Thanks. That is interesting. Our bodies are so intricately woven; each person presents with their own set of challenges.
Mine is cold agglutinin disease. CAD occurs when RBCs are exposed to low temperatures. It basically clumps the RBCs together and then they are destroyed by the antibodies. Low temperatures, but it has been discovered, infections can also set the “complement cascade” in motion. I put scare quotes around complement cascade as I don’t understand it. I only know it is there.
Did I read that you have surgery today - Tuesday? Or is it next week? Let us know how that goes. My prayers are with you.
Complement cascades can be scary. There is always some nascent complement awaiting a trigger. Once triggered, it's like a pack of dogs going after the target. That just sets the stage for the follow-up action. Hemolysis in your specific case. Stay warm and comfy. No ice bucket challenges.
When I was in grad school immunology, each student in class participated in a blood test. A sample of blood is placed on a slide and a reagent consisting of very fine teflon balls in a orange carrier fluid is dropped onto the sample. The slide is gently rocked to mix the reagent with the blood sample. Many others started ahead of me and kept asking what was supposed to happen. Nothing for most. My slide turned almost solid with just 3 gentle "rocks". Hey, this is different. The basis of the test is the teflon spheres become coated in antibodies from the serum. If there is an auto-antibody present, it will cling to a RBC. If another RBC nearby contacts the same sphere, it "glues" the RBCs together (agglutination). In my case, all of the RBCs converted to a flat, stiff mat on the slide in under 2 seconds. I suppose it would be a bad idea to ever allow teflon spheres in my blood supply. The test is intended to expose the presence of auto-antibodies and often heralds rheumatoid arthritis in later life. It was spot-on in that respect.