Why Am I Seeing a Hematologist?

Researchers comparing slides in hematology lab
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A hematologist is a doctor who is trained in diagnosing and treating blood disorders. This includes non-cancerous blood disorders, like bleeding and clotting problems, and cancerous blood disorders, like leukemia or lymphoma.

Understanding the expertise of a hematologist will hopefully give you some peace of mind, so you can move forward with caring for your blood health.

Disorders Treated by a Hematologist

If your primary care doctor or family doctor diagnoses you with (or suspects) a blood disorder, you will be referred to a hematologist.

Here are example scenarios of why such a referral may occur:

Blood Clot

Perhaps you have a  blood clot (like a clot in a major vein of your leg) and are on a blood thinner. A hematologist can help determine the "why" behind your clotting problems, as well as the duration of your blood thinner therapy. 

Bleeding Disorder

Maybe you have a history of excessive bleeding, and your doctor suspects an underlying bleeding disorder like hemophilia or von Willebrand's disease

Blood Cancer

Findings on a blood test, called a complete blood count, may make your doctor suspect blood cancer, like leukemia. In order to diagnose leukemia, a hematologist will perform a  bone marrow biopsy

Anemia

A routine blood test (or one ordered due to symptoms of fatigue and/or paleness) may reveal a low number of red blood cells, indicating some type of anemia.

Depending on your unique symptoms and the severity of your anemia, your primary care doctor may run other tests to determine the type of anemia you have (before moving forward with a referral to a hematologist).

You may be surprised to learn that anemia is the most common blood disorder, and iron-deficiency anemia is the most common type.

Other types of anemia, include:

    Chemotherapy and kidney disease may also be culprits behind anemia.

    Not Every Blood Problem Warrants a Hematology Consultation

    It's important to understand that not everyone with a blood disorder necessarily needs a hematologist's care. It's generally the primary care doctor that makes this call. 

    For instance, if you are anemic and also tell your primary care doctor you have noticed blood in your stools, he will refer you to a  gastroenterologist for a workup that may include a colonoscopy, a test that looks for bleeding in your colon. 

    In this case, you would not be referred to a hematologist, as the source of your anemia is likely from your digestive tract. 

    What to Expect From Your Consultation

    Seeing a hematologist is very much like seeing your primary care doctor. Your specialist will ask you questions about your symptoms, as well as family and medical history. He or she will also perform a physical exam.

    Depending on why you were referred, your specialist may order more blood or urine tests, imaging tests (for example, a CT scan), or perform a bone marrow biopsy. Your hematologist should communicate with both you and your primary care physician on how to move forward with your plan of care.

    Hematology Treatments 

    After the initial consultation, the direction of your treatment plan depends on your condition.

    For instance, if you lost too much blood from a trauma or major surgery, have an illness that destroys red blood cells, or recently underwent chemotherapy, you may need a blood transfusion

    If you have acute leukemia, you will need chemotherapy, which are medications that kill rapidly dividing cells (like cancer cells), and possibly a stem cell transplantation

    Of course, there are many other treatments utilized by hematologists, like managing clotting factors and blood thinners or caring for patients in the hospital, like those with sickle cell disease or heparin-induced thrombocytopenia.

    A Word From Verywell

    Hematologists treat a variety of medical conditions, and tests ordered by your primary care doctor are usually the first step leading to a referral to this type of physician.

    That said, by gaining knowledge about your blood disorder, you are already taking an active role in your healthcare. Next, be sure to ask your doctor lots of questions and remain open about your worries. Don't be afraid to seek out a second opinion either, especially if something doesn't feel right. 

    Sources:

    American Society of Hematology. (2017). Blood Disorders.

    Wallace PJ, Connell NT, Abkowitz JL. The role of hematologists in a changing United States health care system. Blood. 2015 Apr 16;125(16):2467-70.

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