Is It Cancer, Or... Fava Beans???!!!
(September 10, 2019)
I have a friend. (Yes, I really do. Several, in fact. But I digress.) One day one of HER friends (known herein on out as FOAF, or the Friend of a Friend) went to the doctor for – well, it doesn’t really matter. I think it was just a checkup. Anyway, one of those regular old, standard blood screening tests that are usually done on such occasions returned some rather odd findings.
The blood cell ratios were all wrong, and the FOAF was given a diagnosis of MDS. That stands for “myelodysplastic syndrome”, and THAT catch-all terms refers to a constellation of different things that can go wrong with the stem cells in your blood marrow. It is also called “pre leukemia” because MDS often progresses to become leukemia.
The symptoms of MDS include shortness of breath, fatigue, easy bruising, and paleness – all the things you might expect in someone who is lacking sufficient red blood cells. Those doesn’t sound so awful in themselves, but because MDS is POSSIBLY a step on the road to leukemia, it is considered to be a big deal. So MDS is sometimes treated with medications, sometimes with transfusions, and sometimes even with bone marrow transplants. Ultimately you can wind up with leukemia anyway, at which point you are For It – chemo and all the rest of the ways we treat cancer.
The FOAF was so freaked out by all this that they started writing their will. But here’s the thing -- the thing that tipped my Friend off to the fact that something was odd here. The FOAF didn’t have any of the symptoms of MDS. No fatigue, no paleness, no bruising, and no shortness of breath. No symptoms of any kind, actually -- they felt pretty good.
We all know that a lot of diseases in their early stages don’t have symptoms. Because of this, if something horrible just happens to turn up on a medical test, all too often people will readily accept it. You know the story – “if the MRI had focused up just a little bit higher, they never would have seen the tumor!” But that's really just drama. Because if you feel fine, and something odd shows up on a screening test, it probably doesn't mean anything. That doesn't mean that you shouldn't check into abnormal findings little further. But if you are really sick, there's going to be more evidence of it than one screwy test result.
In this case, the alert Friend, upon hearing her FOAF's story and thinking that there was something fishy about it, took the FOAF to a new doctor. This new doctor did not just grab the test results and run with them. He thought that the next step should be to rule out non-pathological reasons that could have caused the abnormal blood test. What a concept! This is a very cool thing that is apparently often done in countries where medicine is not the third leading cause of death, like it is here.
It turns out that both heavy drinking and heavy consumption of fava beans can make your blood tests look like you’ve got MDS. And guess what! The FOAF was big on both of those things. So now you know what happened next. They quit the fava beans and the alcohol, and the scary test results are very rapidly returning to normal.
(No more fava beans or Chianti. They can keep eating liver though. Ha! Just kidding. Which movie was that? Quick!)
This is a true story. It was not meant to scare you -- rather the opposite. It also wasn't meant to make you think, “oh that could never happen to me”. Because it damn well could. Or worse, god forbid – to someone you love. It was meant to illustrate – well, I think it illustrates about a zillion things. But I’ll stick to the three most important ones.
1) You need to have a good primary care doctor. Not just the one on your list who works closest to you. Find one, start a relationship with him/her, and consult them anytime you have a problem that requires medical advice. ANY TIME. After a while they will get to know you and what’s normal for you, and will be able to sort out easily and accurately when something is really to worry about or not.
2) Any time you get a scary diagnosis (or prescribed a treatment that doesn’t fix the problem), consult at least one more doctor about it before you accept it. Certainly get a second opinion before you begin a course of treatment.
3) Mr. Google IS your friend. Although he should be used somewhat sparingly up to the time you get diagnosed with something (because if you start googling vague symptoms like “fatigue”, you will rapidly become lost), once you HAVE a diagnosis you’ve got an enormous amount of information available to you. And once you are diagnosed with something, you should definitely do your best to become an Expert on your problem.
That’s because every disease is different. Even if the disease is the same, people are different, and that means therefore that no two people have exactly the same disease. You know YOU better than anyone else does already. Once you are informed about your problem, you will probably know more about it than anyone, just because of that. And your intuitions and feelings (although not your wishful thinking) become quite valuable at that point.
Treat things that need treatment. Do NOT treat things that DON’T need treatment. And that way, even if you aren’t a doctor, you will First Do No Harm – to yourself.
--dr. diane holmes
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