It is not clear what causes finger clubbing. It may be due to large cells called megakaryocytes getting stuck in the small blood vessels in the tips of the fingers. Megakaryocytes are usually in the bone marrow and make platelets, which we need for blood clotting.
Her spleen, normally tucked beneath the lowest left rib and no bigger than a peach, was so engorged with white blood cells it was the size of a cantaloupe. She could hardly walk. Her skin was ghostly, her blood dangerously short of red cells. To breathe was a chore. Regular vomiting. Stabbing aches deep in her bones, where the marrow was frantically cranking out white cells, or leukocytes. Recurring fevers. And cold, strangely, unnervingly cold: she was freezing under the hospital blankets.
She was too old and too sick to undergo a bone marrow transplant, a grueling, highly risky treatment for her blood cancer, chronic myeloid leukemia (CML). She had already tried the other standard CML treatment, regular doses of the powerful compound interferon. But it so intensified her nausea, fevers and bone pain she abandoned the medication, come what may. With nothing left in their leukemia-fighting arsenal, the doctors were down to Dilaudid, a derivative of morphine, the narcotic painkiller. It was calming, it was comforting and for a patient in her condition it was, of course, the end.
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