Gardening questions. I understand we should av... - CLL Support

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Gardening questions. I understand we should avoid mowing the lawn and digging the garden, but what about weeding- same thing I guess....

romarin profile image
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i am looking at my jungly garden in despair.... any thoughts.

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romarin profile image
romarin
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djgolding profile image
djgolding

Hi romarin,

Wear a facemask, goggles and gloves and get on with it! - the secret to being as normal as possible is to be sensible about personal hygiene - lots of hand washing and showering after anything like gardening (undress whilst still wearing the mask and goggles to reduce exposure to airborne hazards and get the clothes in the wash) - never mind what the neighbours think. If you look at the possibilities when gardening then everyone should be taking the same precautions, not just the immunocompromised! - but then we've all got lives to lead and risks have to be assessed and rationalised.

I have to get on with my smallholding regardless so I've built precautions into my routines and get others to help when the really dangerous tasks (mucking out the hens and goats) need doing. I wear my PPE and supervise from a bit of a distance.

DJG

romarin profile image
romarin in reply todjgolding

Thanks so much for such a positive response. I'll get on with it!

Kwenda profile image
Kwenda

The MD Anderson cancer clinic has many free publications and this months blog ' Focus on health ' has details on gardening.

See these links.

mdanderson.org/publications...

ALSO

mdanderson.org/publications...

The only warning for gardeners who have CLL is to be EXTRA careful with compost or rotting materials of any kind.

The fungal spores from rotting materials can be breathed into the lungs and cause severe problems as these spores then grow inside the lungs. Our weakened immune systems cannot deal with it. One fungus is the Aspergillous fungus that is extremely difficult to remove once inside the lungs.

The fungal spores are spread when the rotting material is dry and they blow in the wind, wet compost is thus mostly safe if handled carefully as mentioned above.

Lots of washing of hands and taking care and you should be OK.

The fresh air and exercise does wonders also...!!

Dick

romarin profile image
romarin in reply toKwenda

Oh thank-you. I was completely freaked out at the idea of such protection every time I wanted to do a bit of weeding. Maybe wise but ti wasn't going to happen. And I really wanted to know WHY - what dangers were lurking there. So this also means that my wood stove looms dodgy now, so be v careful with the wood and wear mask to carry logs?

djgolding profile image
djgolding

I certainly mask up when chainsawing my weathered logs. I make a lot of compost (not personally but from my chickens and goats) and take great care with that. I've got wormeries but they are fairly damp and tend not produce aerosols. But sensible precautions are the answer, watch for particulates from grass cutting especially if using a flymo-type machine.

Enjoy the summer.

AussieNeil profile image
AussieNeilPartnerAdministrator

Lots of good advice above on avoiding illness from any activity that is likely to stir up material that may contain fungal spores, bacteria or viruses that you can breathe in by wearing a particulate mask.

What no one has mentioned is the increased risk that you put yourself to if you smoke! With your respiratory system a major avenue for infection, your body already has plenty of defences against infection by that route, much more so if you breathe through your nose rather than your mouth. Smoking reduces the effectiveness of these defences, putting you at increased risk of lung disease and cancer.

Here's an explanation from Healthline of how smoking paralyses you lung's cleansing mechanism:

A layer of protective mucus, called a mucus blanket, covers a large portion of the membrane lining the bronchial tree (within the lungs - Neil). The mucus is an important air purifier.

You produce about 125 milliliters of mucus daily, which is slightly more than half a cup. Microscopic, hair-like cilia move the cleansing mucus up to the pharynx—part of the throat between the mouth and esophagus—from the lower part of the bronchial tree. Cigarette smoke paralyzes the cilia, which allows mucus to accumulate and leads to what is called smoker’s cough.

healthline.com/human-body-m...

A classic example showing the effects of paralysing this cleansing mechanism is the greatly increased risk that smokers face of developing often fatal mesothelioma if they are exposed to asbestos particles. I've seen reported rates of up to 80 times higher risk! It is though that by paralysing the lung cleansing mechanism, smokers increase the risk of asbestos particles lodging in the lungs which leads to the development of this cancer.

Neil

Damms profile image
Damms

I am a smallholder to, and havent been given any direction regarding any work on my little farm by the doctors.

One doctor only mentioned house pets as Unhealthy.

But I am keeping my dog, cat and the girls guinea pigs.

djgolding profile image
djgolding in reply toDamms

yep, still got guinea pig, dog and 6 cats along with the hens and goats so plenty almost automonous handwashing and avoiding direct contact as much as I can - but, have you noticed that when they should stay away from you that makes them want you more - oh well off to wash my hands again! Every room has a bottle of alcohol handwash in it just to remind everyone that handling animals means hand cleansing - a practice we always had anyway but now reinforced.

Oleboyredw-uk profile image
Oleboyredw-uk

I do most things in the garden. Have taking to wearing a Tilly hat and builders gripper gloves. I sometimes wore a facemask anyway as I suffer hay fever and found it makes alot of difference when mowing the lawn. Only thing I've stopped is spreading compost. Wife does that now for me.

Rob

Damms profile image
Damms

I think it also comes down to quality of life.

I dont wanna live my life in a boble being a spectator to my life. I wanna participate :-)

But I take my precautions, Wash my hands often, avoid public transportation and buffets.

DocM profile image
DocM

Good morning romarin. These are just my personal thoughts on your question. For the last number of years, people have been obsessed with health food. Mind you it has all been one-sided..."physical health" food. What about mental health and spiritual health food? Nobody talks about how uplifting chocolate is, or steak fat. The same goes for gardening with me. While CLL has dramatically changed my energy levels and reminds me that at least at this stage of my life, that putting in a full work day is not going to happen, I do not let it be my identity. I love to be outside and I love to garden. What it does for my mental and spiritual energy is more than any vitamin D tablet or rest can do. If you worry about the moulds, put on a respiration mask while you work. As for me, I will take "some" precautions, but for me living as fully and robust as I can is more important that imprisoning myself to "health care". When I have energy, I mow the lawn or rake it...I plant flowers and weed...but then I take a break, put on my MP3 and headphones, and lay outside on the lounger. It's a good life and my philosophy is that living free is preferable to "existing" over-cautiously. Just sayin... have a great day, it's spring

ThreeWs profile image
ThreeWs

The risk depends on the state of one's immune function. It is not much discussed, but many of us CLLers appear to have highly effective immune function while others less fortunate are frequently coming down with multiple and serious infections. Where do you find yourself on a general scale of healthy or chronically sick? Caution is advised just having CLL but overly paranoid protective measures can be destructive to the quality of life. After I was diagnosed in 2006 I experienced a spontaneous remission of two longterm illnesses, one a foot fungus contracted in Viet-Nam in the early 60s and the remission of herpes simplex of the right nostril. Added to that, I only had one cold in 2008 and was subsequently free of any infections until the Fall of 2011 when I was treated with Ibrutinib. You may be at either end of the health spectrum but do know that I live a rural life style cutting and burning wood for heat and garden.

WWW

gemit2000 profile image
gemit2000 in reply toThreeWs

Speaking of the variability of one's immune function, do you or does anyone know if this applies to someone getting the Shingles vaccine if they had a normal functioning system? I came to the conclusion that I would not get the vaccine when I read something on the topic where the author used the word 'never' - but written as NEVER (those caps were enough to scare me off of thinking about thinking about it). Yet it's never been totally clear to me whether getting the live vaccine is dangerous to CLL patients because their immune systems are weakened and if so does 'NEVER' becomes 'perhaps if one's immune system is still healthy?

Given my partial ignorance it begs the question, 'what blood levels indicate a healthy immune system?'. My most recent tests indicated continued normal levels of all granulocytes as well as immunoglobulins. My RBCs have always been in the normal ranges too. Of course by definition my ALC is abnormal but relatively low at 12K (around 9K with initial Dx two & a half ago). So I'm wondering if being overrun by dysfunctional lymphocytes is enough to make one immunodeficient and not a candidate for Zostavax. And perhaps I'm unaware of other chemical indications not mentioned of a compromised immune system. Anecdotally I have felt that it takes a lot longer for things to heal these days and now that I think of it have gone through a tube of Neosporin trying to keep a bug bite I got a month ago from becoming infected.

Thanks

Gene

Cllcanada profile image
CllcanadaTop Poster CURE Hero in reply togemit2000

No CLL patient should be given Zostavax... based on the collective wisdom of a number of CLL experts as well as the drug company contraindications...

The diagnosis of CLL brings with it a compromised immune system. How compromised is anyone's guess. Early on the immune system is generally better than pre-treatment. Post treatment, with chemoimmunotherapy for example, your immune system is worse than pre-treatment...

Certainly immunoglobulin A,G,M levels give some indication... of function...

ThreeWs profile image
ThreeWs

Hi Gene,

You are tackling an important set of questions for which I will offer my non-medical lay-patient opinions to further the discussion.

First of all there is no such thing as a single immune system. The human body has multiple interacting and redundant immune systems. What is focussed on is the role of certain cell types and how well they respond to continual threats from three main categories of pathogens being bacterial, fungal and viral. The fourth category is how well components of the immune systems function to repair or destroy mutated or damaged cells that lead to cancers. I like to think of the various immune systems as layered, reflecting our evolution in time and reacting to what we have been exposed to in our lifetime. The complexity of just how the immune systems function extend to the communities of bacteria in our guts to the viruses that live in the nerve ganglia, mostly dormant but become activated from time to time.

With CLL our immune functionality is in a state of what I think of as "fragile chaos". Immune function in some patients is clearly and severely compromised in that it allows all manner of pathogens little resistance, resulting in chronic illnesses. Some patients have hyperactive immune system function that loses its ability to recognize certain tissues as "self" resulting in autoimmune conditions such as ITP (Idiopathic Thrombocytopenia Purpura), AIHA (Auto Immune Hemolytic Anemia) and even more rare non-hemic autoimmune conditions. There are others like me where I believe having CLL had the effect of actually stimulating elements of my immune system. I remained free from all manner of pathogenic infections, with the sole exception of one cold, from late 2005 to 2011 when I began Ibrutinib and began to have an expected level of minor colds. The real weird thing was that as my CLL became aggressive during 2006 I lost two longstanding chronic conditions being a foot fungus I had for over 40 years and herpes simplex perennial blisters I would get every Fall on my right nostril. Go figure!

Given my relative freedom from infection to address your question of assessing the risk vs benefit of any live vaccine like the shingles vaccine I came down on the side of abstaining because even when CLLers are not getting sick and appear healthy we are living with a fragile balance of immune function that could swing into hyperactive autoimmunity or drop off the cliff into ineffective defense. We just don't know. In spite of my "healthy" appearance regarding lack of pathogen caused infections for so long I did developed a secondary Squamous Cell Carcinoma (SCC) cancer one year after first treatment with FR. Was the SCC a treatment caused secondary cancer or because my immune function, great in dealing with pathogens, was fundamentally weak in allowing the SCC to get started or maybe a synergy of the two?

Since being DX I have noticed, like you, a sluggish response to healing from wounds even now that Ibrutinib has got me into a CR after 31 months. My blood looks numerically normal as well as my once bulky and pervasive lymphadenopathy. My neutrophils, another measure of functioning immunity, are normal as are my IgGs. Numbers do not always equate to functionality. Ironically my foot fungus returned in Dec. 2013 as my ALC (Absolute Lymphocyte Count) was approaching numerical normalcy.

Bottomline for you or anyone DXed with CLL is to avoid all live vaccines until tests are developed to demonstrate the specificity of immune function or dysfunction on an individual patient basis. Although there is a correlation between levels of pathogenic illness and IgG, IgM and IgA numbers, the strength of the immune response cannot be determined and should be assumed to be compromised. Your bug bite issue is demonstration enough that your immunity is not up to par.

WWW

gemit2000 profile image
gemit2000 in reply toThreeWs

Thank you for the wise, weighty, and worthwhile explanation. I"m grateful for the education - salient and in-depth yet understandable ( I'm doubly grateful for you taking the time!)

Sincerely yours,

"Mutated" Gene

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