"anion gap" test is irrelevant

[redbird]

Before giving me my MS drug last week, the nurse drew blood for tests. The automated test result that I received within the hour included a flag for a low anion gap, whatever that meant. Googling told me that it's related to blood pH, but nothing about why they did that test or what it meant in my case.

I emailed the doctor this morning, and got a quick reply, saying I should ignore it, because that test is only relevant to sick hospitalized patients. I thanked him, and am not going to pursue the question of why that test was even done, or why I've been given it a few times before. (MyChart offered a graph of past test results.)

Comments

[lisajulie]

There’s a suite of blood tests that are run on a single tube of blood through an automated instrument that includes 10-12 (don’t remember exactly how many right now). Frequently information from some tests isn’t necessary, but is collected all the same.

[pameladean]

They do that test for me too, and the explanation and the normal range provided make basically no sense. It's relevant to a rare side effect of a couple of my medications, so I have to suppose my doctor is looking at it. She never mentions it when going over the results, though.

P.

[hrj]

Getting direct access to lab results has both an up side and a down side. I really like having the access, but then I work in healthcare and have the background knowledge and resources to put the results in context. I could easily see that someone with less context could worry about things that don't need worrying about. But conversely, sometimes the doctors are too overloaded to put all the pieces together properly. (Like the doctor who somehow forgot that we were monitoring my liver enzymes because I'm on a blood thinner and decided the reason my enzyme levels were high was because I'm fat.)

[sine_nomine]

How fast did you fire that doctor?

[hrj]

By the next time I had a specific reason to make an appointment. Besides which, I had the excuse that I'd shifted the optimal location for routine doctor visits so I could just say I was making the change for convenience. (I'd already made the more salient point to my previous doctor in email, but never got a response.)

[redbird]

Mostly I glance at the automated report to for anything unexpected. That's primarily results flagged as out of range, which I ping my doctor about if they seem to be significantly out of range, or if, as with this test, I have no idea of what's going on. There was also a flag for blood sodium level, one whole point below the reference range, and that seems unlikely to mean anything.

They drew blood ten days before this, because in order to get this MS drug, I have to have a negative hepatitis B result within the previous 12 months. On that report, I noticed that they ran three tests for hepatitis B, all of which were (as expected) negative, plus a TB test. If any of those had been positive, I would have been calling the doctor.