Update on Marian

Marian's white count came down a little more today. It is now 37.8. When she began treatment it was over 50K. She is responding well to CAL-101. But she has developed another problem, which seems to be completely unrelated to her CLL and treatment.

Her blood calcium level is 11.5. Normal range is anywhere between 8.8 and 10.2. So hers is significantly elevated. It was detected two weeks ago in her regular blood work. She stopped taking calcium supplements and had a follow up test today. It was still elevated.

About a month ago, Marian started telling me she was more tired than usual. But I didn't worry about it, since she is 78 years old. Between her age, the stress she's had this year, and having CLL; I thought ... Who wouldn't be tired? But after her last checkup and the phone call about her blood calcium level being high, I started doing my homework on the probable causes of high blood calcium. And I immediately noticed other symptoms I had been attributing to her age.

When she arrived yesterday, she told me she was so tired she felt like taking a nap. Marian never says that. She told me she had been having to make herself eat lately because she didn't have much of an appetite (another symptom) and that she had lost a little weight (another symptom). But when she said, "I think I've lost my taste for wine. I haven't even wanted any. I try to drink it and it doesn't even taste good..." I said, "Houston, we have a problem."

This morning as we were leaving for her doctor's appt., she said she felt so weak and it had worn her out just getting dressed. I could tell she really felt bad. She told me she didn't like the way she felt and it was all she could do to put one foot in front of the other. I just knew her blood calcium level was still elevated.

In my online research, I was reminded of something I knew (and had forgotten). High blood calcium is almost always caused by hyperparathyroidism. The parathyroid glands control calcium in the blood. There can be other causes, but they are rare. Ninety-nine percent of the time, the cause is parathyroid disease. And removal of the parathyroid gland that is not functioning properly cures the problem.

I called this afternoon for the results of today's blood test and, as I expected, it was still high. So I called an ENT surgeon in Evansville whom Marian has seen previously. And we took the next available appt. of January 7. I will drive up there so I can go with her. If he rules out her parathyroid as the cause of her elevated calcium, then we will have to investigate other possibilities. But it only makes sense to me to address the "99% of the time" culprit first. And since I've read that primary care physicians often misdiagnose this condition, I thought we'd save a little time by going straight to the specialist.

Even though hyperparathyroidism is treated with surgery, this would be the most simple problem to cure. And from what I've read, a surgeon whose expertise is in this area can perform the surgery in about twenty minutes and send the patient home the same day.

Jeff (John's brother) and his wife Lu just came to get Marian and take her to their house in Madisonville for a few days before she goes home. She was concerned about being able to drive herself tomorrow. She has slept most of the day.

If you're one of her friends back home in Evansville, be sure to call and check on her next week. And tell her Shari told you to remind her to make herself eat and stay hydrated. : )

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