I've been anemic pretty much forever. Or at least since just after college, which... yeah, basically counts as forever at this point. I believe the first time I became aware of the issue in any meaningful way was not too long after I was married, when I went with Dario (who, like his father--and my father, for that matter--was a regular donor) to give blood... and was rejected. I was a little offended, frankly. What, my American blood wasn't blue enough for their fancy continental tastes? As it turned out, I guess, it was a little too blue. My iron was too low.
I asked the harried hospital intern running the blood donation office that day what I should do.
He shrugged. "Eat more horse meat." I declined to follow his advice.
After that, any time I went to a new doctor, the initial blood tests would show that I continued to be iron deficient. The doctor would prescribe iron pills, I would take them for a few days until, uh, I could no longer tolerate their side effects (we'll leave it at that), and that would be the end of the discussion.
It kept getting worse, over time. Doctors prescribed different workarounds for my insupplementability--different formulas, chase it with orange juice, try to get as much dietary iron as you can (although I continued to draw the line at horse meat)--but none did much good, and none were really sustainable.
On the other hand, I didn't seem to be suffering any real negative effects, either, so it didn't seem that big a deal. The numbers continued to drop, and I still remember the astonished face of the lab tech looking at my results and exclaiming, "But you don't even have any ferritin left! How are you able to live a normal life?" This was a question I had no answer for.
When I moved to the States, I got into the habit of warning new doctors. "You'll find," I'd tell them as they wrote instructions for various basic tests, "that I'm very anemic." Sometimes there was a flicker of interest, sometimes not. Occasionally my claim was met with skepticism. "You don't look anemic," they'd tell me, sizing me up. I can only guess that my skin wasn't quite pale enough, my look not quite frail and waifish enough, my demeanor not quite sickly enough. I would just smile, knowing exactly how the situation would play out.
Every time, when the results came back, they'd take a completely different tone. They seemed surprised and a little awed at just how empty of iron my bloodstream really was. After the initial reaction, though, and a half-hearted attempt to supplement that always fizzled out, no one seemed to really care that much. No one suggested that there might be some kind of long-term negative effect.
Weirdly, the severity of my non-havingness of iron, coupled with the whole "not looking anemic" and "managing to live more or less like a normal person" thing, became an odd point of... not pride, exactly. But like a personal quirk. Amy can do that weird thing with her tongue, Rick can bend all his fingers in a completely unnatural and really quite disturbing direction, and me? Hey, I can be stealthily anemic. It was one of my Very Minor Superpowers. I admit I kind of felt like a badass, Ironless Woman, out there every day livin' it up despite having little more than water in her veins. I imagined myself pulling off a heroic rescue at a junkyard thanks to my being completely impervious to those giant magnet-cranes they use to pick up entire cars.
(I never really sketched out the details of this rescue mission, beyond vaguely envisioning the bad guys desperately pulling levers, increasingly frustrated as I dashed nimbly through the dump to make my escape with the kidnapped baby under one arm. Then, of course, one of them would go out to check and see if, maybe, the whole thing had been accidentally demagnetized like a credit card, only to find himself immediately sucked into its force field and firmly imprisoned up against its surface. Ha! Should've eaten less horse meat, suckah.)
(Okay, I guess I had some details in mind. Except, like, where the baby came from and why it had been kidnapped. But that part's not about me and my magical iron deficiency, so it can wait until I write the full graphic novel someday.)
Then, this past summer, I got sick. A lot. And my doctor treated me for the flu, and then for bronchitis, and then for pneumonia, and then didn't have any free appointments for the rest of the summer. Meanwhile, I was miserable, and very tired of being sick. So I got myself a new doctor.
Our first order of business was to stop me from getting sick all the time. So we concentrated on that. (Boringly, the ultimate cause appears to be that--like a lot of people who move to the desert--I'd developed allergies for the first time in my life. Untreated, they made my body a lovely petri dish for any passing virus or bacteria.) Of course, he also ran a bunch of blood tests. We recited the familiar litany, straight from the Mass book:
"I should warn you that you'll find that I'm very anemic."
"Oh, really? You don't look anemic."
"So I've been told. But, yeah. It's been that way for years, and I can't handle iron pills, so..."
And this was the point at which we deviated from the script. Because after--lord--over twenty years of being told I was anemic, and at least fifteen years of it being so severe as to arouse a certain degree of shock and awe in medical professionals, he asked the one question no one else before him had ever thought to pose.
Uh. I... dunno? I'm just built this way? I was honestly embarrassed to realize that it had never really occurred to me to wonder about the cause, either. It just was, and always had been.
And thus began an odyssey of tests and specialists, that is coming to something of a head at the moment. For one thing, tomorrow I'll be having my very first iron infusion, in what will probably be a long series of them. Four or five times, on a monthly basis, maybe even every year. My hematologist also wants to make sure there's no internal bleeding going on. (When I asked whether I'd still be alive if I'd been bleeding internally for twenty years, she shrugged and said, "You'd be surprised what people can survive.") So she also sent me to a gastroenterologist, who will be poking around my innards from various directions, and in extremely intimate ways, in about a month. Meanwhile, he also ran some tests, and as it turns out, we have a possible cause: H. Pylori, a family of charming little helical bacteria, has set up camp somewhere in my plumbing. Hell, they've probably already had their own Renaissance and are discovering gravity and the solar system by now, if they've been there since the beginning.
This hardly makes me unique. Wikipedia informs me that over 50% of the world's population has it, so there goes my special snowflake status. You might have it yourself! Apparently 80% of those whose gut has been colonized by the little bastards have no symptoms. One of which happens to be chronic iron-deficiency anemia.
Tomorrow I start a course of hardcore antibiotics (twelve pills a day for ten days--that's a lot of pillage). The scopes will show whether I also have a gaping ulcer (a common result of having a bacterial colony plant a flag in your stomach, apparently), or any other damage. It's annoying, but after a lifetime of being Ironless Woman, I think I'm ready to turn in my superhero costume and see how the other half lives. The half that isn't hosting a whole civilization inside. The half that doesn't get exhorted to eat horse meat for health reasons.
Guess that kidnapped baby's just going to have to find another way out of that dump.