restricted access Chapter 1. What Is Lymphoma?
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3 CHAPTER 1 What Is Lymphoma? My Story Iam a neurobiologist. In 1994, I began an academic position at a liberal arts college in a beautiful area in the Berkshire Mountains of western Massachusetts. After many years spent working in the laboratory, I found the combination of teaching and doing research to be very challenging : both exciting and stressful. I was putting in sixteen-hour workdays and going short on sleep to get everything done. I lost weight, and I felt tired. At the end of May, after the academic year was over, I got married. In fact, the ceremony took place at the same time as the final exam for a large introductory course that Paul, my husband, and I had taught together. We spent our official honeymoon grading exam papers, but we were able to take a few weeks off later in the summer after I got my laboratory set up. In November 1995, I had elective gynecological surgery to clean up some fibroids and endometriosis that my doctor and I thought might be interfering with my ability to become pregnant. A month later, after I passed my postsurgical checkup, Paul and I went out to dinner to celebrate. I got food poisoning. After several days of uncontrollable vomiting, I ended up in an emergency room on Christmas Eve. Unexpectedly, the blood test taken in the emergency room, to see if all that vomiting had disturbed my blood chemistry values, showed that I was marginally anemic—my blood iron levels were a little bit low. This anemia could not be attributed to vomiting. I was very surprised: through multiple bouts of fibroids (accompanied by very heavy menstrual periods) and three gynecological surgeries, I had never shown the slightest tendency toward anemia. Indeed, my surgeon liked to say that my postsurgical blood iron levels were higher than most women’s presurgery numbers. However, noting that anemia in women of childbear- U 4 Living with Lymphoma ing age was very common, my primary care physician indicated that anemia was not a matter for great concern. Ninety-five percent of the time, he told me, it simply had to do with menstrual blood loss. This seemed unlikely to me—after all, I had been menstruating for many years without any sign of anemia—but I thought the anemia might be related to blood loss during my recent operation. My doctor started me on iron supplements and told me to come in for a repeat blood test in a month. Over the next few months I became progressively more anemic, began to feel more and more tired, and started losing weight. I did everything I could think of to increase my iron supplies. I increased the amount of iron supplements I was taking, started taking these supplements with foods that didn’t interfere with iron absorption, and incorporated more iron-rich red meat into my diet. Vaguely remembering that anemia was associated with deficiencies in folic acid, a B vitamin, I increased the level of the folic acid supplements I was already taking in anticipation of becoming pregnant. None of this seemed to affect how I felt. By the end of the spring semester, I felt more exhausted than I could ever recall. I would arrive home from work and collapse. My typical weekend was spent lying in bed. Again, I was puzzled: the second year in my job had been far less stressful than the first. On the other hand, I had wrenched my back while lugging around equipment to set up a teaching lab, and a thirdyear colleague told me that she, too, had felt overwhelmingly exhausted at the end of her second year of teaching. And many women told me about their bouts with anemia and how awful it made them feel. I wondered how so many women could possibly go around feeling like this and ever manage to get anything accomplished. But I decided that what I was experiencing must be normal, and I became caught up in the excitement of getting back to the laboratory for the summer. My May blood test showed the anemia was getting worse, and I was still exhausted, even after a two-week vacation. When I realized I was getting out of breath every time I climbed a flight of stairs, I decided it was time for another visit to my doctor. Sensing my concern, he reassured me that this wasn’t the beginning of the long slide down. I admitted that...


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