Wednesday, February 22, 2012

Rheumatology

The rheumatologist was young-as young as my daughter. Now that I think of it, almost everyone looks young to me these days. She was very bright and very thorough. She spent over an hour taking a full history, discussing my health, doing a physical exam.

She ordered a repeat ESR and an electrophoresis. The ESR was up to 65 and the electrophoresis interpretation was “AN ABNORMAL PROTEIN BAND IS DETECTED IN THE BETA GLOBULINS AND MAY REPRESENT A MONOCLONAL IMMUNOGLOBULIN OR LIGHT CHAIN. THE GAMMA GLOBULIN APPEARS DECREASED.”

Well, I’m not a doctor, but I have walked with my dad through this and I recognized the term “monoclonal immunoglobin.” My dad has Waldenströms macroglobulinemia (WM) and it all started with similar test results. The exact cause of WM is not known. However, scientists believe that genetics may play a role because the disease has been seen to run in families. Waldenströms  is a rare type of slow-growing, non-Hodgkin lymphoma-that is, a cancer that begins in the cells of the immune system. It causes overproduction of a protein called monoclonal immunoglobulin M (IgM) antibody.

The rheumatology nurse called and said I need to get into a hematologist pronto. She made an appointment for me for the following week at the Cancer Center. Wow. This all started with vague symptoms and a slightly elevated sedimentation rate and now I’m headed to the Cancer Center. My dad was not diagnosed until he was 80. I felt kind of shell-shocked. As is my custom when I am upset, I started talking to God about it.

I asked God to make me strong; more than anything else, I want Him to be proud of me. I asked Him to use my situation, whatever that turns out to be, as a catalyst to move people toward Him. I want to be more intentionally open to others about my love for Jesus and what He has done for me. Every other religion requires you to do the work and pay the price in order to be “acceptable.” Christianity is the only religion where God Himself paid the price required in order for me to be accepted. I asked Him to be glorified in my life. I asked Him, when it is time, to empower me to die well: honoring Him and loving people.

People would ask me, “How are you holding up?” and I’d surprise both them and me when I’d say, in all honesty, “So far, I’m fine.” I guess I am able to put off anxiety until I know for sure. FINALLY-my tendency to procrastinate has a purpose- I’ve been waiting a long time for that to happen. God has been with me through all the high points of my life, and through all the valleys of despair. He has never deserted me; He has always brought me through to a better place. Why would I doubt Him now?

My husband, my daughters and my friends have all been praying for me and I know that God is allowing them to participate in His work in my life. Every once in a while something will ambush me-words of a song, a photo of my granddaughter, a hummingbird at the feeder-and I tear up. But most of the time I feel peace-a peace that is not really consistent with the circumstance I find myself in. When I’m in that place of peace, I realize that I’m in a win-win situation; if I die now, I get to go be with Jesus. If I don’t, well, I still get to go be with Jesus, I just need to wait a little longer.

Scripture reference: 1 Peter 3:18; Romans 5:10, Colossians 1:21-22
Read my father’s blog: http://georgefield.pathiwalked.com/






Sunday, February 19, 2012

Early warning

My grandmother was a consummate gardener. She was also a woman of strong opinions, given to pithy and somewhat acerbic comments. I remember as a child hearing her say, with some passion, “Getting old ain’t for sissies!” I have come to believe she was right.

Like my grandmother, I am a gardener and I tend a large garden. My husband built it, a lovely series of raised beds and terraces flowing down a hillside. It is a joy and a privilege to have this vast playground in which to experiment, labor and create. I’m afraid my other responsibilities have sometimes been shirked during the season as I would spend 8 hours of the day out there immersed in the beauty and the demands.

Being in the garden can be a spiritual experience. It is hard for me to separate gardening from God; He is everywhere I look. God tells us that His invisible qualities-His eternal power and divine nature-are clearly seen, being understood from what He has created, and so it is. From the intricate beauty of individual flowers, to the power of the windstorms, to the green nubs of perennials that poke up in early spring promising renewal, God’s incredible creativity and His authority over His creation are constantly demonstrated to me.

Late winter is, counter intuitively, a busy time for a gardener here in the Pacific NW. Leftovers from last year which remain for the benefit of the birds or perhaps for winter interest must be trimmed back. The beds must be cleaned and tidied up in preparation for a blanket of mulch. The mulch will moderate temperature fluctuations in the soil as we head into spring and avert the takeover being planned by shot weed lurking in the shadows. We use about 20 yards of good compost to make a 3-6” blanket over all our beds.

I am not someone who enjoys exercise, but I love gardening so much that I use an elliptical in the off season so I’ll be ready for late winter. In January of 2010 I noticed that, despite my resolve to stay fit, I was moving very slowly. I was only able to work a few hours a day and then I’d be exhausted. I presumed that in a month or so I’d have gotten back into shape and up to speed.

Instead, the fatigue continued and I noticed that I was having a lot of joint pain, especially in my hands, wrists and-most annoying-elbows. I coincidentally had a conversation with a friend, a Master Gardener, who had been recently diagnosed with rheumatoid arthritis. She mentioned that the symptom that drove her to seek a diagnosis was pain in the elbow joints.

I visited my doctor for a physical and explained about the fatigue and joint pain. I have a history of infrequent migraines, but I’d been having some headaches that were different-sort of localized, severe but short lived and recurring. He ordered all the standard lab tests and I asked him to include a rheumatology panel-just to eliminate the possibility that I had RA or some other joint pain disorder. It turned out that my sedimentation rate (ESR)  was elevated-although not dramatically. Zero-20 is considered normal; mine was 50. An elevated sed rate can mean almost anything-inflammation from a cold, overworked muscles-or auto immune disease.

My physician was not concerned about the sed rate but he is very collaborative. My daughter is an MD and she felt that since I was over 50 years old and I was also having unusual headaches that I should take the time to see a rheumatologist and rule out temporal arteritis. So, I obediently made an appointment with the rheumatologist for 3/02/10.

For pictures of my garden see my garden blog: www.susiesgarden.com
Scripture reference: Romans 1:19-20