Me again!
Hydrocortisone
As I've said in previous blogs, I do have the occasional energy crash due to a lack of Cortisol - usually at the weekend. The last few weekends, following a consultation with my Endocrinologist, if I know in advance I will be doing something strenuous then I take an extra 2.5mg (quarter of a tablet) of Hydrocortisone. So far it seems to be working. I didn't expect to be doing much this last weekend, so didn't take any extra, however did end up doing some gardening and had an energy crash. But in contrast the previous weekend, I was digging out a large stump from a bush in the garden, so had taken the extra 2.5mg and voila, no energy crash. So at least I have a way to avoid the energy crashes now....that is the theory at least, I will try it out over the following few months to see it it pans out.
Testosterone
I have always taken a gel to replace my Testo, which has been working ok but it does get a bit of a faff and also does severely dry my skin sometimes. So I talked to my Endocrinologist about trying a Testosterone injection instead. You only have to have the injection every 12 weeks or so, and although it is supposed to be a bit uncomfortable initially it saves worrying about daily gel rubbing.
So I had the injection yesterday (in the bum cheek), and although it is a bit tender initially the 'pain' (it's barely pain) subsides and hopefully that's that for a few weeks. The doctor will test my Testo levels at 12 weeks to see if I still have adequate Testo levels, and if I am a bit low then I might need to have the injection (say) every 10 or 11 weeks instead. But we won't know until then how quickly my body absorbs the injection. The Testo injection is suspended in an olive oil like substance so that the body can't absorb it too quickly. I'll report back in due course to see how it goes. The only slight reservation I had yesterday was that it made my right leg go a bit numb, and my left leg go a bit more numb than it already is....as you know I have the lingering numb/tingly leg thing since I damaged a nerve somewhere. It seems a bit better today, so hopefully a temporary thing.
Other than that, all is good on the Pituitary front. Long may it continue! :-)
Subscribe To
Posts
All Comments
Tuesday, 4 November 2014
Friday, 24 October 2014
October 2014 - the state of the NHS
There are probably hundreds of not thousands of blogs like this across the Internet. So let me add my two-penneth!
Here's some facts for you, taken from this website
http://www.nhs.uk/NHSEngland/thenhs/about/Pages/overview.aspx
Here's some facts for you, taken from this website
http://www.nhs.uk/NHSEngland/thenhs/about/Pages/overview.aspx
- The NHS employs 1.7 million people. Including:
- 39,780 general practitioners (GPs)
- 370,327 nurses
- 18,687 ambulance staff
- 105,711 hospital and community health service (HCHS) medical and dental staff
- Only the Chinese People’s Liberation Army, the Wal-Mart supermarket chain and Indian Railways directly employ more people
- Funding for 2012/13 was around £108.9 billion
Reading the media over the last year or so, you cannot fail to have noticed all the chatter about the state of the NHS, how it is going to fail soon with the stress of workload and lack of funding. Then coupled with that all the articles about 'eat this' 'don't eat that' 'miracle cure for this' and various scaremongering stories. Also people seemingly routinely choosing to go to A&E to get seen quickly rather than using their own GP surgery or the 111 NHS phone service. I really don't know what to believe from stories in the media, and I can see how the general public must be completely confused over what to do or not to do, and whether or not the NHS really is in the level of crisis suggested. But as the old saying goes "there's no smoke without fire", I'm sure at various levels things need fixing, but on a day to day basis can things really be THAT bad?
I think speaking as a patient, I can only comment on my experiences which have been generally good, or very good with just the odd gripe here and there. But at an individual level, every NHS worker I came into contact with has just had the 'will' to care and look after patients at their very core. Whether I'm talking about my local GP/surgery, the people that diligently cleaned the hospital wards I was on, served the meals, the nurses, the doctors and the consultants....all showed the will to provide that care.
I went to our local hospital open day recently and had a tour of both the radiotherapy dept. showing off their amazing machines used to treat cancer and also the mortuary. Speaking to NHS staff in the radiotherapy dept. they spoke with expertise and passion about the job they did and how they put plans in place to treat patients and how precise the treatment was. The accuracy and effectiveness of the treatment available was incredible to understand. But what really stuck in my mind was the mortuary tour and not for the reasons you might imagine.
One of the staff who did the tour still referred to the bodies they receive as "patients" and how what they do is still part of the treatment, the last thing they can do for that patient in their journey, compassion was evident in abundance. The person who really impressed was Brett (Lockyer, I think) the Pathologist, he explained in detail what his job was and how long he had been in training to do that job - 16 years training in fact! He had been through doctor training and then a doctor in various departments including A&E leading up to the job he is doing now (classing all this as 'training') and his ambition to become a forensic Pathologist. How lucky are we that there are people like Brett who are prepared to do the job they do, and spend so much of their lives dedicated to doing it, to wanting to do that job. I can never imagine doing the job Brett does, but spending some time listening to his passion could even persuade someone like me to want to go into the medical profession (not now, I'm too long in the tooth). It strikes me that if the NHS really is struggling to recruit GP's, then the NHS needs to talk to young people at the right age, spread that passion that I witnessed to impressionable young minds. If that passion was infectious to me, it surely would have been to a 14 year old me. As with any organisation, its strength lies in its people and they will be the saviours of the NHS.
Yes, that is a simplistic view, politics and money have to come into play. But I don't think it will matter which political party sticks its oar in, I don't think any of them have a true grasp of how to fix a problem like the NHS. In reality it is a complex myriad of things. With the population generally living longer maybe we should all be prepared to pay just that little bit more out of our salaries each month, I'd willingly do this if there was a robust plan in place to spend it wisely.
So here's my plan for the NHS:
Make good models standard
Identify models/practices from across the NHS (across the world!) that work well, hell that work perfectly, save money and use those models as a basis for care in every hospital, GP surgery etc. If you have a process that is helping patients, saving money, creating efficiency etc. then it should be adopted as a standard, no arguments. I know not every patient has a standard 'need', but if a model for (say) excellent Diabetes care exists, why wouldn't every hospital/CCG area implement it? Should they even be told they HAVE to implement best practice?
Pay more
We should be prepared to stump up a bit more from our salaries to help fund the NHS. There are about 30 million people working, if they all paid an extra £1 per month or £12 per year, that is an extra £360m into the coffers....£3 a month would make £1bn. My simple sums probably don't stack up, but it is surely a rough guide? Could the NHS use an extra 1% budget, I'd have thought so.
Spread the love
Get those passionate experts out into the community, let them tell the world about the job they do and get recruiting, persuading and educating the potential next generation of NHS heroes what a great and exciting place to work the NHS could be for them.
Finally, us, the patients
Where possible, we do have to look after ourselves. Health is a fickle beast and it isn't always within our grasp to be healthy all the time, but eating correctly, not smoking and generally not doing things can land us in hospital is our responsibility. Lifestyles have changed even from when I was young, not that long ago! My cycle & walk for miles as fun is today's Xbox/PS4 fun. Probably a subject for a different blog right there......
So.....I feel like perhaps I have rambled on a bit, but the summary of all that is....I've got no faith in any political party to fix the problem, I think we all need to be prepared to pay a bit extra to support the NHS and that the best chance of the NHS being 'fixed' is for the NHS to promote its most excellent models and make them standard. And finally let some of that NHS passion out into the wider world, help persuade new talent into the NHS and make sure that the NHS continues to be the envy of the world for years to come.
I think speaking as a patient, I can only comment on my experiences which have been generally good, or very good with just the odd gripe here and there. But at an individual level, every NHS worker I came into contact with has just had the 'will' to care and look after patients at their very core. Whether I'm talking about my local GP/surgery, the people that diligently cleaned the hospital wards I was on, served the meals, the nurses, the doctors and the consultants....all showed the will to provide that care.
I went to our local hospital open day recently and had a tour of both the radiotherapy dept. showing off their amazing machines used to treat cancer and also the mortuary. Speaking to NHS staff in the radiotherapy dept. they spoke with expertise and passion about the job they did and how they put plans in place to treat patients and how precise the treatment was. The accuracy and effectiveness of the treatment available was incredible to understand. But what really stuck in my mind was the mortuary tour and not for the reasons you might imagine.
One of the staff who did the tour still referred to the bodies they receive as "patients" and how what they do is still part of the treatment, the last thing they can do for that patient in their journey, compassion was evident in abundance. The person who really impressed was Brett (Lockyer, I think) the Pathologist, he explained in detail what his job was and how long he had been in training to do that job - 16 years training in fact! He had been through doctor training and then a doctor in various departments including A&E leading up to the job he is doing now (classing all this as 'training') and his ambition to become a forensic Pathologist. How lucky are we that there are people like Brett who are prepared to do the job they do, and spend so much of their lives dedicated to doing it, to wanting to do that job. I can never imagine doing the job Brett does, but spending some time listening to his passion could even persuade someone like me to want to go into the medical profession (not now, I'm too long in the tooth). It strikes me that if the NHS really is struggling to recruit GP's, then the NHS needs to talk to young people at the right age, spread that passion that I witnessed to impressionable young minds. If that passion was infectious to me, it surely would have been to a 14 year old me. As with any organisation, its strength lies in its people and they will be the saviours of the NHS.
Yes, that is a simplistic view, politics and money have to come into play. But I don't think it will matter which political party sticks its oar in, I don't think any of them have a true grasp of how to fix a problem like the NHS. In reality it is a complex myriad of things. With the population generally living longer maybe we should all be prepared to pay just that little bit more out of our salaries each month, I'd willingly do this if there was a robust plan in place to spend it wisely.
So here's my plan for the NHS:
Make good models standard
Identify models/practices from across the NHS (across the world!) that work well, hell that work perfectly, save money and use those models as a basis for care in every hospital, GP surgery etc. If you have a process that is helping patients, saving money, creating efficiency etc. then it should be adopted as a standard, no arguments. I know not every patient has a standard 'need', but if a model for (say) excellent Diabetes care exists, why wouldn't every hospital/CCG area implement it? Should they even be told they HAVE to implement best practice?
Pay more
We should be prepared to stump up a bit more from our salaries to help fund the NHS. There are about 30 million people working, if they all paid an extra £1 per month or £12 per year, that is an extra £360m into the coffers....£3 a month would make £1bn. My simple sums probably don't stack up, but it is surely a rough guide? Could the NHS use an extra 1% budget, I'd have thought so.
Spread the love
Get those passionate experts out into the community, let them tell the world about the job they do and get recruiting, persuading and educating the potential next generation of NHS heroes what a great and exciting place to work the NHS could be for them.
Finally, us, the patients
Where possible, we do have to look after ourselves. Health is a fickle beast and it isn't always within our grasp to be healthy all the time, but eating correctly, not smoking and generally not doing things can land us in hospital is our responsibility. Lifestyles have changed even from when I was young, not that long ago! My cycle & walk for miles as fun is today's Xbox/PS4 fun. Probably a subject for a different blog right there......
So.....I feel like perhaps I have rambled on a bit, but the summary of all that is....I've got no faith in any political party to fix the problem, I think we all need to be prepared to pay a bit extra to support the NHS and that the best chance of the NHS being 'fixed' is for the NHS to promote its most excellent models and make them standard. And finally let some of that NHS passion out into the wider world, help persuade new talent into the NHS and make sure that the NHS continues to be the envy of the world for years to come.
Thursday, 9 October 2014
October 2014 - emailing health professionals
I wanted to divert away from the normal flow of my blog for a minute, so rather than be about me I have a couple of blogs that have been nagging away at me for a while regarding the beloved NHS. I say “beloved” because it is to me and to many people I know, we have come to expect it to be there for us when we need it and for all the issues that are being flagged up in the media right now, I still think this model is a shining light amongst healthcare systems around the world.
Clearly my views here are as a patient of the NHS, so I am not that familiar with the complexities and politics of the NHS, which is probably a good thing, because it helps see the issues more clearly. If you are a healthcare professional reading this, you may or may not agree with what I’m saying, and that is fine and often the way with a bit of healthy debate. I’m absolutely not an expert in healthcare, and I’m not suggesting that things aren’t being done all the time to improve patient experience and outcomes, because I know they are, I read about the good things all the time. But this is straying into the other nagging blog subject I’ve got in my head!
So my first subject is health professionals emailing patients, and vice versa. I’ve been involved in a few Twitter chats where this has come up, always views for and against the subject of emailing patients.
The consultant I have had the pleasure to deal with is Dr Partha Kar, Endocrinologist at Portsmouth’s Queen Alexandra Hospital. He is a big advocate of email as a useful patient support tool, in fact before my dealings with Dr Kar, I didn’t even realise it was an option. Let me tell you why I find it so beneficial.
A recent exchange was something like this – I had a regular Endocrine check-up coming up, so I had some blood tests to get done before my appointment with Dr Kar. I couldn't remember, and wanted to check, whether these blood tests were ‘fasting’ or not. So the two basic options were going to be:
Without email – I telephone the Endocrinology department, speak to the receptionist about my question, they take my details, details about the blood tests etc. and make a note to contact Dr Kar (exactly how this would happen I’m not sure, presumably either a computer system note, or pop in and see him in-between clinics, or after clinic)…..then once the relevant information has been obtained, telephone me back (if I'm not in, it may not be 'allowed' for them to leave a message on my answerphone). I envisage that depending on how busy all parties are, this may take a day or so, depending when I originally called, maybe the same day if I called early in the day.
With email – I email my question directly to Dr Kar. He answers within the hour, a simple “no” was all that was needed. A minute of his (valuable) time to read my email and reply.
I know which of the above is easier and quicker for me as a patient. I’ve had various exchanges of a similar nature, those queries which are really simple and quick to answer.
Now of course, not all patients are created equal and not all consultants are created equal. A patient may not have ready access to email, may not even want to use email. And of course the consultant may not want to give out their email address.
I know there are several worries that health professionals have – “I don’t want to give out my email address because patients will contact me all the time”, “email isn’t secure, important patient details could get ‘hacked’ or lost”, “I haven’t got the time to start answering lots of emails”. So let me try and answer some of those…..
I don’t contact Dr Kar all the time; if I did I strongly suspect he would have put me straight by now. I know that his time is precious, so I’m not about to befriend him and drop him an email to say what a wonderful weekend I’ve had, or pass the time of day. I’m only going to use the email medium when I feel I have to, and when I am asking a question that is easily dealt with by email, mainly yes or no questions or quick updates on something we have spoken about at a face to face appointment. On the very rare occasion when I’ve misjudged that, Dr Kar replied to say make an appointment to come and see him.
OK, email isn’t totally secure or foolproof. Is there a single secure system available to health professionals that allows them to send and receive emails securely….from the Twitter chat I’ve seen there doesn’t appear to be ‘a single system’, although there does appear to be methods out there. The NHS is obviously strapped for cash, and developing such a system is going to take time and money, and certainly the latter may well be better spent elsewhere. But right now there are emails, easy to use and essentially free. I believe that more use could be made of email as a tool to make communications with doctors and patients easier, clearly it isn’t suitable for every medical occasion.
With regards to the “not enough hours in the day” argument. Doctors and patients have to converse somehow, and if you can spend a minute or two answering that simple yes or no email, isn’t that better than tying up other valuable resources in the process of answering those things. And whilst I’m saying the doctors answer the emails, it needn’t necessarily be (I know receptionists are horrendously busy too, but answering a few emails to cut down the number of phone calls.....might be a better balance?). I think there are healthcare professionals out there using email to their benefit and this best practice should be shared with others….if it can work for one it can work for others. Don’t just go down the “it won't work here” route because of course it won't if you don’t want it to. It must be possible to introduce this way of working in the short term whilst working on that longer term solution, if such a thing exists.
Also there will be a difference between the way email would work for hospital consultants and GP’s, but I have seen examples where some GP’s do offer communications by email, so again as above it can work in one practice it must be able to work in another. Sure you may not want to introduce blanket email for all patients about all subjects, but introduced sensibly and in a controlled way, what's the problem? I know that the doctors surgery I attend, and another surgery nearby work differently in quite a few ways, neither uses email to my knowledge. But why should there be such differences when they only about a mile apart?
The other example I saw today was the advertising of flu clinics using not only email, but also on the surgery website, Facebook and Twitter. So whilst I am advocating email here, other frequently used channels exist. How people communicate with the world is changing, if the surgery has a presence on Facebook, and the patient has ‘liked’ the page, then hey-presto a message appears in their feed that their doctors surgery is booking flu clinics. I don’t check my doctors surgery website every day, but I do read Facebook/Twitter every day. (well most days….) Yes, I know social media opens up another channel of communications you have to manage, but the same message from me, some obviously use it, why not others? Tell patients up-front what it can and can't be used for.
So I think that is all I wanted to get off my chest for the time being. The wider issue about all the things that the NHS has on its plate probably makes the debate of email seem all rather insignificant. But if you separate the seemingly massive insurmountable task that is ‘fixing’ the NHS it surely boils down to what little things can you do to improve the patient experience, what little things can be tried to help things just that little bit for patients. Things that may not even cost that much money to implement.
Why not try it, I can't guarantee it will 100% work for you first time, but I think your patients may thank you for it.
Clearly my views here are as a patient of the NHS, so I am not that familiar with the complexities and politics of the NHS, which is probably a good thing, because it helps see the issues more clearly. If you are a healthcare professional reading this, you may or may not agree with what I’m saying, and that is fine and often the way with a bit of healthy debate. I’m absolutely not an expert in healthcare, and I’m not suggesting that things aren’t being done all the time to improve patient experience and outcomes, because I know they are, I read about the good things all the time. But this is straying into the other nagging blog subject I’ve got in my head!
So my first subject is health professionals emailing patients, and vice versa. I’ve been involved in a few Twitter chats where this has come up, always views for and against the subject of emailing patients.
The consultant I have had the pleasure to deal with is Dr Partha Kar, Endocrinologist at Portsmouth’s Queen Alexandra Hospital. He is a big advocate of email as a useful patient support tool, in fact before my dealings with Dr Kar, I didn’t even realise it was an option. Let me tell you why I find it so beneficial.
A recent exchange was something like this – I had a regular Endocrine check-up coming up, so I had some blood tests to get done before my appointment with Dr Kar. I couldn't remember, and wanted to check, whether these blood tests were ‘fasting’ or not. So the two basic options were going to be:
Without email – I telephone the Endocrinology department, speak to the receptionist about my question, they take my details, details about the blood tests etc. and make a note to contact Dr Kar (exactly how this would happen I’m not sure, presumably either a computer system note, or pop in and see him in-between clinics, or after clinic)…..then once the relevant information has been obtained, telephone me back (if I'm not in, it may not be 'allowed' for them to leave a message on my answerphone). I envisage that depending on how busy all parties are, this may take a day or so, depending when I originally called, maybe the same day if I called early in the day.
With email – I email my question directly to Dr Kar. He answers within the hour, a simple “no” was all that was needed. A minute of his (valuable) time to read my email and reply.
I know which of the above is easier and quicker for me as a patient. I’ve had various exchanges of a similar nature, those queries which are really simple and quick to answer.
Now of course, not all patients are created equal and not all consultants are created equal. A patient may not have ready access to email, may not even want to use email. And of course the consultant may not want to give out their email address.
I know there are several worries that health professionals have – “I don’t want to give out my email address because patients will contact me all the time”, “email isn’t secure, important patient details could get ‘hacked’ or lost”, “I haven’t got the time to start answering lots of emails”. So let me try and answer some of those…..
I don’t contact Dr Kar all the time; if I did I strongly suspect he would have put me straight by now. I know that his time is precious, so I’m not about to befriend him and drop him an email to say what a wonderful weekend I’ve had, or pass the time of day. I’m only going to use the email medium when I feel I have to, and when I am asking a question that is easily dealt with by email, mainly yes or no questions or quick updates on something we have spoken about at a face to face appointment. On the very rare occasion when I’ve misjudged that, Dr Kar replied to say make an appointment to come and see him.
OK, email isn’t totally secure or foolproof. Is there a single secure system available to health professionals that allows them to send and receive emails securely….from the Twitter chat I’ve seen there doesn’t appear to be ‘a single system’, although there does appear to be methods out there. The NHS is obviously strapped for cash, and developing such a system is going to take time and money, and certainly the latter may well be better spent elsewhere. But right now there are emails, easy to use and essentially free. I believe that more use could be made of email as a tool to make communications with doctors and patients easier, clearly it isn’t suitable for every medical occasion.
With regards to the “not enough hours in the day” argument. Doctors and patients have to converse somehow, and if you can spend a minute or two answering that simple yes or no email, isn’t that better than tying up other valuable resources in the process of answering those things. And whilst I’m saying the doctors answer the emails, it needn’t necessarily be (I know receptionists are horrendously busy too, but answering a few emails to cut down the number of phone calls.....might be a better balance?). I think there are healthcare professionals out there using email to their benefit and this best practice should be shared with others….if it can work for one it can work for others. Don’t just go down the “it won't work here” route because of course it won't if you don’t want it to. It must be possible to introduce this way of working in the short term whilst working on that longer term solution, if such a thing exists.
Also there will be a difference between the way email would work for hospital consultants and GP’s, but I have seen examples where some GP’s do offer communications by email, so again as above it can work in one practice it must be able to work in another. Sure you may not want to introduce blanket email for all patients about all subjects, but introduced sensibly and in a controlled way, what's the problem? I know that the doctors surgery I attend, and another surgery nearby work differently in quite a few ways, neither uses email to my knowledge. But why should there be such differences when they only about a mile apart?
The other example I saw today was the advertising of flu clinics using not only email, but also on the surgery website, Facebook and Twitter. So whilst I am advocating email here, other frequently used channels exist. How people communicate with the world is changing, if the surgery has a presence on Facebook, and the patient has ‘liked’ the page, then hey-presto a message appears in their feed that their doctors surgery is booking flu clinics. I don’t check my doctors surgery website every day, but I do read Facebook/Twitter every day. (well most days….) Yes, I know social media opens up another channel of communications you have to manage, but the same message from me, some obviously use it, why not others? Tell patients up-front what it can and can't be used for.
So I think that is all I wanted to get off my chest for the time being. The wider issue about all the things that the NHS has on its plate probably makes the debate of email seem all rather insignificant. But if you separate the seemingly massive insurmountable task that is ‘fixing’ the NHS it surely boils down to what little things can you do to improve the patient experience, what little things can be tried to help things just that little bit for patients. Things that may not even cost that much money to implement.
Why not try it, I can't guarantee it will 100% work for you first time, but I think your patients may thank you for it.
Monday, 29 September 2014
September 2014 - Latest check-up results
Hi there, after a long break, I'm back!
Today I went to see Dr Kar my Endocrinologist to have a check-up on my progress. It has been one year and 4 months since I waved goodbye to my Pituitary tumour, 18 months since I started on the Hydrocortisone tablets and a year since I started on the Testosterone. Having reviewed my blood tests, Dr Kar confirmed that everything is normal. Lets just celebrate that word again
Don't you just love that word - even though 'normal' means different things to different people, to me it means feeling full of energy (well, not all the time), being fitter, having more mental 'get up and go' and just so many other little things. Yes, even being hairier!!
There is still the odd glitch here and there, I still have energy crashes at the weekend where I am physically a lot more active than I am during the week, which on advice I may be able to counteract with a slightly higher dose of Hydrocortisone.....but not go mad with the higher dose as I have to be careful not to make a habit of it. But all in all, so much better.
I have another check-up in February of next year and another MRI scan after that to make sure my tumour isn't making a re-appearance.
General health-wise, I've had my glucose levels checked because I had developed a concern (a silly concern really) that I may be at risk of developing diabetes, but my blood glucose is 4.8 which is apparently fine. I need to have another Cholesterol test, because I was showing a bit high around 18 months ago, but that was before my hormone levels were sorted out. So I'll have a blood test soon to make sure that hasn't got any worse (I think it was about 7 before, where the ideal is 5mmol/L) and maybe even got better. Who knows, I'm not overly worried about it, but still I ought to have it checked.
As for the numb/tingly leg/foot, it is still there and I think I'm probably stuck with it. It has settled to a fairly low-level annoyance....it hasn't got any worse or better for a while and I think I impinged a nerve in my lower back somewhere....but all the tests for really bad things have come back negative, so that is a good thing.
So I'm still here, and still improving. All in all, today was a pretty good day!
Sunday, 24 August 2014
August 2014 - Man vs. hedge revisited
Around this time last year, I did a couple of blogs
Man vs Hedge
Man vs Hedge part 2
Well I thought I would revisit this part of the blog, as this bank holiday weekend it was conifer hedge trimming time again. The plan was try and do as much as possible on the Saturday and Sunday, as Monday the weather was supposed to be rubbish. However than plan didn't start out very well.
The one thing you need more than anything else before you trim a conifer hedge, is very sharp shears or a very sharp electric/petrol hedge trimmer. Well, we certainly haven't got the latter and anyway I much prefer the finish on the hedge with shears. So my expert blade sharpener was employed (my wife) and sure enough the blades of our 2 pairs of shears were super sharp. However, sharp as they were, they simply would not go through the hedge. It was taking about 6 cuts to do what one cut should do, so I was getting nowhere fast. Despite lots of adjustments, we came to one conclusion, we needed a new pair of shears. So off Deb went to buy some, and an hour later she returned and voila, the new shears went through the hedge like a knife through butter. The only problem was, the best part of the day was wasted now, and we were behind schedule. That meant only one thing, I had to be on top form in order to rush through the job.
However, my body decided to let me down a bit, after lunch I was in a right strop because of the shears problem and was having a bit of a rant, and I had "that feeling" that I get when I am lacking Cortisol....Deb knew it straight away, apparently I have a "look" that tells her straight away. So when she went off to get the new shears, I sat down and had some food and drink and a rest. She returned, and by then my body had caught up with itself and I was off. For about 3 hours I went at the hedge with the kind of vigour I could only dream about prior to this time last year. I sheared almost without rest and my arms just felt like they could go on and on. Then today (Sunday) although my arms were a bit achey from yesterdays (a bit over the top) shearing prowess, I blitzed through the rest of the hedge whilst Deb had started cutting the hedge to height (I'd done the sides). By the time the day was done, We had so nearly finished the hedge, bar about 10 feet of the top, which we'll try and finish tomorrow depending on the weather....had we not had the shears issue, we would have finished. And as I said in one of the previous man vs. hedge blogs, I did really push it for those 3 hours, because there is a part of me that wants to see just how hard I can push myself.....just to see how far I've come. Silly bugger really, but that internal drive to push myself has really come back into play....I think that may be the Testosterone at work.
So I have proved that I have SO much more stamina and strength than I had, better still than this time last year, when I had surprised myself. But still there is that niggle that for some reason, almost always at the weekend, I can still suffer with a lack of Cortisol. I don't think there is anything to be done about it, I think it is because during the week I do a desk job which is not that physically active, then at the weekend, my life is very different and much more active....and sometimes (not always) my body struggles to cope. As I've said before, if the Cortisol 'drop' is just before lunch as it often is, an early tablet dose sorts me out. This was pretty rare in that it was after lunch and when I'd already taken my tablet....so a rest seemed to allow it to kick in. Odd.
So a positive experience, but not without its problems. Never mind though....I'm still feeling very lucky to be in the position I am in.
Man vs Hedge
Man vs Hedge part 2
Well I thought I would revisit this part of the blog, as this bank holiday weekend it was conifer hedge trimming time again. The plan was try and do as much as possible on the Saturday and Sunday, as Monday the weather was supposed to be rubbish. However than plan didn't start out very well.
The one thing you need more than anything else before you trim a conifer hedge, is very sharp shears or a very sharp electric/petrol hedge trimmer. Well, we certainly haven't got the latter and anyway I much prefer the finish on the hedge with shears. So my expert blade sharpener was employed (my wife) and sure enough the blades of our 2 pairs of shears were super sharp. However, sharp as they were, they simply would not go through the hedge. It was taking about 6 cuts to do what one cut should do, so I was getting nowhere fast. Despite lots of adjustments, we came to one conclusion, we needed a new pair of shears. So off Deb went to buy some, and an hour later she returned and voila, the new shears went through the hedge like a knife through butter. The only problem was, the best part of the day was wasted now, and we were behind schedule. That meant only one thing, I had to be on top form in order to rush through the job.
However, my body decided to let me down a bit, after lunch I was in a right strop because of the shears problem and was having a bit of a rant, and I had "that feeling" that I get when I am lacking Cortisol....Deb knew it straight away, apparently I have a "look" that tells her straight away. So when she went off to get the new shears, I sat down and had some food and drink and a rest. She returned, and by then my body had caught up with itself and I was off. For about 3 hours I went at the hedge with the kind of vigour I could only dream about prior to this time last year. I sheared almost without rest and my arms just felt like they could go on and on. Then today (Sunday) although my arms were a bit achey from yesterdays (a bit over the top) shearing prowess, I blitzed through the rest of the hedge whilst Deb had started cutting the hedge to height (I'd done the sides). By the time the day was done, We had so nearly finished the hedge, bar about 10 feet of the top, which we'll try and finish tomorrow depending on the weather....had we not had the shears issue, we would have finished. And as I said in one of the previous man vs. hedge blogs, I did really push it for those 3 hours, because there is a part of me that wants to see just how hard I can push myself.....just to see how far I've come. Silly bugger really, but that internal drive to push myself has really come back into play....I think that may be the Testosterone at work.
So I have proved that I have SO much more stamina and strength than I had, better still than this time last year, when I had surprised myself. But still there is that niggle that for some reason, almost always at the weekend, I can still suffer with a lack of Cortisol. I don't think there is anything to be done about it, I think it is because during the week I do a desk job which is not that physically active, then at the weekend, my life is very different and much more active....and sometimes (not always) my body struggles to cope. As I've said before, if the Cortisol 'drop' is just before lunch as it often is, an early tablet dose sorts me out. This was pretty rare in that it was after lunch and when I'd already taken my tablet....so a rest seemed to allow it to kick in. Odd.
So a positive experience, but not without its problems. Never mind though....I'm still feeling very lucky to be in the position I am in.
Saturday, 16 August 2014
August 2014 - I've been ID'd
Hi there, long time no speak!
Still much the same here, taking the tablets, spreading the gel and symptoms unchanged. Still getting gradually fitter, still doing Pilates, walking and some weight training.
Reason for the update is that I have finally got around to buying myself some medi-alert ID stuff from this company www.onelifeid.com. They do all sorts of ID styles, so I decided to go for both a bracelet and an ID card for my wallet (and car). I've talked about them in the blog before but it has taken a while to properly sit down and get it done. In part because it takes some thinking through what exactly to have on the ID, phone numbers, description of what is up with me etc.
But it has become obvious that when I go out for a walk in the morning and have nothing on me except my house/car keys and my phone, how exactly would anyone ID me at all if I got run over, let alone know that I had a requirement for Hydrocortisone. So now I will wear my shiny new bracelet with pride and all someone has to do is ring the emergency contact number on the bracelet, or scan the barcode to bring up a more detailed set of instructions (I've obscured the phone number, not sure Deb wants her mobile number posted on the web!!)
So there we are, finally I've accepted that I really ought to carry some sort of information about my condition around with me. The card for my wallet is really good too, it has more space for a bit more information. It also made me a bit more aware generally to look out for these kinds of things on other people, it is one of those things you hope never has to be used, but if they do have to be used, they could just be a lifesaver!
Still much the same here, taking the tablets, spreading the gel and symptoms unchanged. Still getting gradually fitter, still doing Pilates, walking and some weight training.
Reason for the update is that I have finally got around to buying myself some medi-alert ID stuff from this company www.onelifeid.com. They do all sorts of ID styles, so I decided to go for both a bracelet and an ID card for my wallet (and car). I've talked about them in the blog before but it has taken a while to properly sit down and get it done. In part because it takes some thinking through what exactly to have on the ID, phone numbers, description of what is up with me etc.
But it has become obvious that when I go out for a walk in the morning and have nothing on me except my house/car keys and my phone, how exactly would anyone ID me at all if I got run over, let alone know that I had a requirement for Hydrocortisone. So now I will wear my shiny new bracelet with pride and all someone has to do is ring the emergency contact number on the bracelet, or scan the barcode to bring up a more detailed set of instructions (I've obscured the phone number, not sure Deb wants her mobile number posted on the web!!)
So there we are, finally I've accepted that I really ought to carry some sort of information about my condition around with me. The card for my wallet is really good too, it has more space for a bit more information. It also made me a bit more aware generally to look out for these kinds of things on other people, it is one of those things you hope never has to be used, but if they do have to be used, they could just be a lifesaver!
Sunday, 6 July 2014
July 2014 - reflecting on that Addisonian crisis
As I have reported in recent blogs I have just passed the anniversary of my Pituitary gland tumour removal and various hospital visits. What I've been reflecting on in particular is the adrenal insufficiency (Addisonian Crisis) event that happened last June. On occasions I still struggle to come to terms with what that really meant and what having Hypopituitarism means now.
Adrenal insufficiency 'features' mentioned in article
Hypotension - I had this (low blood pressure)
Hyponatremia - I had this (electrolyte imbalance in the blood)
Hyperkalemia - I definitely had this (lack of Potassium in my blood)
As I've said before, my Cortisol levels will have been gradually lowering over several years prior to May 2013 when I was diagnosed with the tumour. Gradually my body got used to ever lower doses of Cortisol, so low that my GP didn't really know how I was getting by. But having sorted that out and started me on the HC pills, suddenly my Cortisol levels were artificially back to where they should have been and once my body got used to that, it could no longer tolerate dropping suddenly back to a level that was much too low....even if that is where it had been for years.
On a day to day basis, I take two hormone replacements (Testosterone and Hydrocortisone) and everything seems totally normal, it IS totally normal. I live my life just like anyone else. But it is when that Hydrocortisone pill taking doesn't work is when it brings all this into sharp focus - more so when I read this article http://www.bmj.com/content/345/bmj.e6333
A couple of quotes from said article:
"Patients with adrenal insufficiency are at risk of developing life threatening adrenal crisis if steroids are reduced or stopped"
"Fatal but avoidable addisonian crisis is the second most common cause of death in patients with known Addison’s disease, accounting for 15% of deaths in patients with this disease" (I haven't got Addison's disease, but lack of cortisol in Addison's patients and me amounts to the same thing)
Adrenal insufficiency 'features' mentioned in article
Hypotension - I had this (low blood pressure)
Hyponatremia - I had this (electrolyte imbalance in the blood)
Hyperkalemia - I definitely had this (lack of Potassium in my blood)
The BMJ article makes several interesting and stark points about my condition, about adrenal insufficiency (see above quotes). I do carry a blue steroid card in my wallet, an emergency Hydrocortisone injection and a stock of HC pills wherever I go...so I never get caught out. But if I end up not being able to take and keep down my pills because of vomiting like last June and I don't take quicker action, as I didn't last June (because of ignorance) then my blood pressure could fall, I could lose consciousness (which I was very close to doing) and in due course, die from my condition.
As I've said before, my Cortisol levels will have been gradually lowering over several years prior to May 2013 when I was diagnosed with the tumour. Gradually my body got used to ever lower doses of Cortisol, so low that my GP didn't really know how I was getting by. But having sorted that out and started me on the HC pills, suddenly my Cortisol levels were artificially back to where they should have been and once my body got used to that, it could no longer tolerate dropping suddenly back to a level that was much too low....even if that is where it had been for years.
When I was ill last June, when my wife was desperately trying to get an out of hours doctor out to see me, the person Deb spoke to on the phone had cottoned on to the seriousness of my condition and was arranging for me to be admitted to the Medical Assessment Unit in the QA Hospital, but they wouldn't take me until I had actually been seen by a doctor. The phone doctor arranged this, and once seen by the doctor who came out, Deb took me in and I started treatment. But what if the phone doctor hadn't seen that risk....who knows.
So the upshot is I was reading the above article to Deb and saying "I really ought to get one of medical alert bracelets just in case" and she said "oh, so you are finally taking this seriously then". That took me back a bit, I wouldn't say I wasn't taking it seriously, all I see is the day to day task of taking tablets....not what happens if I don't or can't. So I really must sort that alert bracelet/pendant out. The other thing that occurs is maybe it wasn't clear enough to me the consequence of not taking the tablets back then, I knew I had to take them and double the dose if I became ill...and I knew I mustn't stop taking them. But exactly how ill I could become wasn't really made clear, I suppose no-one really expects that to happen so soon.
The other worrying thing is hoping the medical professionals that I come into contact with, are aware of what condition I have, and making sure they fill me up with steroids at the appropriate times.
So now I've got that off my chest, a quick update. Still going fine, feeling great, put on a bit of weight but have levelled out at just under 11 stone for the time being. Still trying to keep fit with the Pilates and some weight training. Still having the odd energy crash, nothing too serious and still have a tingly leg and foot, I think very slowly it is improving but a year down the line, still there.
The other worrying thing is hoping the medical professionals that I come into contact with, are aware of what condition I have, and making sure they fill me up with steroids at the appropriate times.
So now I've got that off my chest, a quick update. Still going fine, feeling great, put on a bit of weight but have levelled out at just under 11 stone for the time being. Still trying to keep fit with the Pilates and some weight training. Still having the odd energy crash, nothing too serious and still have a tingly leg and foot, I think very slowly it is improving but a year down the line, still there.
Subscribe to:
Posts (Atom)