22 May 2020

Sickle Cell Anemia, Aplastic Crisis, Aplastic Anemia and a Virus

Bone Marrow Diseases (AA&MDSIF designation) Awareness Ribbon
I had a younger cousin who, when we were barely entering teen years, lost a gallant battle with aplastic anemia that had lasted a few very long years.  His father being in the Navy from which he eventually retired, the Navy covered the cost of treatment which included increasingly long hospital stays.  Ronnie was kept aprised and knew as much about his condition and treatment as the team treating him, more in some cases associated with the specific hospital care he required.  He was going to be a physician if he lived.  I still vividly recall the day of our Grandfather's funeral when all of us cousins took a walk to Grandpa's woods and sat around quietly on stumps for a while, in reverie, before returning to the house.  Ronnie broke the silence, calmy and quietly stating that he was going to die - and did approximately nine months later.

After nearly 40 years in which we never spoke of Ronnie, his brother finally talked to me about him.  The illness and loss had caused deep sorrow in the entire extended family.  He told me that the protocol created to treat his brother eventually resulted in the first successful effort to prevent a patient's death from Aplastic Anemia.  He also said Ronnie's medical records are still studied by medical students and fill up an entire room.  Additionally, he said that flexible IV containers were created to replace the bottles, initially, because of the demands of Ronnie's treatment.  Ronnie had needed  numerous and repeated blood transfusions for two years. 

My cousin finally seemed at peace with that part of his life that had been a widely share grief.  And it was an amount of closure for me.  Even though Ronnie did not live to become a physician, that he had more or less been the successful "test case" at the center of and focus of a team which finally created a successful treatment,  means that because of the suffering he endured which caused extensive grief for so many including those who studied the case and treated him, people have since been able to regain their health from a condition patients did not recover from in the past.  Until then I had only known that Ronnie had been treated at a Spokane Hospital (Sacred Heart, where my life had be spared, twice before age 2 1/2), and that the Navy and covered the cost of treatment.  In later years I learned that Walter Reed Army Hospital had become renown for treating Aplastic Anemia.

Additionally, until I read this relative short article a few months ago,"Aplastic Crisis", I was unaware in what ways Aplastic Anemia is connected to and similar to Sickle Cell Anemia, other than both being blood disorders.  It looks like they are very closely connected, even though they are each a result of differing causes.  It looks like Sickle Cell can be exacerbated by a virus, and that a virus could be the cause of Aplastic Anemia which, from what the article, says seems to be a permanent aplastic crisis that does not resolve on its own and then requires much more complex treatment. The article states that what causes an aplastic crisis is usually a virus, commonly Parvovirus B19, but that "other viruses besides parvovirus can cause an aplastic crisis."  The article makes the connection clear - at least clear enough for me have learned more - enough more to have new questions in place of the long-term old questions. 

Apparently a temporary "aplastic crisis" is a HUGE problem for folks with sickle cell anemia.  This article provides insight into the problem of an aplastic crisis.  Given the fact that people without Sickle Cell can also experience an aplastic crisis, and the fact that  a virus can create problems for people with Sickle Cell by causing an aplastic crisis, it seems possible to deduce that a virus can induce an aplastic crisis in anyone, in conditions where the immune system has been weakened, whether or not a person has Sickle Cell.  It may even be possible to extrapolate that long term effects of a virus being present could cause a condition of permanent aplastic crisis in anyone, or something like it perhaps in those with Sickle Cell who would suffer from the problem much sooner than most. 

Labeling of the medical condition as "Aplastic Anemia" suggests, to me at least, that it could be considered a permanent aplastic crisis.  Like Aplastic Anemia a permanent aplastic crisis would require much more complex and extensive treatment efforts to  attempt to undo the damage and restart the normal bodily processes which create healthy red blood cells.  I do not know if the protocol that was a result of my cousin's condition can be and is used, in some revision or another, for extreme cases of Sickle Cell, but it seems reasonable to imagine so, depending on the severity of the Sickle Cell case, that it would be and has been, whether or not there has been an episode of aplastic crisis from which a person with Sickle Cell has recovered.

That this came to my attention in current time and place several months ago, connecting it to current issues seems called for even though "a virus" is ubiquitous terminology.  Even so, it suggest to me that it would be wise for the medical field, for everyone, actually, to be vigilant about the possibility of unexpected "novel corona virus", CoVid-19, side-effects, some of which seem to already be more common in children.  In the "better safe than sorry" category, seems to me it would be advisable to be vigilant about the possibility of aplastic crisis as a later side effect of Covid-19, in some, especially in those who may be more immunocompromised at times - thus more at risk - like people with Sickle Cell Anemia.

15 May 2020

2020 Hindsight and Foresight

Wondering how many other folks are tired of feeling like we are all living as test subjects in a medical school experiment in cahoots with the psychology folks' experiments (emotions causing psychosomatic illnesses) - individuals in both demographics cooperating (in some cases unbeknownst) with government's efforts to try to create dictatorial tyranny in nations where it does not already exist.  That seems the intended outcome of diligently using all forms of media to create confusion for everyone about causes and effects of CoVid-19 which cavalierly has lead to a lot of victims as collateral damage due to ill intended chaos which has spawned unavoidable incompetence. "Victims" because people, rightfully so, are not willing to be self-sacrificial at the altar of obvious corruption. The motives of the efforts?  Apparently they are personal gain, and support of personal gain for all those who enable the incompetence and ill-intent which more or less have been having the effect of feeling like concentrated efforts from many directions to create dictatorship since the start of the year.  How else can the well planned chaotic unpreparedness that has been intent on creating cognitive dissonance in as many people as possible, be interpreted?

That method is an effective way to wear down entire populations of people so that their day to day struggles eclipse, as a  priority, their recognition of what looks like and feels like contradictory and bungling efforts to create tyranny - the corrupt bungling not being as obvious when people are a captive audience focused on survival issues, due to circumstances.  Fact is that many of us had parents and/or grandparents who taught us about these types of corruption as hallmark efforts which resulted in destruction of the economy and lead to WWII.  Perhaps all war (whether one-sided, two-sided, or world-wide) is a result of similar efforts of people in government with dictatorial intent to build empires at cost of entire populations of people - their own and those in other nations they want to occupy and colonize.

Where is this leading?  Well, only partly to wondering if other folks were sent e-mail from census.gov asking covid questions "for statistical purposes"; questions inquiring about emotional states associated with income being interrupted, worry about not being able to pay bills, needed products not being available, food insecurity,  negative feelings of depression, hopelessness etc.   So why has census.gov been tasked to do this - an added task in a census year?  Why not at least wait until the end of 2020?  After all, when we make time to pay attention, timing can be everything!  Is it an effort to try to understand how successful the unreasonable facsimile year of 2020 has been, so far?  An effort to have statistical results ready by the end of June which is only half way through the year?  Are results intended to dictate revisions to the path forward for those who have so egregiously conjoured up the schedules of events for 2020? 

Does it help to know this is not the first rodeo for many of us; to know that we have reasons for well-founded suspicions associated with the intent of obvious corruption - obvious even without the substantiating facts which time will reveal?