A slight case of overblogging

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!

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.

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!

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 :)

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.

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!

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.

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.

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.

It took an hour to go to the docs and back, and cost 13 quid in taxi fares, but at least I got to buy some more food in the co-op while I was out. 3 more blood samples taken, the results will take another couple of days, and then the doctor will want to make an appointment to talk about them (I'll make sure to make it for later in the morning though, that way the local taxi firm will have finished with the school run and it'll be cheaper).

Right now the ankle seems to have ceased getting much better. I can walk around the house, but if I try any longer distance I've got a really painful step about 1 in 20 or so. And of course all my muscles are weirdly stiff from being used in unusual ways. But I have an offer of a lift into work a couple of days next week, which will be good.

I am becoming rather too fond of Deal Or No Deal and Come Dine With Me, both of which really are car crash TV, but conveniently on at lunch time.

Amusingly Mike also stopped at the co-op on the way home and bought identical bread (something our co-op seems much better at than those in Oxford) and the same chocolate puddings. And he used yesterday's leftover gravy to make a lovely lamb stew, which ended up leaving more gravy. Which we ate while watching Reservoir Dogs, which I'd never seen before. A combination which was perhaps a little unwise. Now I'm off back to my book. I'm 7 books behind in cataloguing the ones I've read this year, which is very lax, but I keep putting it off in order to have more time reading :)

PS the comment spam this time was remarkably relevant, so apologies if I deleted anything genuine. If you wish to make comments but don't have a livejournal account please sign or initial them, if you wish to make anonymous comments which aren't mistaken for spam you could sign them "anon".