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Old Fri Sep 9, 2011, 03:13 AM
Lisa V Lisa V is offline
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Join Date: Aug 2006
Location: Waimanalo, Hawaii
Posts: 401
Sometimes doctors can go too far trying to put things in layman's terms, though.

This is a bit off the AA/MDS topic. I have a dermatologist who I like very much, but he has developed a whole repertoire of analogies that he uses which probably appeal to a lot of people, but which I find a bit too dumbed-down to be really helpful. Some of his patients may be satisfied with the explanation that a topical medication "acts like PacMan and gobbles up all the bad cells", but that doesn't really explain how it works, and how it "knows" which cells to destroy. Upon further questioning, I was able to extract from him that precancerous cells have a higher metabolic rate than normal cells, and that the medication is designed to detect that and respond to it. That still isn't highly technical medical terminology and doesn't go into the specific biochemical mechanisms involved, but that was the level of explanation I needed. I just had to let him know how much I was capable of understanding so he could adjust his approach.

The same is true for the hem/oncs. It helps to engage in a dialog and let them know how much you already understand and how much you want to know. Some are easier to talk to than others, but a good physician will welcome active participation. Of course if you start throwing around a lot of big words without a fully confident understanding of what they mean, rest assured that they will pick up on it and may try to put you in your place. Doctors have egos, and they don't like a know-it-all any more than the rest of us do.

Meanwhile, back to the original question of transformation....... I can understand how AA can morph into hypocellular MDS with the development of chromosomal mutations which may be more efficient at cloning themselves than healthy cells. What I am less clear on is how or why a hypocellular marrow transforms into a hypercellular one, as most MDS is. Or are most cases of AA > MDS transformations to hypo MDS? Also, can an auto-immune condition transform into one that is not?
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-Lisa, husband Ken age 60 dx SAA 7/04, dx hypo MDS 1/06 w/finding of trisomy 8; 2 ATGs, partial remission, still using cyclosporine
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