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How can I look so well and be soooooo ill?
Mar 24, 2002

Dr Dezube, Do you have any patients that by looking at them, you cannot tell they are so ill. I have had 4 relapses of non-Hodgkin's lymphoma, Chemotherapy for 20 months and now going for Stem Cell Transplant. All the doctors, nurses and techs who do the scans, comment on how well I look and how great my numbers are and how I bounce back quickly after chemotherapy. How can the immune system be so damaged and yet on the outside people are shocked that you're ill because you look so well. I'll never understand this disease because it's so deceptive.

Response from Dr. Dezube

You ask a very commonly-asked and very important question-- how can I have so much wrong and yet look so well! Although it is true that how a person look often reflects how they feel and how serious their disease is, this direct correlation does not always work. Most health care providers can easily remember patients who look well yet had very, very serious illnesses, and vice versa, patients who look ill, yet had very little wrong with them. Often how a person looks reflects their health status prior to their illness. I've taken care of two marathon runners with lymphoma who always looked healthy, even when they were not.

If I could make an analogy, consider a criminal line-up. Although one may be tempted to assume that the seediest looking person on the lineup is the one that robbed you, it could just as easily have been the best-dressed and the best-groomed person on the lineup.

You acutally raise an issue that I deal with on a regular basis. I recently had a patient who, no matter how bad he feels, always dresses and grooms himself meticulously. He then went to get rehabilitation benefits. The counselor acutally called me and said that a guy who is dressed so well and groomed so well could simply not need their services. It took a bit of convincing, but I was able to convince the counselor "not to judge a book by its cover".

Good luck with your stem cell transplant.


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