Blood Letting

Imagine my surprise, having, first, been told I have a genetic blood disorder, to learn the only way it can be treated is by bloodletting, a medical practice that’s been in use for more than 3,000 years, all the way back to Ancient Egypt.

These days, they call it phlebotomy and it’s not performed by barbers or dark alley quacks, but by specialist medical practitioners under hygienic conditions, in modern hospitals. Well, for the most part, anyway.

In modern medicine, it is used in the treatment of polycythemia (excess of red blood cells), as well as haemochromatosis (iron overload).

Bloodletting is one of the oldest medicinal practices and was practiced by Egyptians, Mayans, Incas and ancient Greeks. It was used to treat a variety of conditions, based on the belief the human body was made up of ‘humours’; blood, phlegm black and yellow bile.

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Depending upon the condition, measured often by the manifestation of these humours, a physician would decide where the incisions were made to drain blood and, ultimately, to draw the humours of the body into balance. In the Middle Ages, the task fell to the local barber, hence a barber’s pole, the swirling red and white, which represented the tourniquet, the blood and the rod gripped by the patient, during the treatment.

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US President George Washington was among bloodletting’s many victims. He had 3.75 litres of blood taken from him over a ten hour period. He had a throat infection. In the 19th century, although bloodletting remained popular, particular with the use of leeches, its effectiveness was increasingly in question, particularly as more people were dying from its use than were recovering.

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For people with an iron overload, however, bloodletting, venesection or phlebotomy is a good thing. As red blood corpuscles carry and distribute iron around the body, then removing blood can reduce the level of iron, too. The trick is to remove it faster than the body can replace it – an inexact science dependent on a whole bunch of factors – and that dilution will result in a reduction of the ferritin level in the body.

So two or three times a year, I have my blood tested for a ferritin count and if it goes beyond 150 then I must return for treatment, a weekly visit to a phlebotomy clinic where about 400ml/l of blood is taken from my blood, then I’m given a cup of tea or coffee and sent home.

Fun with Metal Detectors

Sinead O’Connor saved my life. Yes, that Sinead O’Connor. We were close friends and lovers at the time. She was dropping her daughter off at school and stopped at a shop to pick up a copy of the Irish Times, on her way home.

There was an article on the front page about a medical conference happening in Dublin and how the keynote speaker, Professor John Crowe, had read a paper about a blood disorder that came close to wiping out the Celtic race, a millennium before.

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She read on and began to realise the symptoms of this disorder were manifested by her boyfriend: arthritic pains in my fingers, particularly the left index; bouts of fatigue and diabetes. So she called me and I called my doctor. I explained to her what Sinead told me. My doctor asked me to come in.

There’s too much iron in my blood. It’s called hereditary haemochromatosis and it’s caused by a faulty gene. The body absorbs too much iron from the diet and then it deposits in the liver and other organs, particularly the pancreas. It also deposits itself in the joints.

Globally, one person in twelve has a chance of having that faulty gene but if you’re Irish, you have one chance in six. That’s why it’s called the Celtic Curse. It has other names, like Bronze Diabetes or Blood Rust.

Twenty five years ago, I was diagnosed with Type 1 diabetes. Ten years later, I began to experience pain in my joints, particularly the index finger of my left hand. As a journalist, who had to meet numerous daily deadlines, that was painful. Think, while you’re typing, how many times your index finger hits the keyboard.

Back then, I was experiencing frequent bouts of fatigue which, considering my work schedule, didn’t surprise but it did frustrate me.

My doctor performed, what I now know as, a ferritin blood test and, since she worked, as a sideline, in the blood testing laboratory of a local hospital, asked me to come back the following day for the result.

As suspected, my blood showed an inordinately high level of iron. It read 1450 units, she told me and what, I asked, is the normal level of iron? Anywhere between 15 and 50, she answered. An appointment was made with an endocrinologist and two days later, I began my first treatment for haemochromotosis.

Since then I’ve got two artificial hips and no, they don’t cause panic in airport metal detectors because they’re made of a chromium alloy, which doesn’t set off alarms. That said, whenever I travel, I carry a letter from the surgeon who performed the arthroplasty (hip replacement), because it is better to be sure, than sorry.

But that’s for another blog…