Issues pile up when I neglect the management of both CAD and my yard

I looked around the yard in dismay after walking through the rotting wooden door of our screened-in back porch to assess the challenges before me. The backyard of our Alabama home didn’t look like this when my husband, Mike, and I left it last summer for our work in Indonesia. My heart sank at the enormity of the work that needed to be done.

It seemed as if the oak trees that rim our backyard had somehow conspired to throw their biggest branches into the open area in the middle. Because the branches had not been cut, gathered, and removed, the weeds had launched an assault on our carefully tended zoysia grass. The thick carpet of our lawn was now a roiling mass of crabgrass and thistles. In our absence, these feral plants had commandeered our once-tamed property.

Things had cascaded out of control, with each neglected item creating bigger challenges. The weeds were the result of the fallen branches, while the rotting door was caused by the buildup of Chinese magnolia leaves, which brought in fungus and mold. These problems can and will be remedied, but it will be costly and time-consuming. Fixing everything will require more energy than properly maintaining it.

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Jan. 22, 2026 by Mary Lott

With my health from CAD steadily declining, I call in the cavalry, part 1

Cascading consequences

This same pattern of small neglects cascading into bigger problems appears in my cold agglutinin disease (CAD). Exposure to cold temperatures causes cold agglutinins to bind to my red blood cells (RBCs), forming clumps, which my body mistakenly attacks. The destruction of my RBCs results in anemia, fatigue, a compromised immune system, and circulatory problems.

CAD has also caused a problem I’ve been dealing with for several days now. Although I think my anemia is almost nonexistent at present, I still tire very quickly after any exertion. Then, I start cycling through a series of low, intermittent fevers that actually feel like an early phase of malaria. These fevers don’t reach 100 F and don’t last long. They break after a few minutes, and my face becomes dewy with sweat.

These episodes last two or three hours in the late afternoons or early evenings. They end when I take medicine to reduce the fever. Last January, however, I learned what can happen when I neglect or ignore the problem. It escalated into a hospital stay, where adrenaline was pushed through an IV inserted into my superior vena cava. I had developed sepsis!

CAD intensifies other things, too, such as the consequences of dropping a board on my toes. For most people, that minor accident would simply involve a lot of pain and colorful adjectives. But because my immune system is compromised, a pesky infection developed, leading to a visit to urgent care.

Another time, I carelessly stepped into a rippling brook during March. My toes became mottled with acrocyanosis caused by the cold water. Subsequently, hemolysis began, and by June, it was apparent I needed medical intervention.

With CAD, small issues can lead to costly, time-consuming remedies.

‘A stitch in time saves nine’

With careful thought, I planned for a slow Thursday last week. I had picked up Mike from the airport late Wednesday. While the Hartsfield-Jackson Atlanta International Airport is only an hour and a half from my home, his flight didn’t arrive until late in the evening. We got home close to midnight.

While my jet-lagged husband was up and about after eight hours of sleep, I drowsed the entire day. Since I haven’t completely recovered from the effects of my rituximab and bendamustine treatment this past winter, I knew I’d need extra time to recover from the stress of the late-night activity. CAD and age keep me from bouncing back quickly.

I have already discussed the repairs and gardening that need to be done with Mike. We’ve shopped for doors online and will purchase new ones this week. The offending tree with its large leaves has already been removed. Branch cleanup commences Monday and will provide firewood for cookouts.

A proverb I’ve heard all my life is “A stitch in time saves nine.” This means that strengthening a garment’s seam with a single firm stitch prevents the need to repair an embarrassing rip later. That proverb is true for my yard as well as CAD.

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.