly painless and develop, when major fluctuations occur in the blood sugar levels of the patient.
Allergies surface in the form of itching, in diabetic patients, and other skin conditions also normally lead to itching.
Also, as you may have noticed, many skin conditions are result of temporary sugar imbalance, so, if you are diabetic and want to avoid such uncomfortable conditions, try to keep your sugar in control. Heck, blood is red because it is full of red blood cells.  Next obvious question, what makes red blood cells red?
When hemoglobin comes in contact with oxygen in your lungs, oxygen gets attached to the iron atom. And as you can see from the reference interval given for healthy individuals, I am doing OK on this front.  Reference ranges are even more important in the case of red blood cells because they are different for men and women.
Remember, just because you have CLL does not give you a pass, a get-out-of-jail-free card from all the other things that go wrong with people as they age.
Hematocrit is the volume of red blood cells in a sample of blood, reported as a percentage.
For example, newly minted red blood cells are just a bit bigger than older RBC that have been around the block more than a few times. If there is a robust number of new red blood cells being made, as well as old ones hanging around, RDW will be a high number because the range of sizes of the cells present is broad. If there are so many CLL cells in the bone marrow that the ‘factory’ is packed to the rafters with these cancerous cells, there is no room left for healthy production of other cells to make up for losses due to normal wear and tear. If the damage is temporary in nature, production will gradually recover and RBC counts will head back up gradually. AIHA can be detected by Direct Coombs test and looking for antibodies targeting red blood cells.
While getting any blood product carries some risk of infection, this risk can be minimized by taking proper precautions.
Leukoreduced means they put the packed red blood cells through another step of purification, where the last remnants of white blood cells (“leukocytes”) are removed, since viruses hang out in white blood cells. You can read the details by visiting “Harvey’s Journal”, the on-line blog we maintained so others can learn from our experience through this difficult period of our lives. But this is not something to worry about unless we are talking of patients who are chronically transfusion dependant. I will pass this on to my family as well.I tell them knowledge is wisdom and we need all the wisdom we can muster with this disease.
It has been one of the most useful aids in helping me and my Doctors see trends in the progression of my disease. They neither itch, not cause irritation, and therefore, they do not demand medical treatment also. These bumps cause itching, and mostly appear on skin of the feet, back of the hand, arms, buttocks and legs. I have recently quit smoking after four years, and I've noticed it's not related, because I got rashes off and on before I quit. The next morning, I am totally rash free, but again in the evening, these red dots come back again and I have redness on the skin of my hands. Answer: because red blood cells have a molecule in them called hemoglobin (also spelled as haemoglobin if you are Brit, and abbreviated to Hb, Hgb or Hg) and hemoglobin is colored a bright cherry red when it is rich in oxygen, but more bluish red in color when it has been stripped of its oxygen. After picking up this precious hitchhiker in the lungs the blood next goes to the heart – the pumping station which circulates blood throughout your body. In my case, the hemoglobin level is a tad low, below the reference range for my lab and hence it is flagged. A low hematocrit usually indicates decreased production, excessive loss, or destruction of red blood cells. Cell size can also change depending on dietary issues – B12 and folic acid deficient red blood cells are larger than iron deficient cells.
A small RDW number suggests there is no extraordinary amount of red blood cells being made in the bone marrow. This may suggest that in spite of the obvious and  crying need for increased production of red blood cells, the bone marrow is not able to oblige. The remedy is to clean out the bone marrow with appropriate therapy to kill the CLL cells there.
Treatment options include prednisone, Rituxan, chemotherapy drugs, spleen removal – some or all of the above, as it becomes necessary. It can also be caused by a digestive disease, such as celiac disease, in which case the treatment may be treating the underlying celiac disease.
I have used multiple institutions, some of which still log in values by hand on crude charts. Only now I feel like crap.I have a panic disorder, am disabled and stressed, but this is a first for me. Did you know hemoglobin is present to the tune of 95-97% by dry weight of red blood cells (if water is counted, then the weight percentage of hemoglobin is around 35%). This oxygenated version of hemoglobin is bright red – which is why arterial blood leaving the heart is bright red. I am a bit anemic, possibly due to low level of iron in my food (I am a vegetarian) and poor absorption of what iron there is in my diet due to early stage Crohn’s disease. Perhaps the marrow is choke full of CLL cells and with the best of intentions the marrow cannot produce new red blood cells because of the infiltration, or perhaps the bone marrow is just not getting the message.  More about this further down.
I too have a mild case of poikilocytosis, because of underlying Crohn’s disease (a kind of autoimmune ulceration of the GI tract).
Think of red blood cells as little sacks full of water and hemoglobin and you will be right on the mark.
Depleted oxygen supply to the cells is slow suffocation, and that is exactly what it feels like. Once the hemoglobin has given up its oxygen to the cells it picks up the waste byproduct of cellular breathing, namely carbon dioxide. Venous blood returning to the lungs and heart is bluish red in color because hemoglobin with carbon dioxide attached to it is bluish red in color. None of the hemotologists I see or my primary MD seem concerned and I have not gotten much of an explanation for it.



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Comments

  1. Ramin4ik

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    05.03.2015