Wednesday, February 20, 2002

I've been sick.

I guess all of you have heard at least a little about the fact that I've been experiencing a prolonged, rather bizarre and potentially worrisome illness. That great purveyor of information, Mom, has let you know some of the details, but since she hasn't known all of what's going on (hell, I don't really know what's going on), I thought I'd send out an update about what we think is going on, what we know and what we're worrying about.

About a month ago I got a hepatitis A shot, since Kathy and I travel a lot, and go to Mexico a time or two each year. A few days later I started having body and joint aches, which are said to be common side effects (in 20% of those getting the shot), but I didn't worry too much; just took tylenol for the aches and waited for it to go away. Kathy got the shot too and had no side effects whatever.

After about six days I started running a low grade fever too. I took more tylenol and Motrin and waited for it to go away. After about two weeks of aches and fevers and feeling so weak that I had trouble climbing the stairs, I went to see a doctor. Now, you need to know that I've never been to see another doc since I became one except for hernia and knee surgeries. That'll tell you how bad I was feeling. We did a blood count and found my white cell count to be over 20,000(about 6-10,000 is generally normal). More interesting (?) was the fact that most (70%) of the white blood cells were lymphocytes (about 10% is normal), not "segs" like you generally see in an acute bacterial infection. Lymphocytes can be elevated in viral infections, but viral infections usually lower the total white count but raise the percentage of "lymphs" (ie, a virus would be expected to drop my white count to,say, 4 or 5, 000 while it raised the percentage of lymphs).

A couple of days later I was feeling worse, temps of 101 or so. I went back and had more tests done. Now we found that I had abnormal liver functions as well. The good news was that I was negative for HIV, hepatitis (at least, the A, B, C, D and G forms), mono (which I was SURE I had), and the so-called "Torch" viruses (don't ask).

I felt so bad, I was off work for essentially two full weeks. I've never missed two weeks of work or school in my life!

A week after my first battery of labs had been done we repeated the blood count and liver functions. One week ago. my white cell count had dropped from the initial 20,000 to 14,000, still very high, but improved. I still had 66% lymphs, however. The liver functions were also improved, but abnormal.

We repeated the labs again yesterday; the liver functions continue to improve, but my white count is back up to 18,500, with 70% lymphs.We repeated the mono test and it's still negative.
Now, my internist, who is a real doc and not a gynecologist like me, says he thinks this is just a rogue virus of some kind and that everything is likely to resolve without any further intervention. I can find nobody that really thinks it was caused by the hepatitis A shot (hey, Bob,could I shake down the drug company for some cash for this, maybe?).

The worry is that a high white cell count with a lot of lymphs could be chronic lymphocytic leukemia, the kind that dad had. The pathologists are looking at my white blood cells today and are considering more sophisticated testing to rule this disease in or out. And that's where we stand, as of tonight.

I'm actually feeling a lot better (but not totally well) and was able to operate all day yesterday (three useless uteruses removed from their former owners!) and work in the clinic today.

I'll let you know if I hear more about my white blood cell smears and any other tests we do.

And now, I've got to go do my Peregrination (hey, I got a note from my doctor saying I could be late; what's YOUR excuse?).