The Power of Negative Thinking

I like to think of myself as a reasonably positive person. I try not to let all my medical bother get in the way of having fun, and I also try, on the whole, not to continually go on about my bloody pituitary tumour to other people (unless they are foolish enough to ask, of course). That's one of the nice things about having this blog. As well as a place to vent after my third phone call to the hospital in a day, and a lovely way to get into contact with people going through similar medical fun times, it provides the option for those of my friends who give a shit about the details of what's going on inside my head to keep up-to-date, and enables those of my friends who don't to… not.

Not that I judge those guys, but if you're reading this, you're one of my favourites. SHH DON'T TELL ANYONE.

One of the things that gets my goat* a little is being told to "stay positive". This only happens very occassionally, but when it does it kind of grates. A) I am trying and B) the nature of reverse psychology gives me an uncontrollable urge to shout "screw you, I can wallow if I damn well want to!" Everyone needs to be allowed to feel blue without being made to feel guilty, and for the most part a hug is all that is required to cheer me up. I should point out that I know the people who say "stay positive" mean well and I do not hold it against them, because it can be hard to know what to say to a persistant offender of the unhealthy variety. But it gets me pondering.

Indeed, I was pondering about this the other day and realised that actually, I would argue that when you're sick, negativity has a useful part to play (as long as you're sensible about it and don't just end up depressing yourself). Take my current situation, for example. I knew that even back last winter when my thyroid blood tests were coming back within the normal range and my endocrinologists were excited that I might be cured, I still felt a bit symptomatic. I could have stayed positive and said "I'm sure it's probably just a bit of a hangover from spending a year and a half ravaged by thyroid hormone. The blood tests say I'm fine so I probably am. Hurrah, I can forget all about this horrible tumour business!"

However if I had done that, then the news that I am not cured and that the tumour has grown back and that I need more surgery and possibly radiotherapy would have been even more crushing. Instead I always tried to keep in mind that more surgery was a possibility because I knew I didn't feel 100% right. And consequently when I got the news, it was less of a shock because I had already prepared myself for it.

Equally I think always taking into account the worst case scenario can not only make the negatives less unpleasant if they finally do hit, but also makes the positives more uplifting. If you go around staying positive all the time, then when you get good news it's not so much of a hurrah-moment, because you're really just getting confirmation of something that you were trying to convince yourself was true. If you're prepared for the worst, on the other hand, even slighty-bad news can seem like an improvement.

I actually think it's really sad when you read articles in magazines (usually in doctor's waiting rooms…) that extol the powers of positive thinking to heal. It really does just pile on the guilt. Feeling sad or worried is a perfectly normal response to illness and to me it just seems healthier to accept that and deal with it and move on. Being constantly instructed to feel positive all the time is only going to make the person feel guilty when they can't manage it. (And please, show me the healthy person who manages to be positive 100% of the time. If moments of negativity caused illness, we would all be sick). When you then compound that by saying that positivity will heal, it creates even more guilt. If the person doesn't get better, it's their fault for not being positive enough. But they're not better so they find it harder to be positive. And so on.

So acting like Eeyore all the time has its benefits.

As long as you don't turn into such an unrepentant cloud of gloom that no-one can stand to be around you.
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*N.B. if you find my goat, please return him immediately.

Human Guinea Pig: Part 7 - How To Get Over Your Fear Of Needles

Holy lord! Who would have thought, when I agreed to go into hospital for all this testing, that the experience would prove to be such a rich vein of blog posts?

Anyway! This is the sixth 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. Here are links to: part one, part two, part three, parts four, five and six!

A Whole Lot of Blood Tests

After my GEM ventilated hood calorimetry test was over, and the strange astronaut hood was removed from my person, you might be imagining they'd let me have breakfast. If so, you are imagining wrong. Please stop.

No, it was time for my blood glucose testing! And so I was presented with this:

Yay, breakfast

No, it's not a refreshing beer: it's a pint of Lucozade. At nine in the morning. And I had to drink it all within five minutes.

Basically the idea is that, having eaten/drunk nothing but air for twelve hours, they present you with a massive sugary drink and then do a bunch of blood tests over the next two hours to see how well your body deals with it. I'll be interested to find out the results of this, as I'm pretty sure my body isn't great at coping with sugar; sometimes eating sugary things really noticeably raises my heartrate - and especially when I'm on my lanreotide injections, I have to try to be really careful about eating regularly, and carry around a packet of Starburst (or similar sugary hit) because occassionally I go hypoglycaemic at unexpected moments. Lanreotide messes around with your insulin and glucagon levels, meaning that it can confusingly cause both high and low blood sugar, and it sure is annoying.

I looked it up, and it turns out Lucozade was originally conceived as an Irish health drink and called Glucozade! Who knew! Between that and Guinness, it seems my ancestors had some peculiar ideas about what was "healthy". It also turns out that Lucozade contains 85g of sugar per 500ml, which is almost all of a woman's daily allowance. Holy crap! You can see why they chose it for my morning tipple.

While I was distracted trying to gulp down the hideous stuff, the sneaky nurses set up the trolley ready for my blood tests. Having finally finished all my Lucozade, I turned around to see this:

Oh, dear lord.

Yep. All those tubes were for me. I got to have twenty-three bloods taken in total - lucky me!

First they put an IV cannula into my arm - basically it's a giant needle that stays in your vein and they can attach tubes and things to so that they don't have to re-stab your arm every time they take another blood. They took about 16 of the bloods immediately, and then I had the rest over the next two hours. I still can't really bring myself to look at cannulas in my arm due to being a wuss, so one of the nurses very kindly bandaged it up for me.

Safely hidden away!

The nurses and my endocrinologist formed a sort of production line around my arm for the first sixteen, with one nurse preparing the tubes, Dr Olive taking the blood, and the other nurse stacking them up (some had to go straight into a bucket of ice; some had to be left to clot).

Once they've finished taking one lot of bloods via a cannula, the tube is flushed out with saline solution (i.e. they effectively inject saline into the tube). This clears the blood out of the tube, preventing it from clotting and blocking the tube in-between blood tests. Of course, then the next time they come to take blood, this means that they get half a tube of saline back before the blood starts coming through properly, which is of no use to anybody. Because of this, before taking further bloods, they take an extra tube which comes out as a mix of the saline & blood, then continue with the tests - and then sometimes (if you're having a lot of bloods taken, like me) they'll re-inject the blood and saline, to minimise blood loss.

I've never written the word "blood" so much in my life as I just did in that last paragraph, but I promise I'm not just trying to gross you out; there's an interesting fact coming up. Before re-injecting the blood & saline, I was asked if I was ok with it. I was very much ok with it, because sometimes having lots of blood taken gives me a Funny Turn (in this case I was fine, probably thanks to the pint of Lucozade) and thus I like to hang on to the stuff. Turns out they always have to ask before re-injecting the blood, in case you're a Jehovah's Witness.

I have long been aware that Jehovah's Witnesses are against blood transfusions, but I'd always assumed that this was due to believing that it was wrong to have someone else's blood put into your body; I hadn't appreciated that in fact the problem is with any blood that has left the body at all, even your own. According to Wikipedia, for Jehovah's Witnesses "Blood represents life and is sacred to God. It is reserved for only one special use, the atonement for sins. When a Christian abstains from blood, they are in effect expressing faith that only the shed blood of Jesus Christ can truly redeem them and save their life".

My Lucozade & Blood Tests Experience:

Hassle: 4/5
Fun: 1/5 (It would have been a zero, but I learned an interesting fact!)
Weirdness: 2/5
Results: 2/5
Total Score: 9/20

A Lesson From My Former Landlady: Part 2

I know what you're all thinking after yesterday's post. Maybe I was just a genuinely awful tenant and this poor innocent landlady was understandably desperate to get rid of me. Maybe that £65 just barely covered the emotional trauma of having to live with me. Maybe my mere presence in a house creates the kind of dark cloud of horror and despair that nothing but years of intensive therapy can lift.

Well, I admit I wasn't perfect. Due to all my dance classes, I had a very unpredictable pattern of kitchen useage, and I did once manage to lock my boyfriend in the house and trap him there, because I am apparently incapable of understanding how keys work. I wasn't allowed to hoover my room in case it scratched the floor, so I only swept the floor occassionally. Sometimes I would move bags that were left in the middle of the hallway, so that I could get by. I admittedly never cleaned the windows. And I did once keep a friendship cake on the sideboard in the kitchen for almost two weeks - although I feel that offence should be mitigated by the fact that I gave June and her kids several of the resultant cupcakes.

On the other hand, here is a small taster of what it was like living with June:

1. She once went on holiday without warning me at all in advance; I just arrived home to find an email saying she wouldn't be back for a week. This would not have been a problem, except she turned off the heating before leaving and I had no idea how to turn it on, so it was freezing, and she locked away the wireless internet box in a room with no key, meaning that whenever I had problems getting internet access, which happened every now and again, I was unable to reset the wireless and had to just wait until it fixed itself, which could be hours. Oh, and she also left her kid's hamster in the house with no-one to look after it but me. I emailed her back about the above issues and she completely ignored it, even when I texted her as well; I didn't call because I didn't know what country she was in.
Fortunately, after four days, just at the point when the hamster's food was starting to run low and I was starting to think I would have to find something for it to eat, her ex husband rocked up at half nine at night to pick it up, with no warning.
2. The whole house was permanently a huge mess (except for my room in the roof… my room was lovely, that's the only reason I put up with it), particularly the kitchen, where plates of congealed food could lie in state for days. At one point, some mouldy bananas were left hanging up in the kitchen for two weeks. That's two weeks after they'd already gone mouldy.

3. When I moved into my room, one of the curtain fittings was broken and falling off the wall. Despite raising it more than once, it was never fixed. Nor was the door to my kitchen cupboard fixed in the months after one of its hinges detached. Apparently June - a fully grown woman with children of her own - was waiting for her elderly parents to come and fix them.
She also got her parents to come and stay at the house for a week while she went on holiday, so that they could do her gardening. They came and worked in the garden and swept her paths and fixed her fence, and they didn't even see her or their grandchildren. This didn't affect me in any way, I just thought it was a pretty crappy thing for her to do.

4. There was a mysterious and horrible smell coming from the downstairs drains for a couple of months after I moved in. After talking to her about it several times, she finally booked a plumber, without mentioning this to me until two days beforehand. She managed to book him on my day off, when I had been planning a lie in and general lazy day, and informed me that I would need to vacate my room that morning by eight o'clock - earlier than I would usually leave for work. I said that I had booked leave and had been planning a lie in and would have appreciated it if she had checked with me that it would be ok. Her response? "Oh well, it's too late, he's booked now".

5. She kept her Christmas tree up and fully decorated until at least the end of March, when I left. Not really a problem as such, just Very Weird.

I could go on, but I'm bored now. In any case, that's got to be enough for you to see that she wasn't the easiest person to live with. However, I have become a much more patient person in the last few years (except when I'm walking behind slow people. OUT OF MY WAY, SLUGGARDS!)* and I do at least try to think the best of people. Despite all the above, I liked my room, I thought I got on fine with June, I kept myself out of the way and I always made sure I tidied up after myself. Even though my mum and boyfriend** clearly (and accurately) marked her out as a Bit Of A Weirdo after meeting her just once or twice, I really did make the effort. So for her to effectively turn on me for the sake of a measly £65 felt pretty horrible, given the amount of effort and patience I had put into maintaining a good relationship with her.

Even after she had her big shouting fit at me and docked her pound of flesh from my deposit, I was naive enough to assume that would be that. I had previously provided her with my new address so she could forward any post; I was pretty organised with getting my address updated with various organisations that write to me, but I've had problems in the past where I've called the hospital and given them a new address, only for them to fail to change their records and continue sending stuff to my old address, so I wanted to be safe. I assumed everything was fine.

This week, I suddenly realised I had failed to provide the professional body that I'm a member of with my new address. They don't usually send me much, but I emailed them anyway. I was impressed when, two days later, they sent me a magazine to my new address. Until I looked at it and realised that it had previously been sent to my old address at June's house. Instead of forwarding it to the address I had supplied her with, she had marked it "Not known at this address, return to sender." Obviously the professional body had received it back and been waiting to get my new address so they could re-send it.

But what a horribly petty, vindictive thing for June to do. She knows my new address perfectly well; writing it on the envelope before sticking it back in the mail would take no more effort than writing "return to sender" before sticking it back in the mail. Fortunately she's chosen to do that with a magazine that's not important. But what if it had been medical information sent to me by the hospital? It's not going to come in an envelope marked "important medical info for Emer, please don't dick around with this".

I had decided to put my previous encounter with June to the back of my mind, but this upset me all over again - because now I'm worried that the hospital could have sent me a letter which I haven't received thanks to her childish behaviour. I have no idea why she would choose to behave towards me in this way. Presumably it hasn't even occurred to her that messing around with someone's mail could have serious consequences - or else it has occurred to her, and she really doesn't care. Maybe that was the only bit of mail that she's done this with, and she just wanted to make some kind of point - but I can't know that for sure.

I'm hoping that, as I spoke to my endocrinologist yesterday, he would have seen any problems with my address on the hospital system and mentioned it, and I will call and check that they have the correct address for me now. But I don't know what to do about June. Part of me really doesn't want to let this go; I think she should be made aware of how serious her actions could be. But equally, I have no desire to have any contact with her ever again. I'm worried if I email or write to her, I might just make things worse - but I do think that telling her about my illness might give her a bit of a wake-up call regarding her behaviour.

Any suggestions?

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* Is sluggard actually a word? It should be. Answers on a postcard, please.

** Some of the few people to have met her - for the most part I didn't invite people to the house because I was embarassed that the kitchen etc. was so horrible

A Lesson From My Former Landlady: Part 1

I was originally going to name this post something else, but in deference to my readers who have delicate constitutions, I decided against it. Anyway. While it will be something of a massive rant, it's actually a good way of illuminating a topic that I've been wanting to write about for a while.

***

So for about eight or nine months from last summer, I lived as a tenant in a house occupied by my former landlady and her two children, who split their time between her house and their dad's. My former landlady - let's call her crazy bitch June - gave me notice in January that she'd need me to move out in June because she wanted to redecorate the room I was in. This seemed a suspect excuse, as my room was the only part of the house not in need of decorating, but no matter; I didn't have the chance to discuss the issue with her because she took the rather peculiar decision not to tell me in person, but to wait until I went on a weekend away and then slip a note about this under my door. I started to look for a new place almost immediately, because I knew I would have exams in June and didn't need the stress of moving out at the same time.

In March, I found a lovely new house nearby and gave her my notice. She said that this was fine as it didn't matter to her when the room was redecorated. I tried to organise a time to go through the inventory and get my deposit back, but she was strangely cagey about it. I offered to go through it with her on the day I was moving out, having just cleaned the room with my mum, but she refused. After moving out, again I kept trying to arrange a time to go through it all with her but she continued putting me off until I suddenly received a text message ultimatum that it had to be on that Friday (a day which I had already informed her I wouldn't be able to do) because she had someone moving in the next day.*

I spoke with my manager and was able to leave work early that day in order to go and see her, despite the fact that things were super busy that week and I knew that I would have to work over the weekend to make up the time I lost by leaving early. So off I trotted to my old house.

The instant I got there, things seemed strange. I was let in, but although I had explained to June that it was an awkward time and I would be in a rush, she seemed surprised that I was in a hurry and she stomped upstairs, obviously in a bad mood.

June was always a shouty woman. When her kids were staying, there was shouting every evening - about eating dinner, about singing lessons, about baths, you name it. What I was not prepared for, however, was for her to turn her shoutyness on me practically as soon as we stepped into my former bedroom. She pointed to a laughably small build-up of scale on the bathroom tap and had a go about it - then when I pointed out that it had always been there, she claimed that if there had been scale on the tap, she would have written it down in the inventory. I pointed out that this was not the case, as there were various holes in the walls and floor, the broken curtain fitting etc. which were not in the inventory - seeing as the inventory is a list of the room's furniture, not a detailed description of every aspect of its decor. She yelled that the holes in the floor were "not the problem" and continued shouting, accusing me of allowing a terrible limescale build-up in the shower, "ruining" a bookshelf, leaving the room dusty, etc. etc.

She accused me of not cleaning the room at all before I left; I pointed out that a) not only has she actually seen me going upstairs and downstairs with mops and buckets and cleaning products on the day I moved out but I had also spoken to her about which mop she would rather I use to clean the floor, and b) because she refused to do the inventory on the day, obviously the room now had two week's worth of dust in it. Which only made her shout more. At one point, she yelled "Frankly, Emer, I don't believe you did any cleaning the whole time you were here!" Which is a bit of a bloody cheek coming from a woman whose kitchen was so permanently disgusting that a) it attracted mice** and b) my appalled yet kindly mother did some of June's washing up on the day I moved out just to make it less horrific.

By this time, all the shouting was really starting to stress me out; I was on the verge of tears. I'd been on the lanreotide injections for a few months, and the thing about them that I think I've mentioned before is that they really do make me a lot more emotional and easily upset, for some reason. I had never told June about the whole brain tumour thing or the injections or anything, because frankly I didn't think it was any of her business and it tends to make things awkward.

Anyway, I asked her (politely!) to stop shouting. She shouted "I'M NOT SHOUTING!" at me, then continued shouting. I was so stressed out by the whole thing that I was physically shaking and feeling sick, so when she told me she was going to dock me 10% of my deposit (apparently cleaning a tap costs £65 these days. I'm not sure she's doing it right) I barely even argued because I was so desperate to get out of there. I was still trying to stay calm but I was kind of furious at myself for being so easily upset, so when she continued ranting as she wrote out the cheque I said: "June, I really don't appreciate your attitude today; I made a real effort to fit in with your plans even though it was extremely inconvenient for me, I took time off work and you've been nothing but rude to me the entire time I've been here." Predictably, she started shouting again, threatened to rip up the cheque, blah blah blah.

When I left my former home (with the cheque, thank Christ), I got about four steps down the road before bursting into tears and I was still shaking by the time I got home, at which point I realised that I was probably a bit hypoglycaemic (occassional side effect of the lanreotide injections), ate a couple of biscuits and felt slightly less awful, despite the fact that I had just effectively paid £65 to run away. Fortunately my lovely boyfriend was visiting that evening and he made me feel a lot better, although the whole story made him kind of furious. I believe pissing through June's letterbox was mentioned, and to this day I slightly regret my decision to take the high ground there...

It seems pretty plain to me that June's plan right from the start - before I'd even vacated my room or she had seen it - was to get that money off me. The way she dodged my emails trying to organise it, and then suddenly demanded to have it on a day she already knew I couldn't do, indicates to me that she was hoping I would say I couldn't come, so that she could just arbitraily dock the money and send the cheque in the post without having to do it to my face. The way she avoided doing the inventory on the day I moved out when my mother was there as a witness, and her incredibly aggressive behaviour as soon as I stepped through the door all make it seem as though she was determined to get that £65 by hook or by crook.

That kind of behaviour isn't acceptable from anyone to anyone. Society might consider it rather worse for my landlady to try to intimidate me, a 23 year old girl than, say, a 46 year old bloke. Is that fair? No. Would she even try it on with a 46 year old bloke? Who knows? I certainly doubt she would have behaved in the same way if my boyfriend had been with me. And what about the fact that I'm sick? If June had known about my pituitary tumour, about the fact that I was on hormone treatment which made me feel emotionally pretty delicate and physically resulted in odd bouts of hypoglycaemia, would she have still done it? If I went up to her now, knocked on her door and said "Oh, by the way, June, just so you know - I have a benign brain tumour," would that change the way she felt about her behaviour towards me?

Because it shouldn't.

You can't always tell if someone is sick. Not every ill person has a wheelchair or a bandage or an obvious badge of their personal infirmity. Heck, even if you now them pretty well - even if you live with them - you might not know about it. Yet the default in society is to treat everyone as if they were well and make 'special allowances' for sick people - once they produce a medical certificate. There are plenty of people in the world who would probably be horrified to realise that the shop assistant they were a bit of a dick to yesterday has a brain tumour, or the slightly unhelpful telephone operator they're shouting at has just come back to work after going through chemo. We do these kind of things all the time - and I'm by no means claiming that I'm innocent of this, by the way - and yet, if we knew of the person's illness, or bereavement, or disability, we would never dream of treating them in that way. And the only way to get around this is by trying to treat everyone with as much respect as you can muster, all the time. And even when someone is behaving appallingly, you need to give them the benefit of the doubt, because you just don't know. And that is a really difficult thing to do.

Because here's the killer question: If I found out that June had just been told she had Huntington's, or MS, or cancer, would that change how I felt about her behaviour - even though it wouldn't excuse it?

Of course it would.

And that's why I'm glad we didn't go piss on her doorstep.

Well... mostly glad.

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* So much for "redecorating".

**Which June then killed, which seemed rather unfair. If she didn't leave food for them around all over the place, those poor mice would probably still be alive, frolicking happily in the compost heap.

Has Obama Had Brain Surgery?

I ran across this (slightly old) news story while searching for pictures of MRI scanners, and it was a revelation to me! Being across the pond in Merrye Olde Englande, I had heard that the rabid frontiers of the American right wing are convinced that Barack Obama is a Muslim who was born outside of the US, but I hadn't come across the parallel accusation that he's had brain surgery, based on what supposedly looks like a scar on the back of his head. There was coverage in the Daily Mail - and David Icke, everyone's favourite herpetologist, also jumped on the theory: a sure sign of credibility.

Obviously the pictures mean pretty much nothing at all. Maybe his hair just grows that way. Maybe he cut his head open in the playground as a kid. Maybe he actually did have brain surgery. Maybe those scars are where his lizard masters buried into his body and started wearing him like a glove. But the rhetoric around it all was both amusing - why is it that apparently becoming the President of the United States entitles the world and his dog to see your complete medical records? - and sad.

Get Ready for Rare Disease Day 2012

Rare Disease Day 2012 is tomorrow, the 29th February, and I hope you're all as excited as I am. Yay, diseases!

The definition of a rare disease in Europe is a disease with an incidence of fewer than one in two thousand people. There are thousands of rare diseases, and although each disease is individually rare, taken collectively rare diseases affect 6% of people in Europe and account for 20% of healthcare costs. Rare Disease Day aims to raise awareness of the problem of rare diseases, and the fact that research into treatment of these kinds of diseases tends to be significantly underfunded.

For more information, check out the Rare Disease Day 2012 website, or infect yourself with an unusual pathogen!

IMFW: "Excited Delirium"?

Today's Interesting Medical Fact of the week is about a medical condition that may or may not, in fact, exist. Wikipedia defines "excited delirium" as "a condition that manifests as a combination of delirium, psychomotor agitation, anxiety, hallucinations, speech disturbances, disorientation, violent and bizarre behavior, insensitivity to pain, elevated body temperature, and superhuman strength." Never heard of it? Neither had I.

Excited delirium is not  recognised as a cause of death by the Department of Health or the World Heath Organisation. It has become an extremely controversial topic in the UK recently, due to the death of Jacob Michael, a 25 year old man who died last year in police custody. The Home Office pathologist found that he died of excited delirium; Michael's parents disagree, arguing that the pathologist ignored the effects of heavy police restraint on their son.

Excited delirium has been cited as a cause of death in a number of death-in-custody cases in the UK, and more in the US; it started turning up in pathology reports in the 1980s. Many of the people who are reported to have died of excited delirium have cocaine or other drugs in their system, and it's been variously suggested that their death is due to excessive adrenaline or organ failure due to a massive spike in body temperature, with the risk of death being increased by pre-existing conditions.  But  Eric Balaban of the American Civil Liberties Union suggested that the diagnosis of excited delirium is used "as a means of white-washing what may be excessive use of force and inappropriate use of control techniques by officers during an arrest", with most reported cases of the disorder found in people who have died in custody.

There may be an explanation for this; Dr Vincent Di Maio, a former chief medical examiner in Texas, suggested that it is the very act of resisting or fighting with police which tips sufferers over the edge, and that police then wrongly get the blame. Some doctors have said that deaths from police brutality are clearly distinguishable from those due to excited delirium, with the physical marks of brutality obvious; others have accused taser manufacturers of using the diagnosis to explain away the deaths of people who have been hit with tasers. It's pretty much a minefield of conflicting opinions.

But Balaban argues that the symptoms of excited delirium are simply the symptoms of mental illness, possibly exacerbated by drug use; and this article looks at other medical conditions which can look like excited delirium, listing delirium tremens (alcohol withdrawal), hyperthermia (severe overheating), severe low blood sugar in diabetes, traumatic brain injury, viral encephalitis and thyroid storm (massive hyperthyroidism often caused by very high stress). The article does not mention epilepsy, but in some cases epileptic fits can lead sufferers to become extremely disoriented and confused, and there are probably several other disorders which could give rise to symptoms similar to those of "excited delirium".

It's an interesting debate to follow, although as someone with little knowledge of either medicine or police work, I'm hardly qualified to draw any conclusions. There's also the issue that the question of excited delirium is twofold; some question whether it is a medical condition at all, whereas others merely question whether it's a medical condition which in itself would actually lead to death. I will follow the debate with interest.

IMFW: Aluminium Does What Now?

Today's Interesting Medical Fact of the Week is dedicated to my lovely boyfriend. No, he doesn't have a weird and unusual illness, or even just a particularly hilarious deformity - but he does have a deodorant made from Japanese sea minerals.

"What are Japanese sea minerals?" I said.
"I don't know," he said. "But it doesn't have aluminium in."
"Do deodorants normally have aluminium in?" I asked, exposing my ignorance.
"Yes," he said. "It gives you cancer."

At that point, my brain practically exploded and I resolved to investigate whether or not he was just winding me up. And thus, my next Interesting Medical Fact was born.

As it turns out, aluminium is a common ingredient in anti-perspirants rather than simply deodorants. But here's the thing: it can be absorbed through the skin, and it's been suggested that there may be a link between use of such products and the development of breast cancer. The short story is that there's no conclusive evidence for a link between antiperspirant use and breast cancer.

Looking at Wikipedia, though, it's not just cancer you have to be worried about if too much aluminium gets into your system. It's a neurotoxin, high levels of aluminium are present in the brains of many Alzheimer's patients - and one study linked the long-term use of antiperspirants containing aluminium with the accumulation of levels of alumium that may increase the risk of Alzheimer's disease. The good news, however, is that a causal relationship between aluminium and Alzheimer's has not been found.

Finally, the only concrete evidence for these antperspirants adversely affecting your health: renal dysfunction. No, aluminium doesn't cause it, but people with renal dysfunction are advised to consult their doctor before using deodorants which contain aluminium. Damaged kidneys cannot clear aluminium from your body as effectively, and thus patients with kidney failure may be at increased risk of building up potentially dangerous levels of aluminium in their systems.

Of course, the fact that no proof has yet been found doesn't mean that no proof will be found for a link between aluminium anti-perspirants and cancer or Alzheimers. But for the time being, they are officially considered safe.

A Weighty Matter

Traditionally there are two things you're not supposed to ask a woman: her age and her weight. This fact has led me to conclude that the staff at my local hospital are ill-mannered oiks, because every time I visit they demand to know my date of birth and promptly stick me on some giant hospital scales (I once had a go in a hospital weighing chair. It's just like a normal chair… except that when you sit in it, it weighs you. Surprise!). I am led to understand that they do this to everyone at the pituitary clinic, presumably because so many pituitary problems can affect your weight. Cushing's disease can lead to significant weight gain; acromegaly can as well, and thyroid hormone disturbances can have disturbing consequences for the waistline.

Before beginning treatment with lanreotide last January, I had presumably been hyperthyroid (ie. had too much thyroid hormone) for at least a year, given my symptoms. Hyperthyroidism is "supposed" to lead to weight loss, by affecting the metabolism; hypothyroidism (having too little thyroid hormone) leads to weight gain. In my case, though, this didn't hold true; I'd been hyperthyroid for a long time without weight loss, and in fact it was when treatment began to reduce my thyroid hormone levels that I started to lose weight, because I found that it reduced my appetite from "extremely peckish" to "normal person". It had never occurred to me previously that my appetite was unusually high* - but as it turns out, the hyperthyroidism caused by my pituitary adenoma was giving me an appetite which more than matched my raised metabolism. When I did begin to lose weight, the lanreotide injections may also have nudged things along, because they effectively turn off your gall bladder for a few days after each injection - the gall bladder stores bile, which aids in the digestion of dietary fats, so the lanreotide leaves the body less able to digest fats for a few days each month. Effectively it's an imbalance of the humors.

But anyway, the short story is that I've lost just about a stone over the last year, pretty slowly but steadily. A stone might not sound much compared to the stories of vast weightloss that WeightWatchers et al may peddle you, but it's over 10% of my bodyweight. That's quite a bit.

The pros of losing weight:
1. Being thinner!
2. More piggyback rides may be demanded from boyfriend
3. Getting to buy a bunch of new clothes

The cons of losing weight:
1. Having to spend a load of money on a bunch of new clothes
2. It worries my mother
3. Newfound paranoia about getting really chubby

Previously, I had never really worried about putting on gallons of weight,** but unfortunately the whole experience has underlined for me the fact that, if I can suddenly lose so much weight without trying, I could just as easily gain it, should my hormones decide they want to screw me over in a whole new way. That is a scary thought. Everyone always tells you that as long as you eat right and exercise you've nothing to worry about, and the cruel common wisdom is that everyone who's fat brought it upon themselves - but the fact is that's not always true; as I mentioned earlier, the symptoms of pituitary tumours often involve weight gain. People with Cushing's disease can eat incredibly strict rations and still put on a lot of weight; over the last year, I've experienced for myself how much even relatively small changes in thyroid hormone levels affect appetite, as well as weight and metabolism. Even right at the beginning of my lanreotide treatment, when my thyroid levels had only dropped slightly, my appetite suddenly crashed back to earth, and throughout the year it has noticeably fluctuated from month to month.

I'm really lucky that my weight change has, so far (and fingers crossed) been in an ok direction, but I can't help but worry that, should I need more treatment in the future, that might change; surgery and radiotherapy both have the potential to knock out my body's ability to produce various pituitary hormones and leave me hypothyroid rather than hyperthyroid

I now have a nightmare where I have to use the extra-large doors they have installed in the hospital for obesity clinic patients. I'm hoping that will only happen if 80's style shoulder-pads come back into vogue.

God forbid.

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*Well ok, it had, but I thought I was just extremely greedy.

**Well ok, I had, but only after watching the BBC's classic (and unspeakably horrific) programme Super Size Ambulance.

IMFW: Arms for A Leper?

Leprosy. As no doubt you already know, it's primarily a granulomatous disease of the peripheral nerves and mucosa of the upper respiratory tract...

Ok, no. There are two things everyone knows about leprosy:

1. It's highly contagious.

2. Your bits fall off.

Interestingly, as it turns out, neither of these facts are actually true. Whilst it used to be thought that it was highly contagious, and sufferers were banished to live out the rest of their days in leper colonies, around 95% of people are naturally immune to the disease - it's possible that in the earlier days of medicine, it was sometimes confused with syphilis, hence the fear of infectiousness. Oddly enough, you can, however, catch it from armadillos.

Leprosy doesn't cause people to lose limbs or digits, but it does affect the nerve endings and impairs peoples' ability to feel pain. This means that people with leprosy tend to injure themselves easily, not realise, and then the wounds become infected, resulting in tissue loss. Fingers and toes can also become shortened due to loss of cartilage in joints.

To this day, despite high natural immunity and the availability of effective treatments, many sufferers around the world are forced to live in leper colonies even after they've been cured, because of the fear and misconceptions surrounding the disease.