Waiting for the Doctor

Cycling easily along the canal towpath, I got a strange reading on my heart monitor. My pulse suddenly jumped up by 20 beats a minute. I stopped for a little while and my heart rate went back to normal. But why on earth did this jump happen? I was going along the flat towpath, not up a steep hill. There had to be something wrong with the equipment. I changed the chest strap and tried again. The strange elevations in my heart rate continued, seemingly at random. Oh drat, it must be an intermittent fault in the sensor or the cycle computer. But this equipment was expensive and made in Germany. So I tested my heart with a finger sensor while one of the elevations was happening. Christ, my heart was actually going at 20 beats above normal. I went to the GP and he referred me to cardiology. The next week, my phone rang: it was the local hospital. When I got over the shock, I was delighted by how quickly they’d responded. They asked me a series of questions. Did I have any pain when my heart rate went up? Not really, I said. They pressed me further. Well, sometimes I did get a bit of tightness on the right-hand side of my chest. Very interesting, they said. The call continued for almost an hour, they seemed to be working their way through a questionnaire. At the end they said I might have a cardiac problem, but they’d only know for sure after I’d done a couple of tests. Good, I said, eager to get some answers. There is a waiting list, they said. Oh, how long? Nine months for the first test, they said, and about two years for the second. Hell, I knew that Northern Ireland had the worst waiting lists in the UK. But I never expected it to be that bad for a possible heart problem. What could I do?

I went to see the GP again. He referred me to see a cardiologist privately. Several weeks later I walked through the shiny portals of a brand new private hospital in Belfast. It was very busy, of course. The cardiologist took my history and asked for my symptoms. He said that my heart rate elevation wasn’t in itself serious, but it could indicate that there might be an underlying problem. He explained that I needed three cardiac tests. I’d be called in for them in a couple of weeks, and I’d see him in a month or so to get the results. I offered heartfelt thanks to my dearest T, who had the presence of mind to enrol us in Benenden health insurance. For a small monthly fee you are able to access private healthcare for diagnostic tests. It’s a valuable scheme because it helps you with something that the NHS has become increasingly slow to carry out. Understandably, Benenden has become very popular. Recently they put up the length of time you have to be a member before you can claim. When we joined it was six months. Now it’s two years.

The Downside of Sunshine

I’ve had some troublesome red patches of skin on my face for a while. At first I thought these were related to the psoriasis I have on my scalp, inherited from my father. I stopped shaving and began to use aloe vera. Some of the patches improved a little. Then I tried pine tar soap, as recommended by the American Psoriasis Association. This helped the red patches under my beard, but didn’t seem to make much difference to the patches on the rest of my face. I went to the GP. She looked at my array of red patches and gave me steroid cream. It didn’t help, so I went back to see her. She gave me a much stronger steroid cream. But that didn’t help either. There was one large red patch on my forehead, about a centimeter across, that I was particularly worried about. I began to look at websites with photos of skin cancers. My large red patch did look suspicious. Then a friend told me about a new skin clinic that had opened near Newry. It was run by a GP who had worked in Australia and had since specialized in skin cancer. I booked an appointment. Dr Finbar examined me, checking the red patches on my face with a magnifier. Then came the verdict.

Actinic Keratosis he said, otherwise known as sun damage. Your skin cells have mutated in exposure to UV radiation. But I always wear sunscreen, I told him. Do you wear a hat too, he asked? Only recently, I said, pointing to my thinning hair. He explained that skin damage accumulated with age, and people who spent a lot of time outdoors for work or leisure were more at risk. I reflected on my five decades of mountaineering, running and cycling, and all my trips to tropical destinations. I suppose that had done it.

You have six patches of actinic keratosis on your face, he said. They are pre-cancerous and need to be removed. Do you want me to treat them now? Of course, I said. He picked up a small instrument, about the size of a mini torch, and froze the patches with liquid CO2. It did feel cold, but it wasn’t painful. He gave me a mirror. My red patches had become considerably larger. Then my face began to sting. He explained that the pre-cancerous skin would die off and healthy skin would grow underneath. I had to keep the areas clean and treat them with Vaseline twice a day. So now I have six scabs on my face. But the bad skin should be gone in a couple of weeks. He encouraged me to return in six months for a review. I’d certainly recommend Dr Finbar’s Skin Cinic. He also has a website with useful information about different skin conditions.

A Miracle Cure?

My troublesome guts have improved enormously. I no longer have to take Omeprazole or Gaviscon and I can eat a wide range of foods again. Several months ago I began working with a nutritionist based at Framar Health in Belfast. My first session with Sarah Trimble focused on allergy and food sensitivity testing. She confirmed my gluten intolerance and explained that I was sensitive to foods which are high in histamine (e.g. nuts, citrus fruits, tomatoes, chocolate, pickled foods, smoked meats, etc). This was very helpful, but not too surprising. I had been avoiding some of these foods for years, as they were on the High FODMAP list. She also recommended that I take a specific probiotic, to help rebalance my gut flora. The testing also indicated that I had an increased need for Magnesium and B vitamins. Sarah explained which foods I needed to eat to increase these nutrients, and suggested several supplements. I’ve followed all of her advice and it's helped me enormously. But the biggest single improvement in my gut health came from another source.

My dearest T used to have gut problems and she reads articles on gut health to keep informed. One of these explained that the symptoms of too much stomach acid (e.g. heartburn, acid reflux, belching) are much the same as the symptoms of too little stomach acid. There was also a simple test to determine which condition you have. I’d been treated by my GP for too much stomach acid for six years, so I took the test: two teaspoons of apple cider vinegar mixed with a little water before a meal. It was a revelation. The persistent and intractable gut problems that had been dogging me for ages disappeared almost overnight. I had too little stomach acid, not too much. This was probably a legacy of my stomach being in the wrong position for years after one of my cancer operations. Taking apple cider vinegar before every meal is a simple and natural solution. I rarely get heartburn, acid reflux or belching. Previously I had to take Gaviscon three or four times a day. Now it's only about once a month. You are what you eat, goes the old saying. I’ve become a new man.

Influenza

We had an unexpected Christmas present. A dose of the flu. It wasn’t from Santa or his elves. I think I caught it at a café in Belfast where I was meeting a pal. So two days before Christmas I was in bed coughing my lungs up. And there I stayed for most of the festive season. T was most attentive, bringing me plates of Christmas food and hot drinks. I marvelled at her support and her immune system. Then almost a week after I got ill, T went down with the very same dose. It seems to have a long incubation period (5-7 days) during which you could well be infectious. T is now in bed with the terrible cough and streaming nose. And I am attending to her. She says it’s the worst dose she’s ever had in her fifty years. It’s certainly one of the worst I’ve ever had. The first week was particularly threatening. My chest was full of gunge and my nose was blocked, I just couldn’t breathe. I kept waking up every hour or so in the night. I suppose my body was doing this automatically. My blood oxygen levels were low and my pulse was high. I had to keep taking my inhaler to expand my inflamed tubes and get my oxygen levels up. It was a real ordeal. Thankfully I’m now on the mend.

This dose of influenza seems to be everywhere. We know that plenty of family and friends are down with it. Indeed, hospitals across these islands have declared emergencies, unable to cope with all the extra patients that are arriving with serious breathing problems. And the number of excess deaths is rising. So what is behind all of this? There seem to be several reasons.

Firstly, the current flu vaccine doesn’t appear to have included much protection for this strain of flu. I suppose that when the mix of strains of flu were being assembled for the annual vaccine, this particular dose wasn’t thought likely to become a major problem. Secondly, because the take up of the flu vaccination is relatively low in the UK, the levels of flu circulating in the community are increased. Only two thirds of adults over 65 got vaccinated this winter, despite the jab being free. Unfortunately, these are the very people who are ending up seriously ill in hospital. The misinformation of the ant-vaxxers on social media has had deadly consequences. Thirdly, the many years of underinvestment and poor management in the NHS mean that it is hardly able to cope with normal health problems let alone an epidemic of flu. So political decisions have had deadly consequences too.

Midwinter

Today is the Winter Solstice. The longest night of the year has just passed. And from here on, the days become longer. So the world has turned towards the sun. Although with an unnamed storm howling outside, it doesn’t feel much like it. This morning I attached sprays of holly and ivy to our front door and brought our Christmas tree inside. We keep one growing in a pot. It used to be just six inches tall. Now it is about four feet. All of our Christmas decorations are up and the house is filled with light. The larder and fridge are stuffed with goodies. When we have greeted family and friends and offered them good wishes, we shall settle down and feast.

Wishing you and yours a Happy Christmas.

Spicy Food (and a menu idea)

We ate at Nando’s last night, the South African owned fast-food chain that specializes in grilled chicken. Their peri-peri chicken is marinaded in a sauce made from olive oil, lime juice, garlic, paprika, oregano and chilli. And you get to choose exactly how much chilli your chicken has been soaked in. The highest option is Extra-Hot. Mindful of how sensitive my guts have become to strong spices, I chose the lowest level of chilli. Sitting next to us were a group of lads tucking into their chicken pieces and piling on more extra-hot sauce from a bottle. My mind flashed back to the time before my four cancer operations (during which my guts were hoiked around by an array of surgeons, and from which they’ve yet to properly recover). In those halcyon days I used to be a very adventurous eater. I really looked forward to all the new dishes I could try on my regular cycle trips to far-flung destinations. After riding all day through the backroads of Laos or China, the group would get together for an evening meal in a local restaurant. None of the restaurant staff spoke any English, so plates of strange food would just arrive from the kitchen and be placed before us. The oddest of these was a dish of chicken’s feet, on a trip through the foothills of the Chinese Himalayas. Yes, yellow chicken’s feet stir-fried in a spicy sauce. When the pile of yellow toes arrived, people shook their heads and turned away. I reached forward with my chopsticks and grasped one. “You must be mad,” said the Englishman sitting next to me. I put the chicken’s foot into my mouth and began to chew. All of the group were staring at me, horrified expressions on their faces.

The foot was rather rubbery and didn’t taste very pleasant. But with a dozen pairs of eyes fixed on me, I felt I had to swallow it. The foot went down with a bit of a gulp. Still they kept staring at me. Were they expecting me to keel over foaming at the mouth, or to start flapping and squawking? I put down my chopsticks and smiled. They responded with a round of applause.

I’m still willing to experiment with food, I just have to be careful with what I now try because of how reactive my guts have become. My four boneless chicken thighs soon arrived. They were tiny, barely a mouthful in each. I bit into one. It tasted good, flavoursome and lightly spiced. Then I began to wonder. Did the Chinese Nando’s serve chicken’s feet?

Back to Porridge and Heater Units

We returned home to piles of things to do. Not just the dirty washing in our suitcases, but the many tasks left undone because we departed in such a rush. Our first adjustment was to the cold and damp of Northern Ireland. Not easy after we’d been in the dry warmth of Mallorca. The first week had days of 25 and 27 degrees. The second week was the usual 21 or 22. But that is pretty good compared to the high of 8 degrees in balmy Co Down today. Our second week had one huge rainstorm. Not on the scale of the terrible events in Valencia, but still pretty dramatic. The street outside our apartment was turned into a rushing river almost a foot deep. In the afternoon, the rain stopped and the sun dried everything out. We were staying in Son Baulo, on the north coast. It’s towards the middle of the bay of Alcudia and marks the end of the developed part of the coast. Beyond is the protected coastline, the nature reserves and the mountains of the east. Ah, never mind, we can always return, like the birds, next Spring. In the meantime, we’ve plenty to be getting on with. First of all, my poor car immobilized by the Fire Brigade.

I took photos of the burned parts and sent them to the mechanic. “That’s the heater unit for the plugs, to start the engine in cold weather,” he said and talked me through disconnecting it. I drove my car to him and he checked it over. “Do you want the good news or the bad news?” he said. I chose the good news first. “The heater unit isn’t expensive to replace,” he said. “Trouble is the wiring loom is damaged too.” That would take a day’s work to check thoroughly and could be very expensive to fix. “But some cars start alright without the heater unit,” he said helpfully. “Even in the winter?” I asked, mindful that it had been minus 10 last year. “Why not try it?” he suggested. So I am. The car is starting alright at the moment. Fingers crossed it won’t get as cold this winter.