MEDICAL MATTERS

[Stanley]

"I will need to get back on the hills as soon as I am able." Yes, but they will still be there. At the moment what you have to do is carry on being sensible and patient even though the situation is bad. I do sympathise but try not to stress about exercise.... Onward and Upward. Excelsior!

[Sue]

So our blood tests arrived yesterday. Bob has to see the GP, we think it is probably his cholesterol which he knows about. It is not diet related but is familial . At least we assume it is that. However because of his problem we always eat low fat and loads of fruit and veg. Infact we nearly overdosed in France eating all the fruity products that we had. So imagine my surprise when I received a phone call to say I was pre diabetic and should make an appointment with the nurse to discuss diet, exercise and weight. You can imagine my response! I also have to see the GP about my cholesterol level, this too knocked me sideways as I have never had a problem. I thought perhaps it was the meal on the ferry the night before but on reflection it was 42 hours before.

So is it because I haven’t exercised as much, is it all the fruit sugars from my yummy pears, it is certainly not a high fat diet.

I explained to the nurse on the phone that I was not overweight, indeed at the health check I was told I was spot on if marginally under, I explained my normal weekly exercise routine of a minimum of 4 hours of moderate to intensive exercise, and my normal diet of low fat , reduced complex carbohydrates and high fruit and veg, and said I felt the practice nurse could not give me any advice. So lets hear what the GP has to say...its a bit worrying and a GP who does not know me. I am thinking of changing the appointment to my own GP.

So much for watching my weight and a healthy diet and lifestyle !

[Stanley]

Sue, I recognise the syndrome! Cholesterol, mine this week was 53 and is classed as OK because it is stable. This highlights the fact that the recommended levels are based on averages and what matters is consistency allied to general health, life style and exercise levels. You are obviously not at death's door and I suspect that what has happened is that the practice has a protocol in place whereby certain results trigger automatic consequences. Your point about seeing your own GP who knows you is vital. If I was you I would be telling him that you are not going to change your lifestyle until you have got an established record of results and proper assessments can be made. Here at Barlick anyone who is established as pre-diabetic is put on the programme under the Diabetic Nurse and common sense prevails. The tyranny of test results is a recognised problem in the medical profession. Too many knee-jerk decisions have been forced on patients and in some cases leads to protests or complaints reflecting on the practice. Give your own qualifications and common sense precedence over anything you suspect is facile and not based on real facts. Like everyone else, you are not 'average'!

[plaques]

....until you have got an established record of results and proper assessments can be made.

We all know that as you get older the body's response to changes in routine can throw up some odd results. First get back to your normal routine and then repeat the tests. As Lance Corporal Jack Jones would say "Don't Panic"

[Wendyf]

Its the fruit Sue! You must have gone over your normal carb tolerance threshold. Refuse all meds and request another blood test in a month's time and stop eating the reduced fat rubbish!
The extra carbs in the fruit will probably have raised your LDL cholesterol levels too.

Worth reading this rather long blog from Dr Malcolm Kendrick.

https://drmalcolmkendrick.org/2018/07/0 ... dl-levels/

[PanBiker]

Sounds very much like Stanley has described Sue.

Just read Wedy's post before I submitted mine, there you go Sue, sorted!

I will be having needles poked into me and a raft of other tests today for my pre-op, joy of joys but welcome to move things along.

[Stanley]

Hello World: How to be Human in the Age of the Machine broadcast at 09:45 on R4 is worth listening to Sue. It's all about diagnosis.

[Tizer]

It's barmy to say someone is pre-diabetic if this is based on one blood test. A scientist would never make a claim based on one reading but unfortunately the health advisors do so. If they get a blood sugar result that they consider too high then they should simply ask for you to have another test to confirm it (or otherwise) before claiming that you are pre-diabetic.

[Sue]

Wendy , Bob HAS TO have reduced fat, he has familial high cholesterol. He won’t do statins therefore it has to be diet, and I am sorry we will disagree on this but high fat is not an option.

We eat butter, ( but one pack lasts the two of us ages because I don’t eat bread except one slice of toast at the weekend) we cut excess fat off meat. Don’t eat cakes and buscuits simply because I don’t like them. One pack of sugar will last us about 18 months . I make jam i make crumbles but rarely eat them . The jam is for Bob the crumbles for when we have guests. We have skimmed milk as I can’t stand the taste of full cream or semi skimmed in tea. We fry with minimal amounts of oil, we eat eggs, I call that sensible fat levels. I have soya milk on cereal as it reduces the problems I have with IBS. I am not averse to cream and creamy products but in France where we have been for 7 weeks they don’t do cream and other milk products we buy we choose carefully because of their sugar loading. I make my own yoghurt there from semi skimmed milk. I eat no more than two small potatoes, two desert spoons pr rice pr pasta when we have it. Rarely pastry, because I can’t be bothered making it!

In France I have had a little more bread and hence a little more butter and cheese but when I think what we bought in 7 weeks so e people would eat in a day.

[Sue]

It's barmy to say someone is pre-diabetic if this is based on one blood test. A scientist would never make a claim based on one reading but unfortunately the health advisors do so. If they get a blood sugar result that they consider too high then they should simply ask for you to have another test to confirm it (or otherwise) before claiming that you are pre-diabetic.

I agree completely and have now managed to get a Consultation with my own Dr who knows me. He over ruled a diagnosis once before on the grounds that it was a one off and did not take into account anything about me. My own feelings about the sugar is the fruit like Wendy said, but the chat with the GPis about the cholesterol levels. I wonder if the good cholesterol has been taken into account. These are things I want to discuss with someone who knows me

[plaques]

Tizer is absolutely correct, Before you can establish a true trend the last point measured is ignored. By looking back at your history you should get an idea of the true trend. For myself after years of highish cholesterol readings, no statins, my last reading was well into the acceptable level. Lots of back slapping by the health worker but I wasn't really impressed I'd done nothing to deserve this accolade so next time it will probably be up again. So what!

[Sue]

Tizer is absolutely correct, Before you can establish a true trend the last point measured is ignored. By looking back at your history you should get an idea of the true trend. For myself after years of highish cholesterol readings, no statins, my last reading was well into the acceptable level. Lots of back slapping by the health worker but I wasn't really impressed I'd done nothing to deserve this accolade so next time it will probably be up again. So what!

I think some health pratitioners forget medicine is not an exact science, as it is a life science and not goverenec by common mathematical patterns. They have their rules I suppose, but fail to regard the exceptions. As you can tell I am a bit upset by all of this , as you know I work hard at keeping fit and healthy

[PanBiker]

I'm sure you will get a better result with your own doctors Sue, I wish you well anyway.

Such a nice day we walked up to the hospital after having lunch at the station. It's only a 10 minute walk over up over the Headrow, we were in plenty of time so we sat in the square opposite the hospital for a while. We went in about half an hour early.

I was scooped up fairly rapidly and it probably took longer to fill the paperwork and questionnaire in than the actual tests. Height, weight then MRSA swabs first, underarm, groin, and nostrils. These will be tested to see if I am carrier (lots of people are) in which case I will need pre-admission treatment, (decolonisation) which effectively is done at home with an antiseptic gel to use in the shower and a cream for the nostrils, a 5 day course (lasts 14 days). BP and pulse done with the same healthcare worker. Passed on to the nurse then who went through the three pages from my questionnaire with me which was all good. She agreed that I did not need another ECG as I had seen the Cardiologist Consultant at Airedale, I had taken his test results letter with me along with my artery scan results which she photocopied for my notes. Signed off by her and passed on with paperwork for blood tests down the corridor and a bit nearer the door. Took the next ticket but there was no one else waiting so hardly had time to sit down when I was called through. Nice Nurse, best stabber I have had up to press felt nothing, five phials and less than 5 minutes later I was on my way. Start to finish only about an hour in the hospital wing. We walked back down to the station and got the next train back to Skipton. Jack was on his way back from work and he picked us up just before 5pm.

That's it now, waiting for MRSA test results and then a date for my Craniotomy. The nurse said that she didn't think I would have long to wait as I am marked as urgent. She also agreed that I did not need the ordered up 3 day ECG from the stoke clinic. I will ring them again tomorrow to cancel.

[Stanley]

That all went well Ian. Good luck with it.
Sue.... "I am a bit upset by all of this , as you know I work hard at keeping fit and healthy" I know how you feel..... Hassan is not letting me off the hook, I go to see him in four weeks with a bottle of pee. That gives me plenty of time to look up bladder cancer on the web and read my LPAs again........

[Tizer]

Ian's experience with the medics is pleasing to hear, they seem to be well organised. My own experience and also with my father was that the specialist nurses are excellent and on a par with the doctors.

[PanBiker]

Better to pick up symptoms early than late though and you can't really fault Hassan for being thorough. The internet can be a blessing or a curse, I hear a report this morning that if you Google the term "motherhood" you get results more like Armageddon than anything useful about a perfectly natural condition. So much so than lots more women are asking for C sections and some even terminations as they are terrified of natural childbirth.

Anyway, back onto manageable stuff. I rang Airedale this morning and cancelled my scheduled 3 day ECG as suggested by the Leeds team yesterday. I came home with raft of leaflets that I have read through, everything from MRSA screening, preventing infection, consent forms, anaesthetics, preventing blood clots (DVT & PE), pain relief and medications. I am about as well informed as you can be I reckon. Full marks from me for yesterdays team.

This morning found another letter behind the door from Leeds. I thought it was a bit quick for surgery date and this confirmed on opening. It's a copy of the letter Mr Anderson sent to Dr Hare who is head of practice at the Barlick Surgery. It's verbatim as far as I remember our consultation 10 days ago. He notes my current muscular weakness on the right side and says that there is a risk that this may become permanent in the arm or leg. Notwithstanding the overall risk factor of the procedure he notes that I am keen to proceed and adds that, "He is otherwise very well for his age and would expect to live for a good number of decades yet".

He says I am on the waiting list and marked as urgent in the hope of expediting my care. He has also suggested further medication that can be prescribed if my symptoms persist.

[Tizer]

I hear a report this morning that if you Google the term "motherhood" you get results more like Armageddon than anything useful about a perfectly natural condition. So much so than lots more women are asking for C sections and some even terminations as they are terrified of natural childbirth.

I read (BBC site, I think) that Mumsnet is a problem in that regard. People referring to natural births as being a `bloodbath', for example. The downside of social media - the shouty people can dominate.

[PanBiker]

One thing I did notice during my assessment yesterday was the reminder notice on the wall that stated 160/100 was the threshold for acceptable BP for elective surgery! Quite high and if at the local surgery they would be looking for a diet or medicinal fix. Thankfully, even allowing for a little white coat syndrome, I tested a lot lower than that and not a lot higher than what I would regard as my average reading.

Reading through the anaesthetic information leaflet. I see that you can ask for a sedated but concious state throughout the procedure. You can even ask to watch the procedure and in some cases have music via headphones. All to be discussed with the consultant anaesthetist before surgery for the best option. Remaining concious is a requirement for some procedures which may effect muscle control. We'll have to see.

[Big Kev]

That sounds like an interesting concept Ian, it would be fascinating to see inside my own head. I was an operating department orderly, for 5 years, when I was in my early twenties and saw inside plenty of other people, the procedures I've had were all under a general anaesthetic so the opportunity has never arisen...

[Stanley]

I had my vasectomy under local anaesthetic and swapped jokes with the nurses. The surgeon asked me what the spinal block injection felt like and I told him that if he was so keen to find out he should have one! A very weird feeling.....

[Sue]

I had a bladder operation under a spinal block but also I was very lightly sedated. They thought I was more sedated than I was because the surgeons were discussing their vasectomies and I joined in. That caused a laugh or too. I need to be consvious to check I still had full bladder function afterwards. I had a prolapse and apparently am one of the lucky ones to have had a mesh support implant with no side effects!

[Wendyf]

Pleased to hear your op was successful Sue, there are some horrible stories about reactions to the mesh implants.
We like to watch "GP's Behind Closed Doors" which is on Channel 5 (8pm Wednesdays) and the new series is based in a Bradford practice where they do vasectomies on site as a minor op with just a local anaesthetic. The cameras have been there for two such ops (no personal close ups) one chap crying out in pain and the other smiling and chatting through the process.

[PanBiker]

Remember when I said I had received a follow up call from the head of the AAU after I was reviewed a few weeks back? Well I have had another letter this morning from him confirming what we talked about and his recommendations at the time. I have quite a dossier building up now and am nothing if not well informed.

[Stanley]

Sue, snap! I had a hernia repaired with mesh and it was totally successful and no problems at all. Must be luck of the draw. 'Keyhole' surgery and an out-patient job, I walked out afterwards. Biggest problem was I couldn't fasten my trousers because of all the gas they had blown in to get room to work!

[PanBiker]

I started with a sore throat last night, not infected just raw, my sinuses were filling when I took to my bed. Coughed and spluttered half the night but my sinuses are a lot clearer this morning and the throat has calmed. Hopefully just a short term virus that will clear.

On another matter, I have got my appointment for my flu jab. it's on the 29th of this month which could be a bit awkward. I have my MRSA test results to come at some point which if clear could come with a surgery date which could be sooner rather than later. It would be good if I could fit it in allowing time for any mild side effects. I will see if I get anything in the post early next week and then take advice from the pre-op team.