Archive for February, 2014

SCD

Pain.  Acute, harsh, and without relief.  Beginning from one mutation in the genome and setting the cadence of life for the rest of your existence.  Hemoglobin, the protein that is supposed to transport oxygen throughout the body has revealed an abnormal configuration, redefining itself and bending your red blood cells to its own design.  Like an osteoporotic man who, far from being full of life is bent, curved over a cane.  Perhaps it foreshadows your future with the pain bending your body to its will.

It’s not supposed to be like this.  Blood cells are designed to flow through vessels with ease.  They aren’t supposed to become stuck in the periphery, jolting and scraping you from the inside out like a relentless animal clawing to be released.  There is no release from the grip the animal has because even if you were to drain every last drop of blood from your veins, your marrow would produce even more of these devious and defective cells.

Hereditary.  Incurable, except for the life-threatening bone marrow transplant procedure that renders your body’s defenses completely unprotected for a time.  Only by the skill and diligence of the medical team will your life not end by a misdirected cough.  Then if you make it through the months of treatment, there is the very real risk of graft versus host disease that could kill you before your disease ever would.

And without the transplant comes the crisis.  Sickle cell crisis.  Perhaps once a year, perhaps once a week.  A fire burning harsher than before with crippling pain that you try and eradicate from your voice as you speak with the 911 operator.  Problem?  Pain.  Scale on 1-10?  10.  Yes I’m being skinned alive.  Ten minutes?  Thank you.

To quell the pain you inundate your system with meds simply to function.  When the 5, 10, 15 pills a day don’t suppress the beast, you clamor for something stronger.  IV morphine, dilaudid, whatever the flavor of the month is.  Whatever pushes back the gut-wrenching, mind-dulling agony back to the depths from whence it came.  And if a nurse’s needle isn’t enough will you turn to something else?  One joint?  One line?  Will there ever be an end if you travel down that dark path?

Maybe you’ll succumb to it, but not now.  One positive urine and it’s a wrist slap, but more and the only relief will be of the illicit nature.  Until then you pray, hope, yearn for the day that a brilliant mind solves the case.  To provide hope would be brilliant.  To provide a cure would be freedom.

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Each inhale; every breath of thickened, sickly air passing through your mouth brings that smile of satisfaction to your pursed lips. Or is it a grimace? Knowing that each breath brings a chemist’s concoction of compounds into your mouth, down your throat and finding a resting place in your lungs. All three regions welcoming whatever carcinogenic particles happen to spin off and wreak havoc on the cells they encounter.

Some cells, of course, will simply die: overwhelmed by the chemical load, deprived of oxygen or by some other way, eliminated. For you, that must be the best-case scenario since these cells will not resurrect as something else, something that will continue its carnage long after it should have expired. When spontaneous apoptosis due to an overwhelming number of toxins is the most favorable outcome of an encounter with your nicotine vice, what is least favored?

There are those cells with an insatiable urge to reproduce: to copy themselves and divide until they are noticed by the body’s defenses. With luck you have a first-rate immune system and the soldiers in your blood defeat this attack, losing ranks with every successive puff. 100 cells, 1000 cells? Whatever sacrifice is needed to keep you alive, only to wrap your lips around that moistened filter and puff on that cigarette again. How many puffs a day? How many cigarettes? How many packs? How much can your defenses take before their numbers are depleted faster than they can reproduce? What if they miss a lesion? What if one cancerous cell in the lungs is all it takes for the intruder to take hold and grow? Nurtured by recruiting your own blood vessels, sending out their alien messengers that tell your body, “It’s fine, normal growth here. Just be a dear and send some more nutrients. I do, after all, share your DNA. For the most part.” But what part? And your body, recognizing a semblance of itself in the bulbous node, accommodates the request.

This relationship, a slowly growing tumor within the pleural tissue of your lung can only last so long. After a short time, the tumor begins its subjugation and your body didn’t realize it would become such an ungracious houseguest. Maybe it starts with a pain in the chest, the ball of alien cells compressing sensitive nerves. Or maybe the cough that lingers just a bit too long produced a speck of blood on that last tissue. Too bad that it’s probably too late. Not much of a warning.

But then there was that one warning. Or several. The surgeon general has become a dull hammering in the background. The gruesome but true effects of smoking printed on the cartons will become something else to look over.  I suspect it will desensitize the consumer even more.

I truly hope you enjoyed that final drag on you cigarette because it may not be your last but it could very well be the beginning of the end.

Quarters: Spring 2013

Posted: February 13, 2014 in Life in General

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My life, as it is, is characterized and organized by the quarters of the year; slices of the year that for one reason or another held a specific feeling or event.  Looking back at almost exactly a year ago, the first major quarter of my recent past was the spring(ish) quarter of 2013.  Leading up to this time (Winter quarter 2012), I had been hard at work gathering my application to an accelerated ARNP program.  After an unnecessarily devastating rejection (I’ll explain in a later post) I decided on taking the slower route through nursing school (still in process).  The dismay I felt was certainly lessened since my first child and daughter; Alexie was born on February 28th, 2013.  To describe the occasion as monumental is a serious understatement.  With minor (though the term is laughable to new parents) complications in the labor and delivery, Alexie had to stay in the NICU for five days following her birthday.  The time spent in the hospital held for me, an incredible spectrum of emotions.  Here let me take you through the day, literally 24 hours:

7am on February 27th, 2013:

  • Disbelief and excitement when my wife, Molly’s water broke.
  • Nervousness and sympathy on the drive over as Molly began contracting.
  • Frustration and mild irritation when, upon arrival they told us to go home since she wasn’t quite in active labor yet.
  • Relief and fear when she began active labor and was admitted.
  • Commiserating pain with each contraction.
  • Frustration again when she couldn’t get the epidural for over an hour after she wanted it (The anesthesiologist had just gone into a C-Section)
  • 5:45am: Euphoria when Lexi was born and an overwhelming feeling of responsibility and love for this little blessing from God.
  • Devastation when we realized something was wrong (they weren’t very vocal about it during/after labor, which in hindsight was probably a good thing) and that Lexi had to be kept in the NICU for at least 2 days (she ended up staying 5)
  • Helplessness that I couldn’t bring Molly down to visit Lexi for a couple hours since she was too lightheaded to travel

Then when we were able to bring her home, 5 days after her birth: Disbelief and nervous excitement that the hospital (and God) would entrust us to take care of this tiny little life.  There were so many more emotions throughout that week but I could clearly see how God saw us through the first few weeks and months of Lexi’s life.