How CAD will affect this year’s Fourth of July celebration

My limited energy will determine which festivities I can participate in

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by Mary Lott |

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Boom! Splash! The night sky exploded with a blossom of color showering down overhead.

I am remembering a past fireworks display. Talking ceased as we all gazed upward. Then, almost in unison, the crowd said, “Ah!” followed by, “Oh,” as the next explosion shimmered downward. For the next 20 minutes, we all enjoyed the spectacle of Fourth of July fireworks.

I love fireworks displays. For me, they are associated with happy memories, summer vacations, leisurely picnics, family get-togethers, summer foods, and friendly competitions doing silly things we never do at any other time of the year. Some families go to a lake and ride in boats all day long. My family would cook hamburgers and hot dogs, always followed by s’mores (a gooey melted concoction of graham crackers, chocolate bars, and roasted marshmallows) for dessert.

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Our ways of celebrating have changed slightly over the years. When my family first moved to Papua, Indonesia, we Americans celebrated privately among ourselves. School was out, so we had picnics and parties at the beach. But fireworks were difficult to obtain. In Papua, New Year’s Eve is when we see the big fireworks displays.

This year, I will be visiting my daughter and her family in Junction City, Kansas, over the holiday.

Numerous colorful fireworks explode across a dark sky as part of a Fourth of July celebration.

A grand display one Fourth of July. (Photo by Mary Lott)

How CAD changes things

As with all things, I judge my participation in any celebration, even a family Fourth of July event, with an eye to my cold agglutinin disease (CAD). This condition means that at certain lower temperatures, my red blood cells clump together (agglutinate) and then are destroyed. The resulting symptoms include anemia and fatigue. Because there are fewer red blood cells, less oxygen is carried throughout my body. The anemia is not caused by a lack of iron in my blood.

I’d been slightly fearful that my daughter’s energetic husband had planned a Fourth of July hike in a nearby park. My CAD has made hiking difficult for me, as I must always make adjustments based on my limitations. This time, I’m dealing with a possible meniscus tear in my right knee. I haven’t had it assessed medically, though, so I’m not positive what the issue is.

About four weeks ago, I became aware of pain in my knee. It hurts to bend my leg, and I must be careful not to twist when moving about, as turning further injures my knee. While CAD didn’t cause the injury, the condition certainly affects my recovery.


Injuries of any sort take longer to heal for those of us with CAD or any type of anemia. When there is damage to the red blood cells, organs and systems don’t receive the nutrients needed to promote healing. I will become very concerned if in two more months my knee isn’t significantly better. But for now, because I know that “CADdies,” as we with CAD call ourselves, take longer to heal, I will continue with my home treatments.

Musculoskeletal injuries are often treated with the RICE technique, which involves resting the affected area, icing the injury, applying compression, and elevating the area. I have no problem with three parts of this technique, but there is no way on God’s green earth that I will put ice on my knee! Nope, I’m not going to do that.

Ice is anathema to CADdies. Instead, I have a heating pad that I wrap around my knee. This website recommends using heat packs “to help increase blood flow and ease aches.” Heat helps me significantly. I can walk more easily and with less pain after several hours of using the heating pad.

I have just learned that, instead of a hike, we’ll be attending a friend’s backyard cookout on the Fourth. Perhaps there will be badminton games, relay races, or other competitions. I will have to opt out of these. If there is a swimming pool, I intend to get in. I love to indulge in warm water therapy.

Fourth of July parties and celebrations are always good fun for me. Whether the group is hiking, playing badminton, racing, or doing other exciting activities, I always consider if CAD will limit my energy and ability to participate. This year, I’m looking forward to the barbecue and watching fireworks, but as for any energetic activities, I will be an enthusiastic cheerleader.

Note: Cold Agglutinin Disease News is strictly a news and information website about the disease. It does not provide medical advice, diagnosis, or treatment. This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website. The opinions expressed in this column are not those of Cold Agglutinin Disease News or its parent company, Bionews, and are intended to spark discussion about issues pertaining to cold agglutinin disease.


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