Tuesday, 8 August 2017

Every silver lining has its raincloud...

Haven't blogged in a while. Things are ticking over okay; my weight is stuck around 113kg after a few weeks of minor fluctuations. I have just under a month to try and get as close to 110kg as I can for my next nephrology appointment. My activity levels are pretty good and I've got some holiday over the next couple of weeks that should get me out and about.
I had my second hypothyroidism test ten days ago, whilst I was at the surgery I asked about the results of my second semen test in early July, the receptionist said the most recent test result (which was the one I wanted) had been tagged 'no action'. I said 'I'm not sure what that means', and she said 'neither do I, you'll need to ask a GP'. So last week I got a phone consultation. The doc called me back and says he's very sorry, but he couldn't understand what the results meant. To his credit he called the andrology lab which confirmed it had detected traces of what are known as non-motile spermatozoa. The lab also advised it had just upgraded its equipment (is there a vasectomy pun in there?) and it would be advisable for me to have another test. As it's better to be safe than sorry that's what I am going to do.
After the consultation I did a bit of googling and it turns out non motile sperm is detected after about a third of vasectomies. Pregnancy is highly unlikely from non-motile sperm, but not impossible, hence why doctors are nervous about giving the all clear when they are present. So, I’ve made a third andrology appointment, but I’ve done it for just before my nephrology appointment so I only need to attend the hospital once.
On the positive side I tested negative for hypothyroidism, although that means I lose an excuse for being a fatty and I also need to renew my annual NHS prescription certificate. Every silver lining has its raincloud...

Sunday, 16 July 2017

Getting jizzy with it!

It's been a couple of weeks since my last post. On Sunday 2nd I completed the Kidney Research London Bridges Walk, it was a good event and I really enjoyed it. I covered the seven miles in my target time of two and a half hours, a reasonable pace given it was a hot day and the route went through some of London's most congested pedestrian areas. Parts of the Southbank and Westminster Bridge took far longer than their physical distance suggests due to throngs of tourists and numpties blocking the pavements trying to take selfies against the backdrop of the Palace of Westminster. Also, on the narrow stretches of the northern Thames Path it was easy to get stuck behind gaggles of Sunday shufflers out for a lazy stroll.
I spent most of the walk listening to the Black Tapes Podcast, which I've become addicted to of late. Although I was nominally walking alone, and it was by no means a race, the other walkers helped me maintain a decent pace and I never risked losing motivation, which might have been the case had it been a random walk along the river. Factoring in my travel to the City Hall start, the walk itself, and the trip to Byron afterwards I clocked up a personal best 25.8k steps. I'm now looking for other similar activities, I know there are walking groups in my area, but my preferred modus operendi is a bit too anti-social for that, I might try and map out some local 5k routes I can walk/jog when I have time.
Last week was my 40th birthday, so my wife, knowing I'd taken a day’s leave, booked me an extra special treat... a trip to the dentist! It's not that I'm afraid of dentists, although I did have a couple of horrible experiences as a child, I just got out of the habit five or six years ago. The practice I was registered with wasn't convenient and as it's not always easy to register with a good NHS dentist I never got around to moving. So, after years of nagging, my wife took matters in her own hands and registered me with her dentist. It was about time; I'd been starting to worry about occasional pain twinges from a twenty-year old filling.
It started with the Hygenist giving my pegs a good scale and polish, they weren't too heavily scaled but what was there was stubborn. Afterwards the Dentist did a check-up and x-rays. Fortunately, nothing of real concern came up, the twinges appear to be the old filling pressing on a nerve, but the filling itself is sound. There was the option to drill it out, line it and refill it, but given it's a negligible issue I decided to leave alone for now.
On the 7th I gave my second semen sample to Andrology at East Surrey Hospital, so I should know this week if my vasectomy has the all clear. If I don’t get the all clear I’ve no idea what happens next. It will be a complete bugger if I have to have another procedure. Also, if my tubes haven’t been properly sealed up what the hell has happened? This week I need to arrange the second blood test for an underactive thyroid, I’ve held off renewing my NHS annual prescription certificate as if I do have hypothyroidism then my prescriptions should become free.
I’m hoping any treatment for potential hypothyroidism will help with my weight loss, but I’m not holding out great hope. The reading that triggered the whole inquiry showed only mild hypothyroidism and my brief reading around on the condition suggested weight loss is only likely with more serious hypothyroidism. I’m still kicking around 113kg, I briefly went up to 114kg after my birthday celebrations, despite high activity levels, but that was due to overindulgence. It just seems I’m in that zone where it takes a lot of activity to shift the dial down even slightly.  

Tuesday, 27 June 2017

London Bridges Walk 2017

I’ve signed up for Kidney Research UK’s London Bridges Walk this coming Sunday. I registered my interest in it a few months ago, and received an email saying I would be contacted when registration opened. Sadly, no such follow up happened, but I remembered to check back periodically and registration actually opened late last month. I don’t know whether they planned to contact me but I got there first, but it does make me wonder how many other people expressed an interest but never got contacted? Online registration is closed now, but people can still sign-up on the day for £10. 
It’s a seven mile walk across many of London’s iconic bridges. It might sound a bit anti-social but I’m quite looking forward to doing it by myself, I enjoy walking, but usually there’s a very functional purpose like getting to work. I don’t often get the time to go for a good long walk without any distractions, my wife has her own interests she’d probably prefer to spend the time on, and I know the kids would only complain about being bored or tired or more likely both after half a mile!
Kidney Research UK sent through the route map earlier today, it’s fairly familiar territory as I’ve worked in and around Central London for over fifteen years, and the course skirts close to both my current and previous employers. I’m going to try and put together a topical podcast playlist I can listen to as I make my way around, I haven’t found the right ones yet, but I know there are a variety of London podcasts out there covering the mix of culture, history and folklore I’m looking for.
I was also hoping to sneak a few crafty beer stops on route, but I rather fear the pickings are slim without taking too much of a detour. There are a few pubs along the route, but a few of them are shitholes or tourist traps, what comes from hugging the river. It’s probably no bad thing really, I’d only have about five minutes to neck a pint and have a pee, and no doubt once the seal is broken I’d spent most of the seven miles bursting for another! I’m also not sure how endearing it will be to more advanced CKD sufferers who have restrictive fluid intakes. Besides, afterwards I’m meeting up with the wife and kids for an early birthday treat at Byron Burger so I can save my 'dead' calories for that.

Is this gun loaded or not?

I spoke to one of the GP’s yesterday, it appears that my recent jizz in a bottle test was inconclusive. It is a little worrying that having been through the vasectomy process it may not have worked! I’ve got a repeat test at the end of next week, so I should know one way or another whether I'm firing blanks by mid-July.

Tuesday, 20 June 2017

Underactive Thyroids and Jizz Jars

I finally made it to the doctors a week or so ago to discuss the underactive thyroid result that cropped up in my recent annual medical. My first attempt was cut short by the NHS hack last month, the second attempt was an evening surgery appointment that got cancelled a couple hour before I was due to attend, till finally the GP surgery squeezed me into one of the last appointments in a regular afternoon surgery. Did I learn anything new? Not really. As my Mum has an underactive thyroid it is entirely likely I have the condition, but I don’t seem to have been hit by any obvious side effects; my weight is still hovering around 112kg which is as good as it’s been for years and any tiredness I feel is probably down to not getting enough sleep! So I’m having a retest done in July and will be going back to discuss treatment about ten days later.

Last week I dropped off my first semen sample to Andrology Services at East Surrey Hospital, so I should get an indication of whether my vasectomy has been effective sometime this week. I’m supposed to do another test in a few weeks time, but I’m hoping this set of results will be conclusive. In a nutshell I had to wank into a little glass bottle and then scoot straight over to the hospital with it in my shirt pocket (close to my body to keep it at a good temperature), where I simply handed over to Andrology. A somewhat comedic process, when you consider I was basically trying to get ready to go to work as well as avoid the kids who were getting ready for school at the same time.

Tuesday, 16 May 2017

Mixed Blessings

I had three medical appointments last week, two planned well in advance, the third a late addition at the GPs request. 

Early on Tuesday I had my regular check in with the Nephrology Consultant; having failed to lose any weight since my last visit (in fact I'd gained 0.5kg) I had some slight trepidation. It turned out my recent bloods had produced my best CKD results for several years and my blood pressure readings are also acceptable, so she was actually very happy with the progress. I explained I've been making efforts to maintain good fitness despite the flat lining weight loss, and she agreed this is definitely making a positive difference. So we’re sticking with the current regime and I said I’d talk to my GP about weight management (although I'm pretty sure the status report to my GP will include the usual weight based admonishments). 

Later the same morning I had my annual review at the GP surgery. The nurse was initially perplexed about why I was there even though the review had been initiated by the surgery, but things were quickly resolved. I also pointed out I'd been sent a further request to make an appointment with a GP to discuss blood test results, basically indicating something required the attention of a GP rather than a nurse (a similar thing happened last year, so I suspected another pre-diabetes flag). 

For the second time that day I was weighed and had my blood pressure taken, fortunately the results were consistent, although I'm now pretty certain my scales at home weigh c.0.5kg heavier than those at the hospital and GP surgery. Pretty much everything in the blood test was fine, cholesterol, liver function etc… It also turned out the HbA1c test that set off the pre-diabetes flag last year ago was now back in the healthy range, my improved activity levels probably reversing early stage pre-diabetes. There was just one exception; the thyroid part of the blood test was flagging a warning which needed to be discussed with a GP. 

So on Friday afternoon I went back to see the new GP at the practice. Unfortunately having managed to knock off work early to get there I found the surgery (in fact the whole local NHS Trust) had fallen prey to the much publicised cyber hack. So the GP couldn’t see my blood test results. Fortunately I was able to explain about the thyroid deficiency flag (that being the only issue flagged) and the GP briefly explained the symptoms of an underactive thyroid. She asked if I was aware I was suffering from any, which I'm not, and she asked if there is any history of thyroid problems in my family, and there is, my Mum has a problem. But as I'm not demonstrating any of the major symptoms of an underactive thyroid, and she couldn’t see my results, she decided not to start treatment but go with the usual next step of retesting in three months. We didn’t get around to talking about weight management, but she said she would call me on Monday to discuss things further, when the system would hopefully be back up. 

The problem with this situation is that it’s tempting to focus on the under active thyroid and retro fit my recent difficulties losing weight on to it. There are weight related issues with this condition, but it’s probably a convenient self-delusion narrative to follow when the truth is that losing weight is just very difficult to achieve even with sensible eating and exercise. Unfortunately nobody was home for most of yesterday, there were two calls from unknown numbers on my home answerphone, but no messages, and I didn’t receive a call on my mobile. So I’m going to give the surgery a call today, although I suspect they are trying desperately to catch-up from Friday.

Friday, 12 May 2017

The Chimp Paradox: a review

I've just finished reading the Chimp Paradox by Professor Steve Peters, a psychiatrist who teaches at the University of Sheffield, who is highly regarded in the field of sports psychology. I actually read it in two chunks, I started a few months ago, got half way through and decided to read some other things before coming back to it. That's probably a good clue to my feelings about it. It's not unusual for me to be reading more than one book at a time, and it's not untypical for me to pause part way through some of them because I feel like reading something else. Usually I pause non-fiction works because I want a short-term fix of fiction, or I've been temporarily gripped by a different book. A pause is a sign it hasn't entirely gripped me, but coming back to it is a sign that it's interesting or useful enough to warrant finishing.

The Chimp Paradox can loosely be described as a 'self-help' book, the first such I've ever read, and is based on a 'Mind Management' model that Prof Peters has developed to assist patients (who include big names in British sport) to better deal with the pressures they face. The idea is the model can help the subject better understand their own behaviour and impulses and manage them to make them to be more successful, confident and happy. 

At the core of the book is the idea that our personality can be split into 'human' (our rational selves) and 'chimp' (our emotional selves), and the ways in which these two interact influences the way we engage with the events we face. Essentially the book offers help on understanding how our inner chimp can disrupt us and offers strategies to managing it. I can see some interesting overlaps between this model and the 'System 1 / System 2' model outlined by psychologist Daniel Kahneman in his celebrated book Thinking, Fast and Slow (currently paused two thirds through on my bookshelf). 

I must admit I'm generally cynical towards 'self-help' books, but I picked up this one because it I thought it might be help my career development, it didn't make any screechy boasts to be a panacea (which seems typical of US published lifestyle coaching/self-help efforts) and it had some credible endorsements like Olympic cyclist Sir Chris Hoy. 

So what are my thoughts? Well, without wishing to sound flippant, a lot of it reads like formalised common sense and is pretty much in key with my own thoughts. It's a gross simplification, but I'd summarise the advice as don't taking headstrong, emotional approaches to problems, take a step back, a deep breath and think before acting. It was far from a waste of time, but probably not what I really need to push my career development. I think Prof Peters approach will be most beneficial to those suffering chronic stress or struggling to control destructive emotional patterns. It might have been more valuable to me a couple of years ago when I was under stress working in a dysfunctional organisation, but I'm in a better place now. However, the techniques espoused offer only partial mitigation to my previous situation, unequal power relations make challenging dysfunctional hierarchies extremely difficult and exiting is not trivial when you're financially dependent on sticking it out. 

Not a waste of time, almost certainly worth having as a backup should things get tough in the future, but maybe I need to find something more specific to my career development objective.