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Friday, June 17, 2011

CRYO what?

This blog will be posted some time after it was written due to an outside directive to not talk about my living donor experience until after I have donated.  If you are reading this, it is because I have completed the donation process.

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March 2, 2011
One of the tests I had to go for was to look at my cryoglobulin . We aren't always aware of what our blood tests are specifically testing for but because I initially went to the wrong kind of lab when I went to have the bloodwork done, i became more aware of the specifics of the test and what its looking for. Despite my many years of watching ER, Grey's anatomy and being a general geek when it comes to human anatomy, I had never heard of a cryoglobulin.  I couldn't even tell you if they were good or bad-until now! And because I thought what I learned was kind of cool I thought I'd share.

Cryoglobulin is an abnormal blood protein associated with several diseases. Normally testing for cryoglobulin is done when a person has symptoms of this protein or is being evaluated for one of the associated diseases.  I had slightly elevated C reactive proteins in one test and this could be the cause of it (although in my case not likely as I don't have any of the associated symptoms).  The associated diseases are things like cancers involving white blood cells, infections, autoimmune disorders, and rheumatoid arthritis.
So what does this protein do?  Well thats what I found interesting.Cryoglobulin clumps in cold temperatures-so at the microscopic level your blood gets clumpy. This causes people with cryoglobulin to have symptoms during cold weather: blanching, numbness, and pain in their fingers or toes; bleeding into the skin; and pain in joints.

How they test for this is pretty neat too.  Everything is HUGELY temperature sensitive (hence my having it done at a hospital I guess). Laboratory testing for cryoglobulin is based on the fact that cryoglobulin clumps when cooled and dissolves when warmed. The test is done on a person's serum (the yellow liquid part of blood that separates from the cells after the blood clots). The serum is kept warm from the time drawn until the cells and the serum are separated in the laboratory. Because of this, the lab folks at Foothills had to wait for th porter to arrive to transport the blood before they could start. It was first thing in the morning so they had to wait for that employee to arrive for the day.  My lab technician was actually standing in the hallway, watching for their arrival.  Once they had arrived he shouted "Cryo-I have a Cryo!!" and was met with an equally urgent toned response of readiness from the porter. They knew it needed to be handled with care.  It was also -37 outside that day and in a drafty old hospital building, even the room temperature could have impacted the test. 


Once it arrives at the appropriate testing lab, the serum then is placed at 33.8°F (1°C) for one to seven days. I'm not sure what the standard is here in Alberta but thats the norm I got off the internet. If there is clumping, cryoglobulins are present. The amount of cryoglobulins is determined by measuring the amount of clumping. They also look at the types of cryoglobulins present (there can be three) as that indicates what disease is likely at the root cause of their presence.

If you have cryoglobulin, the amount is reported back to the doctors.  A lot of it is often associated with white blood cell cancers or other white blood cell abnormalities while moderate amounts are assoicated with auto-immune disorders or rheumatoid issues. A little bit means an infection. There is often a type associated with each of these levels as well.

I think this is yet another part of medicine that is so fascinating-how did they figure this out?  What made them first look? The whole idea of something being temperature sensitive as well to that degree is really interesting. I understand the impacts can be painful, disfiguring and very unfortunate but at the very least it is identifiable-I can only imagine how it was viewed before science figured out what it was and its impacts.  It amazes me how much is understood about some parts of our anatomy and illnesses we get while others which seem simple remain so much more of a mystery to diagnose.



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