Blood-iron Reducing Techniques

Go to any other web site dedicated to this topic and you will find suggestions far less painful than the ones I am going to articulate here. Most will talk about diet, the sorts of things one should or should not eat, which supplements one should or should not ingest, and what sort of remedial activities actually will cause a loss of ferritin. Most of these are innocuous and generally affect nothing but your whole way of living your life. My modest proposals will be as effective as those proposed by the pantywaists at other websites, but far more memorable.

I personally recommend bike-riding. Barnacle Raff and I do that from time to time and as counter-intuitive as it sounds, free wheeling can bring about a sharp drop in ferritin. The first two forays that Raff and I took involved hardly more than getting into his truck, with our bikes loaded up, and managing to avoid mid-morning traffic on our way to the Riverwood Shopping Center. I have to say that the potential for a cost-effective blood-letting had been on the street both times we made the trip. Unfortunately, Raff's driving skill are prodigious and I neither went through the windshield nor was I ejected from our vehicle at impact. I did over-hear some blood-curdling screams from various parties along the way, but I have not discovered whether curdling one's blood actually affects the ferritin count. The trips from Riverwood to Vivian Park were not exactly fraught with danger, except for the occasional "mountain trail" that Raff likes to take. I saw several boulders with my name potentially written all over them in my own blood; rich iron deposits those.

The trip from the BYU Motion Picture Studios down to Utah Lake, however, was far more promising and productive. Last Thursday (not yesterday, but a week ago), Raff picked me up and because the weather was just a little nippy, he decided that we ought to do a longer, flatter, but warmer excursion. Hence, the Lake Effect. The ride began well, but there were far more travelers on the path than what I was used to. Raff decided that we needed to go about 10:00 so that we would avoid the ice on the path. There was only about a two-mile stretch that had any ice on it. What he had not foreseen, however, was the three-inch pile of leaves that made the path a bit slimy in places. Out of the 14 miles we biked, only 13.99 miles had this problem. Hence, when we came upon the two skateboard enthusiasts with their dogs on their forty-foot leashes pulling them down the trail, the opportunity for ferritin iron reduction was realized.

The usual practice for the patrons of the trail is that those traveling on foot are supposed to hunker to the right while we on bikes pass by them on the left. This practice can vary according to those who are walking and those who are riding and who really thinks that they own the walkway. In other words, anyone traveling along the Provo River Walkway probably ought to anticipate some sort of major injury about every third trip.

The boys on the boards were coming toward us about the same speed we were going towards them. They were engaged in activities other than watching out for Raff and me. I suspect that they were texting each other. In any event, one fellow was on the right side of the path with his dog checking out everything within forty feet on the left. The other fellow was doing the same, but with the orientation reversed. The dogs, of course, had minds of their own (perhaps the four travelers only had one mind between them) and were wandering around to see what the other had discovered. Raff and I shouted at the two boys that we were coming through. It was then that it became clear that the fellows had earbuds inserted as well, listening to KDAVOLA. It was then that things went awry.

Raff slammed on his brakes. As it turned out, he had tried to stop on the .01 mile of the trail that had neither ice nor leaves on it. I, however, was still on frozen tundra. I began to slide and fully expected to hit my 77 year old friend in the back with all of the iron-overloading that still could be measured. I did the only thing that I thought that I could do: I laid my bike down, and did a magnificent "tuck-and-roll" off the path and into the bushes next to the river. On the way down my left knee struck the asphalt. When I got up from my tumble, the two boys and Raff were very solicitous, hoping that I was not seriously injured. When it became apparent that there were no grounds for a personal injury suit, the four-some scampered off to continue their reign of terror elsewhere.

Raff said, "Are you really okay? Do you want to head back?"

"No," I replied, "I think I only scraped my knee a bit." I pulled up my left pant leg and discovered that I had a about a four square inch patch of missing skin on my kneecap that was quietly weeping ferritin.

"Wow! Are you sure you can go on like that!"

"Sure," I replied. "This is all part of my regular iron-overloading therapy. It is facing the Krrrakin that I am worried about." I went to the Krrrakin cave this morning and I was happy to discover that my graceful descent from my bike into the undergrowth had done no damage to my bonal arrangement. So, for those of you looking for new ways to eliminate ferritin from your system, find a place to go bike riding that has lots of sharp protrusions along the trail and a bevy of mindless teenagers multitasking. In no time you should be able to remember exactly what things the other websites have to say on this matter.

If this has been helpful, I may add blogs on cutting fingernails with a lawnmower (I have done this very thing) and giving one's self a haircut with a chain saw (I have come close on several occasions). Remember, it is in the loss of skin, blood, fingernails and hair that the body sheds its iron.

In an hour I go to the Infusion Center to have Nurse Chappell take another pint. I may be less ouchy about the process today.

Iron Futures

The stock market has been taking a hit lately, even the S&P 500 where I have a small percentage of my investments. Years ago I decided that I would not be completely dependant upon the vagaries of the free enterprise system. Instead I determined to diversify economically. I thought that if I put most of my savings in Guaranteed Funds, say 60%, I could count on a constant though minimal return on my money. I decided to put 30% into Mutual Funds, specifically the Bond Market. A lowly 10% went into stocks, the afore mentioned S&P 500. I have done fairly well for that 40-year period and even though the stocks are all seeming to tank, my portfolio is still generating revenue. I have friends who have invested in gold, coins and bullion, and have given me to understand that they have gone very well for themselves. I have watched that commodity rise and fall hundreds of dollars an ounce and I cannot imagine anyone being bright enough to keep a handle on the market sufficiently to make money with gold trading. I suspect that the brokers do fine. however. I mention all of this because I think that there is only one precious metal that is making anybody, anywhere, any money at all: iron.

I mentioned in a previous blog entry that there was a time when I could go to the blood bank and sell a pint of my musical blood for about $25.00. That is in 1962 dollars. I hesitate to guess what that would be in 2008 dollars. In other words, I could go to the bank every six weeks or so and make about a third of my monthly salary as an enlisted man in the Air Force just by sitting quietly with a needle rammed into one of my veins for 20 minutes or so. As I indicated earlier, my visits did not appear to be profitable for the Red Cross or any one else, given the amount of juice and cookies that I would eat during the phlebotomy. I suspect, I do not know, that the blood banks must have been making something of a profit, however, when my blood came off the shelf. Certainly blood, particularly my winsome B+ kind, would have had some value to a man who was undergoing some other kind of "-otomy". Would he not be willing to pay a premium for a commodity that he was in dire need of? Would not the blood bank suggest that the blood which they had extracted from me at such great cost to themselves ought to require a substantial compensation? This is free enterprise at work and those willing to invest in a renewable resource like "me" must have thought to do well or they would not have started the bank in the first place. I do not know what their markup was and it probably just as well that I do not know. But every indication is that if you want to make money, buy iron.

Hemochromatosis was invented in 1995, at least that is when the medical profession began turning a coin by specifically treating the disease. I have yet to discover how much my "cure" is going to cost, but you ought to know that every time I go to see "Doc Holliday" I pay five dollars to the receptionists at the front desk. I think that DMBA and Medicare have to pony up a bit more, considerably more, astonishingly more, inconceivably more.... Well, you get the idea. Maybe when I am feeling just a little more effusive, I will run up to the bill box and figure out just how much the "Doc" and his gang are banking every time I go to talk with them. I did think, however, that it would be a helpful begining if I simply told you about the lucrative business of the phlebotomy itself.

To date, I have had two phlebotomies. One in August and again in September. I have already chatted with you about those visits and how well I was treated, how cheerily each of my jokes was received, how charismatic I was made to appear. In the end, I felt that giving my pint was a delight to everyone concerned. I now know that other than sticking the needle in and taking the needle out, with the addition of a couple of mess preventatives, I did all the work. First, the nurse wrapped a piece of rubber webbing around my arm so that my veins would bulge out more than they normally do. After finding a nice plump rise near the inside of my elbow, "Nurse Chappel" (a young Majel Barrett) would slide a "teensey-weensey" needle under the skin nearby so as to deaden the immediate area so that when she put the business end of the sump pump into my arm, I would not scream bloody murder. Once the sandwich-size ziplock bag was hooked up to the needle and the clear plastic tube, I was given a rubber ball upon which to focus my anxiety. "Just squeeze this, sweety", Majel said. Of course, when I did so, all of the rippling muscles in my forearm began forcing more of my blood into the bag. I suppose that the nurse could have created the same effect by pushing all of the blood from my wrists up toward my elbow. But, noooooo... she made me do it. I thought how much this was like milking a cow and that if she had put an electric milker on each of my fingers she could have saved both of us a lot of time and effort. After the pint was taken, the nurse put a cotton ball on the gaping hole in my arm and wrapped more of the rubber webbing on it to hold it fast so I didn't scatter sunshine all over the floor.

So, what did all of this cost my insurance company? How much overhead was involved in the extraction? How much did "Nurse Chappel" and her cronies profit by the ten minutes I was in the chair? I have an itemized list.

Building, suite, and cubical of the Infusion Center for 10 minutes: ($30,000,000, amortized over 35 years, at $1.63 a minute): = $16.30
Use of Nurse Chappell for 10 minutes ($25.00 per hour; $.42 per minute): = $4.20
Use of one 14-gauge needle for 10 minutes ($20.00 reusable for a year; $.00003 per minute): = $.0003
One sandwich sized ziplock bag: = $.47, (but they probably paid a bit more because it wasn't used for any of the staff's sandwiches).
One 3-foot plastic tube: = $.67, (but they probably paid more because it wasn't used for syphoning gas from my car in the parking lot; this time)
One really nifty cotton ball: = $.02, (but only because they were able to get it with about 4 billion others)
Two feet of sticky rubber webbing: $1.03, (but only because the alien suppliers from Alpha Centuri were overstocked this month)

If I have done the resulting math problem properly, the total overhead cost for each of my phlebotomies was $22.6903. The Infusion Center charged my insurance company $107.00, making someone a tidy profit of $84.3097. Well, it would have been a tidy profit had it not been for the $87.54 worth of root beer and Lorna Doones that I consumed during the operation. This profit/loss margin is known as "leveraging". They were hoping to make money on me, possibly with the sale of my commodity in mind, but alas, all was for naught since they had to put it in the trash can, the expense of which they also failed to consider.

As I said earlier, I went to the University Health Care Center last Monday in order to have a ferritin check done. Since I did not get any cookies at all during that five minute exercise, I suppose they are on a better foundation financially. "Doc Holliday" called me this morning with the results of my test. "Well, said he, "I have good news and bad news"

"Oh?"

"Yes. First of all your ferritin count is down to 591. Another 150 points and you will be down to high normal". I was pleased with that. I started out at 827 and after one phlebotomy dropped to 684, and now I am at 591 after the second one. Another couple of months and I will be completely under control, insofar as the hemochromatosis is concerned.

"That is really good to hear. What's the bad news?"

"You don't have to come to your appointment tomorrow."

"What's so bad about that?"

"Well, I was really hoping to take my wife to the Bahamas this weekend, but I think that I am going to have to put that off for another time."

"I'm sorry things didn't work out for you."

"Oh,that's okay", he said. "The New England Journal of Medicine just identified another genetic disease that I think that you just might have, and it has 'Paris' written all over it. Something about 'root beer and cookie' overloading."

Buy "Barq's" everybody. "Lorna Doones" are going through the roof.

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.