Dr. Mary S Muscato MD

Hematologist-Oncologist | Hematology & Oncology

1705 E Broadway Suite 100 Columbia MO, 65201 Show map

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About

Dr. Mary Muscato is a hematologist oncologist practicing in Columbia, MO. Dr. Muscato specializes in the diagnosis, treatment and prevention of blood diseases such as anemia, hemophilia, sickle-cell disease, leukemia and lymphoma. Hematologist Oncologists are also trained in the study of cancer and its attack on other organs.

Education and Training

Med Coll of Pa, Philadelphia Pa 1975

Philadelphia College of Osteopathic Medicine 1975

Perelman School of Medicine at the University of Pennsylvania

Board Certification

Internal MedicineAmerican Board of Internal MedicineABIM

Provider Details

FemaleEnglish 42 years of experience

Dr. Mary S Muscato MD

Dr. Mary S Muscato MD's Expert Contributions

My Answers

Is thalassemia genetic?
Thalassemia is a genetic hemoglobinopathy. Abnormal hemoglobin formation is passed down from one or both parents, as their ancestors lived in an area with lots of malaria--the Mediterranean, SE Asia. If malaria is common in an area, people with thalassemia or sickle cell anemia do better than those w/o it, as their red cells are less densely packed with hemoglobin molecules than normal people's cells. With Thalassemia, globin chains are not made correctly, so there is less hemoglobin, to carry oxygen, but with less densely packed cells, the red cells are less likely to burst from the malaria bacteria multiplying inside them. That's why they have a survival advantage in areas with lots of malaria. Thal minor or intermedia people do pretty well. Thal major have more severe anemia, absorb too much iron, can have liver and heart problems from iron overload, and are very anemic. Thalassemia is one of the diseases that has persisted because people with it do better than normal in malaria-infested areas. READ MORE
Is high white blood count serious?
It depends on how high it is and what kind of white cells they are. Normally we have 5 types of WBC- neutrophils, eosinophils, basophils, lymphocytes & monocytes. The first 3 arise from the same stem cell, as they mature. Neutrophils can engulf & destroy bacteria. Eos rise if there's a lot of allergic stuff going on. Basos contain histamine--related to allergies too. Lymphs are a big part of the immune system. They also live in lymph nodes & the spleen. They recognize foreign materials & make antibodies against them. Monos deal with foreign matter too. Normal WBC is between 4.5-10,000. Too low means you are less able to fight off an infection. High WBC happens if there is an infection, to fight it. The number & type of white cells are very important to fight infections, & keep the body healthy. READ MORE
What is the best medicine for treating anemia?
The best treatment for anemia is the specific right treatment for a particular disease. Iron deficiency needs iron, B12 deficiency needs B12, etc. you have to find out the cause like GI bleeding, & fix that, besides giving iron, to really fix the problem. READ MORE
How can you treat anemia?
Your question is very broad-based. There are many, many causes of anemia: bleeding, low iron, cancer, inflammation, infection, congenital problems like Sickle cell anemia, many more than these! Your doctor should work on what it might be, & if it's complicated, send you to a hematologist. It is often fixable, but one can't treat it till you know the cause. READ MORE
Slight high MPV on CBC?
The MPV refers to the average platelet side. Young platelets are bigger than older ones. Platelets usually live 10 days. If there is some condition you have that makes you co-dime plots faster than normal, your plts'd be on the big side, being young. There is a. Autoimmune disease--ITP means idiopathic thrombocytopenic purpura, where people make antibodies against their own platelets, which the spleen then grabs, then pls don't circulate for the normal 10-day lifespan of platelets. The platelet number is usually lower with ITP too. If no one's said the platelet count is low, I wouldn't worry, esp if the platelet count & size are pretty stable. READ MORE
Blood check?
If you mean that the CK or CPK, a chemistry test, creatine phosphokinase, was very elevated, it certainly is very high. If you meant that you work out a lot, like several hrs a day with intense physical activity, that could cause some muscles to release CPK into the bloodstream. It could also be a sign of muscle cells bursting open, called rhabdomyolysis, which can be dangerous to the kidneys. You should go to your dr. & get this test repeated, check the aldolase, another muscle enzyme, your urine & kidney function also. READ MORE
How long does a bone marrow biopsy take to heal?
It takes a few days for the skin to heal; the bone may take a little longer, but the biopsy is only about 2 mm wide, and maybe 1/2 inch long. Hope it doesn’t hurt anymore! READ MORE
How long does it take hemoglobin to recover after surgery?
How anemic did you become after surgery? And what was your Hb pre-op? And what kind of surgery was it? If you were not iron deficient pre-op, & didn’t have a lot of bleeding, nor inflammation post-op, you should be able to start making new red cells w/in a week post-op. If there were a lot of complications, infection, bleeding, etc., it might take longer for your body to start producing new red cells. Inflammation decreases red cell production, as it causes hepciden to be secreted by the liver, which doesn’t let more iron get absorbed, if you’re not going to make new red cells then anyway. If you have no extra iron stored, like if you bled during surgery, you won’t be able to make new red cells till you can get more iron into your body. If there were no unusual circumstances around the surgery, your Hb will probably be back to normal by a few wks post-op. READ MORE
Does anemia go away?
Anemia is a very broad diagnosis, any time the number of red cells is low. Can be caused by a million different things! Iron deficiency, low B12, low folic acid, kidney disease, any inflammatory or infectious disease, bacterial, viral, fungal, can be secondary to serious conditions, too, like cancer, leukemia, organ dysfunction. If you can be more specific, we could tell you more. READ MORE
Leukocytosis treatment?
With an inflammatory disease, it is common to have the WBC elevated. Small red cells are not especially a part of this; anemia of chronic disease could be going on, but you’re not really anemic. Red cells being small make me think of iron deficiency, but were red cells bigger before? I don’t think you can really tell if lymphocytes are clonal by looking at smear. Need to do flow cytometry for that. Ferritin is normal, but goes up w/ inflammation too. READ MORE
Is high leukocytes in blood dangerous?
How high is the white count? 5,000-10,000 is normal. If higher, check for infections, inflammation, being on steroids, check other meds. Leukemia’s can do it, but are much less common than the above problems. The types of white cell make a difference too. Are the percentages of the kind of white cells normal? READ MORE
What anesthesia is used for bone marrow biopsy?
Usually, versed, in an IV shot, local lidocaine, to the skin & more deeply, to the cortex, of the bone marrow. I always make sure to check to be sure I’ve got the right area numb, before removing the needle from the back, & starting to do the procedure. Good luck!! READ MORE
How long can blood transfusions be stored for?
42 days, red calls can be stored, refrigerated. READ MORE
Blood work?
There is a lot of potassium inside red cells. If a lot of them broke w/the fall, perhaps some K+ leaked out into the serum & raised the potassium reading. If you have kidney problems, it could be more significant. READ MORE
Atypical Lymphocytes?
I think a hematologist should look at the slide, to see the atypical lymphocytes, to be sure they aren't a problem. They can be seen in viral illnesses, like Mono, and other ones, and are a reaction to the viruses, not a permanent thing. They don't look like blasts, the very immature cells that are the first line in precursors to adult lymphocytes. Blasts, finding too many, and more than one, once in a long while, usually mean the person has acute lymphocytic leukemia. I'm only saying this because an atypical lymph DOES NOT mean that I'm worried about you having this disease. READ MORE
Multiple lymph nodes, weight loss and fatigue?
You need a lymph node biopsy, by a surgeon, & to see a hematologist, who will look at your blood under the microscope, examine you thoroughly, ask you more about wt loss, fevers, energy level...who did the beta 2 microglobulin on you? That is a tumor marker for lymphoma/myeloma. It isn’t a lymphoma for certain, but we need more info to determine what’s going on. Good luck! READ MORE
Is sickle cell disease genetically passed on?
Yes, it is passed on through chromosomes, equally from each parent. Two copies give you the disease, one copy, from one parent, gives you sickle cell trait. Trait has few but not zero symptoms, but two genes give you full-blown sickle cell disease. Need to see a hematologist and have a hemoglobin electrophoresis and a CBC done. READ MORE
How long can anemia be left untreated?
How anemic are you? If it’s severe, and you’re exhausted, short of breath, and lightheaded, you might need a transfusion of packed red cells. If you're just a little tired, it’s not an emergency, but the reason for the anemia must be sought so it can be fixed. Most common reason in a young woman is iron deficiency, either from heavy menses, having children, or both. The doctor needs to do a CBC, complete blood count, look at the slide, look for how small the red cells are, as they get small w/increasingly low iron, and make sure the white cells and platelets are okay. Platelets can go up from bleeding, iron deficiency, so that would go along. White cells should be normal. MCV, size of red cell should be normal to small, smaller if very anemic or if it’s been going on a while. Red cells live 120 days, so newer. READ MORE
How long does it take to treat anemia?
It depends on why you are anemic, & how anemic you are. If it’s from iron deficiency, if they give you enough iron, it’ll take 2 mos. for your marrow to turn all that iron into red cells, at the most. There are many causes of anemia besides iron deficiency, including B12 deficiency, folate deficiency, & besides those, with sickle cell, thalassemia, what are called hemoglobinopathies, (making Heme or globin abnormally), there are others like lead poisoning, that need to be corrected. Then, there are many diseases of the marrow itself, like leukemia, myeloma, where there isn’t enough room in the marrow to make enough blood. If you can find out more details, we could tell you more. READ MORE
Should I be concerned about elevated platelets?
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