Pig Iron

I went to the Infusion Center a couple of days ago and gave my bi-monthly pint. Prior to doing so, I called up the International Red Cross to see how their movement toward allowing hemochromatosis patients to give blood for public use. For those of you who have been following my adventures with this unexpectedly unrare disorder, I had called them once before about this matter because I thought that $107.00 per pop was just a little too much to pay in order to share my lovely B+ blood with the land fill. I called the local office; the Donor Acceptability Department. I was greeted by a somewhat familiar voice.

"Hello, Mr. Beeblebrox. What may I do for you?"

"How did you know it was me?" I asked.

"Caller I.D.. I find it is a lot more personal if I greet our patrons by their names. Is there something I can do for you."

"I was hoping that I could do something for you. I am wondering if you have changed your policy on the donation of iron-overloaded blood. I understood that the policy was supposed to change in this region after the first of the year."

"Oh! I don't know. This is just the Donor Acceptability Department. I will have to put you in touch with the Donor Acceptability Department in Boise, Idaho. Can you hold?"

Before I could ask the obvious question, I was put on hold. A few seconds later, another voice (I say another voice, but it sounded surprisingly the same as the one that I had just been speaking with, whom I thought hailed from Provo, Utah) picked up the line and sweetly said,"Hello, Mr. Beeblebrox. What may I do for you?"

I replied: "I was hoping that I could do something for you. I am wondering if you have changed your policy on the donation of iron-overloaded blood. I understood that the policy was supposed to change in this region after the first of the year." I have to do these repetitions frequently as I move up the information ladder. Someday I am doing to figure out a way to scissors-and-paste my voice.

"Hmmmm! I don't know. Let me check with my supervisor. Can you hold?"

At what point does anyone know anything about who qualifies as an acceptable donor of blood? Eventually, the girl came back on line. "Well, Zaphod (I began to wonder if I had called them more than once), it appears that the policy has not changed. You will still have to go to the Infusion Center to do your duty to yourself and your sister. Bye-bye now."

Somewhat dazed at the exchange, I found the number of the Infusion Center and asked to set up an appointment. The person at the other end of the line said, "Hello, Mr. Beeblebrox. What may I do for you?" I was certain that this was the third time I had spoken to the same person.

"I would like to come down as soon as possible and have a phlebotomy. I have a standing order from my doctor."

"Yes, yes, we know, but we are really busy this morning. There have been a goodly number of people who have fallen off the wagon over the holidays. Could you come sometime after 2:00 this afternoon?"

I said that I could and would. As it turned out, Trillium and I went up to see T-ma about 1:00 or so to see how she was getting along with the staff, and how many times she had hit any of the therapists there with it. All of this progressed, the drive to and fro, from home to The Shire, to the Infusion Center, and back home in one of the worst snow storms in Utah history. Our stay at The Shire was short, but we had time to play one game of Phase 10 before moseying off to Provo. I am a little dim about who won. I think that T-ma did; by one card. I faded fast once she began swinging her cane at me. (Now no hasty chastisement here; you all know that this scene was fabricated for artistic effect. My mother-in-law and I get along just fine.)

At the Infusion Center, I signed in once again in some detail. If one does not show up at their place more frequently than once a month, then all of the paperwork has to be done all over again. I was taken to a cubical, very similar to all of the others in which I had been previously ensconced. While I was sitting there waiting for someone to deflate me, a very large man raced by, his hand over his face, and blood streaming down his arm. I was naturally curious. While I waited there, the same man passed by the front of my cubical several more times in the same attitude and condition. When my paperwork arrived from Registration, Nurse Chappell flounced in and began preparing me for my blood-letting. I took the opportunity to ask Majel the burning question. "Who is the fellow with the bloody nose?"

"Him? Oh, just another phlebotomy guy. I'm not sure whether he asked for a second can of root beer [this she said looking at me with a knowing eye] or whether they just had trouble finding a good enough vein in his arm to draw from."

I am not vain about my veins, but I was happy that they seemed to be cooperating that afternoon. I can't help but wonder though, how long it would take to give a pint of blood through one's nose. I went went home rejoicing in the condition of my cardio-vascular system, even though the hole in my right arm was obscenely large.

Now in another vein.

I have tried to be at least a little bit conservative in my eating habits, but there appears to be one thing that I cannot seem to do without. At some point in my childhood, I happened upon a really hot hotdog and finding no other ready condiment, merely put butter on a piece of bread and wrapped the slice around the dog. It is sort of like a "corndog", but it is more like a "wheatdog" without the stick. I love these things. I can eat them for breakfast, lunch, or dinner and sense no shame whatsoever. I just had one a few minutes ago, even though Trillium fixed a lovely (and supremely healthy) meal for dinner. It is an addiction.

How much life-threatening, liver-destroying, pancreas-eroding, brain-frying, heart-stopping iron is there in a "wheatdog"? Who cares?
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(I need an attitude adjustment here!)

Iron-Clad Humor

It would appear that there are only two people other than myself that are reading my blog: my wife and my youngest daughter. When I was beginning school at BYU, my Freshman composition teacher, Steve Walker (yes, the Steve Walker), taught me that every writer has to be aware of his audience and adapt appropriately. Yesterday afternoon, half of my readership suggested that I was trying too hard to be funny, that the second entry was a somewhat strained effort when compared with the first. I reread both and failed to see the difference. This morning Trillium brought me a four-page paper written by my friend Marvin Payne (yes, the Marvin Payne) that had appeared in Meridian Magazine. "This is funny", she announced. I read it over toast, a piece about rocks, water conservation, and a pioneer what had three wives at the same time each of whom was named "Mary Ann". I found it more droll than funny and told Trillium so. She smiled and went off to her workroom to put the finishing touches on my mother-in-law's new blog.

I have to say that I can make my wife laugh, generally in public, and from time to time in private. I am always surprised when it happens. Trillium is far from being dower and my 41 years plus with her has been filled with a great deal of laughter. But she has a unique sense of humor which I have had some difficulty understanding and far less success exploiting. I may have just expressed a universal truth about husbands and wives.

I have always tried to make people laugh. I think that it is true because that I, myself, enjoy laughing. I find humor in just about everything. This has sometimes been misinterpreted as light-mindedness, perhaps a victory for the gas-giant theorists of my life. I have discovered, however, that together with my desire to have everyone around be in a good mood, I almost always break into joviality when I am under stress or have some kind of impending doom to deal with. This business of hemochromatosis serves as a case in point.

At the first consultation with "Doc Holliday" after I was diagnosed with my genetic condition, the whole business of the "cure" came up. The "cure", of course, is to have one's blood drawn weekly for a time and then on a regular basis. The whole "14-gauge" needle and subsequent "buckshot" jokes derived from that. As I have stated elsewhere, needles trouble me deeply, and I dealt with my cringiness the best that I could. At some point, "Doc" said that I ought to look into giving blood to the Red Cross. I did so. The folks at ARC Headquarters said that at present only those of my ilk living in the Northwest part of the United States (Washington, Oregon, and environs) could donate blood to the Red Cross. The Northwest was accepting blood from hemochromatosis patients on a trial basis. It is now known that hemochromatosis is a digestive condition more than a "blood" disease. The Red Cross told me that my region (Utah, Idaho, and Montana) would probably begin accepting hemochromatosis blood after the first of the year. The financial aspects of this scenario were not lost on me.

When I was considerably younger, the Red Cross was extremely proactive in getting out the blood-donors. The media blitz was extraordinary. Blood drives were being held everywhere. The Eagle candidates of our Stake in Garden Grove, California, were using the blood drives as part of their Eagle Projects, and I, as an avid Scouter did my best to keep up. Notwithstanding my preternatural fear of needles, I volunteered to give blood when any of these drives came along. The Red Cross was delighted for my generosity, inasmuch that my blood type, B+, was somewhat rare and extremely useful (who knew that my blood type was an expression of my fundamental personality and could be passed on to others?) After a few of these visits, however, the folks at the Red Cross invited me not to participate again. Apparently the quart of orange juice, the fifteen cookies and the gurney that was occupied for 45 minutes did not figure into their idea of efficiency, temporal or financial. More than a generation has passed away since I last gave blood; perhaps no one will remember me.

In younger days, I gave blood for money. For a quick pint, the blood bank would give me $25.00. I do not know whether or not they still do. When I went to the "Infusion Center" in Provo, I asked them what they were going to do with my blood, since it was unacceptable to the American Red Cross. The nurse said that they would probably just throw it away. Sad; I could have used the money. What I found out later was they they were going to charge Medicare nearly $200.00 for extracting that singular iron-ladened pint. I thought to myself, "Well, I can save my government a fabulous amount of money as soon as the Red Cross gives the Utah Region the go-ahead to take blood from hemochromatosis patients. I wonder if the ARC will give me $25.00 for my trouble." Then the thought occurred to me, "What if I have to give $12.50 to 'Doc Holliday'?" So I asked him. Trillium laughed, the "Doc" grimaced. Once again, I had only managed to entertain half of my audience.

Trillium suggests that I provide a little information along with my ruminations, so that after I am gone, the other members of my family will know how they are going to go, and when. The blood analysis reports are filled with fun facts, most of which are undecipherable to those with degrees from the School of Humanities. I believe that the medical profession has arranged this on purpose in conjunction with their inability to write legibly. I have already given a little bit on the "Blood Urea Nitrogen" fiasco and the ripple about the "eGFR" results. There are many other delightful aspects of a blood analysis that can set the heart to racing. For now I will focus on the hemochromatosis data.

There are, at present, four components to hemochromatosis testing: Serum Iron, Iron Binding Capacity, Iron Saturation, and Ferritin. What is given below as standards, vary from laboratory to laboratory and, thus, are not really "standards" at all. The information provided is in the parking lot, if not actually in the ball park.

Serum Iron: Men and women in the "normal" range have between 20 to 150 nanograms of iron per milliliter of blood. At least that is what I think "ng/mL" means. As of the last test, my count is 207. "Doc Holliday" says that when the Iron Serum gets to 300, I start "clanking" when I move. The treatment for lowering the serum iron is to draw blood until the level drops to 15. In other schools of thought, this is known as "bleeding out".

Total Iron Binding Capacity: Because this phrase almost makes sense, most medical practitioners have abbreviated it to "TIBC" just to keep their patients guessing. "TIBC" measures how well a person's blood can transport iron. For men and women, the normal range is 250 to 450 ng/mL (what the heck is a nanogram? It sounds like a Hallmark card for one's grandmother). In my case, my Total Iron Binding Capacity is not good at 195. What I found completely fascinating is that when one has high serum iron (which I do) and low TIBC (which I also do) one probably has sideroblastic anemia (oh joy!), a condition that prevents my red blood cells from using iron. Whether I have this condition or not is irrelevant ("clank").

Iron Saturation: This must mean what it seems to mean, but probably in reference to where the "sideroblastic anemia" is stuffing all of the extra iron that the blood is not using. Maybe this is where "bronzing" comes in. Since one does not excrete iron (a circumstance that would bring a whole new meaning to constipation), perhaps the body is attempting to push the excess iron out of the pores. Normal people (unlike myself) have from between 20 to 55 % Iron Saturation and I have 106.2 % (thus saith the deponent from the University of Utah lab). WOW! I am 100% iron and have extended my ironness 6.2% into the realm of wherever. Needless to say, the medical profession has concluded this to be high ("clank, clank"). It is data like this which compels me to break into nervous laughter. Transferrin Saturation, in reality, is a figure derived by dividing amount of Serum Iron by the TIBC. This is, of course, a mathematical calculation which is outside of the pay grade of most medical types. It is certainly outside of mine; I have no clue what it means so I am forced to make stuff up.

Ferritin: Prior to being diagnosed with hemochromatosis, I though that "ferritin" had to do with the work of private investigators. I have since been disabused of that notion and of what I thought was the accompanying humor. The ferritin count indicates storage iron which is not essential to maintain life. Normal people (again, not yours truly) have a reading of between 17.9 to 464 ng/mL, except for 100% of my readership whose range should be between 20 and 120 ng/mL. It is not that 100% of my readership is abnormal (which does make some sense), its just that 100% of them right now are women. As I reported previously, my Ferritin level is 827 ng/mL. This, according to my own lights, would make me a great private eye, but ("clank, clank, clank") not all that private.

Well, there you have it. My status as of today. I have had one pint of blood withdrawn. I have clipped my fingernails, brushed my hair, vigorously bathed, all of which apparently helps in getting rid of the excess iron. Trillium says that I am more pleasant to be around even though my humor is still a little heavy-handed.