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.

In maternal discomfiture

In maternal dispute

Just about 6 months ago, I went for a neurological diagnostic test just to ensure that my concerns about memory and reaction were not a systemic degeneration of my capabilities, though for what I had noticed about my concerns I had designed elaborate compensations for.

Blog - My HAND on my head - Memory Screening Tests

It so happened that all my considered reflexes and powers of recall were fine even if order and precision were not exact, my consultant did not think there was a problem. However, he did recommend I do a barrage of blood tests just to determine if there were other treatable conditions to assess.

The results of the blood tests suggested a Folic Acid Anaemia Deficiency (FAAD) for which I was to take Vitamin B12 and Folic Acid supplements.

Blog - Folate, I must, lactate, I can't

Keeping the flu at bay

To deal with the FAAD, I got Folic Acid 400 µg from the pharmacy and was not particularly comfortable with the label that suggested it was for pregnant women as it contributes to maternal tissue growth during pregnancy. As it transpires, everyone needs Folic Acid for cell growth and development, and this should be obtained sufficiently from diet except when pregnancy demands more than is supplied in the diet.

This morning I called my General Practitioner to schedule my influenza vaccine which I took for the first-time last year and has on the recommendation of my consultant to be taken annually. I was given an immediate appointment from an hour hence and I walked up two streets to see the nurse.

When I was called in, after the basic formalities of my identity and a few questions about reactions and allergies, she brought the vaccine out of the fridge, pricked the upper shoulder muscle of my left arm and injected me. I am usually surprised at how they call the prick of a needle a scratch because it is not. However, the needle is quite thin that it rarely bleeds after the injection.

In maternal balance

Then I asked about a possible Vitamin B12 injection booster that my consultant told me of at our last meeting in September, but the nurse needed to see recent blood tests to be sure of whether that was necessary. Going through me online file, she found a recent letter from my consultant which indicated my FAAD issue had gone and my readings had returned to normal.

To be honest, I was not keen on the Folic Acid supplements and I only took fortified cereals for breakfast for a few weeks. I am not a breakfast person, but I was glad to learn of the development, though surprised that I had not yet received a letter from my consultant about my latest blood tests from September.

A slight discomfort from the injection and I will be fine.

Folate, I must, lactate, I can't

A 'Don't Worry' Call

A couple of days ago, I saw a message on my phone. The doctor's surgery had called with a message from the hospital, I was to contact the surgery for a chat, but it was nothing serious for me to be concerned about.

There is a psychology to delivering news pertaining to health, and as long as it does not appear to be a life-threatening emergency requiring immediate action, they do well to allay your fears.

So, I called the surgery yesterday morning, where the conversation revolved around calling in to see the doctor for another few check-ups but for the fact that we could not find suitable scheduling since I spent the weekdays working in Scotland.

My lifelong gestation

The alternative was to have a quick chat to the doctor and see how things go from there. A few minutes later, the doctor picked up the phone and the conversation pertained to the results of the blood tests from the HAND analysis I did last month.

Then, the consultant ordered a battery of blood work to eliminate possible and manageable causes of my perceived short-term memory issues and attendant matters.

Apparently, I have Folic Acid Deficiency Anaemia, Folic Acid which is Vitamin B9 is also somewhat related to Vitamin B12. These two vitamins are essential to forming red blood cells, they help nerves function properly, Folic Acid is also essential in forming genetic material in every body cell, hence enabling perfect replication.

Knowing the reason why I forget to remember

Now, my knowledge of the use of Folic Acid supplements was for terms of pregnancy and though I have never seen my own period since before I ever knew what they were, I did wonder.

However, the deficiency explained the tiredness, insomnia, the occasional lethargy and the forgetfulness that I had highly compensated for through aide memoires, double-checking and reticence in proclaiming logical conclusions at work. That the cause could be dietary was also worrisome. I am working away from home and hence have no luxury of home cooking.

To make amends, I have to introduce cereals fortified with vitamins into my diet and I will consider supplements, yet I must be careful at over 50 not to run in excess of my daily allowance.

In three months we'll have some bloodwork done to ascertain if the deficiency has been remediated. I may not naturally lactate, but I must folate to keep well.