Men's things XXXV: A Man's Search for Dignity

Pursuing a Diagnosis

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I have found myself at the intersection where solutions designed for women seem to be just as suitable for men.

Many years ago, this first arose when I set about addressing folic acid deficiency anaemia. It was flagged when I noticed an out-of-range and irregular reading of my MCV (Mean Corpuscular Volume) blood test, which pointed, in the first instance, to a possible nutritional deficiency of folic acid, iron, or vitamin B12.

At my insistence, I persuaded my GP to order the specific tests for serum folate (folic acid), serum ferritin (iron), and serum B12. It was discovered that my folic acid levels were quite low; hence the diagnosis of folic acid deficiency anaemia.

Since then, I have requested the granular serum tests that sit beneath the headline MCV.

Pills Made for Mothers

I bought over-the-counter folic acid tablets, each with a strength of 400 micrograms. The label on the container carried the message, “Supports the overall health of your baby during conception and pregnancy.”

Well, I did a double take. The ability to conceive or carry a baby is not one I possess. My GP then gave me a prescription for folic acid at a strength of 5 milligrams, twelve and a half times that of the over-the-counter tablet. It meant I was not going to fix my deficiency by popping chemist pills.

A New Reality

Anyway, we have grown inured to watching adverts for sanitary towels and pads on television, and to seeing what the women using such protection get to do once their fear of leaking, and of embarrassingly revealing their flow, has been overcome by advances in sanitary towel technology.

Now, following treatment for prostate cancer with radical radiotherapy, I have experienced occasional bowel incontinence and regular bladder incontinence.

Once, in the case of the latter, it was the cover of darkness and a long overcoat that spared my blushes when my red chinos were soaked through.

Searching for Protection

For anatomical reasons, I could not simply start wearing feminine sanitary pads, just as I had taken to correcting folic acid deficiency anaemia with pills marketed primarily to fertile and pregnant women.

The male incontinence underwear I found was expensive, and it did not contain the urgency to the extent needed to forestall embarrassment.

The protection did not entirely eliminate the fear of emission or excretion; it offered only temporary safety, in the hope that you might reach the refuge of a convenience before the dam burst.

Adverts Not for Men

It goes without saying that the strain of advert music with the line “body formed for you”, or the tagline “Always with wings”, does not pertain to menfolk. Either we are too poorly served, or I need better discreet guidance when I visit a department that accounts for dignity in its solutions, without public spectacle.

So, imagine how I felt when a new advertisement came on television this afternoon for the Always Discreet Maxi Comfort Pads 9 Drop, offering the highest-absorbency pads designed for heavy bladder leaks, with a wider back for 50% more coverage and OdourLock technology. If only that catered for me too.

What We Actually Need

You might ask why I have not considered nappies for adults. It is a valid point, but that also suggests a level of incapacity and loss of control that is probably excessive for my current situation. It is a concession I do not think anyone, adult female or male, would make willingly if nature had not imposed it without option.

Minimal, unintrusive, anatomically aware, fully absorbent, and effective is what we need: coverage, protection, and odour lock without bulking out your trousers. There, I have written the advert for a product that serves bladder incontinence in men.

Breaking the Silence

My own route to this predicament was prostate cancer, but I am hardly the only man walking about with a secret and a spare pair of trousers in mind. Age brings it, an enlarged prostate brings it, so too do surgery, diabetes, neurological conditions, and plain bad luck; the company is far larger than the silence would suggest.

That silence is convenient for everyone but the men living it, and it is worth naming the circular trap at its heart: manufacturers under-serve men because men under-report, and men under-report because they find themselves so poorly served. Somebody has to break the loop, and it will not be the men, who have every reason to say nothing.

Which leaves the people who make and sell these things. I have, after all, written their advert for them; the product is the easy part, and dignity costs no more to design in than to leave out.

A slim thing built for male anatomy, an honest range of absorbencies, odour locked away, trousers uncreased, and a shelf a man can reach without rehearsing an explanation, none of this is beyond an industry that manages it handsomely for women.

A Matter of Dignity

The country decided, from January 2021, that period products should carry no VAT, recognising them as a plain necessity of life rather than a luxury; a woman buys them relieved of tax and relieved of explanation.

Incontinence products, as it happens, can also be had free of VAT, but only once you have declared yourself “chronically sick or disabled”, the very badge of incapacity I was at pains to avoid. [The UK Parliament: VAT on incontinence products (PDF)]

So, the tax is not quite the point. The point is that one necessity is met with a shrug and the other with a form; that dignity, for some of us, still comes conditionally. These things need thinking about, even if men's things rarely get talked about.

Related blogs

Blog - Folate, I must, lactate, I can't - June 2017

Blog - Lazy January is a call to change - January 2024

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Blog - Men's things XXXIV: Saving the life, and saving some lifestyle

A Gemini Notebook AI Podcast on this blog

Lazy January is a call to change

Resolved not to resolve

I stopped making New Year’s Resolutions quite a while ago, not out of the lack of discipline to stick to a resolution but for the fact that the self-flagellation that follows any such decision is more brutal and guilt-ridden than necessary.

Whilst times, dates, and seasons offer much to reflect on and deliberate with some self-awareness of the lacking and the possible, any day can be chosen to resolve to do anything without becoming a hostage to fortune.

For instance, some people have attached themselves to the Dry January campaign, the resolve to keep the month alcohol-free until I saw some making exceptions for one thing or the other, and soon, the dry had become wetter than a fish in water. Exceptions and adjustments matter in terms of the inadvertent or the unexpected, the ability to accommodate variance makes for a better-rounded personality.

Stepping off the steps

However, it was when I checked my Huawei Health app to see if I was doing something as regularly as I had somewhat thought of doing but in the review was hardly even getting anywhere that I realised I have had a Lazy January. I had only exceeded 10,000 steps twice in the month, I could not bear to step on the weighing scales to see the numbers and I have gained a bit more to the circumference of my midriff as my belt would appear to suggest.

This is not what I expected as I had reached my lowest weight in over a decade just some 4 months ago. I have to do better, as my resting heart rate has increased and my blood pressure is reading numbers I have not seen in a while. Just some exercise should fix that.

My maternity issues again

The other cause for concern is anaemia because of Vitamin B12 and folate deficiency (Yes, we all need folic acid, not just pregnant women.), this is something that appeared in the bloodwork from about 5 years ago. Not enough of it is getting in from my diet and the risk of peripheral neuropathy with its otherworldly feel is so strange. The feeling of intense pain at the back of the hand with numbness in the phalanges, and yet you can move your fingers with all dexterity, I might just give my doctor a call for injections instead.

One thing I have meditated about and quite resolved to do is to get back to walking again. Any dog that dares to approach me I will rebuke in the name of Jesus, I have no time for being nice to dogs out of control. Those who as I saw this morning seem to think their XL Bully dogs do not need to be on a leash and muzzled as the law requires are soon to have a tragedy of many proportions.

Let’s get to being fitter and healthier, for no other reason than it gladdens the heart, and you feel hale and hearty. We are consigning both the Dry and the Lazy January to the dustbin of irrelevance. Just be good to yourself loving yourselves each day.

Related Blogs

Blog - Resolutions unlimited (December 2003)

Blog - Happy New Year - 2007 (January 2007)

Blog - New Year's Considerations (January 2008)

Blog - Folate, I must, lactate, I can't (June 2017)

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.