I’m Going To Follow David Cameron
On Wednesday, I seemed to get a bruise on my left wrist.
My Bruised Left Wrist
So I think, I’m going to follow David Cameron’s example and not where a watch. but then Sam Cameron doesn’t either and neither did my late wife.
Conclusions From Self Testing My INR Daily
Tomorrow, it will be eleven weeks since I started self testing my INR on a daily basis. The results are here.
I should say that after I had my stroke, an eminent cardiologist said that if I got my Warfarin right, I wouldn’t have another stroke.
So can I come to any conclusions from the tests I have been taking?
I did miss one day early on, but otherwise I’ve taken the test successfully on a daily basis.
I’ve now developed a daily routine in the morning, where I do my stretching and exercises after checking my computer, then have a shower and breakfast, before doing the washing-up by hand, which warms my hands. I then take the test and only rarely do I fail first time and need a second strip.
So the first conclusion, is develop a routine for when you do your tests, that suits your personality and lifestyle.
One thing that you notice from the tests, is that there is quite a large variation between days. A change of 0.5 in the INR, either up or down is not uncommon. This is not a problem, but it could with some people worry them and then they might start to chase their target INR, by constantly changing the dose.
Hot days incidentally, do seem to try to force the INR upwards and although you won’t find this on the Internet, a medical professional has told me that it happens.
I use a very simple manual algorithm, based on my training and experience as a Control Engineer. I know from when I was living in Suffolk, that a Warfarin level of 4 mg. a day is about right to meet my target of 2.5. So I use a simple algorithm, summarised as follows.
INR less than or equal to 2.2, take 5 mg.
INR higher than or equal to 2.8, take 3 mg.
INR between 2.2 and 2,8, take 4 mg.
So how has my INR behaved?
If I look at the average value of the last 28 days, it is 2.56 and this rolling 28 day average has been within 0.1 of 2.5 for the last seven weeks. I couldn’t calculate it before, as I didn’t have enough data. An interesting figure is that the standard deviation of the readings is about 0.3. Effectively this says that nearly all of the readings are within 2.2 and 2.8, which is within my target range of between 2 and 3.
So as the patient, I think I could safely say that my simple algorithm works.
But perhaps what is most interesting is that the 28 day average for the dose I’m taking is around 3.8 mg. So rounding this to the nearest tablets, that means if I can’t take a reading for some reason, then I should take 4 mg.
So I can conclude that the daily testing has given me a very sensible daily dose, which is virtually the same, as I took, when the tests were done by nurses, hospitals and laboratories, at great expense to the NHS.
So should all those going on Warfarin be assessed to see, if they could self-test their INR levels?
I believe they should! And it’s not just me!
An organisation called the Anticoagulation Self-Monitoring Alliance is pushing for more self testing. Be cynical if you like, but it is part-funded by Roche, who make the self testing meters.
On the other hand, how many diabetics test their blood sugar levels regularly and have a better lifestyle because of it?
French Think About Beach Smoking Ban
The French Minister for health has said, that she might like to ban smoking on beaches. It’s reported here on the BBC. This is the first paragraph.
A call by France’s health minister for local authorities to ban smoking in parks and on beaches has sparked debate as a heat wave grips the country.
Marisol Touraine told the Journal du Dimanche newspaper she wanted to see more tobacco-free zones, to protect children’s health.
The Socialist minister said she hoped smoking would also be banned outside schools and on university campuses.
According to the article, there is actually a ban at La Ciotat near Marseilles, where they say it has been well-received.
In my view, anything that cuts smoking is a good idea.
Not One Of My Problems!
This story about treatment for varicose veins shows how a lot of medical treatments are going to get more hi-tech. This is the first bit.
People with varicose veins should be offered laser or heat treatment, say new guidelines for England and Wales.
The National Institute for Health and Care Excellence (NICE) says, in most cases, surgery should be a last resort.
Both my parents had bad varicose veins, with my mother’s being particularly bad. She had them operated on at the old Highlands Hospital in Winchmore Hill in the mid-1950s. The strange thing about that operation was that the surgeon was an Indian lady, who did her ward rounds in a sari. I don’t think, I actually saw the surgeon, as eleven-year-old children weren’t allowed to visit their parents in hospital in those days, but my father would recall if her surgery was as as good as her looks, then my mother would be fine.
It’s strange, but you don’t seem to see the awful varicose veins you did fifty years ago!
I certainly don’t seem to have inherited them from my parents!
The Birth Of Our First Son
With the birth of the baby to the Duchess of Cambridge expected within a day or so, it is perhaps a good time to tell the true story of our first son’s birth in 1969.
Our circumstances just before the birth on the 16th of July, were a bit chaotic to say the least. I did outline them to a certain degree in this post about waiting for Apollo 11.
To summarise, we had no hospital for the birth, were living with C’s mother in Barnet and the baby was four weeks overdue.
C thought it would be a good idea to go and sit in St. James’s Park, as it was getting rather oppressive with her mother, who had no idea or experience about childbirth as C had been adopted. Mother felt she should be in the Victoria Maternity Hospital in Barnet. You never told C what to do, if it was against her wishes. Especially, if you were her mother!
It was a lovely day and we sat in deck chairs in the Park until about five o’clock, when C said that she thought she was in labour. As I said in the other post, she decided she was going to the old Middlesex Hospital, where because of her imminent state, she was seen by a doctor and admitted as an emergency.
As I said in Part 2 of the waiting for Apollo 11 story, I stayed all night and nothing happened, except that about midnight the contractions stopped. C always said she was telling me to go back to her mother’s and get some sleep, but whether I was being loyal or stubborn, I don’t know and I just stayed.
I went to work on the Monday and the evening was another of waiting, with the odd contraction thrown in.
Part 3 gives the full story of the birth, with our first son being born soon after midnight.
Only after we had returned to her mother’s did C reveal the truth about what had happened. Until about four or five hours after they broke the waters, did she ever have a proper contraction.
She had fooled the doctors, so she could get into her chosen hospital.
I doubt the Duchess of Cambridge is faking!
Barts Take A Strong Line Against Smoking
This story in the Standard has the headline.
Hospitals warn smokers: no treatment and £75 fine if you light up
I can’t why this isn’t in force all over the country.
More On Immunocore
I found this excellent article on Immunocore, which is the company behind the possible cancer cure, I mentioned yesterday. \Here’s a flavour of the article.
In all probability, Immunocore is the only company worldwide that has been able to develop a way to harness the power of the immune system’s natural-born killer cells: the T-cells of the blood that kill invading pathogens, like viruses and bacteria, the Independent reported.
Obviously, it’s too late for my wife and son, but hopefully it will bring a pathway to help others in the future.
Is This Bad News For Cancer?
This report from the Independent headlined, Exclusive: Cancer – A cure just got closer thanks to a tiny British company – and the result could change lives of millions, was flagged up on BBC Radio 5 this morning and is a fascinating read.
It seems that researchers may have found a way to get the body’s T-cells to attack the cancer cells.
I think everything in the report sounds feasible and the company in Oxford; Immunocore, have now got masses of backing from two of the largest pharmaceutical companies. So money for the research won’t be a problem.
In some ways, this research all fits with my belief that if you have a healthy immune system, you are less likely to get cancer. Hence my gluten-free diet and abhorrence of smoking.
Is It Goodbye To Trafford General Hospital?
Trafford General Hospital is going to be downgraded in phases according to this report. Here’s the first three paragraphs.
Campaigners fighting to save a hospital A&E department where the first NHS patient was treated say they will challenge the decision in court.
Health secretary Jeremy Hunt said on Thursday that Trafford General Hospital was to be downgraded in phases.
He said the decision had been taken because there were too few patients using the department.
My son was in that hospital several times, a few months before he died and they had no idea he had pancreatic cancer.
I certainly won’t miss its passing and I suspect as it seems to be suffering from Stafford Syndrome, with a lack of patients, neither will any of the people who live near the hospital.
But then as long as I can remember, NHS patients have always chosen to go to a better hospital a few miles away. When I lived in Suffolk, my local hospital was at Bury St. Edmunds, but I always drove to Addenbrooke’s at Cambridge. I suspect the good people of Trafford, go to somewhere in Central Manchester.
But then the first sentence in the BBC report says it all. It treated the first NHS patient. But we don’t want to keep hospitals as museums!
Did The Hot Weather Cause A Jump In My INR?
The last few readings of my INR have been.
Monday, July 8th – 3.2
Sunday, July 7th – 2.3
Saturday, July 6th – 2.4
Friday, July 5th – 2.6
Thursday, July 4th – 2.3
Wednesday, July 3rd – 2.2
Tesday, July 2nd – 2.5
Monday, July 1st – 2.8
Sunday, June 30th – 2.6
Saturday, June 29th – 2.6
I don’t think anybody would complain at those figures, as I’m supposed to keep the INR between 2 and 3, with a target value of 2.5.
I know from past experience, that in the summer, my Warfarin level is around 4 mg. a day. So generally, I take this amount every day, but if the INR is 2.8 or over, I take 3 mg. and if it is 2.2 or under I take 5 mg. It is a classic simple algorithm of the type I learned at Liverpool University in my degree in Control Engineering.
But notice how today, after the very hot and sunny day yesterday, my INR rose sharply. I shall be watching the figures intently.
The Anonymous Widower 