The Anonymous Widower

My Strange Skin

As a coeliac, a stroke survivor on Warfarin and a lab rat for a medical research centre, I’ve had my blood taken many times in the last ten years. I also have several injections a year for vitamin B12 and a yearly one for flu.

I never need a plaster, as despite being on Warfarin, once the needle is taken out, the skin seems to shut the hole tight.

On the other hand on a typical night, I’ll lose just over a kilo in weight, whilst I sleep. I once spoke to a sleep expert on the radio and they said that was normal.

But the funniest thing that happened, was one day not unlike today for weather with rain about and not cold, I fell asleep on the living room floor in my underwear.

About half-an-hour later, I awoke and thought for a moment, that I’d gone blind, as I couldn’t see a thing.

I then realised that the room was full of water vapour, as if I’d left the kettle on the stove. But I have an automatic kettle and there was nothing on the stove.

So where had all the water vapour come from?

There was only one place! It had leaked from my skin and the temperature and pressure, were just right for the fog to form.

My skin is often very dry and I usually start the day with a deep bath, when I put my head under the water and irrigate my dry eyes, which an eye surgeon, once described as the driest he’d seen.

April 28, 2020 Posted by | Health | , , , | 1 Comment

My First Real Telephone Consultation With A GP

Last Monday, I had my three-monthly B12 injection, as I have since I was diagnosed as a coeliac around twenty years ago.

I said that I needed to see my GP, or at least talk to him, as it was time for my Warfarin review, where we check my dose and order more tablets, as appropriate.

The receptionist said, she’ll get him to give me a call and professionally checked that they had my correct telephone number.

I’d been home about thirty minutes, when the GP phoned and we review the Warfarin and he said, he’d sent a prescription to Boots. I also told him, that my hand would need a proper examination after we’d got rid of the menace of COVID-19.

The call took about five minutes and I suspect that we’d both rate the outcome with at least four stars.

I find it strange, that in my seventy-two years, I’ve never before had a telephone consultation with a GP.

Even, when my wife and son, were dying of cancer, I never spoke to my GP at the time by phone. I did occasionally send messages by FAX to the surgery, as that was the only way to leave a message, as e-mail and text wasn’t an option.

Surely, though simple systems could be developed, so that everybody can have a telephone or video consultation with their GP, if the patient has the technical knowledge.

With my Warfarin review, I might send a message, by phone, e-mail or text, saying I need the review.

  • The GP’s system might then text me to say, my phone appointment was at 14:00 on the 17th, in much the way it does now!
  • I would be able to use a simple reply system to say that was OK or not!
  • The doctor would hopefully be able to phone at the appropriate time.

All sorts of systems would be possible. I’m sure Zoom has something suitable.

If COVID-19 means that GP capacity is increased because of the need to social distance, so be it!

There is also the benefit, that on a wet and windy day, walking to the GP, might not be what I want to do.

April 27, 2020 Posted by | Computing, Health | , , | 1 Comment

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!

April 3, 2020 Posted by | Health | , , , | 1 Comment

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.

  1. The box of new strips was faulty. I have had dodgy ones before in the past, but not recently.
  2. There is an interaction between bisocodyl and warfarin. There are no reports on respected sites on the Internet.
  3. There is an interaction between bisocodyl and the Coaguchek testing process. There are no reports on respected sites on the Internet.
  4. 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.

February 16, 2020 Posted by | Health | , , | Leave a comment

Rats Are More Intelligent Than We Think

I heard this story from a retired gamekeeper, who was very much a proper countryman, after I said I had had a stroke and was on Warfarin.

When you raise chickens, especially free-range ones outside, rats can be a problem, as there’s nothing they like better than a nice piece of chicken.

So Warfarin is put down to poison the rats.

Anybody like me, who is on the drug, knows you must ignore Vitamin K, which is found in leafy green vegetables. I do generally eat my five a day, but they are mainly fruit, tomatoes, beetroot, beans and potatoes.

Apparently, modern chicken feed contains high levels of itamin K, as there are probably a lot of green forage crops in its ingredients.

So as the rats are also looking for their vegetables to go with the chicken, they’re eating the chicken feed.

And the Vitamin K in the chicken feed, could be giving them protection against the rat Warfarin-based rat poinson.

I also suspect, there could be a bit of natural selection at work!

July 18, 2019 Posted by | Health | , , | Leave a comment

A Double Database Cock-Up From The NHS

At three on Sunday morning, I phoned NHS 111 to ask for a bit of help with my terrible cold that was stopping me from even getting to sleep.

I had some advice which helped, but I was also booked in to see a doctor at 09:00 in a surgery a short bus ride away.

So far so good and no complaints.

I duly saw the doctor and he prescribed several drugs, which I took to my local Boots later in the morning.

I should say at this point, that four years ago, I officially changed my name from the one my parents gave me to the one I’ve used continuously since 1968. I was starting to get problems with some airlines, where my passport had a different name to my bank account. My current GP has only ever known me by the latter name and I’m registered with their surgery using it.

When I got to Boots, they initially rejected the prescription, as for some reason it showed by old name, although my address, NHS number and other personal details were correct.

How did the wrong name get on the prescription?

Luckily, Boots were pragmatic and as they recognised me, I got some of thew drugs.

But not all!

The pharmacist recognised that two drugs were incompatible with the Warfarin I take.

So why did the NHS computer system allow the doctor to prescribe the drugs?

As someone who was at the forefront of database technology, I believe, these two problems are inexcusable.

My incorrect name could have led to failure to obtain needed drugs.

The lack of interaction checking, could have led to serious problems for a patient.

January 7, 2019 Posted by | Computing, Health | , , , , | 4 Comments

Preparing For A No-Deal Brexit

I am doing a few things to make sure, that I survive a no-deal Brexit, as unscathed as possible.

Savings

I keep all of my spare cash in Zopa, moving it in and out as required. Effectively for about seven or eight years now, I have used the first peer-to-peer lender as a high-interest, thirty-day access deposit account.

It has probably paid around five percent before tax in that time and it has safely ridden the peaks and troughs of governments and financial instability.

Today, I calculated how much cash, I need in my current account to see me through to end of the year, and the spare money was tranferred to Zopa. It was a fast painless transaction and now it is available to lend to Zopa’s customers.

Warfarin

Warfarin stops me having another stroke.

As it only comes from Eastbourne, I suspect supply of this comment drug.

But I have enough to last me to until Summer 2019.

INR Testing

I test my own INR, which determines the Warfarin dose.

Today, I ordered enough test strips to get me through to Summer 2019.

Beer

Every time, I go walking around London, I take a large bag, that can hold up to eight bottles of my favourite beer from Marks and Spencer.

Supplies from Adnams in Suffolk seem good at the present and I usually liberate a few from a boring life on the shelves on every trip.

As with other products, I aim to have enough to last me through to Summer 2019, at a rate of three a day.

November 30, 2018 Posted by | Finance, World | , , , , | 2 Comments

Thoughts On Alcoholism

In the last month or so, I’ve done something that I’ve never done before in my life.

I’ve drunk perhaps half a bottle of beer when I’ve got up. Admittedly, I’d left the bottle half finished by my computer.

It was good.

In the 1960s, I could drink a lot of beer. I just seemed to need it.

About that time, I decided I needed to drink large amounts of fluids and swapped to tea and Coke.

My doctor understands my needs for fluids and the practice nurse has the same problem. The nurse puts it down to leaky skin, which he has.

I actually love walking in the rain, so that might help explain it. We all live by the laws of physics.

My father warned me off alcohol in a practical way, by giving me halves of Adnams down at Felixstowe Conservative Club, whilst we played snooker, when I was about fourteen.

My father drank a lot of fluids, but I never saw him drunk and most doctors would say he was a sensible drinker. Like me, he also drank a lot of tea!

He had a reason to control his drinking! His father had died from complications of being an alcoholic at 40, when my father was about twenty.

My grandfather had lived just around the corner from where I live now and my father had once told me, he had drunk large amounts of beer and had moved on to whisky.

Around 1900, there was very little to drink except beer, so did my grandfather’s need for fluids mean that he turned to what was available?

Now I like a good beer and know of its properties to slake a thirst when you’re dry. I’ve worked in foundries in the 1960s and beer was always available.

So is there a type of person, who needs a lot of fluids and if beer is available they turn to it. In some cases does this lead to alcoholism.

As to myself, I must have gluten-free beer and because I’m on Warfarin, I must keep my alcohol consumption down.

So I now drink a gluten-free beer, that is just 0.25 of a unit and tastes like real beer from Marks and Spencer.

But then it is real beer, as it is brewed in Southwold by Adnams.

My life has come full circle.

 

 

March 18, 2018 Posted by | Food, World | , , , , , , , | 2 Comments

Keep Taking The Medicine

On Sunday, I usually fill up my daily pill-boxes.

I use my old Coaguchek strip containers, which each box having the pills for one day.

Eleven White Boxes

Eleven White Boxes

If I find that I can’t get seven sets of pills, like last Sunday, I know it is time to get my boots out and go to Boots for some more.

The great advantage of individual boxes, is that when I go away, I just take an appropriate number of boxes – two more than the nights I’m away.

Counting out the pills has been a lot easier, since my doctor decided that one pill wasn’t needed any more.

So now, I just put 4 mg. of Warfarin (one blue and one brown), a statin, two other drugs and two vitamin pills in for each day.

I check my own INR and have used 4 mg. a day, for a couple of years now and it tends to hover around the 2.5 level, that I need.

I test myself bi-weekly and only if it is below 2.2 or above 2.8, do I take any action.

Usually, I just stick to the 4 mg. and retest the next day. Very often, it has bounced back, as it was probably something I ate or drunk. Or it could be the weather, as the INR can rise in sun or fall, when you get back to miserable weather.

Some doctors may not like that I choose my own level of drug, but setting the level, is just the sort of problem for which I have a B. Eng degree in |Control Engineering from Liverpool University.

Some of the regimes, I’ve had from doctors and their systems, are pretty complicated and I suspect quite a few patients get confused.

 

November 20, 2016 Posted by | Health | , , , | 1 Comment

INR Testing Around A Simple Procedure

A couple of weeks ago, my dentist found a small lump in my mouth,so he advised getting it removed and tested to see that it was nothing serious. The procedure was booked to take place on Thursday, the 30th of July and he advised me to make sure my INR was lower than 2.4 and not to take any Warfarin on the day before. Obviously, he didn’t want me to bleed too much, especially as the position of the lump made stitching impossible.

My INR had been 2.6, 2.5 and 2.6 on the Sunday, Monday and Tuesday, taking my normal dose of 4 mg., which as I take it most days, is unsurprisingly my average dose.

On the Tuesday, to lower te INR slightly, I cut my dose to just 1 mg., with the consequence by Wednesday morning the INR had dropped to 2.3. As the doctor had said no Warfarin on the Wednesday, my Control Engineering training said that could drop the INR below 2. So I just took 1 and the INR was 2.1 on the day f the operation.

After the operation, as I wasn’t bleeding I took 3 mg of Warfarin, but by the Friday morning my INR had dropped to 1.6, so that evening I took 6 mg. On the Saturday morning, the INR had gone up a bit to 1.7, so to nudge it towards the desired value of 2.5, I took six that day.

In the week of the operation despite changing the dose to control my INR, I sactually averaged 3.8 mg. over the week.

Since then I’ve taken my normal 4 mg. and my INR has been fairly steady around 2.4.

I think this exercise shows the value of self-testing your INR. Admittedly, I was employing my Control Engineering training and experience to give the doctor what he wanted and keep my INR at a reasonably safe level, but the ability to self-test regularly around an operation must make things better for everybody concerned.

The doctor told me afterwards that I hadn’t bled too much, but then when I’m cut by a professional as opposed to torn in a fall say, I don’t seem to bleed much!

In the end, the lump had been removed and I heard today, that it was totally benign.

 

August 10, 2015 Posted by | Health | , | 3 Comments