Wednesday, October 7, 2009

Good news on the GI front

I am told by my wife, my GI scopes, up and down were fine, not that I remember a thing. No need for another exam for 10 years.

Apparently I was pretty nonsensically in the recovery room. So how is that news?

Looks like the bone marrow biopsy showing no iron was plain wrong. Does that make the rest of its finding suspect? Probably not- they use different techniques.

I will ask for a repeat in 90 days.

It is good to be able to eat again. That gallon of liquid prep was not Zagat rated.

I love my homely veggies and nuts.

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Tuesday, October 6, 2009

Scatological studies

On my bone marrow biopsy, they found no iron stores. That is very rare in men. Could mean internal blood loss.

But wait you say, you're vegan. Couldn't that explain it? Well, vegan may have no good source of B12, but all iron comes from the ground and is found in many leafy greens (the cows you meat eaters boast of for their high iron content got theirs from eating greens). Veganism does not explain away my low iron.

But you said you are not anemic. That's reassuring, isn't it? Sorry, but that is the last place an iron deficiency shows up. An analogy: The car may still have a full tank of gas, but the petrol station is bone dry.

You might even know that ferritin, the terribly important iron binding protein, is a very sensitive marker of low iron stores and yours is normal so no worries, mate. But remember that CLL is a looking glass world where appearance can deceive, and all things protein and protean are not reliable. Ferritin levels fluctuate with inflammation and are less trustworthy in CLL.

The real contradiction is that the iron studies in my blood, the total iron, the percent that is bound, and the total iron binding capacity are all within normal limits. That makes no sense with no iron in the marrow.

Add it up and what do you get? A contradiction. Now that is familiar CLL territory.

Likely my iron is fine in both my blood and in my marrow, but the test was messed up. It was a poor specimen, and the leaching technique to get rid of the calcium for the iron stain, if not done perfectly, can botch the results.

So how is this scatological? Seems more hematological?

Because the contradiction must be resolved, I need a colonoscopy and EGD tomorrow to make sure I am not bleeding from some occult GI source. Time for a look-see. My last scope was when I turned 50, so it's time anyway.

For those of you who have experienced the prep, you know I am not leaving home tonight. I am not even venturing far from the toilet.

Now you get the scatology.

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