column logo Alithea Athans

I have been diagnosed with autoimmune hemolytic anemia, specifically cold agglutinin disease (CAD), which has been identified as primary. I am immune-impaired and my anemia is mild in that my hemoglobin (HGB) hovers in the 10s.

I am always cognizant of the fact that I can’t get cold, and that I should avoid getting sick, but I don’t think of myself as immune-impaired. I typically feel well, or I am so used to the symptoms that I do have that I don’t consider them to be abnormal.

I do my best to avoid getting sick. A month ago, I needed to travel by plane—something I have avoided since the pandemic.  Airlines have been in the news a lot over the past few years and it has seemed to be nothing but delays, people catching viruses, and many unhappy people acting out.


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I had no choice; my family member was sick and we needed to go be with them. So, we traveled down south, the flights were uneventful, and it is just a faster way to travel. The one thing I did notice in the South is no one wears a mask. It made me nervous.

Once we arrived at their house, we went through his schedule and what appointments he had. The first stop would be the doctor’s the next day and immediately after that we wound up bringing him into the emergency room. We were there taking turns going in, as only one person was allowed at a time. The people in the emergency room (ER) were so sick—coughing like I have never heard before. It was bad.

The subsequent days we spent going back and forth to visit him. After a week, he was released, and we continued our visit. The flights home were filled with sick people of every age, but still no masks.

I took every precaution on this trip from the beginning to the end. I washed my hands constantly, I never touched my nose, and I wore a mask.

Read about therapies for CAD

Fast forward to a few days later: I found out the person we were visiting wound up with respiratory syncytial virus (RSV). I started to get sick as well. They tested me for COVID and the flu, and they were both negative, but they never tested me for RSV. He and I had the same symptoms. I have never been this sick. In fact, it has been almost a month and whatever I caught has now morphed into a sinus infection. I have been on a Z-Pak, prednisone, and Mucinex and then they put me on doxycycline. As I started to feel better, I missed one dose of doxycycline and my symptoms came back instantly. The only positive is it didn’t affect my HGB levels.

It has been a nightmare; in fact, I have been sicker than when I had COVID. Granted I did get the monoclonal antibodies, which makes me wonder how sick I could truly have been had I not been vaccinated or had the antibodies.

I can tell you all of the different viruses that are going around are no joke. I should add that everyone else with us did not get sick. We were in all the same places doing all the same things. Only he and I got sick.

The common denominator is he and I are both immune compromised. My best guess is that he and I picked this up in the ER.

Guessing aside, there were other factors I can recognize. I barely slept when I was there and when I do not get enough sleep I start to feel run down and I usually catch something. They kept the heat high for me, which was nice, so it wasn’t about getting cold. However, I was out in places I would normally not go. This was a very stressful situation and that can also affect you. I also usually eat a lot of fruits and vegetables and my diet was completely off because I wasn’t home doing what I usually do, and I kept forgetting to take my folic acid.

With all of that said, I am not sure if it affected me enough to make it easier for me to get sick.

The one thing I did learn is I need to keep it front of mind that I am immune deficient even with a decent HGB and even when I feel well. This exists whether I am consciously aware of it or not. It is of utmost importance to protect yourself.