Sprouts: A Festive Warning

Regular readers - and anyone who's ever had a roast dinner with me - will be aware of my aversion to Brussels sprouts. I might go so far as to call it a hatred of them.

And finally I have conclusive proof that eating sprouts is bad to for you (albeit only under highly specific conditions): a man was hospitalised last Christmas after eating too many Brussels sprouts. Sprouts contain a very high level of vitamin K, which promotes blood clotting and as a result of the sheer amount of sprouts the poor man had eaten, the high levels of vitamin K served to counteract the effect of the anticoagulants he was taking due to heart failure.

Docftors were baffled as to why the medication wasn't working until, presumably, one of them smelled him.

DANGER! DANGER!

Hypoglycaemia time!

Had my first bout of post-lanreotide hypoglycaemia today. It's silly, you'd really think I would be used to handling it by now but it still catches me unawares now and again. Fortunately I had a delicious and nutritious dried fruit bar with me to help out, although it's not quite as good as Starburst. Mmm, Starburst.*

In other news, since having my Somatuline Autogel injection last wednesday I have been feeling rather better; I've been able to take fewer beta blockers because my heartrate has been a little slower, which has been reeeally nice - and also slightly surprising, because my heart is usually extremely slow to react to hormone changes, as far as I can tell. Plus it has been noticeably easier to go to sleep and to get up in the mornings which oh my goodness is seriously appreciated.

Also I was reading a newspaper article about the Olympics and I got a little teary-eyed, so I guess the "overemotional" aspect of these injections has also jumped in to play. People who know me in real life, you have been warned! Don't show me pictures of sad animals or I might drown you in my tears.
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* No, I'm not sponsored by Starburst. I'm just hoping if I mention them enough they'll take pity on me and send me some free Starburst.
Mmm, Starburst.

Human Guinea Pig: Part 3 - Actiheart Monitor & Step Test

This is the third part of the story about my overnight stay in the hospital's research department, having lots of tests to look at the effect my pituitary tumour is having on my body and metabolism. You can read the first part here, and the second part here.

Actiheart Monitor & Step Test

Once my body composition scan was finished, there was a certain amount of fretting that I would be late for my MRI scan appointment, so I was immediately whisked off to have my step test and Actiheart monitor fitted. This meant I was still wearing giant scrubs and no bra when I was supposed to be doing mildly athletic deeds, which proved somewhat inconvenient.

The Actiheart monitor is a teeeny tiny heart monitor which attaches to your chest by means of two sticky pads coated in glue so vicious it's almost impossible to wash off without taking the top layer of skin off too. I was informed I would be wearing it until midday Friday (I had not had any kind of advanced warning about that!) and that they wanted to carry out a step test to calibrate it. Essentially, while standing in a room full of cycling machines and a giant treadmill, you have to spend eight minutes stepping alternately onto and off of a purple plastic step, in time with a computerised voice which says "Up. Up. Down. Down." and gradually gets faster. The Actiheart records your heartrate as you do so, and then this is compared to the recording of your heart over the next few days, and used to gauge your activity level against your heartrate.

It's so tiny!

This explanation seemed pretty bizarre to me, because they were recording my exercising heartrate while I was off medication and therefore had an unusually fast heartrate, and then using this to calibrate the results of the heart monitor recording my heartrate when I was back on the medication. I have not yet had a satisfactory explanation of why this isn't stupid, but I live in hope.

Anyway. The computerised voice started up, and after only a minute or so began to take on a strangely hypnotic quality as I stepped endlessly up and down. By 5 minutes 30 seconds, the voice saying "Up. Up." started to sound more like an evil "Ha. Ha." and I became convinced the computer was laughing at me. The whole time, I had to hold up the trouser legs of my giant scrubs because they were too long as well as too wide, and I was concerned I would trip and fall on my (apparently worryingly fat) arse. Pro tip for the creators of Actiheart: I have to say that the whole experience would be vastly improved if you set the "Up. Up. Down. Down." man's voice to trance music.

Having just been told that I was 36% lard, I became quite concerned that I must be hideously unfit and would utterly disgrace myself by being unable to complete the step test, but in fact it was totally fine and even when he got quite fast at the end I was still happilly stepping away.

There was no printout of results to take away with me; I have to wait until the five-day recording has been analysed and then I should get some feedback through the post. I can't believe quite how small and awesome it is, compared to the 24-hour heart monitors which I've had to wear previously, which have invariably been vast, bulky and inconvenient.

My experience of the Actiheart Monitor and Step Test:

Hassle: 5/5
Fun: 3/5
Weirdness: 4/5
Results: 2/5
Total score: 14/20

Human Guinea Pig: Part 1 - The Research Facility

 I turned up at the hospital at 2pm on Tuesday and met up with the endocrinologist who's been in charge of arranging the series of tests which I was due to undergo  (she needs a top secret blogging name; we'll call her Dr Olive). We went to the research department where the tests would be carried out, and I was delighted to be introduced to my private room - complete with en-suite bathroom and free TV (and sharps bin, and cardiac arrest instructions).

My charming room

I think I've mentioned this before, but just in case - the tests which I had done over the past few days were done partly as general research into my condition and partly as a guide on what kind of treatment I should be given next. Firstly, a nurse was called in to do my initial tests; height (5'7"), weight (57.9 kgs), blood pressure (105 over 77), blood oxygen (97%) and resting heartrate (116 beats per minute - normal rate is 70-100 bpm). She had obviously not been informed about my tachycardia, because when she saw how fast my heart was going she looked at me askance and said "Did you come here running?" I assured her I had not, and that 116 bpm was perfectly normal for me. Later when Dr Olive looked at the results I think she was quite surprised; I had explained to her that I had tachycardia but she was surprised that my resting heartrate could be so high; of course, at that point when she took my pulse it was a perfectly standard 79 bpm.

I also had my breathing rate observed which was deeply disconcerting, as it essentially involves a nurse staring at your boobs for a solid minute while you attempt to "breathe normally". It is strangely difficult to breathe normally when you know someone is counting every inhalation.

Next came my ECG (electrocardiogram, a.k.a. EKG), where they put a bunch of incredibly sticky pads on your wrists, ankles, and across your chest around the heart. Then they attach a bunch of wires to the pads, which feed into a machine, which then prints out a trace of your heartbeat. It doesn't take very long but it is a bit of a hassle - the worst part is peeling the sticky pads off afterwards, although as the very nice nurse - let's call her Carla - pointed out afterwards, it's definitely a lot worse for blokes with hairy chests!

After that, I had to give my consent to the various tests that they wanted to do, and answer a few questions about my medication, my pituitary adenoma and any other medical conditions. It wasn't particularly exciting, although when Carla asked me if I ever suffered from any kind of recurrent pain, I said no. It was only after she'd asked me two further questions about pain that I finally remembered the fact that I have hypermobility syndrome and consequently have fairly regular bouts of joint pain, and have done since I was a child. I apologised for apparently being a massive idiot and she laughed and said people often forget these things when it becomes normal for them.

Some people with hypermobility/Ehlers Dahnlos Syndrome are incredibly flexible - later, Dr Olive came to ask me another set of questions, and when I mentioned the hypermobility again I think she was faintly disappointed at my lack of hilariously bendy joints. My little fingers do bend backwards alarmingly, but the joints that are most affected are in my legs and feet so they're not very impressive - and at the moment I can't even get vaguely close to touching my toes thanks to damaging a muscle in my left leg dancing.

Once I had been thoroughly questioned, I was left alone to contemplate my crimes - or at least, someone else's crimes, thanks to Arthur Conan Doyle, Sherlock Holmes and my Kobo e-reader, a birthday present from my parents and an excellent device for anyone planning to spend time in hospital.

Not quite an ocean view...

You can read the next post about my time in the hospital, and my DEXA body density scan, by clicking here.

IMFW: Beware Boxing Day

It's Boxing Day and all, so I'm keeping today's Interesting Medical Fact of the Week short, snappy, and slightly concerning; science informs us that you're more likely to have a heart attack on a Monday. Apparently, this is ascribed to the twin horrors of overindulgence at the weekend and the shock of returning to work. Given today's date, hopefully you're not back at work - but the "overindulgence" issue may well apply...

My Heart Goes Sha La-La La-La

My rate of posting has dropped slightly recently, down from those heady days in November when I was continually finding out new facts about Russell Watson, and stalking unwitting commentators on the Guardian's website. This is not because I have lost interest in such matters - far from it - but because I'm taking exams at the moment and consequently dedicating my energy to revision and work, rather than obsessive tumourhead fact collection.

Incidentally, the most popular search term for my blog is currently "peoples big noses". Say what?

In any case, as well as spending my days drawing extensive mind maps, and making full use of my considerable collection of coloured pens,* I have discovered a new and interesting fact about my post surgery self; namely that my traditional mild pre-exam nerves (which previously I rather cherished for their ability to get me writing quickly) now serve to completely undermine my body's new-found ability to regulate its own heartbeat.  So, with a speedy speedy heart, the exam was a slightly more stressful experience than I had expected, and I will definitely be carrying beta blockers with me next time.

Ah, tachycardia.

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*Because that's what revision is about.

Owner of A Lonely Heart: Attempts at Diagnosis

When I was a very small child, a combination of my bad hearing and an obsession with ponies meant that I thought the classic Yes song Owner of a Lonely Heart was actually called Owner of a Lonely Horse. Ah, the folly of youth.

As the years went by, I became increasingly good at distinguishing between the hollow muscular organ which pumps blood through the circulatory system, and the large solid-hooved herbivorous ungulate mammal. No doubt this helped enormously when it came to talking to the doctors about my heart problems. Anyway. At the end of my previous post on the subject of my lengthy road to diagnosis, I had left my local hospital's A&E department with a heartrate of 140 and no explanation...

The next day, I went to my GP, who prescribed beta-blockers. Going through my symptoms (rapid heartrate, tremors, fatigue, hair loss, etc) it seemed that thyroid problems were an obvious possibility. I'd had my thyroid levels tested at A&E and they came back fine, but my GP checked again. They were still fine.

And that was the problem: in fact, my levels of thyroid hormone (free T3 and T4) were much too high. But when doctors suspect you have too much thyroid hormone - hyperthyroidism - that's not what they look at. Instead, they test your thyroid-stimulating hormone (TSH) levels. Low TSH implies hyperthyroidism (because your body is trying to lower your thyroid levels by producing less TSH) while high TSH implies hypothyroidism (because your body is trying to increase your thyroid levels).

Unfortunately, my TSH level was within normal ranges, even though the whole time I had a tumour sitting on my pituitary gland, giggling frantically to itself and oozing TSH with the enthusiasm and verve of a naughty child left unattended with a box of felt tips and a newly papered wall. It was on the high end of normal, but without measuring the T3 and T4 you'd never realise that it was too high for my body. I should point out at this stage that I don't blame my doctor for not doing the other blood tests. A pituitary adenoma producing TSH (a.k.a. TSHoma) is a one in a million illness.*

It's not my doctor's fault that he didn't recognise how incredibly special I am.**

So the next obvious possibility was that my sinus tachycardia (rapid heartrate) could be due to - gasp - a heart problem! And boy, did they ever check me out. I wore 24-hour heart monitors on several occassions - once I was wearing one when I went to a formal dinner, and had an interesting half-hour beforehand trying to find a way to conceal the bloody great thing using only a lace bolero and my native wit - and I had an ultrasound scan of my heart. Ultrasound heart scans are pretty cool to look at, but I can't help thinking that they must be more fun for men, who (in most cases) don't have boobs. Boobs are not usually a problem, but they aren't half inconvenient when someone's trying to use The Power Of Sound to examine the circulatory organ located somewhere beneath one of them.

After six months I finally got to see a cardiologist. He told me that I didn't have a heart problem, that it was almost certainly hormonal and I should have further blood tests, and that I should stop taking my beta blockers.

Two out of three of those statements were correct.

I'm still not entirely sure why he ordered me to stop taking my pills immediately, when every other doctor I've seen since has emphasized the importance of coming off beta blockers slowly to prevent rebound tachycardia. And equally, I'm not sure why I didn't protest more. Regardless: I came off the beta blockers, spent a week feeling as though walking across a room was a labour worthy of Hercules, then angrily phoned the cardiology department and insisted that I was going back on the bloody medication.

But despite this slight hiccup, progress had been made. The cardiologist had ordered the right blood tests. I was referred to endocrinology...

UPDATE: You can click here to read about how I finally got a diagnosis. Or click here to go back and read about my first trip to hospital.

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*In fact, a friend of mine who's a medical student told me that one day, when a group of med students were med studenting, a patient's symptoms were described and they were asked for possible diagnoses. One girl suggested a TSHoma. The doctor's response: "Don't be ridiculous, that never happens." I asked my friend if she stepped in to mention that she knew someone with a TSHoma. She did not, apparently because the girl who suggested it as a diagnosis was a bit of a know-it-all and was overdue a put-down. Of such fine things are doctors made.

**Interpret "special" as you will...

IMFW: heART

It's not precisely an interesting fact this week; more like an interesting set of pictures. But still cool. The British Heart Foundation ran a competition, inviting scientists to submit the best images they have of their work on heart disease, and the results are surprisingly artistic.

Medical imaging has certainly come a long way from the day that Röntgen first used x-rays to create an image of his wife's hand. She was purportedly unimpressed with his efforts, believing that the picture of her own skeleton was a herald of death - although as she lived for another 25 years, it was a herald rather ahead of its time.

My Head Revisited: First Trip to Hospital

I have set this post to appear online at precisely 11.11am on the 11/11/11. If I could define it down to the second, believe me I would. Because I am lame that way. Anyhow. On to the story...

***

In January 2010, a chain of events was set in motion which led to the first of my many trips to hospital and, incidentally, the first time I tried sushi. Of the two experiences, I preferred the latter. From what I've seen, hospital visits rarely come with a side of pickled ginger.

And I love pickled ginger.

Sadly I can no longer remember the date in question, but I think it was around the 18th January; I was back at university and, being a studious and dilligent character, I had spent the entire day sitting in my room reading books about Old English poetry. Consequently, I couldn't quite work out why, ever since I'd woken up, my heart had been beating as fast as though I'd just run for the bus.

At about four o'clock, I used the excellent online stopwatch to work out that my heartrate was around 140 beats per minute. So I decided to do what any sane individual would do when their local doctor's practice is a two-minute walk away. I called NHS Direct.

NHS Direct sent me to the doctors. Feeling like a bit of an idiot, I ambled into the reception, was immediately rushed in to see the nurse (ever wanted to skip the queue? Just develop heart problems!)* and found myself wired up to an EKG, which looked rather like some kind of creepy mechanical chest octopus. I sat there for a few minutes and the nurse agreed that yes, my heart was rather speedy. Then I was sent to a doctor, who took a look at the creepy mechanical chest octopus printout and agreed that yes, my heart was indeed rather speedy.

So the doctor sent me to the hospital. My very nice college booked and paid for the taxi to take me to A&E and I grabbed my very nice friend Cherry to accompany me.

"Heart problems" is one of those magical phrases that gets you rushed through A&E much faster than, say, a mere broken bone or accidental breadknife incident - although of course it does mean that, as an entirely healthy-looking young person, you're liable to get a few evils from the folk who've been waiting there, oozing gently, for an hour.

Once I went through to see a doctor, the fun really started. Immediate assumptions were that either:

1) I must be having a panic attack.
or
2) I must have taken some kind of exciting illicit substance.

I think that option 1 was rapidly discounted due to the carefree nonchalance with which I munched my way through a packet of McCoys** and giggled as the doctor on duty made me blow through a small tube and massage my neck in an attempt to get my heartrate down. Of course, no matter how many times I insisted that option 2 was not an option, they refused to believe me.

Eventually they admitted defeat and sent me deeper into the hospital, where I got a whole bed to myself. Yay! I had a smorgasbord of blood tests and was wired up to another heartrate monitor which, annoyingly, was set to beep frantically any time my heartrate went over 140bpm. As it spent the whole time hovering around the 140 mark, this quickly got extremely irritating.

Cherry kindly volunteered to read aloud my book of translated Old English poetry to me, which resulted in her learning quite a lot of new and exciting vocabulary, like "seraphim", "fetters", and "vassal". Quite inexplicably, she lost interest only partway through a poem.

I sat in the hospital, waiting for my blood test results to come back, until about 11 o'clock at night. The doctors weren't sure whether I'd have to stay overnight, and so Cherry, as well as looking after me very well, (although I can never forgive her lack of interest in Anglo-Saxon literature) also had the fun job of phoning my parents and boyfriend, to let them know what was going on.

Finally, late at night, having had no dinner, it was announced that all my blood tests had come back fine, they had no idea what the hell was wrong with me, and that I should go home. If my heartrate was still fast in the morning, I was told to go back to the doctors.

It was good to be able to phone my parents and reassure them that I was not on death's door, but attempting to go to sleep with a heartrate of 140 is virtually impossible, and I was not reassured when, the next day, the doctor incredulously asked me "they let you go home from hospital with a heartrate of 140 and no medication?", with a look of horror on his face.

But more of that at a later date...

UPDATE: Click here to read my next post about getting a diagnosis. Or click here to go back and read more about my initial symptoms.
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*N.B. This doesn't work as well in the supermarket.

**Incidentally, I hadn't noticed until recently that McCoys advertise themselves as "man crisps". WTF. Seriously, are their marketing team like five years old? Wikipedia, my one true love, tells me that McCoys are, and I quote, 'promoted by United Biscuits*** "as the only overtly male-targeted crisp brand"'.  Don't believe anyone would say something that stupid, let alone base an ad campaign around it? Here's the website.

***Words fail me.