16 November 2010

me and my ANCAs

They have been with me for at least ten years, i.e. that's when they were detected first but who knows how long they have made their home in my body.
No, no, to be fair to these little critters: who knows how long I have been producing them.
ANCA stands for antineutrophil cytoplasmic antibodies and there are different types, cousins so to speak. My variant is p-ANCA which stands for protoplasmic-staining antineutrophil cytoplasmic antibodies.
They are busy little creatures actively involved in targeting my white blood cells or parts thereof anywhere in my body. They will stay with me for good since I am actually producing them myself, see.

Some time ago - and the guesswork includes several scenarios ranging from a miscarriage in the early 1990s, some tropical bugs during my Africa/India years, an overreaction to penicillin in 2000 to space invaders and goblins coming during the night - my immune system (now there is another entity open to guesswork) messed up and went into overdrive, a programming error sort of. And since then it has produced ANCAs in reliable regularity.

That in itself is not the problem. It needs to be watched, ok, but who knows how many people have a slight hitch in their immune system. The tests are expensive and labour-intensive and there isn't a health system in the world that would do this routinely.

The first I knew about them was when a routine health check in 2000 showed that my liver was not well. And the liver is a fairly sturdy organ, all smooth and broad and busy day and night. And it knows no pain. Your liver can pack it in and all you notice at first is that you have a tan and need to sleep more. So when all the usual suspects (various hep viruses, alcohol, obesity) were excluded the serious testing and probing started and bingo, ANCAs were found and my liver was biopsied and the face of the youngish hepatologist was all businesslike when he suggested that I put my name on a donor list as - ahem -  this could mean liver failure in five years.
Well it didn't: my liver decided to recover and is doing well, thank you.

Some years later, my intestines started to act up and to cut a long story short: the critters had found a new playground. But there they have behaved themselves sort of. I throw some benign medication at them every morning and go about my diet a bit more carefully and all is well above, behind and below my belly button.

Boredom must have hit them, because next, my ANCAs discovered my eyes, messing about with one cornea at a time, throwing little ulcers here and there. Nothing dramatic, nothing that a few drops of this and that couldn't clear in time. After a year they dropped the eyes and went into hiding.

So, we  - me and the various medical experts who I have come to know thanks to my immune system - let them be, monitored their levels and hit them with this and that when they got a bit overactive.

Me and my ANCAs, I used to joke when asked, we have come to an arrangement.

Little did I know... as the narrator says in a low voice at the beginning of the horror movie.
Last year, they discovered my inner ears, the place where my hearing and my balance live. Hello? This is not funny anymore and I for one don't call this well behaved.

And they have invited friends to come along. These are called PR3 or proteinase 3 antigens. I am really angry with them and I am not going to waste my time writing about them. So there!


  1. Due to my mother's recent illness, I've learned more than I want to know about the pancreas. Dratted microscopic critters!

  2. Amazing what's out there.

    I naively asked my cardiologist to explain something about hepatology. She said, "Mike, I only have 20 minutes.

    It angered me at the time but after delving for several hours online, I was lost in a maze that would require years of study to suss out which way to go.

    The old joke about it being hard to find good help seems more apt than ever. But the available information is now so huge I can almost sympathize.

    By the way, the video that the link on another post to Your Historic Moment has been removed due to copyrightd content. Do you have another?

    Have you read Nancy Mairs work?

  3. I meant "hematology."