Thursday, 30 September 2010

More time with the medics

Time now to return to the events of Tuesday 7 September 2010 and you will recall that I am in the consulting room of my haematologist. Let us call her “Dr M”.

Some time during the proceedings a younger woman had slipped into the room, unnoticed by me. Doctor M now introduced her as “Dr H”, explaining she would be carrying out my bone marrow biopsy in about an hour. I was assured that I would be able to drive home after the procedure and—oh, the joy of small mercies—that it should not be necessary to extend my allowed time in the hospital car park.

Dr M then took me briefly through an explanatory leaflet about my newly diagnosed condition, which she handed to me to read more fully in the 50 minutes or so that now lay between me and my next meeting with Dr H. You may read the text of the leaflet here. She drew my attention to the existence of The International Waldenström’s Macroglobulinemia Foundation (IWMF), based in Florida but with an English membership (about whom more in several entries’ time).

That, for the moment was very largely that. I shook hands with Dr M to close the proceedings and found my way back to the lift and from there to the hospital cafe near the main reception on the floor above. I needed refreshment. It was clear by the time I was paying for a bottle of still water and a cereal bar that to the foggy malaise created by my existing physical symptoms had been added a full-force blow to my central core of confidence. I read and re-read the information leaflet, half-taking in and then losing grip on the facts I so badly needed now to understand if I was to have a sense of how my life would be from these moments on…

To boil things down, about five years ago certain B-cells in my bone marrow took it upon themselves to start producing abnormal quantities of an otherwise desirable paraprotein called immunoglobulin-macroglobulin (IgM). Herein lies the malignancy of the disease, that this rather large molecule accumulates slowly but surely in such profusion that it silts up the circulatory system, leading to the complications described in the leaflet as the resulting inefficiency of the system leads to organ damage and ultimate failure. The goal of treatment is to suppress the production of the abnormal protein so that balance may be restored between the many different constituents of the blood. My son drew the protein or me a day or so later, but I include the cartoon here, having added certain facetious elements designed to help me cope with all this drastic news.

The medicines I would receive the day after next from Dr M, assuming diagnosis could by then be confirmed, would therefore be my very own WMD: Waldenström Macroglobulinaemia Destroyer. Please bear with me if, on those rare occasions when I mention the condition's name in full, I use the English (and ultimately Greek) spelling of "macroglobulinaemia" and retain the second "a" in that word. Around such small pivots does my peace of mind sometimes revolve.

The narrative of this day will conclude soon, but please forgive me if I slope off to bed now. I am very tired.

Normal proteins make their views known to a member of the enlarging IgM community, shortly to be ejected by the incoming boot
(artistic and many other debts to the late Spike Milligan readily acknowledged)

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