Thursday, December 17, 2009

Just When You Thought It Was Safe to Go Back Into the Water

It is wonderful to have people interested in your welfare. My immediate family has been quite supportive of my occasional tirades against the genes that force my duodenum to inhale vast amounts of iron. When I have hinted that my physician, “Doc Holliday”, has seemed somewhat cavalier about my progress or lack thereof, the whole outfit wants to break out the pitchforks and torches, and storm the castle where he regular hooks me up to the diodes running from the lightning rods on the roof. “Doctor Holinstein! Ve har komink fur SIE! Let ur liddle bunny go!” Well, it just warms the heart.

Once in a while I get a remark from some of my readers throughout the world. Most of the time they are supportive; others have desired to advertize their own products of whimsy; others, from time to time, actually make suggestions that have significance. Hence, the “Flying Finn” has often suggested that I need to eat European chocolate rather than the wax-overloaded American kind. For this suggestion I have been grateful, inasmuch as it has justified my penchant for buying 20-pound sacks of Riesens, a delightful product that only has 7% of my daily requirement for iron, and that is only an estimate because they are not quite certain how many animal parts actually got caught in the machinery. Remember, if it is tangy, it can’t be bad for you.

In response to my previous blog, “Rusted Nut” (not his real name….. I hope) made mention of something I had not thought of before. He suggested that maybe my ferritin spike might have come from an inflammation or an infection, if I had been under the weather at the time my ferritin was drawn. He spoke of ferritin being an “acute phase reactant”. BINGO! I have had some sort of sino-bronco-throato gunk weighing me down for the past month. I have been miserable, loading up on Clariton D-12, Robitussin DM, Halls cough drops, and Riesens on a daily basis as part of my treatment. I was feeling so bad the day that I went into have my ferritin sample drawn, that I laid my head down on one of the arms of the extraction chair and the Lab Tick filled her jar by tapping into a vein in my ear. “This is it! My ferritin went up, not because I am some sort of tooth and claw carnivore, but because I am a beef-eating mensch with a cold".

I, therefore, have thrust myself into the deep waters of cyber-space again to see what I could find out about “acute phase reactants”. The water is black, ice cold, and speaks German. As part of my research I came across the finest explanation yet as to how ferritin and transferrin work in the body and how they relate to hemochromatosis. The article is called “Ferritin and Transferrin In Iron Deficiency and Overload” by Rolf D. Hinzmann, M.D., Ph.D., European Scientific and Technical Support, Beckman Coulter, Germany. It originally appeared in “Immunodiagnostics Today” 12:1 Spring Fall 1999. I came away from the read as well informed as any other incident in my personal studies. I commend it to you

With regard to elevated ferritin counts produced by infections, even the CDC was helpful in their article on ferritin.

Ferritin is present in the blood in very low concentrations. Plasma ferritin is in equilibrium with body stores, and its concentration declines early in the development of iron deficiency. Low serum ferritin concentrations thus are sensitive indicators of iron deficiency. Ferritin is also an acute-phase protein; acute and chronic diseases can result in increased ferritin concentration, potentially masking an iron-deficiency diagnosis. The generally accepted cut-off level for serum ferritin below which iron stores are considered to be depleted is 15 ng/mL" did not disappoint either.

If ferritin is high there is iron in excess, which would be excreted in the stool.” Well, well, well; another mystery solved.

Ferritin is also used as a marker for iron overload disorders, such as hemochromatosis and porphyria in which the ferritin level may be abnormally raised.” Let’s hear it for Abby Normal and Igor quivering in the dungeon of the castle. "Help us, Doctor Holinstein! Oh, the torches! Oh, the pitchforks! Oh, the humanity!"

As ferritin is also an acute-phase reactant, it is often elevated in the course of disease. A normal C-reactive protein can be used to exclude elevated ferritin caused by acute phase reactions.” Well, the Lab Tick certainly didn’t think of that as she was massaging my left earlobe, did she?

Ferritin can be elevated during periods of acute malnourishment.” So, in an attempt to improve my ferritin count, we all went out to eat at Carrabas last night where I stuffed myself with Lentil and Italian Sausage soup, Pollo Rosa Maria, Broccoli Ambrosia, and loads of hot bread dipped in olive oil and special seasonings. I have felt absolutely transcendent ever since.

Finally, as a ray of hope, I discovered that aspirin might help reduce my ferritin by reducing the inflammation before trundling off to the Little Shop of Horrors in January. So, if I am still hacking up lung parts after New Years, I will add a little Bayer (more German) to my regimen and watch my ferritin tally plummet to new lows. Thanks RN (not his real name…. I hope), you have made the holidays far more enjoyable.

Wednesday, December 9, 2009

“The Name is Bond, Zaphod Bond”

Since receiving the results of my ferritin check last Saturday, I have had three movie scenes stuck in my head, all of which have serious implications in my battle against iron-overloading.

The first was actually from a television series called “Hunter” that ran from 1984 to 1991. It was television’s answer to Clint Eastwood’s “Dirty Harry”. I do not think that I ever watched a complete episode. Given the ratings, I am doubtful that anyone watched a complete episode. However, one evening as I was channel-surfing, I happened upon the final scene of a “Hunter” episode that completely bowled me over. Hunter (played by Fred Dryer) and his partner McCall (played by Stefanie Kramer) had chased a villain to the top of a high-rise in Los Angeles. The culprit was standing on the ledge of the building, being defiant and sassy, and before Hunter could shoot him in the head (which was Hunter’s style), the guy slipped and fell twenty stories to the sidewalk below. Hunter walked over to the edge of the building, peered over, raised his eyebrows, and uttered his favorite catch-phrase, “Works for me!” Accompanying the lab report from the University of Utah, “Doc Holliday” sent a note that read, in part, “Excellent ferritin levels, Zaphod. Keep up your current treatment of phlebotomies. Works for me!”

The second scene is from a movie that I have never watched from beginning to end. Like the Hunter episode, I have only seen the end. In 1963, Burt Lancaster, Deborah Kerr, and Gene Hackman starred in a movie called “The Gypsy Moths”, a film developed from the novel of the same name by James Drought. The story involves three sky-divers and their thrill show during a 4th of July celebration in a small mid-western town. The catch-phrase in this movie is one that Lancaster says regarding the spirit of sky-diving: “When you turn on by falling free… when jumping is not only a way to live, but a way to die too… then you’re a Gypsy Moth.” In the final scene, Lancaster makes his final jump of the show, free-falling a mile or so, drawing closer and closer to the ground. All of the crowd is horrified; his partners watch calmly, knowing that there is plenty of time for Burt to pull his rip-cord. Burt gets closer and closer to the ground, people are screaming hysterically, the partners are beginning to get nervous. Then Burt hits the ground doing about 500 miles an hour. He bounces some, but not a lot. I have wondered about that bounce for a long time, how it would feel. When I opened my letter from the University Health Center last Saturday, I had my answer. I think that Trillium, my sister Judie, and the rest of my concerned family, once they finish reading this posting are going to wonder about the bounce, too.

The third scene is, for my money, the greatest scene in all of the James Bond movies. Pierce Brosnan is at the top of the highest dam I have ever seen in my life (the Verzasca Dam in Switzerland), dressed in ninja black, and after the camera pulls back a little, he jumps off in a lovely swan dive. I am not certain how long the scene takes, but at 32 feet per second per second, James Bond must have been about to break the sound-barrier near the end of the dive. Just at the last second, the enormous bungee cord comes into play, 007 is able to shoot his little dart gun, and reel himself to the top of the building at the bottom of the dam. There were two things about that scene that have troubled me. First, what happened to the cord when James cut himself loose? The whiplash from the tension should have taken out half of the Soviet army. Second, how much taller was our hero after that jump? I estimate about a foot and a half. Needless to say, I favor this last picture over the previous two for a couple of reasons. First, I am the hero who overcomes all eventualities and second, I don’t die a miserable death by actually hitting the ground. That is how I feel about the lab report on my ferritin levels.

Four months ago, my ferritin level was at 136, after a year-long, continuous free-fall from the astonishing heights of 827. Two months ago, probably due to the rather cavalier attitude that I had developed about my prospects, my ferritin went up one point to 137. I had been expecting another 50 point drop, but it was not forthcoming. So for the last two months, I have tried to be good. Other than an occasional Swedish meatball, and an infrequent wheat-dog, I have really been circumspect about what I have been eating. Saturday’s report snatched me by my bootstraps: my ferritin had gone up to 160. “Doc Holliday” was happy, my family was momentarily horrified, and I started looking for my little dart gun.

I am not certain what has happened, but I am being proactive and during the next few weeks I will be posting my findings. I have also conjured up some rather radical treatment plans which should prove amusing, if not effective. Fear not! I am not splattered around the countryside; I am just having to duck beneath every door jam in the house.