Yesterday, I had my second appointment with my third hematologist. Dr. Alfredo Lopez is a really likable guy. However, I have to admit that during the two months since my first appointment with him, there were times I was perplexed, annoyed, concerned and even angry with him.
Dr. Lopez kept telling me to just keep doing what I had been doing, from a treatment perspective. This didn't make sense to me since I was moderately to severely Neutropenic almost the entire time. (Neutropenia is what it is called when you don't have enough infection-fighting cells.)
I wanted to believe that it was alright not to worry, since he didn't appear worried, but I was afraid he just wasn't paying attention. I was afraid I would get sick with an infection I could not fight, become seriously ill and possibly even die because that's was what I kept reading (and have been told) could happen to someone who is severely Neutropenic.
Yesterday, Dr. Lopez explained that he and a team of hematological experts have reviewed my bone marrow. Apparently, all of them are in agreement about what it looks like. He said it looks like I have an immune mediated condition.
What does that mean? I'm still learning but according to Wikipedia, Immune-mediated diseases are conditions which result from abnormal activity of the body's immune system. The immune system may over-react or start attacking the body. Autoimmune diseases diseases are a subset of immune-mediated diseases.
(The idea that I might have an autoimmune disease has come up a few times. Autoimmunity is the failure of an organism to recognize its own constituent parts as self, which allows an immune response against its own cells and tissues.)
While I had been discouraged by my number of Neutrophils (a specific type of infection-fighting white blood cell), Dr. Lopez was encouraged by my total white blood cell count. He said it was super.
He said my counts are at a functional level and he believes this is because I have had a nice response to Neupogen (the medication that was supposed to help me make white blood cells).
He's also very encouraged that my condition has stabilized. (I was sick before. I haven't been sick lately.) This has been encouraging to me too.
However, Dr. Lopez says there is something going after my infection-fighting cells and knocking them down. He said this thing thinks there is something wrong with my infection-fighting cells (which is not the case. I just have less of them than I should.)
He stressed this point, that there is nothing funny, sick, weird or abnormal about my infection-fighting my cells, several times, saying it was key and really important.
Even though the quality and function of my infection-fighting cells is good, he said there is a mother cell driving them out. When I was explaining this to Cam & Sam last night, Cam said it was like the Death Star was attacking me. Death Star: an instrument of terror posing threat of annihilation...
So where is my Death Star? Dr. Lopez thinks it is my lymphocytes. Lymphocytes are a type of white blood cell that plays a large role in defending the body. They make antibodies that attack bacteria and toxins or even attack body cells directly when they have been taken over by viruses or have become cancerous.
Dr. Lopez thinks mine are confused and attacking my Neutrophils. So what do we do about it?