Living Without a Spleen?

My son, 14, lost his spleen due to an accident. What can I do to keep him healthy? He has had the vaccines recommended and took penicillin for two years. He is now on a multivitamin. He plays golf but complains of being tired.

– January 1, 2008

The spleen, located in the upper left of the abdomen under the rib cage, is part of the immune system. Its functions include storing old, damaged blood particles and helping identify and destroy bacteria.

Your son can live perfectly well without a spleen although he will be at higher than normal risk of contracting serious or even life-threatening infections. When the spleen is removed, patients need to be vaccinated against pneumococcal pneumonia, a bacterial infection of the lungs and other organs. Some doctors recommend vaccinations against other types of bacteria as well, and, in the case of children, may suggest long-term treatment with antibiotics to prevent bacterial infections of the bloodstream (sepsis). Long-term antibiotic use is usually not necessary in adults.

The most important strategy you can use to safeguard your son’s health is to make sure that he gets medical attention for even minor illnesses such as sore throat or sinus infections. Sometimes, antibiotics may be needed here as well.

The removal of his spleen is unlikely to be a factor in the fatigue your son is experiencing. Many teenagers complain constantly about being tired. Bear in mind that fatigue due to disease usually worsens as the day goes on while fatigue due to stress is often worse in the morning. If no underlying medical reason for his fatigue has been found, make sure that he is getting enough sleep (teens need about nine hours a night). Consider, too, whether your son might be depressed, also a leading cause of fatigue in adolescents and teens. If you suspect that he might be, ask his physician to recommend a psychologist or counselor.

You also could try giving him Eleutherococcus (Siberian ginseng), which, taken regularly, can help people who are run down, weak, lack energy and resistance, or suffer from chronic illness. Look for Eleuthero products in herb and health-food stores, or combination products that include cordyceps and ashwagandha, two other herbs I recommend to address fatigue. They vary in concentration and potency, so follow the dosage recommendations of the manufacturer.

Andrew Weil, M.D.

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