My First Christmas Snack Supper Of 2022
I saw the first of Marks & Spencer’s gluten-free Turkey Feast Christmas sandwiches in their Finsbury Pavement store today.
Note.
- The only allergens in the sandwich are egg and mustard.
- The cranberry sauce is real, but there appear ti be not enough cranberries to affect my Warfarin-controlled INR.
- Although the Adnams Ghost Ship 0.5 % is labelled as containing gluten, it seems to have no adverse effect on my body.
- I have discussed this with the brewer and they have told me, that there is so little barley in each bottle, that some might find the beer appears to be gluten-free.
I do think it the best humble sandwich, I’ve ever tasted.
Goodbye To My Gallstones
It is now some weeks since I said goodbye to my gallstones.
They were in my bile duct and were discovered by using an ultrasound probe on an endoscopy at Homerton Hospital. I didn’t even put on a hospital gown.
I had that endoscopy, as I did my two previous ones at Addenbrooke’s Hospital in Cambridge to check for coeliac disease without a sedative, as Addenbrooke’s likes to be efficient and cutting out sedatives reduces the manpower required, cuts the need for recovery beds and allows patients to drive home.
After this endoscopy, I came home the way I arrived – on the bus!
I would say that a good endoscopy operator should be able to do the procedure without a sedative. Although in this case, the nurse holding the oxygen tubes up my nose, was stroking my beard to calm me down. Not that I needed it! But it was a nice action!
I had the removal of the gallstones with a sedative, but I only remember the anaesthetist saying something like “Lovely” as he threaded the camera and attachments down my throat.
They broke into my bile duct from the duodenum and then inserted a balloon, which was then inflated to flush the stones back into my duodenum.
I must have dropped off and I woke without any pain or even discomfort.
One complication for me, was that I am on Warfarin, but I dropped my INR to one before the operation, so that there wasn’t blood everywhere.
I have had some after effects.
Where Has My Constipation Gone?
Since I was about sixty, I have suffered from constipation and my GP has prescribed a laxative.
I felt it was a family trait as my father was also a sufferer.
But since the operation, I have only taken one pill, that may not have been necessary.
My Appetite Has Returned
I am certainly eating better and I have not put on any weight.
Conclusion
If you have gallstones and removal is suggested, go for it!
My Strange Relationship With Vitamin B12
For the last couple of days my eyesight has not been its best.
My typing has been not of its usual quality for a one handed typist and I even have had difficulty with doing up my shoe laces. So much so, that yesterday, I wore my best slip-on shoes with a royal warrant from the Queen.
My INR yesterday was 2.2, which is within range.
Last night, I decided to give myself a pseudo injection of B12 – a tin of sardines and two eggs baked in the oven. Serial Cooking -Sardines And Baked Eggs gives the recipe and full instructions.
- My typing this morning is so much better.
- I just tied my shoe laces with alacrity.
- But my INR has risen to 3.3.
I do wonder, if after my stroke, that my brain directs the B12 to the damaged areas and that those, who advocate B12 after stroke are right!
As to the INR, I’ve just found this page on Valve Replacement.org.
But as a Control Engineer, I have the solution. Test my INR every day.
My INR Readings Before And After My Second AstraZeneca Jab
I am on long-term Warfarin after a serious stroke.
I also measure my own INR using a simple hand-held meter.
So with all the fuss about the AstraZeneca vaccine and blood clots, I thought I’d do an experiment around my second dose of the vaccine.
I maintained a constant Warfarin dose of 3.5 mg, which is the daily dose, I have agreed with my GP.
I maintained a reasonably constant diet. That is fairly easy if you’re coeliac and on a long-term gluten-free diet, as I am.
I measured my INR every morning.
These are my results.
- April 12th – 2.3
- April 13th – 2.8
- April 14th – 2.8
- April 15th – 2.9
- April 16th – 2.5
- April 17th – 2.3
- April 18th – 2.3
- April 19th – 2.4 – 2nd Jab
- April 20th – 2.2
- April 21st – 2.2
- April 22nd – 2.6
- April 23rd – 2.5
- April 24th – 2.4
- April 25th – 2.7
- April 26th – 3.0
- April 27th – 2.7
- April 28th – 2,5
- April 29th – 3.0
- April 30th – 3.1
- May 1st – 2.9
- May 2nd – No Data
- May 3rd – 2.8
It would appear that the results have been less stable since the second jab.
I am a Control Engineer with a B. Eng. from Liverpool University and I’m not surprised at these results.
It’s just like the bounce you get when the wheel of your car hits a pothole.
I would suggest that more research needs to be done.
Blood Clots And Vaccines
I had a little bit of trouble with my Roche Coaguchek INR meter yesterday and had to phone Roche.
I indicated that I would soon be having my second AstraZeneca jab and measuring my INR before and after as a medical experiment.
I was then told that all vaccines can cause blood clots. That can’t be right?
But Roche should know!
Fighting My Way Through The Covids
I owe it to the memory of my great-great-great-grandfather; Robert, who arrived in this country around 1800, from Konigsberg in East Prussia, that I fight my way through the covids.
He had to leave Konigsberg because he was eighteen, male and Jewish! Unless, you were a member of a privileged family, you had to leave. As he had just finished his apprenticeship to be a tailor, he at least had a trade and could carry the tools he needed in a small case.
He became a tailor in Bexley and lived to a good age. I am also sure, that he contributed coeliac disease to the family’s gene pool.
In this post, I will talk about various topics, as I fight my way through to normality.
On the mother’s side of the family, the male line in Huguenot, who probably arrived about 1750.
Did I Fall Because Of A Blood Pressure Problem?
I had a fall in my bedroom, a couple of months ago, as I wrote about in An Accident In My Bedroom.
My GP thinks I might have a blood pressure problem, so I’m now taking my blood pressure sitting down and then standing up for five minutes before taking it again.
These are my readings.
- September 1st – 132/74/182 – 123/102/79
- September 2nd – 145/75/85 – 138/51/82
- September 3rd – 102/77/69 – 123/64/87
- September 3rd – 143/74/75 – 150/64/74
- September 4th – 140/54/64 – 139/64/73
- September 4th – 124/62/92 – 120/51/79
- September 5th – 106/67/51 – 138/52/64
- September 5th – 127/78/67 – 136/62/73
- September 6th – 10:45 – 138/104/76 – 116/53/55
- September 6th – 16:00 – 138/63/54 – 137/88/74
- September 6th – 22:00 – 136/71/59 – 131/77/61
- September 7th – 09:30 – 147/98/76 – 152/82/75
- September 7th – 22:30 – 164/80/74 – 145/61/77
- September 8th – 09:15 – 121/77/66 – 119/71/66
- September 8th – 11:45 – 109/47/70 – 119/48/78
- September 9th – 08:45 – 114/70/73 – 137/51/73 – 129/64/92
- December 9th – 11:00 – 107/146/73 – 143/43/83 – 116/49/87
- September 9th – 20:00 – 131/54/84 – 140/53/78
- September 9th – 21:30 – 131/78/80 – 156/64/81
- September 10th – 10:00 – 148/77/74 – 141/78/63
- September 10th – 13:00 – 106/61/82 – 122/60/81
- September 11th – 09:15 – 137/44/71 – 135/80/66
- September 11th – 10:00 – 126/72/72 – 116/58/70
- September 12th – 10:30 – 119/69/78 – 117/66/70
- September 12th – 20:00 – 111/68/75 – 140/78/69
- September 13th – 10:45 – 112/73/61 – 109/57/69
- September 13th – 15:30 – 106/59/62 – 110/43/65
- September 14th – 09:30 – 116/63/91 – 109/61/85
- September 14th – 17:15 – 117/59/97 – 126/57/79
- September 15th – 08:30 – 134/78/54 – 107/75/76
- September 16th – 06:00 – 113/79/77 – 130/66/80
- September 17th – 09:00 – 117/69/91 – 113/50/63
- September 17th – 22:00 – 118/54/85 – 146/76/86
- September 18th – 09:00 – 147/81/69 – 139/71/67
- September 18th – 21:00 – 124/109/69 – 113/60/83
- September 19th – 10:00 – 143/57/66 – 152/83/75
- September 19th – 19:00 – 118/57/55 – 121/74/81
- September 20th – 09:50 – 143/69/52 – 135/67/66
- September 21st – 09:30 – 158/72/73 – 150/73/66
- September 22nd – 09:15 – 147/49/77 – 149/59/73
- September 22nd – 20:22 – 108/65/82 – 141/66/73
- September 23rd – 08:10 – 140/63/70 – 109/73/60
- September 23rd – 15:00 – 97/65/83 – 109/61/68
- September 24th – 09:00 – 134/52/74 – 143/62/62
- September 25th – 09:00 – 149/70/69 – 130/92/77
- September 25th – 13:00 – 108/75/78 – 135/68/73
- September 26th – 17:30 – 120/62/77 – 124/63/68
- September 27th – 10:00 – 139/64/74 – 132/70/74
- September 28th – 08:00 – 140/73/77 – 140/73/60
Note.
- The first reading is sitting down and the second is after standing up for five minutes.
- My blood pressure meter isn’t the best.
- I didn’t note the times, when I started.
- The third reading is taken about four minutes later.
I don’t know anything about understanding these readings.
Managing My INR
My GP and I have agreed that I should be on 3.5 mg. of Warfarin a day to control my INR.
- So I alternate between 3 and 4 mg.
- I also test my INR every two days.
These are my figures for the last few days, with my Warfarin dose.
- September 1st – 4 mg – N/R
- September 2nd – 3 mg – 2.5
- September 3rd – 4 mg – N/R
- September 4th – 3 mg – 2.7
- September 5th – 4 mg – N/R
- September 6th – 3 mg – 2.8
- September 7th – 3 mg – N/R
- September 8th – 4 mg – 2.4
- September 9th – 3 mg – N/R
- September 10th – 4 mg – 2.3
- September 11th – 3 mg – 2.7
- September 12th – 4 mg – N/R
- September 13th – 3 mg – 2.5
- September 14th – 4 mg – N/R
- September 15th – 4 mg – 2.2
- September 16th – 3 mg – N/R
- September 17th – 5 mg – 2.2
- September 18th – 3 mg – 2.8
- September 19th – 4 mg – N/R
- September 20th – 4 mg. – 2.5
- September 21st – 3 mg – N/R
- September 22nd – 4 mg – 2.2
- September 23rd – 3 mg – 2.3
- September 24th – 4 mg – N/R
- September 25th – 3 mg – 2.4
- September 26th – 4 mg – N/R
- September 27th – 4 mg – 2.1
- September 28th – 3 mg – 2.4
Note.
- If the INR is 2.5 or greater, I take 3 mg that day and 4, the next.
- If it’s less than 2.5, I take 4 mg that day and 3 the next,
- I also check the 30 day average of my Warfarin dose and currently it is 3.6.
One advantage about Warfarin, is the degree of control, you have of your INR.
A couple of years ago, I needed to have a small operation on my mouth.
The surgeon wanted to use an anaesthetist to boost the bill.
- So I said, what INR would be safe and he said 2.1!
- In the end I reduced it, by not taking four mg of the drug.
- After the successful operation, I brought it back up to 2.5, by taking an extra four mg.
- I suspect it cost me a tenner for the extra strips!
Good value and I avoided the lottery of anaesthesia.
I’m Drinking A Lot
In a four-hour period a few days ago, I drank two litres. Is that excessive?
It did include half a unit of alcohol, but was mainly mugs of tea.
And I still felt the need to drink more.
General Health
Like most coeliacs, I know on a gluten-free diet, I’m doing fairly well in the pandemic.
Not one of us has had a severe dose of the covids. But then I’ve never had flu since I went gluten-free and I’ve only had a flu jab since 2005.
Could this be related to the fact, that the gluten-free diet gives us a strong immune system and seems to protect us from cancer, according to research by Joe West at Nottingham University?
Roche To The Rescue?
This article on the BBC is entitled Covid Antibody Test A ‘Positive Development’.
This is the introductory paragraph.
A test to find out whether people have been infected with coronavirus in the past has been approved by health officials in England.
After false starts with dodgy and unreliable Chinese tests, this certainly is a positive development.
Personally, I trust Roche and their technology, as I regularly use one of their Coaguchek devices to test my INR.
My Equilibrium INR Has Risen Under Lockdown
For something like four years my Warfarin regime has been to take 4 mg. every day and to self test every Monday and Friday. It has been a simple regime that has worked well and my INR has stayed between two and three, with 2.4-2.6 being the common readings.
In other words what I would call as a Control Engineer, my equilibrium INR is spot on.
In the past, I have noticed that in times of hot weather my INR has tended to rise and in times of cold weather, it has occasionally dropped. A change of dose to three or five mg. has generally kicked it back towards 2.5 mg.
Doctors and this Control Engineer would say that you shouldn’t chase the INR by constantly changing the dose.
Warfarin also seems to have a cumulative property. A couple of years, I had to have a small operation. I dropped the INR to 2.1 for the operation over three days, by cutting back to 3 mg. After the operation three days at 5 mg. brought it back to 2.5.
Under lockdown, my equilibrium INR rose initially to 3 on a dose of 4 mg. every day.
In a telephone conversation with my GP, we agreed to alternate the dose between 3 and 4 mg. every day. My INR now seems to be stabilising between 2.5 and 2.8.
Why has my equilibrium INR risen under lockdown?
My house can get hot, as it wasn’t designed and built correctly and because of that I am drinking a lot of fluids. When I prick my finger for the self-test, the blood seems more watery than usual, so are all those fluids diluting my blood and causing my INR to rise?
Bodies can’t disobey the laws of physics!
Oh! For a walk by the sea in the sun!
Lockdown And INR Testing
I am on Warfarin and have to be tested regularly for my INR.
I have been doing it for at least seven years now and know that if I test twice a week and take four milligrams of the drug my INR stays well within limits.
This is a testing regime, which fits well with the COVID-19 lockdown, that I’m currently enforcing on myself!
Is There An Interaction Between Bisacodyl And Warfarin Or INR Self-Testing?
I am on long term Warfarin and since 2012, I have self-tested my INR using a Roche Coaguchek device.
I have had no problems and for perhaps the last five years, I have been on a regular daily dose of four mg.
I should say, I’m a trained Control Engineer and if you can keep any inputs, like drug dose, constant, you should get a stable system.
Recently, I have been suffering from severe constipation and my GP has prescribed bisacodyl. I have taken it perhaps five time before bed and it works well
On Friday, I was feeling constipated, so I took one of the bisacodyl tablets before bed.
On Saturday, I tested my INR using a strip from a newly-arrived box direct from Roche and found it was a rather extraordinary 5.2.
I had never seen a result higher than 3.2 before and put it down to one of the following reasons.
- The box of new strips was faulty. I have had dodgy ones before in the past, but not recently.
- There is an interaction between bisocodyl and warfarin. There are no reports on respected sites on the Internet.
- There is an interaction between bisocodyl and the Coaguchek testing process. There are no reports on respected sites on the Internet.
- I inadvertently took the wrong dose of warfarin.
I took a dose of two mg. yesterday and this morning I tested myself again twice.
- With a strip from the new box, found a reading of 5.3.
- With a strip from an old box, I found a reading of 5.
I shall test myself daily until I sort this out.
The Anonymous Widower 