Wednesday 21 February 2024

Read and analyse the bloody tales and trends

Above range readings

Earlier this month, I contacted my GP (doctor) to discuss the results of tests I took in November when some indicators gave me cause for concern. Usually, I would wait for my next biannual checkup and visit with a range of questions and analyses of trends I want explained in essential layman’s detail to my understanding.

Especially now that every single result is posted to a personal portal from which you assess the test results against the expected normal ranges and the trends over a period. Two measurements stood out in the blood tests I took in November, the Mean corpuscular haemoglobin (MCH), measured in picograms per red blood cell [pg] with a normal range of 27 to 33, and the Mean corpuscular volume (MCV), measured in femtolitres [fL] (10-15) with a normal range of 80 to 98, and it is a measure of the average volume of a red blood corpuscle or red blood cell.

When they measure above the normal range, this might be indicative of a form of anaemia related to iron, folate, or Vitamin B12 deficiency, and since I once had folate deficiency anaemia, I wanted this addressed before other issues resulted from it.

Even more detail

My GP invited me to the surgery for a complete set of blood tests where each of the indicators would be checked and I was ready to pursue better outcomes by looking the trend between November and February to urge immediate action.

On reviewing the new results, the MCV had returned within the normal range, but the MCH remained the same reading as before, a note from the assessor suggested no further action was required, I begged to differ and consequently we had a conversation today about those results.

What made the difference this time was serum levels were read for ferritin pertaining to iron, which was normal, Vitamin B12 was also within range, but the folate was well below range. I had already been taking vitamin and folic acid supplements from over the counter, however, I felt a stronger prescription was needed.

The prescription matters

I picked up my prescription from the pharmacy and when I opened the pack, the comparison between over-the-counter medication and the prescription was astounding, I would never have been able to get back into the normal range with the supplements and just my diet. The over-the- counter medication has a dosage of one tablet daily with a strength of 400µg, the strength of the daily dose of folic acid is 500mg, meaning I would have had to take 12 and a half tablets of the non-prescription medication to have any prospect of righting the folate deficiency.

For all that I have written, the main takeaway from me to anyone who takes good consideration of their health is to read to understand every test result you get. Ask questions where things are not clear. Fully pursue any concerns you might have, and seek a second opinion if you are unsure, uncertain, or unhappy.

Always follow through

The NHS is in the process of implementing Martha’s Rule, a set of protocols that would ensure that concerns about a patient’s deteriorating condition are subject to rapid review when raised. It would not be enough to just get assurances or be fobbed off by superciliousness, someone would have to attend the situation and arrive at a conclusion with commensurate action to address the emerging or emergency.

Hence my advice to read the bloody tales and ensure someone is addressing anything that falls out of the normal ranges with alacrity, consideration, and professionalism. In my case, we’ll have another review in a few weeks.

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