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.

My HAND on my head - Memory Screening Tests

Now I Remember

‘It loves the brain.’ He said. In fact, there are many things that go after brain for all sorts of reasons my lack of medical expertise cannot explain.

Quite particularly, sexually transmitted diseases, everything appears to happen down there and once contracted they want to travel to the very top and take control. Nature seems to have beings in the ascendancy.

I had an appointment at the hospital on Thursday, if I can remember clearly, I thought it was in relation to the abdominal scan I had just two Saturdays ago since the letters literally arrived at the same time.

I took an Uber cab for the 9:50 AM appointment which was on a surge pricing and we made it on time without any of the stress of the appointment before the last. Ushered in by the staff, rather than stand on weighing scales I sat on one and it appears with clothes on, I am dropping kilogrammes.

Correct in my assessment

My blood pressure also read within the limits of acceptable for the first time in 4 visits which was really good news for me. I was called in to see the consultant where I was told it was my appointment for the HAND clinic or the Memory Screening Clinic.

Now, for a person above 50, I needed to be sure that certain elements of my activities in forgetfulness, responsiveness and anxiety which I somewhat have found compensatory mechanisms for were either age degenerative or as a result of my long-term condition.

The session which lasted almost 90 minutes started with filling in a Hospital Anxiety and Depression Scale form that pointed towards elements of anxiety that needed a bit more analysis. However, since this was our first clinical assessment, much was dependent on what I subjectively thought were issues bothering me.

Suffice it to say, I completed that form and even annotated a grammatical correction to give a sentence a finality in context rather than the open-ended inquiry. Then I was passed the 'Questionnaire for HAND clinic' that required long form writing and I probably gave a detailed treatise to about 20 or so questions.

Convention is indistinct

After that, a number of cognitive tests were performed on transcription, memory, recall, acuity, reflexes, alertness and so on.

One such activity required drawing a clock with time 10 minutes past eleven, I went for a square face with 4 cardinal point numbers and then the minute and hour hands. A majority, I was told, draw a round clock face with all the numbers in before putting in the hands. Minimalist and functional works for me and that was some reflection on the kind of personality that I am.

I was good with the numbers tests, but I was never able to recall the words in the right order, even though every time I got all the words right and then after ten minutes of other activities. The reflexes seem to be fine and it would appear I have good cognitive skills that fall well within the standard deviation of normal.

Remember to smile

It would take a couple of tests over years to determine if there is any degeneration and whether through the results of the blood tests there are other noticeable indicators that can be controlled with reference to my thyroid, my liver, blood counts or folate functions. I might be in for a computed tomography scan of my brain – awesome, but will not be keen on a lumbar puncture for the drawing of cerebral spinal fluids.

By process of assessment, analysis and elimination, it is good to have this kind of activity in professional hands than leave it to my personal perception and watch some deterioration as a matter of course. It would appear there is not much to be concerned about, but I can in future request clinical psychiatric assistance if needed.

The ‘It’ at the beginning of the blog is HIV and the HAND is HIV-Associated Neurocognitive Disorder which in my 15^th year since diagnosis, though on my 8^th year of treatment seems to be well managed with an improving CD4 count and an undetectable viral load. All other indicators from my blood tests of two months ago seem fine too. I guess I remembered most of what happened and kept some back for privacy.

Everyone with HIV should consider attending a HAND clinic and at least every 12 to 24 months thereafter.

Hospital: Gasping for breath on an ultrasound scan

Gasping and rasping

“Breathe in and hold your breath.” She said the second time and she must have forgotten to say I could breathe out. As a reflex, I took a sharp intake of breath, an indication of a number of things that I need to address.

Firstly, I do need oxygen more than I need to expel carbon dioxide and it was a sign of my being unfit that I could not hold my breath for as long as might be ordinarily expected. My morning walks do not seem to be enough exercise over the last couple of weeks.

Having returned from Edinburgh late on Friday night, I had an appointment for an abdominal scan on Saturday morning, quite a fortuitous appointment that would normally have been on a weekday. After my check-up in March that had me noticing that my last liver scan also included scans of my pancreas and gallbladder, the consultant suggested a review.

Scans of the innards

Going from the major cyber-attack that affected the NHS amongst other institutions and companies on Friday in about 99 countries, I was concerned my appointment might be cancelled, but on seeing nothing of significance on the hospital website or getting any notices by SMS text, I hoped for the best and arrived on time for the appointment.

Having an ultrasound scan [NHS] rather than an X-ray [NHS], a CT scan [NHS] or an MRI scan has many advantages, the preparation is less cumbersome and the side effects are minimal apart from the possibility that the high-frequency soundwaves might heat up tissue and cause air bubbles, but it has not been considered a serious risk. Ultrasound is also quite well-suited to reviewing soft tissue, though the most common application of this is viewing the foetus in the womb.

However, in preparation for the scan, I could not eat at least 6 hours before the scan and whilst I could drink water, I was to avoid carbonated drinks, milk or fatty foods before the scan. Having the scan in the morning meant I did not have to go hungry for long. I was to wear loose clothing too.

Gels for the cells

Soon after I was registered I was called into another waiting room where a few minutes later I nurse called me into the examination room. I took off my jackets and laid on the bed pulling up my shirt and my vest, in eventually had to take off my shirt. Lying on my back, she applied a gel to my belly which was pleasantly warm, warmed by the instruments in the room, I suppose and different from the cold shock I had some two years before.

The handheld probe was then put against my skin and she began to move it around, clicking on the keyboard at intervals, possibly taking snapshots. I must say, there was a bit of pressure applied and for my somewhat weak ribcage, it felt uncomfortable but not painful. When I had to turn on my side, more gel was applied, this time, a bit cold and this was where I had to breathe in and hold my breath for probably over a minute before respite.

Done and gone

The whole activity took about 15-minutes and though I knew not to ask her medical opinion, she volunteered that there were no radical changes to my gallbladder from what was observed two years ago. I will return in just under two weeks to see my consultant for the medical opinion.

Apparently, the hospital was not affected by the ransomware attack because the moment they learnt of the attack all ingress traffic to the hospital was blocked and technically, they isolated themselves from the world.

I guess I was in the hospital for just about 30 minutes before I left to do some shopping for ethnic goods and returned home to catch up on some much-needed sleep. I had not slept that well overnight, maybe out of excitement or anxiety and I had to rested well enough for my early journey back to Edinburgh today.