One Day at a Time: Dem bones, Dem bones....

Monday morning I had a bone marrow test, and yes I had worked myself up into a bit of a tiz about it, and no it wasn't as bad as I thought! Im still a bit sore but nothing else, the results will take 4-6 weeks to come through .

I have an appointment at the hospital on the 4th September, although Dr CM is not expecting to see much except a few tired bone marrow cells.....charming.

Whilst I was there he took the opportunity to give me a blood test, followed by a G-CSF injection. (G-CSF (granulocyte-colony stimulating factor.) This helps your body to make more white blood cells.) He wanted to see how my blood cells reacted to the drug, and so I went back to have another blood test Tuesday and compared results.

I started off with a white cell count of 1.8 (the lowest) and finished up at 8.2 (8.0 is the high in the 'normal' range. So at least (as we know through the chemo days) my body does respond to the injection.

Then we chatted (actually he chatted I sat and listened trying to make sense of it ) about MDS - fair to say its not the most cheerful subject, but one that applies to me. I did a bit of research and came up with this :-

Myelodysplastic Syndromes (MDS) are a group of diverse bone marrow disorders in which the bone marrow does not produce enough healthy blood cells. MDS is often referred to as a “bone marrow failure disorder”. MDS is primarily a disease of the elderly (most patients are older than age 65), but MDS can affect younger patients as well. To help you better understand MDS, it might be helpful to first consider some basics about bone marrow and blood. The bone marrow functions as a factory that manufactures three kinds of blood cells: red blood cells, white blood cells, and platelets. Healthy bone marrow produces immature blood cells — called stem cells, progenitor cells, or blasts — that normally develop into mature, fully functional red blood cells, white blood cells, and platelets. In MDS, these stem cells may not mature and may accumulate in the bone marrow or they may have a shortened life span, resulting in fewer than normal mature blood cells in the circulation.

Low blood cell counts, referred to as cytopenias, are a hallmark feature of MDS and are responsible for some of the symptoms that MDS patients experience — infection, anemia, spontaneous bleeding, or easy bruising. Anemia (low red blood cell counts), neutropenia (low white blood cell counts), and thrombocytopenia (low platelet counts) are the major types of blood cell cytopenias, and are discussed below. In addition to reduced numbers of blood cells, the mature blood cells circulating in the blood may not function properly because of dysplasia. The formal definition of dysplasia is the abnormal shape and appearance, or morphology, of a cell. The prefix myelo- is from the Greek and it means marrow; so myelodysplasia refers to the abnormal shape and appearance — or morphology — of the mature blood cells. Syndromes comes from the Greek and means a set of symptoms that occur together.

Failure of the bone marrow to produce mature healthy cells is a gradual process, and therefore MDS is not necessarily a terminal disease. Some patients do succumb to the direct effects of the disease: reduced blood cell and/or reduced platelet counts may be accompanied by the loss of the body’s ability to fight infections and control bleeding. In addition, for roughly 30% of the patients diagnosed with MDS, this type of bone marrow failure syndrome will progress to acute myeloid leukemia (AML).

WHAT CAUSES MDS?

With a few exceptions, the exact causes of MDS are unknown. Some evidence suggests that certain people are born with a tendency to develop MDS. This tendency can be thought of as a switch that is triggered by an external factor. If the external factor cannot be identified, then the disease is referred to as “primary MDS”.

Radiation and chemotherapy for cancer are among the known triggers for the development of MDS. Patients who take chemotherapy drugs or who receive radiation therapy for potentially curable cancers, such as breast or testicular cancers, Hodgkin’s disease and non-Hodgkin’s lymphoma, are at risk of developing MDS for up to 10 years following treatment. MDS that develops after use of cancer chemotherapy or radiation is called “secondary MDS” and is usually associated with multiple chromosome abnormalities in cells in the bone marrow. This type of MDS often develops rapidly into AML.

Long term exposure to certain environmental or industrial chemicals, such as benzene, can also trigger MDS. While benzene use is now highly regulated, it is not clear which other chemicals may predispose individuals to MDS, although certain occupations have been labeled “at risk” for the development of MDS or AML (e.g., painters, coal miners, embalmers). There are no known food or agricultural products that cause MDS. While alcohol consumed on a daily basis may lower red blood cell and platelet counts, alcohol does not cause MDS. There is insufficient data available to determine if smoking increases the risk of developing MDS. However, it is known that the risk of developing AML is 1.6 times greater for smokers than for non-smokers.

Patients and their families often worry that MDS might be contagious. No evidence exists to suggest that a virus causes MDS; thus, MDS cannot be transmitted to loved ones.

MDS is not inherited. In fact, it is a very rare occasion when family members, including siblings, are diagnosed with MDS.

As I said although it's fascinating ( and I've never been down a mine, just the odd pothole on a school trip) Its not the sort of information that you want to be reading about yourself.

Good job we can't look into the future. "Most of the things in life we have no control over-but we do have a choice about how we see them"

To finish the week off nicely I have a mammogram booked in for tomorrow (good luck to whoever is on duty at the hospital- you'll need a magnifying glass) At least my chest xray came back as normal ( husband chips in that its the first time I've had a 'normal' chest). There is no fluid, which would have explained the breathlessness, which, by the way is getting better.

The picture gallery as promised...

Surprise guest AB!!