Comorbidities

what does this actually mean?

Day 1 of blogging my life until I get a stem cell transplant 

Song of the day: Lift your head weary sinner – Crowder https://www.youtube.com/watch?v=xPpEOUVpxrM 

I am currently in an insurance battle for an approval for my rare disease to be treated via a stem cell transplant. I am chronically ill with many different diseases, all of which can be connected as comorbidities. 

Now what do I mean when I say comorbidities?  A quick google search will give you the  definition: 

“the simultaneous presence of two or more diseases or medical conditions in a patient.”

But what does that actually mean? Well we know that there are many different systems in the body. Over time we have named these different systems individually such as our nervous system, the gastrointestinal tract, endocrinology system, musculoskeletal system, cardiovascular system, etc. This is why there are so many sub-specialties in the practice of medicine. 

Say you have a headache or chronic migraines, you would want to see some sort of head specialist like a neurologist. Or if you break a bone you would want to see the orthopedist (bone doctor) or a surgeon who works on bones. Having trouble with digestion? You would want to find a gastrointestinal doctor or a nephrologist. Heart or blood pressure problems? A cardiologist would likely be your first stop to modern medicine help. 

So as a society we have pulled apart the human body into these sub-specialty groups in order to better focus on a specific problem or issue that the patient is having. This system has worked well for the majority of the population for thousands of years. Because the majority of the population has a very easy time being placed and sorted into set boxes.

Many people accredit Aristotle to be one of the first scientists of the world. And I disagree with this statement personally. Here’s why: he was a great organizer, he was a great categorize-r. He put like things with like things. Where is the science in that? All he did was classify groups of things.

Do not misunderstand me here though; as the classifications of everything Aristotle put together was an enormous feat for the time as his work spanned all human knowledge today. I am simply saying; classification and categorization don’t mean much when we live in a world that does not fit into one box. Especially with the practice of medicine. There is no exact science in medicine. 

I boldly say that there is no exact science in medicine. This frustrates and ruminates in our heads. As patients, as medical students, as doctors, as insurance company agents, as simply being human. It is called practicing the art of medicine. If medicine was an exact science and each category we have placed our body parts into worked individually and independently from one another, then maybe we could call it a direct science? Yet we all know that to be an untrue statement. 

For example: the brain uses glucose as a source of energy. In order for the brain to have glucose to use as energy, you have to eat food – the glucose. This connects the gastrointestinal tract with your head. This type of headache is cured by eating or drinking food. 

Now, comorbidities with disease kind of work like this. Because the entire body does NOT exist in nice little separate boxes, but constantly intertwining in ways that we are still learning and discovering about. 

Here’s a great video on my disease that can go further into detail of what I mean on this: 

https://www.youtube.com/watch?v=n1Vk7znoz4M&t=21s 2

So as in hopes to have a better picture, Dr. Saperstein, world renown expert in the field of Ehlers Danlos Syndrome, breaks apart the pieces of a patient that has this condition. As we can see; the root cause is thought to be a defect in collagen production. That default in collagen affects more than one system in the body. Often multiple systems are affected but not connected right away because of our categorization system. Comorbidities do not fit into one box, and may seem totally disconnected from one another.

So tying this all together with me: I am a rare disease Ehlers Danlos Syndrome patient. I have nearly every comorbidity there could be for this condition. One extreme comorbidity that has disabled and destroyed my life is the condition of Mast Cell Activation Syndrome. For me, this has been so life threatening I have used countless epipens, been in multi system organ failure, and almost lost my life daily depending on what I put into my body. We have tried so many treatments at this point, and seeing world renown hematologist and oncologist and allergist to try and control my disease.

Hence the treatment of stem cell transplant being on the horizon, and me currently fighting insurance for an appeal to give me one. This is extreme treatment for a comorbidity of a disease we still know so little about, making it difficult for someone to want to cover such a “risky” procedure. I would be the first for mast cell activation.

So until we get this appeal I will be blogging life again. The ups and downs of my rare diseases, and explaining more about comorbidities of the different body systems.

Because this is worth fighting for. This is worth the research and education. If nothing else may my medical journey help prevent the severity or find a cure to all the comorbidities us rare zebras live with every single day.

Reference: 

  1. Shields, Christopher, “Aristotle”, The Stanford Encyclopedia of Philosophy (Spring 2022 Edition), Edward N. Zalta (ed.), URL<https://plato.stanford.edu/archives/spr2022/entries/aristotle/&gt;.
  2. Center for Complex Neurology. (2019). What is Eds. YouTube. YouTube. Retrieved March 3, 2023, from https://www.youtube.com/watch?v=n1Vk7znoz4M&t=21s.