Sunday, April 12, 2009

The Origins of Hemochromatosis

There are many uncertainties in the universe, but there is one thing that you can count on: when there are two months between phlebotomies, something like that which follows is bound to happen.

“Why me?” This is a cry heard around the world, uttered by one out of every 250 people. “Why is my duodenum extracting every molecule of iron out of my beef burrito and stuffing it into my liver, pancreas, heart, and brain?” Well, as it happens, I have an answer. Actually I have two answers; in matters of such import, a plethora of explanations cannot help but illuminate. Both of these theories have currency. They are at the heart of the meaning of life, the universe, and everything, about which your humble correspondent has some expertise.

The first theory as to why there is iron overloading at all is called "The Big Iron Bang Theory". Approximately 13 billion years ago (you know, when I was a kid going to school, my teachers told me that this event took place 3 billion years ago; time flies when you are having fun), the universe did not exist. There were no stars and planets, no galaxies of any shape or size. In fact, there were no elements as we know them today, just an enormous number of sub-atomic particles living together in an extremely small condominium. Again, about 13 billion years ago, some sort of accident took place; the condo was condemned and all of the sub-atomic particles fled the inner-city to the suburbs. This shift in demographics fundamentally changed all of the sub-atomic particles. Some became hydrogen; in fact most of them became hydrogen. According to Carl Sagan, for every atom of any other element, there are “billions upon billions” of hydrogen atoms. In honor of the great astronomer, this ratio of “billions upon billions to one” is affectionately referred to as a “Sagan” (pronounced with emphasis, it becomes a "Shy-Sagan"). So, as a result, helium is hard to come by, as is oxygen, nitrogen, and argon. Seaborgium and Ununbrium are difficult to pick up at Wal-Mart as well. Iron, as it turns out, is a rare earth metal when compared to the amount of hydrogen bouncing around the universe. Why, then, do I end up with so much of it?

I was watching PBS yesterday and I found out why. It all has to do with the life of a star. In the beginning, a star is formed by the aggregation of an immense number of Bok globules, several Shy-Sagan-Sagan’s worth....... At this point, astronomers want to talk about hydrostatic equilibrium, Herbig-Haro objects, and proto-planetary disks. This, however, would be a digression from our main theme, so we will push on.....

When a star first flares into existence, its business is the fusing of hydrogen atoms together into helium atoms. The more helium there is at the core of the star, the brighter the star becomes. This continues for about 90% of the star’s life. As the star ages, it suffers what Sagan and his boys call “metallicity”, the dreaded creation of elements other than helium. At first, the process merely fuses helium into such innocuous particles like oxygen and carbon, but the malady continues with the specter of the “carbon-burning process”; the “neon-“ , “oxygen-“, and “silicon-burning” processes quickly follow. As might be expected, there is a point of diminishing returns, and that point is when iron is produced by fusion and the star cannot get rid of it. So, you guessed it, the star stuffs the iron into its own liver, pancreas, heart, and brain. Eventually, the inert iron core becomes so massive (about 1.4 times the mass of our own sun) that it collapses under its own weight and a supernova occurs, splattering all of the iron and all of the other elements all over the place, to be used in the formation of planets and all of the life on them. What no one has figured out before, but which I am sharing with you now, is that there are some stars that produce and store three times the amount of iron as regular stars. These are hemochomatosis stars.

Joni Mitchell, a famous songwriter and erstwhile astronomer, wrote a song in 1969 called “Woodstock” in which she explains why it is that we are all the way we are, why it is that I, my sister, and one out of every 250 people on this planet have hemochromatosis. The tag of the song, the chorus if you will, is as follows:

We are stardust
We are golden
And we’ve got to get ourselves
Back to the garden

So there you have it. The disturbing thing about all of this is that no matter what I do, I am gaining more weight. I play racquetball with Jenny for six weeks and I put on six pounds. I resort to eating nothing but heads of lettuce for lunch and I can’t fit into my suit pants. I fear that I am no longer in the hydrogen-fusing stage of my existence. I am a “red-giant” ready to collapse into a “white dwarf”. All I need is just another solar mass of iron before my heavy metals can be blasted all over the earth. It’s time to defrost the tri-tips.

The other theory explaining the existence of hemochromatosis is called the “Intelligent Wrought-Iron Design Theory”, but at present we can only talk about that in the state of Texas.

Saturday, April 4, 2009

The Iron Mean

Yesterday I went to visit with the good “Doc Holliday” to find out what kind of condition my condition was in. To everyone’s delight, my ferritin had dropped to 223, 170 points down from January and 600 points down from last August (I say “to everyone’s delight”, only because Trillium and Judie had not, as yet, seen the numbers; they want me to be completely de-magnetized). We spent an hour together poking and prodding each other; he physically, I informationally. All of my organs appear to be in good working order (he thumped and poked a couple of these). Therefore, the hemochromatosis prognosis is good. I am supposed to go to the Infusion Center for a phlebotomy once every two months (bad news for the boys and girls in that institution). Since I dropped fifty points doing that from November to January, I am not opposed to the treatment.

After reviewing all of the blood work, “Doc” thought that my triglycerides were high (248; the high end of normal being 149). My HDL was one point below normal (39 instead of somewhere between 40 and 60). My LDL was 30+ points higher than the extreme (130 instead of between 0 and 99). Some of this could be explained by the fact that I was not fasting at the time the blood was drawn. That’s my story anyway. The truth probably has to do with the number of maple bars and “wheat dogs” that I have eaten during the last couple of weeks…. along with the potato chips, the salt water taffy, and the leftover Chocolate Christmas Oranges that I have been compelled to eat (by compelled, I mean that they were left out in plain sight). He said that I need to exercise (“Ooooohhhhhh! Nooooooooo!”) and change my eating habits (dirt instead of food).

I asked “Doc Holliday” what would happen if I did not pay attention to these numbers, if I just went on my merry way, content that I was not part of the static electricity generating machinery of the planet. He said, “Well, there is a .5 percent chance that you could have a heart attack or a stroke in the next five years.” I then asked what would happen if I went on this regimen that he was suggesting, a procedure that would mean that every time I ate something it would seem like I was grubbing for truffles in the back yard. He replied with a smile, “Well, your risk would be reduced to a .25 percent change of a heart attack or a stroke.”

“So,” I said, “What you are saying to me is that the odds of my not having a stroke or heart attack are 99.5 to 1 if I keep on eating what I am eating, but if I switch to daily doses from my compost pile I can improve my odds to 99.75 to 1.”

“That’s essentially it. Isn’t medicine wonderful? Aren’t you glad you came to seek my advice about all of this? Welcome to the club, brother; we are all going to be miserable together!” I went home with mixed emotions, which I quickly unmixed by having a handful of sour cream and onion potato chips, followed by a pork loin sandwich.

This morning I thought better of all of this and decided that I needed to be a little more rational. During my slumbers I had the phrase “the Golden Mean” pass through my mind several times, together with the phrase “the Iron Mean”. Not wanting to ignore communications from my “space pillow”, I came down early this morning to flesh out this entry by Googling the two phrases. Needless to say, I have enough material now for about six 5000-word essays.

There are four major “Golden Mean” entries to be found on the web. The first is an epistolary novel by Nick Bartoch, the third in the “Griffin and Sabine” trilogy. It sounds boring and since Bartoch lives in British Columbia, it probably is; the book is no doubt beautiful, but boring none the less, kind of like Vancouver.

The second entry has to do with mathematics. I read several articles on the “Golden Triangle”, the “Golden Rectangle”, and the special relationship between a man’s belly button and his nose. The conclusion that I came to was that Johannes Kepler and his fellow mathematicians all had a thing for maple bars and pork loin sandwiches and did not beat the odds. The best thing that can be said about all of their number crunching is that the whole universe may be reduced to the square root of the number 5 divided by 2. These guys may also have been suffering from undetected hemochromatosis with ferritin counts in excess of 1,618,033, all of the iron having been deposited in their brains. I was not impressed.

The third is an Aristotelian concept, suggesting that the relationship between truth and beauty may be mathematically quantified. All the numbers aside, however, the simplest redaction of his ideas may be stated thusly: “Both beauty and truth have symmetry, proportion, and harmony”. I had noted this already in the perfect dimensions of the “Maple Rectangle”.

The fourth articulation of the “Golden Mean” was conjured up by Confucius in the sixth century BC. It is sometimes called the “Unwobbling Pivot”, or the “chung yung”. In this philosophy the mind is to be in a state of constant equilibrium (a kind of intellectual mugwumpism that does not include maple bars or pork loin sandwiches; no extremes of any kind). The advocate of the “Golden Mean” never leaves the path of duty (he does exactly what his doctor, his wife, and his sister tell him). The man that observes the “Golden Mean” is a gentle teacher and never has contempt for his inferiors (which leaves out sarcasm, broad humor, and just about anything that makes me laugh, including this blog). And finally, a man of the “Golden Mean” always behaves himself according to his status in the world (What in the world does that mean?).

I have concluded that I am not fit for any of the preceding definitions of the "Golden Mean" and have decided that I should be an advocate for the “Iron Mean”. I Googled that phrase later this morning and found that there was actually such a thing as the “Iron Mean”. Here is the mathematical formula for the "Iron Mean":

“The percentage of time I love you now far exceeds the moments when I want to brain you with a skillet”.

Iron reduction, truth, and beauty are all interrelated! This is the key to Einstein’s Unified Field Theory! I need another maple bar to see if I am right!