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.

Men's Health: Do the important and intimate checks

Looking forward

I have noticed an enthusiasm with which I talk about becoming 60, I am hardly 2 months into being 58, yet, next year is the golden jubilee. I first noticed this when I attended a group session that involved yoga exercises, I could not help but notice my apparent flexibility as compared to many of the younger participants. Our yoga instructor herself is 60.

However, it is not just a matter of age but one of wearing it well, the whole body positivity discourse also involves a bit of work on our part, it should not be a license to just let everything go. Indeed, we should be happy with our bodies, especially with the things we cannot change, things we can change with regards to losing pounds/kilos, healthy eating, a bit of exercise, and basic medical check-ups must be attended to.

Screenings galore

Those things have had my medical minders harping on about what should be checked and noticed so issues can be caught and dealt with promptly. The other day, it was the NHS sending a bowel cancer screening kit that required a sampling of my stool for analysis to be sent in the post for a result that thankfully meant there was nothing to be concerned about. This, I am informed, would be checked every two years.

Another range of issues that have come up have to do with blood pressure, diabetes, prostate cancer, liver and kidney function, and cholesterol checks. Most of these I have twice a year under my regular clinical checks apart from the prostate cancer prostate-specific antigen (PSA) test. This has come up in a few discussions in group sessions and even closer to home but has been left unattended to.

Blood tales

When the results of blood tests came in just over 2 months ago, I found that my mean corpuscular volume (MCV) and mean corpuscular hemoglobin (MCH) were reading beyond the normal range on the high side and indicative of both Vitamin B12 and folate (Vitamin B9) deficiency. This would mean despite my consumption of red meat and other aspects of diet; I was not getting enough from food and even supplements. All other indicators are normal.

This issue of Folic Acid Deficiency Anaemia came up about 7 years ago and I took supplements for it that subsequent readings came within range. It is the symptom of peripheral neuropathy in my right hand, that got me a bit concerned that I had to call my GP surgery for a conversation, and this meant I was in the surgery early this morning to give blood for a whole battery of tests to assess basically everything.

Eye on the future

It is not only for peace of mind, the knowledge about how your body is performing can allow for the necessary adjustments to keep you well and healthy. I know it is difficult for men to broach and discuss intimate health issues, but what is worse is leaving it to a point when you literally have no other options apart from facing terminal and possibly managed decline.

Having once had life-threatening cancer almost 15 years ago, I am aware of the need to be informed and understanding of the conditions in my body. There are probably times I have been fatalistic thinking I did not have much time left and did not effectively plan for the future. There have been such great advances in medicine and outcomes, then the good results of tests conducted over a decade that would suggest that I have been miraculously blessed to have better health, fitness, and strength than I have had in decades.

This calls for apprehension and anticipation, regulation, and planning, even so, the consideration beyond self to others with whom one shares life, experiences, hope, and a future. If anything is to be learnt, it is, health is wealth and men need to do the healthy to remain wealthy.

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)

Coronavirus streets in Manchester - VIII

Here comes the sun

This is the fourth Bank Holiday under the Coronavirus lockdown, one in which we have been under certain restrictions in terms of movement and travel especially that we have pleasant weather.

For me, it was the first opportunity to expose myself to the sun and build up naturally occurring Vitamin D which I should consider taking supplements for, in general.

When I fell ill, I had asked my friend to get me a box of cornflakes, whilst I expected the Kellogg’s brand, it was a store brand from one of the more affordable supermarket chains. Checking the nutritional information on the box, it had no vitamins and minerals content. I thought it was a given that boxes of cereal had a basic set of those.

On another low-cost brand he bought at the time he was housesitting for me had the full complement of Vitamins B6, B12 & D, and Folic Acid which I do require, along with Niacin (B3), Thiamin (B1), Riboflavin (B2), and Iron. All at various required daily intakes. However, as I do sometimes have Weetabix or Kellogg’s Rice Crispies, I might increase my breakfast consumption of those.

Longing for him

With my arms and legs exposed, I took to sitting in the sun at the New Islington Wharf. It was quite busy, but I had the concrete bench to myself, watching the world go by. The biggest feeling of regret I had was not being out with Brian as I remembered the many times we walked from our apartment in Cape Town to the Victoria & Alfred Waterfront. As there were many same-sex couples holding hands taking in the atmosphere.

My outing was counter clockwise to my Friday walk, through Angel Meadow Park that was crowded without a bench free or a patch of grass with enough distance from others. Not that I would have sat on the grass. I did stop beside the Co-operative Group head office building, which had long rows of unoccupied benches in the sun and then with a nerve ending twitch in my hip hobbled into the shopping precinct.

Blog - Coronavirus streets in Manchester - VII

Flower snatching crazy woman

Another resting point before the final stretch home, there was a flowerbed behind me, a violated the social-distancing requirement without apology lunging for full-blown flowers to give to two kids in strollers, one of which she was pushing. I probably should have shouted at her or even waved my stick, a typical public vandal who cared nothing for others around them. I did not have the strength, not that it would have dissuaded her entitled mien.

On getting home, I was tired enough to take a nap. I hope when tomorrow comes, strength, verve and enthusiasm are at peak levels to enjoy the first day at work.

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.