COVID-19 and low lymphocytes with Crohn’s

I know I haven’t written in quite a while, but I’ve been doing fine, so there hasn’t been anything to write about.

My last in-person appointment with my gastroenterologist was in April 2019. At that appointment, she told me she had started offering eVisits, and she asked if I’d like my next visit to be online. I said that would be great. Usually, the earliest appointment I can get for my gastro is at 9 am, and my work starts at 9 am, so whenever I have gastro appointments, I end up missing time at work, which I prefer not to do. My appointments usually take at least half an hour, because usually the doctor is running behind, so I spend a lot of time in the waiting room. Since I take the bus, I also have to wait for the bus, then spend more time on the bus. By the time I get back to work, it’s usually almost time for lunch, so I actually took the day off in April for that appointment.

Anyway, eVisits are super convenient for me, so I was very excited to have that as an option.

My first eVisit was in December 2019. My appointment was at 9:15, my doctor joined the call right on time, I spoke with her for about ten minutes, then I hopped on the bus and arrived at work before 10 am.

Back to today, June 2020. We’re in the middle of the COVID-19 pandemic, and I’m guessing my doctor is doing a lot more eVisits nowadays.

Two months ago, I got an email notifying me I had an eVisit scheduled for June. I usually go for bloodwork just before my appointment, but I realized I had forgotten to ask for a new bloodwork form at my last eVisit. I really didn’t want to get bloodwork done in the middle of a pandemic, because I feel like a bloodwork lab is somewhere that you’re more likely to run into someone who’s been exposed to the coronavirus, and I didn’t want to put myself or anyone else at risk.

I was especially worried about getting bloodwork done because my lymphocyte count is low. I’m not a doctor, but Google tells me lymphocytes fight viruses, and COVID-19 is a virus, so… that doesn’t sound good. I’ve been lucky enough to be able to work from home, so I haven’t left my house since March, and I really didn’t want to spend two weeks worrying that I might have been exposed to the virus while getting bloodwork done, so I decided not to phone the doctor’s office and ask for a new form.

Yesterday, I received another email reminding me about my eVisit. The email contained a link I could use to test my microphone and camera before the visit, and another link I could use to start the visit.

This morning, just before 9 am, I opened up the link. It told me the host hadn’t joined yet, so I waited. I’m not sure what time my doctor joined the call, but I definitely hadn’t been waiting long. She asked how I was doing in these crazy times. I said I was doing pretty well, and it hasn’t been much of a change for me because I don’t go out much anyway, and in terms of my Crohn’s, it’s been fine. She asked about my family, and I told her they were all working from home as well, so we’ve all been keeping safe.

She said the last bloodwork she had for me was from November. She didn’t chew me out for not getting new bloodwork done, which I knew she wouldn’t, but a little part of me still felt like a kid who hadn’t done their homework. I think she said they had mailed me a new bloodwork form, but I hadn’t received one (or if I had, I must have misplaced it). She made a note to have them send me another one. She said they couldn’t email the bloodwork form because of privacy reasons, because they could accidentally send it to the wrong person.

She mentioned again that the only thing of note on my last bloodwork was the low lymphocyte count, but since it has been low for years, that just seems to be normal for me. She also said that she had talked to another doctor, I believe she said it was a hematologist, and I guess they weren’t too concerned about it.

I asked her about the low lymphocytes, and does having low lymphocytes mean I’m more at risk for coronavirus? She said that there are coronaviruses going around all the time, and if the low lymphocyte count put me at risk, then I would have been getting sick all the time just from going to work, so the lymphocytes are obviously doing their job and fighting back against viruses. She said if my lymphocyte count was much lower, like 0.2 or something, she would probably send me to a specialist to see if there was something else that was affecting my lymphocyte count. But basically, she just re-iterated that this was my normal, and I don’t need to worry about coronavirus any more than the next person.

She also ran through the usual checklist of questions like: how many stools do I have per day? are they liquid or formed? any bleeding? am I getting up at night to go the bathroom? any night chills or fevers? am I taking any new medications?

She said she wanted to see me again in six months, so around December, and she wants me to go for bloodwork in November.

She also said that my last colonoscopy was three years ago, so she’d like me to do another one. I thought she’d previously wanted me to have colonoscopies every five years rather than three, so I’m a bit bummed that I have to do another one so soon. This will be my fourth colonoscopy, so I know the drill. She said they’d book me in for December, since the hospitals have started opening up again for routine procedures rather than just emergencies.

And that’s it. Just like my last eVisit, I was done in about ten minutes, but this time, the commute to work was even quicker. I’m not looking forward to another colonoscopy, but at least now I know I’m not considered to be overly at-risk for COVID-19.

Of course, this is just my own experience: anyone else who has low lymphocytes or Crohn’s and is worried about whether or not they are considered at-risk for COVID-19 should talk to their doctor.