Wandering Hand Disease

by Patsy Collins
^{(creative writers at http://www.morewriting.co.uk)}

"What are you doing, Nigel?" Lauren giggled and moved his hand back to her waist.

"I told you there were advantages to going out with a medical student; this is one of them."

She gave him a look over the top of her 'medicinal' glass of red wine. "You mean I get to play doctors and nurses with you?"

"Lauren! How can you say that? This is entirely for the good of your health, you know. I'm giving you the benefit of a full and thorough private examination."

"You seem to be examining some bits rather more thoroughly than others," she replied and again repositioned his hand. "I suppose you've got some clever reason for that?"

"Indeed I have. Right now, I'm checking to see if you have swollen lymph glands."

"And have I?"

"I won't know until I've examined you, will I?"

"I suppose so ... Hey! Are you sure I've got lymph glands there?"

"Positive. They occur throughout the body."

"So why aren't you examining my feet?"

"Well, there are areas of the body where the lymph glands are grouped together in chains. These include the armpits, groin and head and neck."

"Oh! I remember that when I was little, my granny used to say about my glands being up when I had tonsillitis or a cold. Is that the same thing?"

"Yes. It's common for the lymph glands to swell after contracting an infection. If you had an infection in your throat then the glands on your neck would be the ones infected. And if you had an infection just here," he said moving his hand across her tight, pink sweater, "the ones in your armpit would be the ones that were swollen."

"Gerrof and explain this properly, you've got me interested - and no claiming you've got an infection somewhere and wanting me to feel whatever is swollen up."

"Lauren, Lauren, you've sadly misjudged me."

"Whatever."

"All right, you win." He touched her behind her ear. "Just here are your occipital lymph glands." He ran a finger down towards her neck. "Would you like me to point out your cervical lymph glands?"

"No! I'm not a medical student, but I have a good idea where my cervix is and there's no way I'm going to let ..."

"You're doing it again."

"Doing what?"

"Misjudging me." He gently tapped her neck. "The cervical lymph glands are right here and down here, just above your clavicle or collar bone are the supraclavicular lymph glands and below them ..."

He moved his hand down. She leant away from his touch and placed her wine on the coffee table.

"OK, I get the idea; there are lots of them all over the place. What do they do?"

"They're an important part of the immune system. The glands are connected by a network of lymph channels. Lymph is a watery fluid that forms between the cells of the body. It travels through the lymph glands, into the lymph channels and drains into the blood vessels. Both the glands and channels of fluid contain white blood cells, known as lymphocytes, and antibodies. These defend the body against infection."

"They don't seem to be protecting me from your wandering hands ..."

"I've told you, you don't need protecting from me."

"Really? Do you think I should phone my big brother for a second opinion on that?"

"Is that the big brother who's an eighteen stone scrum half for the university rugby team?"

"That's the one."

"Then no; we don't need to bother him." Nigel sat up straight, picked up the wine glasses and handed one to Lauren.

"I thought not," Lauren said after a couple of sips. "What about the lymph glands, do we need to bother about them?"

"Not usually. Most people aren't really aware of them. They're normally pea-sized and can sometimes be felt under the skin."

"Even when they're not swollen?"

"Yes."

"Can you feel mine?"

"I wouldn't like to take such a liberty; I'll keep my hands to myself."

"Are you sulking?"

"Certainly not! Just making a point."

"Oh, OK. Go on then."

He did.

She slapped his hand. "I meant go on with the explanation!"

"Ah. So sorry; my mistake." He didn't look sorry.

"The lymph glands that are under the skin become more noticeable and easier to feel if they swell. They can get to the size of a biggish marble. There are also lymph glands deeper in the chest or abdomen, but they can't be felt even if they swell."

"And they just swell when there's a nearby infection?"

"That's the most common reason. As the immune system deals with the infection the glands swell and can become tender. In that case they'll go back to normal a week or so after the infection. If the infection is a more generalised one, rather than localised, then glands all over the body could become swollen."

"Are there other reasons for them to swell?"

"Cancers could have that result. Occasionally cancers can spread to nearby lymph glands. As with an infection, the glands nearest to the site of the cancer would be affected. Lymphomas and leukaemias which are cancers of the lymphatic and blood systems might well cause a lot of glands to swell."

"Can you tell the difference between that type of swelling and one that's just due to an infection?" Lauren asked. She finished her glass of wine.

"Generally swollen lymph glands due to cancers develop more slowly than those due to infections. They also tend to be painless at first. There may not have been any infection to explain the swollen glands and they're unlikely to return to normal size as would be expected if the swelling was due to infection."

"So if I found a swollen gland and didn't know why it was swollen and it didn't go down, I should be worried?"

"I don't want you to worry about anything. Have some more wine." He refilled her glass and handed it to her. "That doesn't mean they have cancer, but it is one possibility. It's also possible that swollen glands could be caused by a reaction to drugs or as a result of another medical condition. Although these are all rare, it's better to check than to let a serious problem remain untreated. It's important for anyone who has unexplained swollen glands or glands that don't return to normal in a couple of weeks, to go and see their doctor."

"Or get a friendly medical student to give them the once over?"

"You see, I knew you'd begin to see things my way."

"Yeees, maybe. So what treatment would you suggest if you found a swelling?"

"That would depend on the cause. Obviously, until I'm fully trained if I thought you needed any kind of treatment, I'd advise you to see your GP. If you'd recently had a viral infection, then you probably wouldn't need any treatment. I'd just check to make sure the swelling went down."

"Hmm. I guess if the gland below my clavicle was swollen, you'd check on an hourly basis?"

Nigel put both of their glasses onto the coffee table. "It's important to be thorough."

"Hmm, maybe I should check yours?" She kissed his neck. "What did you say this one was called?"