Dr. Evan Vosburgh, MD

One is eligible to donate blood with diabetes as long as it is under control and your general health is okay. The Red Cross website has a long list of conditions and medications that may or may not affect one's eligibility to donate blood.

Fatigue and weakness are very common medical complaints and the causes are many and varied. Anemia is only one cause along with poor sleep, depression, drug side effects, thyroid dysfunction, viral and other infections, an a long list of other causes. A thorough history and physical exam can often provide clues, and at a minimum rule out the more serious causes.

Thalassemia and blood type are two different and unrelated characteristics of red blood cells. One does not predict for the other. Thalessemia is group of inherited disorders of hemoglobin (in red blood cells) that run in families. If there is any history in either parent's family, then testing can be done to see if either is a carrier of the Thalassemia defect. A child has to inherit the defect from both parents to have a clinical disease rather than be a carrier.

There are a number of possible causes and it is difficult to differentiate the cause without more information. However, if the platelet count is the only abnormality identified on the CBC (complete blood count) then some of the possibilities would include reaction to underlying inflammation (infection, chronic smoking), iron deficiency, trauma, or surgery. Other possibilities would be congenital or surgical absence of a spleen, bleeding. Less likely, but more consequential are disorders of the bone marrow. If the platelet count is not excessive (say well under one million) one need not evaluate urgently. The first step would be to repeat to see if the value was spurious. If still elevated a blood smear evaluation and guidance on further evaluation from a hematologist would be warranted.

It will all depend on the type of "blood cancer." It is safe to say that there are treatments for all blood cancers. Depending on the type of blood cancer, the condition of the patient, and other factors - these treatments can be effective (control the condition for some time), very beneficial (induce a remission to last for some time) or even potentially curable. With more details a very informed discussion of the possible benefits of treatment can be discussued.

There are many causes of enlarged lymph nodes - from local irritation (say underarm deodorants, shaving related) to infections, to tumors such as lymphoma or other tumors that can spread to lymph nodes (i.e. breast cancer). The CT scan may have had additional information about other sites of lymph nodes being enlarge or normal. A proper physical exam, good medical history and simple blood tests could help narrow the possibilities. If otherwise healthy, many MDs would suggest a course of antibiotics to see if lymph nodes reduce, and if not then consider a biopsy of the enlarged lymph nodes

If the nephew has sickle cell disease, and not sickle cell trait (two versus one copy of the sickle cell gene mutation) then this is a potentially serious medical condition. Sickle cell patients suffer from anemia, can have frequent painful episodes of bone pain, and more serious complications. There are treatments that provide benefit, and specific treatments at the times of serious complications. The nephew should be evaluated by an MD with expertise in sickle cell diseases, preferably at a center with a multidisciplinary group of experts that understand this important medical condition.