Listening G.P

[bamber]

Good news got through to G.P on telephone and although - not my my G.P he was the head of the practice and has met me before (lots in the past), but luckily not so often recently. He understood the need for higher dose antibiotics and gave me something for thrush I sometimes get too. (Even in through throat once - lost my voice lol! good thing).

He thought it strange I still take an antibiotic all the time(and still get an infection) - until I explained the replacement therapy doesn't reach the mucus membranes. Can't remember why something to do with not being able to collect it from donors. Hence lots of sinus infection possible. I even had surgery to make drainage better.

Any way he listened. I may still try and talk to my immunologist nurses, to get some more guild lines for the G.P and/ or update them.

[liz2mac]

Hi Bamber,
I know this is an old post but hope you're doing ok now. Good your GP listened. My understanding of why we are still subject to infections despite replacement therapy is as follows. Hopefully Sam will pick this up and add a scientific aspect to it!
Firstly, so many of us have got damage to our lungs and sinuses due to repeated infections before diagnosis. This damage to the mucosal membranes means that we have lots of nice moist and warm places ready to invite bacteria in to come have a party!
Secondly. Our replacement therapy is nearly 100% IgG. It is IgA that is "expressed" (put out through) the mucus membranes in a healthy person and it is this IgA that really hits the bugs on the surfaces of our sinuses, noses and lungs.
Thirdly. In a healthy immune system, the invading organism is identified by one part, then another part kicks antibodies to be made to match the organism exactly. The invader is then engulfed by another part, sucked up and spat out! Well that's totally non scientific but that gives a sort of overview. Now all we have are the ready made off the peg antibodies that our donors have given us. Whatever they've been able to make antibodies too we've got. However, once that particular antibody in our replacement therapy has been used up then we get no more until our next infusion. A healthy immune system just keeps on making those specific antibodies until the invader admits defeat and crawls away somewhere to die.
If this doesn't make any sense, get back to me and I'll ask someone to write it again!
Liz