Friday, June 02, 2006

This is a true story.

This is a true story. My memory was prompted by Jenny Lou's posting that a watery discharge from the eye turned into white pus after steroids.

It happened about 20 years ago, before we had acyclovir. In those days I had a patient with a very high white count, well over 400K, with massive lymphadenopathy - glands in the armpits about 15cm in diameter - but a normal haemoglobin and platelet count. His serum immunoglobulins were just about undetectable; this was also before iv Ig. Every time we tried to give him chemotherapy he developed widespread herpes simplex lesions all over his body.

In desparation we turned to leucocytapheresis to control his disease. This was quite an ordeal for him as he was 87 years old, but he bore it patiently and even developed an interest in teh creamy solution we were extracting from his blood.

After several session he approached me after the nurse had gone home for the afternoon. "Doctor, I think I have discovered why I have this CLL."

I'm always interested in new theories, so I played along with him, "What do you think it's caused by then?"

"I haven't had sexual intercourse with my wife for 37 years," he said, "it's back pressure."


Jenny Lou said...

I am so laughing......your sense of humor is up there with my favorites!! You Rock Terry.

Steve Madden said...

Making note in "101 CLL pick up lines". Now how do I get into a clinical trial for back pressure therapy.

Terry thanks for the laugh.

Steve Madden said...

I do note that the wikipedia does have a picture of a lymph node with a back flow valve.