More health stuff

At the end of July 2009 I was called in for a medication review by my GP practice. I have Diclofenac Sodium (a non-steroid anti-inflammatory or NSAI) on long-term repeat prescription for my various osteoarthritic joints, together with Cetirizine (a gentle, non-drowsy anti-histamine) and a Nasonex steroid nose spray for ’mild allergic rhinitis’. I’m supposed to take the Diclofenac three times a day, but unless I’m more-than-usually achey I only take one with breakfast (with the Cetirizine) and one at bedtime with a glass of semi-skimmed milk (a habit I got into when I was prone to nocturnal heartburn - I don’t know whether the milk has prevented this or it’s just gone away, but I enjoy the milk anyway).

So I dutifully made an appointment, seeing a new young doctor. He decided that, as a long-term NSAI-user I should have a kidney-function test. He took my blood pressure, which was as usual on the low side of normal for my 66 years and checked that I’d recently had a cholesterol test - I had, and that too had been reassuringly low. Then he asked if I’d ever had a diabetes test, and I hadn’t, so he booked one of those along with the kidney-function one.

That was when I got into a bit of trouble: I said I’d like to mention a couple of other problems, and was told that this wasn’t ’appropriate’ at a medication review. Then he relented and I told him that I had a bit of urinary-tract irritation and was concerned about my eyes. He wrote a note for a urine test, but told me that my optician should have referred any matters of concern about my eyes to him - and hadn’t. I battled on, and in the end he agreed to refer me to the Eye Clinic.

I’ve had fairly bad floaters in both eyes for years. In fact I became sufficiently aware of the first one to get a hospital referral in my twenties. It was a single dense black blob in my right eye that bounced along the line as I was reading, a bit like the bouncing ball on a karaoke screen. I was told that this was quite common and there was nothing to be done. Then, in my forties or fifties, I raised the problem again as both eyes had quite a collection of floaters, and got another referral. This time the consultant agreed that the floaters were fairly severe, but humourously told me that they weren’t about to jump into my eyes and sweep them up! Later still, Philip Bradley, my excellent optician in Derby, told me that there was surgery for the problem. This involved inserting a tiny propeller in the vitreous humour (the jelly between the lens and the retina) and chopping all the floaters up before sucking the vitreous out and replacing it with some sort of oil. However, as there was a serious risk of the propeller-thingy damaging the retina this operation wasn’t done until the patient was pretty well blind. Just live with it, mate...

I had been struggling generally with my vision, though, and for the past couple of years my eyes had become irritable and bleary, alternately runny and dry.

Meanwhile, back at the blood tests. The next thing that happened was that I was called back for a repeat diabetes test as the result had been ’borderline’. Then I was asked to make a ’routine’ appointment with my new GP , one of the lady partners (I think the nurse doing my tests had picked up that I didn’t want to stay with the new young guy). I saw her on the 6 August, and it turned out that I was definitely borderline for Type 2 Diabetes. I was weighed and scored over 15 stone without my shoes - which at 5ft 10in is a lot more overweight than I’d thought I was. The good news was that my condition should be mangeable with the usual lifestyle upgrade: five-a-day, cut down on the fats and alcohol, lose weight, take more exercise and stop smoking.

The good news was that the kidney-function and urine tests were fine.

This was really just what I’d needed (not the Diabetes - the wake-up call). Being the sort of guy I am, I read up the condition on the Web and, the following morning, started my campaign with a half-hour brisk walk. (I started writing this exactly two months after that.) I tried to manage my eating, reducing portion sizes and avoiding second helpings. I did less well with the alcohol, tending still to shift half a bottle of red a night. As for the smoking, I started putting my daily maximum of seven cigarillos in my tin each morning and trying to build up a surplus (I’d previously got a bit sloppy and had been smoking up to ten on some stressful days - but at least I don’t inhale!).

Lunches have probably been the main change: most days I have two Ryvitas scraped with Utterly Butterly, one with a little Marmite and one with a modest smear of my favourite French honey. Of course I allow myself the odd treat: I ate half of a medium Melton Mowbray pork pie for lunch one day last weekend! You need the occasional bit of self-indulgence...

I settled into a routine of weighing myself before my morning tea but after my very regular trip to the loo, and then walking before breakfast a minimum of half an hour as fast as I could comfortably manage at least five days a week. Also being the sort of guy I am, I set up a spreadsheet to record my weight and walking time!

Oddly, my weight went up quite violently, and then fluctuated before stabilising - mostly. However, on the 3 November (almost three months after starting the project) I got below 14 stone for the first time.

The graph below was exported from Excel on the 23 February 2010.

It’s strange how it settles to periods of slow falls and levels, with occasional fairly violent peaks and troughs. However, the upshot is that in just under three months I went from a high of 15 stone 3½ pounds to 13 stone 12½ pounds - a drop of 19 pounds in 88 days, or an average of about 3½ ounces a day or 1½ pounds a week. As you can see from the graph, getting a bit complacent has allowed the line to climb gently since then, but I?ve been hovering around 14 stone (1¼ stone down from the shocking initial weight!) for quite a while. I really must get back to more controlled eating and drinking...

The most dramatic spikes seem to correspond to days when I’ve drunk quite a lot more alcohol than my usual half a bottle a red a night. So they must show a lot more fluid being retained to deal with the booze. There’s certainly no way I could put on - or take off - two or three pounds of fat or muscle in 24 hours!

The walks have varied, starting at around half an hour but now including some of over an hour. I now do one every day except Mondays, so that’s six a week. I did a ’hike’ with a friend one day - almost two hours - but the total time walked is now (3 Novem ber) up to just under 50 hours. If you calculate the calories burned in walking, these trips probably aren’t doing much for my weight, so the better eating habits must be the main cause of the loss. However, I feel an awful lot fitter and my abs have tightened up quite a lot.

I’ll try to update this regularly.