A white blood cell (WBC) count three weeks ago was 17,000, with predominant neutrophils and slight lymphocytes.  He has been fatigued since that time. His past medical history is significant for lobectomy for lung carcinoma 18 months previously, and prostate carcinoma (Gleason 3+3) six months ago. He is currently seeing a urologist regarding his prostate cancer, but no treatment has yet been given. He has had a left hemiplegia for six years. He is usually wheelchair bound, but does walk with a walker.   He states he quit smoking about six years ago.  He has a history of hypertension and hypercholesterolemia.  He denies any urine infections, history of arthritis, fever, weight loss, tingling or numbness. He does report a recent weight gain of 10-12 pounds. He has no recent changes in his medication.