Once upon a time, I was going along fine resigned in the knowledge my time on this earth is some what limited.  Even knowing I was anemic didn’t seem to phase me. Except for some fatigue [possibly more depression related], I was still feeling reasonably well. At least as well as an anemic, 61 (soon to be 62) year old with a terminal illness could feel.

So why in the world did I have to notice the word “hypochromia” on my latest blood test? It was on the two previous tests, and I didn’t notice it. So why now?

If I hadn’t noticed it, I would still be merrily rolling along [pun intended] riding my bike 150 to 200 miles a week, drinking 4 to 5 cups of green tea a day, working 2 days a week, even planning some vacation or what not, with the sole intention of trying not to focus on anything negative.

But now that I have, it’s hard not to focus on the negative. Especially the colonoscopy, and likely endoscopy, needed to help determine the cause of the iron deficiency. I’ve had both procedures before, and neither were the most pleasant to endure, and which will be made even more problematic due to my enlarged spleen. (For all you doctors out there, it extends 4 fingers below my rib cage.)

So while I wait for my colonoscopy consultation (for which I’m not in any hurry), I’ve started taking an iron supplement, in the hope I can reverse the deficiency, knowing full well that any improvement may only be masking the real problem, and that a colonoscopy will still be required. But even that is presenting some issues.

I’ve learned, after doing much reserach, that taking an iron supplement is not such a simple a task. For one thing, the body only absorbs about 10% of the iron it consumes, and that many things can interfere with the absorption, including green tea, chocolate, and even wine, 3 things I partake in quite often, just to name a few. And then there’s vitamin C, something I have avoided (at least in supplement form) since my diagnosis with MCL, which aids in the absorption of iron.

Consequently, I now keep track of when I eat (and drink green tea), so I know when to take the iron (determined to be 1 hour before and 2 hours after eating) to maximize absorption.

Unfortunately that has caused another issue. Like the fact, it’s 10 AM and having just finished a cup of tea, means I can’t take an iron tablet until noon, and can’t eat lunch until 1 PM, but I’m hungry now.

This is when will power really comes in to play. I just hope I can hold out till noon, when I can at least eat the orange I brought with me (remember Vitamin C aids in the absorption of iron) when I take the iron.

Oh well, if nothing else this should at least aid in my quest to lose some more weight.

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Went to see my VA oncologist on Wednesday. I’m still not completely comfortable with him just yet. He seems conscientious enough, and is willing to spend time talking with me, going over the various options available, but at times he’s difficult to understand (he has a strong accent), and he is pretty young. Of course my Kaiser oncologist is young as well, so I can’t really hold that against him.

He’s also convinced I have Splenic Marginal Zone lymphoma (SMZL), not MCL, but I did point out that with the t(11;14) translocation, SMZL is not a likely diagnosis. I’m not sure he was convinced though.

In any case the treatments would not be much different, and he expressed a willingness to use Rituxan, as a single agent therapy initially, as the prospects for beginning some sort of treatment draw nearer, which is what I was hoping to hear.

So I am adapting, and I do realize at my age change is difficult.

Anyways, my counts were basically stable, including my hemoglobin and platelet counts. Platelets were even up to 194 thou/cumm, but I have always found the VA lab to be slightly higher in all readings, even with the same reference ranges. Obviously it has a lot to do with the equipment and the techs interpreting the results.

There was also something new this time on the report, hypochromia. Briefly speaking, hyprochromia is an indication of a lighter than normal color of the red blood cells, obviously due to my anemia, and likely resulting from an iron deficiency.

I know I eat plenty of red meat and other foods with iron, so maybe it’s time to break from my policy of not taking any vitamins or supplements, and start taking an iron and folic acid supplement. A few people, including my Kaiser oncologist, have suggested I take them, indicating they would only be of benefit (much like a flu shot I guess), but I have been stead fast in refusing.

But who knows, maybe it will help with the overwhelming fatigue I have been dealing with lately, and even delay the progression of my MCL and the necessity for more aggressive treatments.

Ok, I guess I’ve talked myself into it. I’ll just call it the start treatment instead of the taking of vitamins or supplements.

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