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It mildly annoys me that because the parathyroid clinic takes place as part of the clinics for diabetes and weight management they always take your weight and BP when you arrive. I'm not sure the consultant was even interested in them, she didn't mention either and they're certainly not relevant to my condition, but they didn't let me relax for even a minute before taking the BP so it was a little high (147/79).

The consultant herself asked me if I was well (yes), confirmed when the surgery was (September 2009) and that it seemed to be a success (given I had no symptoms at diagnosis this is hard to quantify, but there's been no recurrence of the kidney stone I had last year). My calcium levels (taken last week) are completely normal. My bone density (scan done in May) is completely normal. So I'm officially discharged. They're not even going to worry about the fact I'm a bit young to have had the problem.

If I ever get another kidney stone I should get my calcium levels checked at that point, but otherwise it's not even worth bothering. I'm all better. Hurray!

Healthy me

May. 11th, 2010 05:19 pm
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Well, I'm back from the hospital. Weighed and BP taken: 160/100 -> 139/86 after 5 mins chilling out - I'm glad my GP taught me that trick! Then a 25 minute wait to see someone I've never met before who didn't even introduce himself, and nipped out partway through to check something with the consultant I was expecting to see. However my calcium levels are just the low end of normal, and my vitamin D levels are a little low, but then it has just been winter so they're not worried. Tick, vg, come back in 6 months to have calcium levels checked again, oh and we'll book you a bone density scan too and see if that's changed, and if all is well we'll discharge you at that point.

All a bit anti-climactic!

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GPs this morning to discuss implications of recent blood tests. It looks like the bad liver function test was almost entirely caused by the statins - I've only lost a couple of kg in the time between the two tests, so it's unlikely that made a difference. Only way to prove it is to put me back on them, but he doesn't see the need for that :) Cholesterol before I stopped them was at 3.3.

Blood sugar levels are also currently OK, although he didn't say what the HbA1C value from the most recent test was, and didn't take fasting glucose last time round. I've never had a value above 7 for fasting glucose though, and the metformin was mostly preventative, so given the excellent weight loss results the current plan is to stop taking that too. I'm to go back in 2 months and he'll test fasting blood sugar, cholesterol and liver function again. Hopefully those will all be OK and we can continue unmedicated thereafter.

Finally he did blood pressure, and showed an interesting effect: first result (immediately after fairly animated conversation) was roughly 150/90 - dreadful. After 60 seconds deliberately relaxing and breathing deeply it was down to 122/74 - absolutely fine.

Ideally I need to continue losing weight to a BMI of 25 or less and then stay there, but the main takeaway message is not to gain any weight from where I am now at about BMI 29.5. I may compromise on somewhere inbetween, depending on how hard it gets to keep losing weight. Overall I'm pretty happy :)

And in other news while checking if I had full access to the BMJ I discovered there's apparently a link between hyperparathyroidism and diabetes/glucose intolerance. Apparently just having had the abnormal gland removed may well have reduced my fasting glucose levels a little! See this relevant paper.


Oct. 23rd, 2009 06:47 pm
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We've booked our wedding venue, and will be getting married on 18th September 2010 at Queens'. We're very excited. Have to go do the Notice of Marriage at the Register Office in the next few weeks, and next weekend me and mum are going to look at wedding dresses. I shall try not to go on about it too much :)

No new health news :) Back to Addies on Monday to get rescanned to see if the kidney stone has really gone. Still waiting for the results of the blood tests they took at the end of September to see if my hormone and calcium levels have gone back to normal. Otherwise pretty well though, scar is already visibly fading, and I'm still slowly losing weight. 5.5kg to go until I'm no longer obese, at which point I might think about trying to maintain my weight instead. We'll see.

A couple of lovely parties fairly recently for Laura and Karen's birthdays. Other than that life's been pretty quiet: lots of reading, lots of watching DVDs, not much else. It's all good though.

Oh, and I'm vaguely considering upgrading to Windows 7, since I can get it cheap as an academic, but it seems my graphics card isn't compatible with their shiny new "Aero" style desktop, I'd need new drivers for my ethernet card (not so bad), my AV won't work on it, I'd need more memory to run the 64-bit version, and it's not clear whether any of my games and so-on would run on it. Oh and it definitely won't do the virtualised WinXP compatibility stuff. So it's not looking like a great move really. I might just buy the extra memory instead :)

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They've confirmed that the enlarged (and removed) parathyroid was indeed an adenoma: a benign tumour. Also taken a blood sample to check calcium and parathyroid hormone levels are back to normal. They'll write to me and my GP and let me know the results, if so we're all done and dusted. He didn't say what happens if they're still elevated! Also apparently my scar should be all but invisible within 12 months, which is excellent news. It's fairly unobtrusive anyway, all things considered. All good.

In other news I'm actively looking at wedding venues now: have three visits to colleges lined up, all inconveniently on different weekends, but Mum and Dad will be able to come along for one of them. V exciting, and scarily expensive looking!


Sep. 6th, 2009 11:01 am
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Thanks all who sent good wishes. Surgery apparently went well on Thursday, and I was allowed home the same evening. Since then I've largely been curled up in my pyjamas under the duvet reading lots and letting Mike look after me. I've finally got up properly today :)

I'm still achy, I've got a big scab a couple of inches long along one side of my neck, but it's right along an existing crease, so once it's healed the scar should barely show. And I'm not in enough pain to be worth taking even paracetamol, which is brilliant.

I'm taking vitamin D and calcium supplements for a fortnight, until the other three glands supposedly recover from being rather suppressed and everything gets back to normal, and I go back to see the consultant in 4 weeks. I'll be seeing my GP on Monday though, to give him my discharge letter and check that I've not got too much calcium in my system now. There's a bit of me that's scared I'll be like my neighbour and find the operation hasn't worked and they need to operate again and look at the other glands. I hope not!

I don't think I'm up to sitting in front of a computer all day yet, it makes my neck ache, but I should be OK by the end of next week I guess, we'll just have to wait and see. Overall I'm a lot more recovered than I thought I'd be though.

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Finally mapped our two long walks in Devon, you can see them here: Haldon area and Dartmoor. 9.2 and 7.3 miles respectively with 1800 and 1300 feet of climbing. No wonder my knees hated me afterwards! The elevation profiles are pretty cool though, and if you zoom in you can see the rocks that make up Grimspound.

Pre-assessment yesterday took all afternoon, but I've been given a clean enough bill of health (despite an irritating blood pressure reading of 158/86), so surgery is on for tomorrow. Alarm clock is set for implausibly early (by our standards) so I can get to the hospital by 7am, for a mid to late-morning surgery. They expect it'll last 45 minutes max, but I doubt I'll be allowed home before the evening. My bag's all packed and I'm pretty much ready to go, if nervous. I suspect I may not get the best night's sleep :)


Jul. 28th, 2009 10:00 pm
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  • I have seen the parathyroid surgeon today and have surgery booked for September 3rd
  • I'm going to go visit baby Oliver (and his mum and dad and grandad and granny) next weekend while Mike is away in Nottingham
  • We are going on holiday: staying in Exeter for a week from the 16th. Conveniently letting me travel there directly from Rae's hen night in Cardiff, rather than coming home first.

It's all good. Apparently the urology appointment I have on 27th August will just be to discuss what to do about the kidney stone, rather than actually do it, but that's not the end of the world. And I have to visit the hospital for pre-assessment 2 days before the parathyroid surgery, but hopefully that'll just be a reasonably short appointment rather than taking a day off work. And I'll have over a week to recover before we're off to Bath for Rae and Adam's wedding.

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Sprained/chipped ankle: sufficiently better that most of the time I don't even remember I did it any more. Even when doing things like attempting to scale a climbing wall. Success.

Hyperparathyroidism/hypercalcaemia: Have appointment to see surgeon on 28th, at which point they'll make an appointment to actually have the operation and take my overactive parathyroid out. Relatively minor day surgery, will need to take calcium/vitamin D supplements for a while afterwards until the other three glands reset to normal operation.

Kidney stone: This is almost certainly caused by the excess calcium in my urine because of the above. CT scan results are in and I have a 4mm stone in my left kidney. At this size it's 50/50 whether it's worth treating, but since I have symptoms (pain again this Tuesday, and I can still sort of feel it now) the GP has referred me to have it broken up using external ultrasound. No idea how long this referral will take. In the meantime I still have enough diclofenac left to deal with the pain.

Metabolic Syndrome: Having lost some weight I've discussed this with my GP. Since I have a strong family history of diabetes it's very likely that even if I lose more weight I'm still going to get diabetes later. He'd rather I continued to take the Metformin and statins, since apparently they can have a protective effect and will hopefully delay its onset. I'm not terribly happy with this, but will review in maybe 6-8 months time, at which point I'll ask them to re-do all the sugar/cholesterol level tests too. This does mean I still can't drink.

Weight loss: 13kg so far to 97kg, which is over 10% of my weight and more than 5 BMI points. I expect to reach 90kg (around BMI 31.5, and my next target) by mid-September. I need to reach 85kg to no longer be classed as obese. Still following Slimming World online, still trying not to go on about it.

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It seems like ages since I wrote anything here. In the meantime I have:

  • Had a CT scan for my kidneys (actually that was before my last entry), but not got the results yet, despite it being nearly 3 weeks now
  • Had some friends over for dinner, on one of the hottest days of the year, and really enjoyed eating with the patio doors open beside us
  • Been given an appointment for July 28th to go talk to the surgeon at Addenbrookes about having my dodgy parathyroid gland out. Apparently I should get the date for the surgery itself on the day, so looking forward to that, though no doubt it'll mean more waiting.
  • Reached the point where I've lost 10% of my body weight, and so should be seeing positive health results provided I keep it off (there's the rub!). Will go see GP (once the damned CT results arrive!) and ask if I can come off the pills. At least the metformin, since it seems to upset my digestive system a bit whenever I forget one or take one with too little food. Have decided to lose a little more and stop at either 90 or 85 kg.
  • Been to a fab BBQ in Histon with Mike's colleagues followed by a bijou party for Pete's 30th, both of which were excellent.
  • My sister now has a date on which they plan to induce her baby (at just over 38 weeks, for health reasons), which is a week on Monday! So excited and looking forward to visiting her and the baby (and Dave) the following weekend assuming all goes well *fingers crossed*
  • Had a day off today to make sure I do use up all my holiday before the end of September. Will still have a week to spare to hopefully go away in August.
  • Looking forward to Rae's hen night in Cardiff in mid-August. Half wishing she'd gone for the hen weekend approach given how long it takes to get there. I will be on a train from Shelford before 7am on a Saturday. Ow.

There's probably other stuff too, but that's the main events. I've generally had a few chilled out weeks, with far too much time spent playing the Sims, and doing quite a bit of reading. I should give Tom his book back now I've finished it. I have applied for a library card and will see if I can borrow the rest from the library in the village. I have at least got round to cataloging the books I've finished over the last 2 months now, and reviewed them all over on librarything. I'm still really glad it's the weekend though.

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Consultant appointment today. They took my height, weight and blood pressure first - where I proved you get weird results from the automatic machine if the cuff is too small - 160/94 became 100/70 when done again manually with a bigger cuff, and she checked it 3 times, once standing up, just to make sure. Consultant took lots of medical history information and didn't say much that I didn't already know, other than to mention that actually my calcium levels are only *just* above normal, and if I were older they wouldn't bother operating, and that after surgery my bone density should go back to normal. They do want to do a DEXA scan to check bone density at three specific points (spine, hip, forearm) and I've got to collect some urine samples and have another blood test done, but if the results of those all confirm the diagnosis so far then I'll be referred to the surgeon. Should take 6-8 weeks to get an appointment to see him and then another 6-8 weeks before the operation, so I guess I'm looking at October. Oh and if the tests *don't* confirm the diagnosis I'll be back to see the consultant in 3 months time, because they only run the clinic once a month and she's not available in 2 months time. I really do hope they say the right thing, I just want to get this *over*. Still, at least I can probably now thing about booking a holiday in late August.

I also got an appointment for a CT scan for the kidney stone through this morning, and that's in a fortnight's time, and will also be relevant. I'm a little unimpressed that wasn't sooner, given that if I were still in pain I'd have to go back to the GPs for a bigger supply of painkillers. Just in case I'm getting hospital withdrawal symptoms in the meantime though I've got an appointment to give blood at the hospital's blood donation centre next week.

In other news this morning I managed to make a boiled egg explode, and cover both myself and the kitchen in egg, including the clean clothes and the clean washing up. It was *not* what I'd call a good start to the day. Don't believe Delia when she says 7 minutes is long enough for a hard-boiled egg, especially not in shallow water. And do prick the yolks *before* microwaving the resulting shelled lumps of half-cooked egg-like mess, if you're attempting to finish the cooking process off. They were fine in the microwave itself, but the one which was most whole did not react well to me cutting into it to see if it was done. Thank goodness I was wearing my glasses!

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I may in the past have expressed some impatience with the fact I've had so many appointments to diagnose and test a condition for which I had no apparent symptoms. This morning however I woke at 5am with a strong pain in my abdomen, mostly in the left lower back, which became stronger and weaker in waves, and kept me more or less awake and uncomfortable until 8am when I could phone the GPs, and get an appointment at 9am. Testing my urine showed signs of blood in it, and it seems that in fact all this extra calcium in my blood has caused the formation of a kidney stone. Ow.

I have yet another referral for yet another hospital appointment for a CT scan to look for stones, which is fast tracked and should be within the next 10 days, and in the meantime I have strong painkillers. And a bit more respect for the power of a tiny over-active gland in my neck. The painkillers work, but it's not how I intended for the last day of my week off work!

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After visiting the nuclear medicine department last week and the week before for some radiography today was the turn of the ultrasound. And a nice chap called Matthew used that to take a look at my neck too. He's confirmed that a) I do have a dodgy parathyroid gland and b) it's where the nuclear medicine people said it was. It's about 10mm along and 6mm across and apparently an ideal candidate for the sort of minimally-invasive day surgery I was suspecting would be necessary. if it were normal he wouldn't even be able to find it with the ultrasound. And it was nice of him to talk more openly about the fact that that's what's going to happen: I've known for ages, but I think that's the first time I've been *properly* told. And even he seemed to think I'd know already. Clinic is next week, when I get to see the consultant, and then I guess we just see how soon they can fit me in.

Bizarrely I was chatting to my neighbour across the road a couple of days back, and it turns out *she's* going in to have surgery for the exact same thing. An unusual version of small world syndrome! Here's hoping it goes well for both of us.

I also took the opportunity of a hospital appointment when I'm coming from home rather than work (I've got the week off) to take the bus and take my crutches back. Which got me a couple of funny looks, walking briskly and carrying them over my shoulder. And it was such a nice day I walked home along the Shelford bike path, enjoying the hot sunshine, the wild flowers and the birds. And I'm pretty sure I saw a yellowhammer. Bright yellow head, sitting on the fence only a few feet away briefly before it flew away. I've never seen anything quite like it but the information boards at Nine Wells local nature reserve had mentioned it, and looking it up it definitely seems right. Lovely. Thank goodness for factor 30 sunblock though. I took a similar length walk when visiting my parents on the bank holiday weekend and factor 8 was definitely not enough for the job.

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Having finally managed to make an appointment for the relevant endocrinology clinic today I've got home to a letter telling me to come to an appointment in Nuclear Medicine next week, so they can inject me with something radioactive and take pictures to work out where my dodgy parathyroid gland(s) are.

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Two calls today, one at 9:15 when I established Nadia wouldn't be in until 10 and would only be in this morning, but did get the person I spoke to to observe that Nadia's phone was giving a useless message and promise to leave her a note. One at 10:30 when I actually spoke to Nadia: she *did* get my message last week, but there was a problem with the clinics and she needed to talk to one of the doctors which is why she didn't call me back yet. And the clinic I need only runs once a month and the next available appointment is on the 9th of June, but I do at least now have an appointment. I explained how much trouble I'd had getting hold of her, and she said they do seem to have phone problems like this sometimes but when they report them nothing is wrong. Hmm. Still, progress at last.

This doesn't manage the "where possible we'll try to arrange your first appointment within five weeks" - 9th June is 10 weeks and 1 day after I saw the GP. I wonder how likely it is that "in line with government policy [...] you should wait no longer than 18 weeks from the time you are referred to a hospital specialist to the time you begin treatment or are admitted for an operation". That would have to be by the week beginning 30th August.

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We had an Easter: Sion and Ingi renewed their wedding vows with a touching ceremony in the light rain in their garden, and a lovely party. And Jan and Owen stayed over so we had a lovely big fry-up for breakfast and lots of chocolate on Easter Sunday itself. And on the Monday we cycled out along the Shelford-Addies bike path and finally got to go for a walk around the little nature reserve and see the Nine Wells springs and the obelisk, as well as assorted birds and wild violets.

Mike and I took Monday and Tuesday off work this week, and had another lovely long weekend. Gardening on Sunday, a long walk out at the gogs on Monday which resulted in minor sunburn (why do I never learn that even in April it's not safe to go out for two hours in a strappy top at lunchtime on a sunny day?). And yesterday was Mike's birthday: we cycled into town to go shopping shopping and had a nice late lunch at Tatties, then came home and spent the afternoon playing Lego Indiana Jones on the wii: one of the few games where game play is much improved by having two players! Then we headed back out on the bus for dinner. The plan was to go to Alimentum, but I hadn't booked, and they seemed to have some sort of function on. We weren't sure if they also had normal tables through in the other room, but it was impossible to say how long it would be before anyone would be available to ask, since the function guests were just arriving and standing around drinking bubbly. So we took plan B and went to Nando's instead, which was fun and tasty if not in the same league. We'll just have to go to Alimentum another time. I've bought Mike membership to the National Trust for a year for his birthday, with me as joint member, so it looks like we'll have to make some holiday plans around that later in the year.

As you can tell from all the cycling and walking my ankle really is getting much better. I've had my first two physio appointments, and am improving vastly. Exercises include practicing standing on one leg and on tiptoes, and now trying to balance on a wobble board. More fun than exercise! I'm wearing my walking boots whenever I'm out and about, and have a walking stick borrowed from Anna: I always feel like I'm barely using it, but then I try walking about without it and find I'm much more hobbling. So today is my first day back in the office completely under my own steam, and it feels very liberating. And all the more new and exciting because the main route into the department has finished being resurfaced and they've finished demolishing the portacabins in the courtyard (which have been here longer than I have) and we're soon going to be moving into a new office, so it's all very shiny.

If I hadn't had my bike key disintegrate on me earlier (now fixed with sellotape) or discovered this morning that the fridge door had been left open a crack and the light had cooked everything on the top shelf it would be a really brilliant day. I still haven't heard from Addies about an appointment to sort out my overactive parathyroid, but I've chased via the GP, and have instructions to chase again in about a week's time. All in all life's pretty damned good though.

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Things I have done recently:

  • Joined slimming world's online site at http://bodyoptimise.com and spent a week following their plan
  • Taken metformin and statins for just over a week: 1 day of nearly gagging while eating, 2 days of diarrhoea, now just the occasional gurgle.
  • Despite the combination of the above I've not lost the huge lump of weight which is typically associated with the first week of a diet, but I shall persevere
  • Had my first day back in the office, and resolved to start going in again next week. Stephen has offered me lifts, since I'm very nearly on his route to work anyway. I'm thinking about trying the bike after Easter.
  • Been out to my first social event since doing my ankle in, the lovely Alison's lovely birthday party, with the most incredible Star Destroyer cake. It was nice to talk to people.
  • Got a letter from the NHS asking me to use their "choose and book" system to get an appointment about the hyperparathyroidism. Only I could neither choose (only one choice) or book (no appointments available) so I rang them up and apparently Addies should write to me directly within the next 14 days and if not I should contact me GP and get them to talk to Addies about it.
  • Had a go on the wii fit: 13 minutes of step and two balance games, and beat my previous scores. With a wii fit age of 29 but my highest weight ever. Though it's 161 days since I last tried it. Without my rides to work I need a little exercise of some sort. Ankle didn't mind at the time, tiny bit achy now.
  • Ascended a monk in nethack! Only my second ascension ever, and the first time I've seriously played a monk at all. It was rather fun.

Don't expect regular weight or diet updates, I just want to quietly get on with it, rather than talking about it.

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Doctor confirms I have primary hyperparathyroidism, which is what's causing the raised blood calcium, and will refer me back to the hospital to deal with it, and it's nice that it's been found. Edit: aha, I have the results of these blood tests in the post: serum parathyroid hormone 188 ng/L (14-72 is normal), parathyroid hormone 19.93 mmol/L (1.48-7.63 is normal). I'm not quite sure what the difference between these two is :)

Doctor also notes that my blood sugar *is* slightly raised (6.5, below 6 is normal, over 7 is diabetic), that I have slightly too high cholesterol (7), and that they did some liver function tests which show I may have "fatty liver". Overall together they add up to "metabolic syndrome". I asked about Metformin, which he agreed was a good idea. He also suggested statins. And I also asked if it could be related to PCOS (as I've only had 3 periods since coming off the pill about a year ago and am a bit hairier than I used to be) and he suggested they probably do all tie together, so I'm going back on the pill too (which can reduce the risk of womb cancer as well as because I'm bored of condoms: I only really came off it out of curiosity anyway, since I've been on one form or another of contraceptive pill nearly all my adult life. So I have a paper bag full of drugs.

I'm also encouraged to lose weight, which will help with all of the above (apart from the hyperparathyroidism, which isn't connected to the rest). Interestingly he reckons since my weight is currently pretty stable I'm probably not overeating, but also that I probably don't need to cut back from what I'm eating now once I've lost weight, I just need to make some serious changes to lose it, and then keep my eye on the ball to catch it if I start gaining again. I'm not 100% convinced I won't just regain any weight lost with more on top, which is what I've done before. We'll see.

To round off he took height, weight and blood pressure, which I'll list here to remind myself. 1.70m, 110kg, 135/87.

So I went to the co-op and bought lots of fruit and veg and some fat free yoghurt. I'm now contemplating whether joining Slimming World again is a good plan, even if it's only online until I'm more mobile. And at the same time not sure if this is even sensible or possible, but I really do feel like I ought to try it and see if it does fix the metabolic and cholesterol problems. *sigh*

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