Northern Lights: A Case Of Missing Immunities?
I like to read mystery novels sometimes, and I started that back in my childhood reading Nancy Drew books. As I became older, I realized that there are many unsolved mysteries in the world, and the medical field has more than its fair share of them. When I consider how medical research in the field of multiple myeloma alone has progressed recently, it seems obvious to me that the more researchers learn about immunity and hematology, the more likely it is that cures can be found for previously incurable diseases.
If you read my columns, you will know that I am keen on getting any available vaccinations to boost my immune system, and that I try to take sensible precautions to stay healthy.
Even so, every winter I seem to catch at least one viral infection, which I attribute to being in crowds, around small children, or even touching hand rails when going up and down to catch trains at subway stations. Hand washing is always a must in my world.
But I recently had a mysterious rash that I had never experienced before.
This spring we had a lot of pollen in the air that came from coniferous trees being stressed after a long winter. It was so thick that it covered windows and outdoor furniture with a yellow dust. I had a cough and runny nose that lasted for about two weeks that I attributed to an allergic reaction to this pollen and other little winged seeds falling from elm trees.
I also love to garden and was doing a lot of pruning and weeding to encourage my perennials to bloom. We have peonies, columbines, daffodils, poppies, roses, prairie crocuses, and flowering trees such as crabapples, lilacs, and hawthorne in our garden, and it is a pleasure to get outside after the long winter.
So when I noticed a rash on my right hand, I just assumed that it was from the garden, and that maybe I had touched a stinging nettle without realizing that. The rash was not itchy, though, as a nettle rash normally would be.
The rash actually spread and went up to my finger tips, plus it was also in a line on my hand. This indicated that it could be viral and was following a nerve. I remembered that I had two ‘non-live’ vaccinations against shingles this spring and wondered if this could be in a reaction to that. Shingles is a viral infection that can spread along nerves.
But my feet were also unusually numb. They still become numb sometimes since I had a reaction to Velcade during the IV infusion of that drug in 2009. The recent bout of numbness occurred after we had been out to a symphony performance and I had been wearing dress shoes. When I looked at my feet afterwards, I noticed a rash also was appearing on my toes. There were red spots that were blistering. After that, spots on my elbows and tongue also appeared.
Could this be measles, I wondered. I have been vaccinated against that after my stem cell transplant, so that did not seem too likely.
It was my husband Dilip, a family doctor, who diagnosed this rash as being hand, foot and mouth disease (HFMD). This viral infection is commonly found in children under the age of 5. It is usually not serious and lasts for 7 to 10 days. That is the path it took with me, and the infection was gone by ten days. I wondered then if my runny nose and cough that I had attributed to being an allergic reaction could also have been connected to this infection.
HFMD is usually caused by the coxsackievirus A16, or less commonly by the enterovirus 71. Generally, adults develop immunity to this infection, but in individuals with low immunity, the risk of developing it after exposure is higher. Based on my recent experience, I think that I still have low immunities, dating back to all the cancer treatments I have taken, including those during the time of my stem cell transplant in 2010.
Luckily, my dear grandchildren, who are all under the age of four, did not have any rash or blisters. I washed all of our toys at home with a disinfectant solution and avoided touching the children for a while. The virus is usually contagious during the first week of the infection, and I did not want it to spread further.
I don’t know how I contracted HFMD, but it possibly could have been from taking the kids to playgrounds. It can actually be infectious even in people who do not show outward signs of it.
I didn’t receive treatment for the HFMD other than an antihistamine to relieve my symptoms. I also slathered on my favorite peppermint foot cream to moisturize up the dry, flaky skin that developed after the rash and blisters cleared up on my feet.
There was no harm done, and sometimes I think that this is how I am building up normal immunities again, by having infections one after the other.
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The quotation for this month is from John Glenn (1921 - 2016), a United States Marine Corps aviator, engineer, astronaut, and U.S. Senator from Ohio, who said: "If we could do something that enhances the body's immune system here on Earth, it would be a tremendous step forward in the fight against disease and cancer and other things."
Nancy Shamanna is a multiple myeloma patient and a columnist at The Myeloma Beacon. You can view a list of her columns here.
If you are interested in writing a regular column to be published by The Myeloma Beacon, please contact the Beacon team at .
Low immunity seems to be the bane of myeloma. My mum has IBS which keeps returning month after month. Even our doctor does not know what to do. She had radiation in her spine and he seems to think that her GI system has hence weakened.
I know I am immune compromised as well, ever since 2012 when I had C diff and meningitis at the same time. Thus I'm on IVIG. With me Revlimid is a contributing factor as I have lower white count since I started back on it. Not sure if the transplant is a contributor with you, but that was 8 years ago and you were revaccinated. Even when we go off treatments, it seems that there is a lingering effect.
Wow, so glad it wasn't something worse! I am religious about washing my hands and using hand sanitizer when I can't get to soap and water. I stay relatively healthy, considering I am out and about germy people a lot. The only things I can't control are when people are too stupid to cover their mouths when they sneeze and cough. Just because they think exposure to germs makes you more immune to illnesses doesn't mean the rest of us are the same!
Nisa123, so sorry about your mum. I, too, have experienced IBS as a side effect of taking Revlimid. I carry anti-diarrheal pills with me just in case, but have found that reducing the sugar in my diet also helps. I'm not saying that's what your mum's problem is, but we have to be detectives, don't we, when trying to control our side effects and figuring out what our bodies are doing.
Dear Nancy,
Thanks for your interesting column. I hadn’t heard of adults contracting HFMD, but this business of vulnerability to infections is very familiar. Just last week I was talking to my myeloma consultant about my frequent eye infections. He said that he thought that after a stem cell transplant, the immune system does not always ‘reset’ correctly. Like you, I tend to think that I am rebuilding immunity as I succumb to, and then recover from, infections. I’m glad you have not had any lasting effects from this one.
Thanks for the interesting comments!
Nisha, I also think that your Mom's IBS symptoms might be able to be controlled with anti-diarrhea drugs, or even with stronger ones. There are threads on the Beacon from patients who have taken bile inhibitors that you might like to investigate. Even a year after I stopped taking Revlimid, I would sometimes get awful stomach cramps and gastro-intestinal problems. I remember taking Immodium, but then that slowed my system down too much! There was no happy medium it seemed.
Ron, I am fortunate that all of my blood counts are now in the low end of normal range. I don't know how platelets, neutrophils, eosinophils, and other blood cells would directly interact with a new virus, though. I think that I had just never encountered the HFMD infection before, since my children never had it. It startled me that I caught an infection usually seen in young children though, and since no one else around me had it, I assume that I was more vulnerable to that virus.
Susan, I agree that we just need to avoid people who are coughing and sneezing if possible. You never know if you are going to come down with something that could be more serious than a cold. Also, we don't want to catch infections frequently! I have taken every available vaccination such as the flu shot every autumn, and I am up to date on the pneumonia vaccines. They are recommended for immune compromised people.
Thanks, Marjorie, for you comment too. Sorry to hear that you get eye infections frequently. I have had 'pink eye', i.e. conjunctivitis, in the last year also. So glad that in this era we have so many antibiotics to treat bacterial infections.
Sorry you caught HFM! My son is 3 and had this last January. It was an all over rash and looked like chicken pox, which came after a few days of fever. This weekend my son complained of sore tongue, then last night we saw a few spots on his face and hand, and we think he has a second mild case of HFM! Luckily I seem to be immune to it, even after two transplants. My mom does not remember any of us having it as kids. I don't know if this is a new virus that came with this current generation of kids? But it goes around through the daycares with great force.
Hi Lys, I am glad that you did not get HFM, even though your 3-year old did! One of my grandsons goes to a daycare, and I did notice that he had a runny nose for about a month! He had some sort of low-grade infection, and I did also have a runny nose before I got the spots! I checked with a friend my age, and we could not remember our children getting this infection (our kids all in their thirties now, and their were six of them between both families) so I think that maybe it is new here in Alberta. Hope the little boy does well and recovers from this bout of HFM quickly.
Update: I caught HFM from my son. Very sore tongue and a few other rash spots. I ended up with a fever and admitted to the hospital for a few days in isolation for febrile neutropenia! I could not fight the infection. After antivirals and antibiotics, I am at home and getting better.
Guess my second transplant killed my immunity! The rest of my family seems fine.
Hello Lys, Hope your white blood cell counts are coming up again! This sounds like a miserable experience for you and your family. I have been in an isolation ward once after my stem cell transplant since I was being tested for C. Difficile. Although ultimately the tests showed that I did not have it, and this was thought to be a reaction to the marrow boosting drug I was taking, it was a bit unnerving to be in a room in that ward, since all the medical staff and visitors wore masks and gloves!
I hope that now you and your boy have immunities against HFM.
I had an update too since after this column was published, I found out that at the day care that one of my grandchildren goes to, they had two cases of HFM. The director immediately had all of the toys and surfaces cleaned with a bleach solution to prevent it from spreading. Sometimes people, especially young children, can be carrying the infection without visible signs of it, so I think that I also caught it from a toddler!