Old Spleens Suck (2021)

As an adolescent around 1990, I burst my spleen in the final minutes of a school ski trip. Nearly bled to death as the school staff transported me home and left me in my living room to be found later by my parents nearly unconscious.<p>Anyway, I got to the emergency room that evening and there was much debate whether to remove my spleen. They decided not to and instead kept me hospitalized for 10 days and then out of school for 3 more weeks after that waiting for it to heal on its own.

There’s another interesting spleen fact that I remember reading: people who survive flight ejections and hitting water at high speed tend to have had their spleens removed.<p>Probably because otherwise the impact causes a rupture and you bleed out too quickly to survive.

I honestly expected this article to be about the other meaning of spleen, a melancholy or depressive longing (as in Baudelaire’s “Le spleen de Paris”). Something about looking forward, giving up old spleens, etc.<p>Instead it’s genuinely interesting information about how an organ changes over time.

The premise of this article is based on a single study in 1969 on mice. I agree with the general premise that the immune system ages and becomes less effective as we get older, but will need more convincing that removing the spleen will make you live longer.

IIRC a lot of our data about human splenectomy comes from World War II, where it was performed often enough that some long term followups were possible with sufficiently large n

I&#x27;ve been without a spleen for longer than I had one. I wonder if -- if any of this translates to humans -- spleens are beneficial to the young but a risk to the old, meaning that since I survived my youth without, it&#x27;s all good going forward; or if young spleens give long-lasting benefits, meaning that the best course is to <i>have</i> the spleen into old age, but then jettison it later in life (than I did).

Is there a good introductory book on understanding inflammation and autoimmune diseases?

I&#x27;m getting my spleen removed on the 11th of April. I&#x27;ll let y&#x27;all know how it going in a few years. I&#x27;d do anything to fight back these wrinkles.

I wonder if senolytics like Fisetin or Quercetin could help reduce those problematic cells.

Huh. Well, this is interesting. As someone who’s been <i>sans spleen</i> since age eight, all I ever heard or read about was my risk for minor bacterial infections to potentially turn into overwhelming sepsis. I was put on penicillin VK 250 mg twice a day prophylactically from the time of my splenectomy until age seventeen, when I transferred to an adult primary care physician instead of my pediatrician. I have to get the pneumovax (which protects against multiple strains of bacterial pneumonia) every five years. And I’m still constantly figuring out if I’m truly up-to-date on all my other vaccines, because some of them (like the new multiple flavors of meningitis vaccines) didn’t exist when I was younger. In short, I’ve also associated my lack-of-spleen with hypervigilance about health, and not as a potential benefit as this article posits.<p>Also, splenectomy led to some fun times during the pandemic because it was and is somewhat unclear whether being permanently immune-compromised due to a splenectomy applied really only to bacteria and sepsis risk, or possibly to virii like coronovairus too, since antibodies and the things that help you “clear” an infection (including a viral infection?) are also produced in your spleen. In the UK, having had a splenectomy was explicitly listed as a condition for what they called “shielding” during the worst of the pandemic, but in the US it was not considered to be a condition named for early access to a full third dose (rather than a booster) of the vaccine.<p>Other side effects, not mentioned in this article:<p>- I now have <i>enormous</i> tonsils, to the point where my uvula hangs at a 45 degree angle, probably because the tonsils are making up for the spleen loss, since they serve a somewhat similar function.<p>- As another commenter here notes, we basically only have long-term data on splenectomized people’s outcomes because of WWII. The small risk of quick sepsis is always going to be there, and did impact their lifespan. But we don’t have enough recent data, in an age of more available antibiotics, to say if there are other potential problems to look for.<p>- As for histamine&#x2F;allergy or autoimmune issues being lessened in mice without spleens —- well, I have the same annoying allergies as everyone else in my family, take Claritin daily, and developed auto-immune antibodies due to celiac and then got the oft-associated thyroid problems. So, a sample size of one here, but a splenectomy didn’t seem to be protective against either of those immune-related outcomes here.<p>All that being said, I don’t miss having a spleen. It was breaking down my entire (congenitally somewhat mishapen) red blood cell supply as a kid, like a swimming pool filter run amuck, leading to anemia and exhaustion and pallor. And while removing it did not make my blood cells gain a normal shape and size, it completely changed my quality of life.

Some insights into a rationale ex-spleen nation of the future. Thanks for sharing.

I think it is obvious at this point that the human body is designed to self-destruct, causing death at old age, once a certain biological threshold is reached. Resistance to this idea comes not from a rational perspective, but a semi-religious belief that your own body would not betray you.