How to Cut Down Strokes and Their Effects
The more I learn about strokes the more I know that the one I had in Hong Kong might well have been avoided.
my stroke was caused by atrial fibrillation. This was detected hen I had a small stroke in March 2010. I now feel that I should have been put on Warfarin, but why the doctors didn’t take this route, I do not not know. Could it be that my previous surgery in Suffolk, wouldn’t use a simple hand-held instrument, but still relied on expensive weekly blood tests? I don’t know, but having been on a system based on a machine since moving to London, I can honestly say that the the system is better from a patient’s point of view. My previous cardiologist, who has an International reputation assured me that if I kept my Warfarin regime, I would not have another stroke.
I am now under the care of University College Hospital in London. I happened to tell the nurse doing my electro-cardiogram there, that twenty or so years ago, I had had one that missed a beat in a flying medical. She said that that should have been followed up as it was indicative of atrial fibrillation. Instead over the past twenty years, I’ve had the odd cholesterol and blood pressure tests and that is about all.
It strikes me that, if I had had a proper heart medical, twenty years ago, then my stroke might have been avoided.
But I didn’t even see a cardiologist after my first stroke.
It strikes me that GPs either need to be better trained with regard to heart problems or less reluctant to refer patients to cardiologists.
I was also lucky in that I had my major stroke in Hong Kong.
There I was given a drip of a clot-busting drug, that provably mitigated my lasting problems. It is common place in some countries and regions of the UK. A BBC London report, showed that it saved money against conventional treatment, by avoiding lots of expensive after care. Additionally, in London, you are always taken to a specialist stroke unit.
So it does look like things are improving in the treatment of strokes.
Pharmaceutical Packaging
If ever there was something that was almost designed to cause mistakes, it is the packaging for pharmaceutical drugs.
The first thing, I do, when I open a packet of drugs is to throw the leaflet in the middle away, as it gets totally in the way, when you want to put a half-used strip back in the box.
I don’t find the bubble packs difficult, but I know some do. But one of the drugs I have, has some bubbles that don’t contain drugs and these could easily cause confusion with someone with limited vision.
Incidentally, I never read the leaflets, supplied with drugs, preferring to read about the drug on the Internet on an appropriate web site. So why doesn’t each drug packet have an easily readable code on it, that you just type into a web site and it gives you everything you could want to know, including the various generic names. One of my drugs comes in two different shapes and sizes, which could easily cause confusion.
The system is a complete mess.
Incidentally, I have to take two groups of drugs; one when I get up and one in the evening. I take them out of the silly bubble packs and put everything I need into old 35mm. film canisters; white for the morning and black for the evening. Usually, I fill the morning one as I go to bed, so that it gets checked again in the morning when I take it. I do the evening one after breakfast and always keep a second set in my coat, so that if I get delayed and stay out, I have my drugs with me. I also have reminders set in Outlook in my computer about when I should take my drugs.
Smoking is so last century: the new stigma is obesity
This is the title of an article in the Evening Standard tonight.
I very much agree, although in many ways they are equally bad.
Two Years On
It is now over two years since I had the stroke in Hong Kong and as you know I’ve now moved to London. So how have I improved in the last year? I’ll intersperse the comments into a copy of last year’s post.
So how am I feeling?
Bodily, I have few issues.
My nails used to be firm and hard, but now they are soft and brittle. My toenails are actually worse than my fingers. My nails were always soft before I went gluten-free and I used to bite them badly and my skin too. I’m not biting them now at all.
My nails went bad at the start of the year and aren’t too bad now. If my left hand wasn’t gammy, they would be better as I could cut them properly.
Q 1. Could it be that as my body is repairing itself from the stroke, it’s using up what I need for healthy nails?
I never got an answer to this question, except that this house has a very dry atmosphere. But they were bad soon after the stroke.
I have an almost cramp-like pain in my left lower leg, which is very like the pain I got, when I trod on a razor shell on the beach in Norfolk in the summer of 2009. It tends to get worse at night.
I still have this, but it certainly doesn’t get worse at night. I think also it’s true to say that I’ve had this problem off and on for ten years or so. Sometimes I get it in the right leg, but not at the moment.
My left humerus is also painful a lot of the time at the same place where it was broken by a bully at school. I think as the nerves for my arm and hand pass close to the bone, it affects them at times.
This is still the case and no-one listens except my physio. But then he’s paid to listen.
I did have pain at the end of my spine, but now that has virtually gone unless I sit on the wrong sort of chair. This again was an old injury, which was very much aggravated by the hospital bed in Hong Kong. I should say that I always sleep face down because of the end of my spine, which curls outwards and I get less cramp in my lower leg, which I’ve always had since a child. I can still feel the cold lino, which I used to put my foot on to cure it.
It’s almost as if my old physical problems have come back!
Q. 2 Does your brain develop new pathways to get round the pain from injuries?
I think now, that’s taken as the case.
Facially, I haven’t too much pain, but my scalp and left hand side are rather tender. My skin actually feels like it did at times before I went on a gluten-free diet before I was diagnosed as a coeliac. One of my main symptoms of coeliac disease was chronic dandruff. It went immediately, I changed to a totally gluten-free diet.
It’s come back with a vengeance this winter and I put it down to the hot dry air in the house. I’ve installed air-conditioning to hopefully kill it.
In fact, at some times, I feel like I’ve been glutened. Not seriously, but my motions are rather loose nearly all the time. Full tests at Addenbrooke’s have shown that there is nothing serious there, although I haven’t had another endoscopy to see what my gut is like.
I still do.
I have just re-read a post on this blog, which was a pain diary, describing how I was trying to control the terrible pain I was having last summer, with codeine and paracetamol. It wasn’t that successful and a few days later or so, I collapsed and ended up in Addenbrooke’s. Nothing was done and I just struggled on. And then a few weeks later, I ended up having a fit like symptom, when I was putting on my coat. I can remember feeling a bolt of pain in my humerus and then I went into oscillation. It’s funny, but I may remember something similar happening, just after I broke the bone, as I walked home from school. Addenbrooke’s put me on Keppra to stop it happening again. It hasn’t.
But I did collapse again.
Q.5 Should I keep taking the Keppra?
I’ve changed to Tegretol.
Because of the pain and because it felt like someone was pouring awful muck down my throat, I went to see an ENT specialist to see if my sinuses were bad.
He found everything clear, but thought that I was suffering from a serious pollen allergy. Now as a child, I was very sickly and was always off school. In my first year at Grammar School I virtually missed all the second term. Gradually it got better and it really improved when first we went to live on the 11th floor in the Barbican and later when I started flying aircraft for pleasure.
I’ve also had some bad winters and springs before, but not as bad as this one, when for much of the time, I just couldn’t breathe. Although in the last twenty years or so, I’ve lived on top of a hill with a strong westerly wind and my late wife and I could afford to take holidays in the sun in January. Funnily, my cardiologist,said that everybody should take two weeks in the sun every winter. I did try to do this in April by going to Greece and backpacking around the islands, but was irritated by everyone smoking all the time.
I know from travelling around the UK in the last year, that when I get out of the pollen I feel better. For instance, I went to Barnsley in March on a breezy day to see the football and felt a lot better that day. On the other hand, I walked past a tree-shredding machine at Euston a couple of weeks ago and it set me off coughing for half-an-hour.
Q.6 So why should all of this reaction to allergens get so much worse after the stroke?
On the other hand, in 2009, I was travelling to Holland a lot in the spring and suffered worse than I had done for years. I put it down to different pollens at different times. It was almost as if I got used to the English ones and then when I went to Holland, a load of different ones set me off.
Some days it’s so bad that all I can do is lie down indoors and listen to the radio. On the other hand, when I went down the London sewers, it helped my breathing immensely.
I do this less often, than I used to.
So how am I managing otherwise.
I have no problem getting around on buses and trains and of course by walking. I did fall over on a bad pavement in Upper Street in March, but haven’t hardly stumbled since, especially since I was fitted properly for a pair of trainers. I have no problems using the top decks of buses and climbing up and down ladders.
I like cooking and do quite a bit, although, as there are now so many Carluccio’s with a gluten-free menu, I am lazy quite a bit of the time.
I do eat a lot of soft comfort food, like bananas and ginger cake between meals. But my weight is still the same as it was five or six years ago.
My only problem with cooking is that my left hand diesn’t seem to like hot or cold, although the finger movement is now almost back to normal. I notice this most with my typing, where although I type mainly one-handed, I now use the left properly for the shift. Incidentally, I’ve always typed with my right hand, because of my bad left arm.
My eyesight to the left isn’t good, but in the last month or so, I’ve been able to play table tennis again, something that I couldn’t do a year ago. On the other hand, it does seem to be worst, when my eyes are streaming from the allergies.
Not really much change here, except that my nose seems to leak like a drain. My eyes are a bit better.
Vandalism In The Service of Ignorance
The title of this post comes from a phrase, describing the protestors, in the third leader of The Times, which defends the work at Rothamsted to create a strain of wheat , which has a natural repellant effect to pests, by crossing it with mint using gentic engineering,
Genetic engineering is a touchy subject to many, but properly used it should benefit mankind. The aim of the Rothampsted experiment is to produce a strain of wheat that uses less pesticides.
On the other hand, I would be against genetic engineering, that produced wheat with the so-called terminator gene, that meant farmers couldn’t use some of this year’s crop for next year.
There are now drugs coming on the market, that have been created by genetic engineering using plants or hens’ eggs as a starting point. Would these protestors stop this process as well? If I suffered from a disease, where the drug could be produced by genetic engineering, I would not be happy.
As I said, provided that the purpose of creating the organism by genetic engineering has a moral purpose, I can see no reason to ban it.
I’m also a coeliac, which is a minor genetic disease. I suspect a few decades down the line, they’ll be able to correct the faulty genes in babies by some clever genetic modification.
The New Leicester Square Emerges
Leicester Square is an iconic place and I took some pictures as it completed its transformation on Thursday.
Note that two pictures, show the old Royal Dental Hospital, which is now a hotel and the sandwich bar, where my mother used to take me as a treat after a visit.
The NHS Gets Gluten-Free Food Spectacularly Wrong
According to a report to be broadcast on Newsnight tonight, the NHS pays things like £17 a go for a gluten-free pizza base. If I remember correctly, that buys more than one gluten-free pizza with a topping from somewhere like Sainsburys. i don’t as I like to buy my pizzas made in a proper oven, by someone who knows what he is doing. The last time I ate a pizza was in Naples.
Apparently, the NHS spent £27 million on gluten-free prescriptions last year and say it helps people stick to their gluten free diet.
I don’t get anything on prescription. I used to until I went through the boring list available with a pharmacist and I decided that as I liked food with taste, I’d pass. For instance on the NHS approved list there are no chocolate biscuits. A couple occasionally would liven things up.
I’ve just returned from the shops and for my lunch today and tomorrow, I’ve bought some gluten-free rolls, some smoked salmon, an egg and potato salad and some melon. I could have bought the salad and fruit unprepared, but with my gammy hand, I’d prefer to let someone else do it.
It is much easier to buy it in the local supermarket, in this case Waitrose, than get the bread delivered by post.
At the moment, I’m not cooking, as my cooker has gone and the new one is not delivered until Monday, so a couple of days a week, I live on gluten-free ready meals from somewhere like M & S. But when I get cooking again, there are so many simple things to cook that are naturally gluten-free, like fish, meat, vegetables and fruit.
So in some ways the solution to the NHS’s £27million bill for gluten-free food, is to get everybody to eat healthily. We already have a pasty tax, so why not have a super-tax on burgers, unhealthy sandwiches and other foods, that cause obesity. I would be pleased, as every day, someone has dumped the old fast food packaging on my front patio, sometimes with the burger remains in it.
If people need help to cope with the expense of a gluten-free diet, then they should get the help directly, not with food parcels, where the administration is the major cost.
There also might be a virtuous circle here, in that if the NHS stopped prescribing gluten-free food, the supermarkets would feel it was a market worth developing.
One interesting development over the last couple of years, is the Marks & Spencer’s widower’s range of ready meals. They call it Fuller Longer and the range contains very few allergens, with perhaps a third of the dishes being gluten-free. Probably the most common allergen is fish! I can live with that!
With food like that who needs the hassle of collecting a prescription of a load of cardboard-flavoured rubbish.
The only problem is probably bread, but then all supermarkets and many other stores, these days have a selection of gluten-free bread and rolls.
Perhaps the £27 million would be better spent on education. Let’s face it, the most expensive gluten-free products are things like biscuits and cakes. I wasn’t a coeliac, when I lived with my mother, but some of the biscuits and cakes she used to make in those days, are well within the skills of the average eight-year-old. There is always the old staple of a chocolate rice crisp, made from Rice Krispies or a gluten-free equivalence. Kelloggs also have an interesting alternative here. Just search Google for chocolate rice crisp.
Let’s assume that in the UK, one in a hundred are coeliacs, which means every coeliac costs the country £43.50 a year for gluten-free food.
Not Getting Pregnant
It is reported today, that the Government is changing the IVF rules. But they should also change a few other things, based on my experience.
I have recently traced my family tree back to the 1820s. What is rare, is that in my father’s line, few of the women have given birth. My sister didn’t for a start.
Ten years ago, I was diagnosed as a coeliac, which showed itself in a severe lack of B12. I now moderate a list on the Internet for coeliacs and have come across several examples of female coeliacs, who have been unable to conceive, because of this lack of B12. A few were diagnosed early enough and after going on a gluten-free diet, they conceived and gave birth successfully.
Remember that coeliacs make up one in a hundred of the population. The incidence is higher in the Irish, Askenazi Jews, Italians and some from West Africa. Some have said that coeliac disease is linked genetically to sickle cell anaemia.
It’s Gibbon Time
I took a New Bus for London up to Piccadilly Circus this afternoon and it was surprisingly busy for a Sunday afternoon.
A Busy New Bus for London
When I got off, I used the rear staircase and I found that the vertical hand holds were alternated for my left and right hands. So I swung down the bus like a gibbon. I’m not sure, whether all buses are like that on the top deck. But if they are not, they should be! The slightly rough texture of the hand holds also gives a good grip for my gammy left hand.
Incidentally, note in the picture, how the handholds slant outwards. Does this effectively make the gangway wider? Or just appear so? I must take my tape measure with me to check!
After all, when you are rehabilitating from a stroke, like I am, isn’t it a bit cheaper to get free exercise in everything you do?
Haringey to Limit Junk Food
The Sunday Times reports today, that Haringey is to going to limit the number of junk food shops in poor areas of the borough. Here’s a flavour of their report.
Health officials in Haringey, north London, plan to curb the number of fried chicken, burger and pizza outlets in poor parts of the borough where men die, on average, nine years younger than those from its leafier areas. It proposes using planning powers to limit fast-food restaurants after finding there were up to six times more such outlets in poorer districts.
Let’s hope it all works out and spreads to the next borough to the south, Hackney. The Kingsland Road has little else, except loan and pound -shops.
The Anonymous Widower 