Another health update – confusion!

Earlier this year I blogged about the dreaded hypertension and eyesight issues.  Right now it all feels a bit confusing, possibly mixed with a little denial(?).  So this little update is about the ‘ins and outs’ as I understand them, together with plenty of gaps.  If you happen to know about these things, please enlighten me a little.

The mysterious Serum creatinine levels

When I was in the process of getting my blood pressure under control, my Doctor told me that he was puzzled as to why I had hypertension.  After all I was doing everything right – good weight, exercise, tee total, haven’t smoked for decades, caffeine free and a vegetarian.  He ran a series of blood tests and found my serum creatinine levels were high.  The test was repeated to ensure it wasn’t an error from the lab and sure enough the readings were correct.

I have since had the tests done again along with my urea levels.  Fortunately for me, I have had a regular check up over the years and so the trend can be seen and you can spot where things went a little wayward:

Date – Creatinine mol/L – Urea mol/L

2004 – 75 – 3.1

2006 – 73 – 2.4

2010 – 79 – 2.3

2014 – 56 – x

2015 – 64 – x

2017 March – 163 and 154

2017 May 159

2017 – November – 200

My Doctor had said my pre-2017 readings were all good, showing my kidneys were working well as they should.  In fact my readings were towards the bottom of the range, even better.  He also said how being a vegetarian is beneficial on the kidneys as they don’t have to work so hard in dealing with the meat-based protein.  Those are the good bits.  He is puzzled at the rise this year asking me if something happened in my life?  Well, that’s hard to answer really.  My Dad died, I changed jobs and Brexit started; surely that can’t be linked?  What about stress?  Maybe but I’ve had this before.

So with the latest tests where my creatinine was 200, I only know the result as I phoned the Doctor’s surgery and was told the Doctor wants to see me as soon as possible.  That ‘as soon as possible’ will be 19 December according to the receptionist.  So much for ‘as soon as possible’ as that’s almost three weeks away.  I pressed the receptionist for any further comment from the Doctor.  She said the only note was the creatinine was abnormally high and the urea was high as expected.

I am none-the-wiser now.  Contrary to my previous liking for grabbing the last appointment of the day and enjoying a chatty consultation, the last time I did this he was running late and no time for chatting (grrrr).  He did say something about referring me to a specialist but I’m not sure about this (when, who, why etc).

By way of answering my questions, he suggested I “Google it” as there was so much on the web for patients nowadays.  Trouble is, I’m not sure I’m starting in the right place and this is where some denial might be creeping in.  This creatinine business points towards kidney disease (ugh) and then when I read some of the other symptoms I wonder if I should start to be worried or not.  The symptoms I experience daily are fatigue, tiredness and muscle cramps, possibly reduced urine.  Other symptoms I’m not getting at all are itchy skin or swollen feet and ankles.

So what’s going on??????

Blood pressure

Not much to report here, everything has settled down with the aid of the medication.  My typical readings are 120/80 which I understand is fine.  On rare occasions it might reach 130/90.  Other times, particularly within a few hours of returning from a run or a workout my blood pressure can go down to 100/70.  My pulse is normally about 60bpm.

Eyesight

After blogging about the dramatic improvement in my eyesight earlier this year, this has mostly held up alright.  Only recently have I noticed a deterioration but I’m not too worried about this as I know the medication is so effective and I can use this again.

All this raises bigger questions….

….such as the merits of giving up work in the foreseeable future.  Don’t know, just don’t know.  I like to work and it feels right.  Our financial plans are based around a few more years of work before I draw my pension and so on.  Or is it really worth slogging away in a stressful job in the longer term?

New infographic - metabolism

It has been a while since I have had an involvement in the development of an infographic and I was intrigued and pleased to contribute to the infographic you see below from those nice folk at Elysium Health in New York.  

The graphic was all about health tips.  Now anyone who knows me will expect me to come up with a lot and be able to happily talk about keeping in good shape for hours, so there was no shortage of health tips from my end.  

You can see below I have mentioned post-workout nutrition. This is important and something I take care to do myself.  Even after yesterday's hilly run (7.5 miles) I made sure I had a glass of cherry juice as I went to have a shower.  So there, I do practice what I preach!  I can't resist pointing out that having something nutritious after a workout, or a run, is helpful if it is rich in antioxidants which help mop-up free radicals which can go on to cause cellular damage later on.  

Speaking of cellular damage, the graphic helpfully explores some of the science behind the metabolism; an integral process within our cells.  Elysium even provides some of their own tips for maintaining good metabolic health.  Having knowledge on these things is powerful and it is always fascinating to learn more about how our bodies work.  This page on NAD+ and cell metabolism is a good place to start.

Take a look below, does it make sense, you see what they're driving at?  Check out the other contributors as well - already I have seen the blog of Michelle Maclean which looks interesting and I think I'll be visiting again.

If I were Prime Minister for a day

We had a funny conversation while driving along. It was if I were Prime Minister for a day - what would I do.  I thought it could be fun to mention here.  Here goes.

Sugar tax

Yep, I'd bring this in properly and not just for fizzy drinks.  I'd include all kinds of chocolate, sweets and the like.  While I'm at it, I'd have a good look at McDonalds, KFC and so on.  Why?  Because KFC = Keep Fat & Chubby.  Feeding such crap to your kids could be described as child abuse.

Alcohol

The Government has previously missed a trick with not introducing minimum alcohol pricing, although perhaps Scotland might have had the foresight to do this.  Considering the immense harm to people's physical and mental health through excessive alcohol, there is a strong case for this.  Add the misery caused by drunk people getting into fights, domestic abuse and general rowdiness, I think a significant hike in price is valid.  Although I am loathed to agree very much with David Cameron, I think he was right in wanting to create a cafe culture to replace a pub culture.

Tobacco

You can probably predict what I'm going to say here.  Double the tax on cigarettes now.

Transforming Rehabilitation

I would order the Ministry of Justice to undo all of the harm Chris Graying has done to the justice system and probably sack him by the time I have my morning coffee break.  I think also I'd look to change sentencing policy so the prison population can come down and invest the money saved in rehabilitation.

Whitehall

While I'm at it, I would transfer much of Whitehall out into the regions i.e. moving the power from central London closer to where it is needed.  So sorry Sir Humphrey, your days are numbered.

Freedom of speech, political correctness

It saddens me when I hear of street preachers getting into trouble for preaching.  This has to change.

The unborn children

Far too many babies are aborted for very dubious reasons.  There is a fine line between medical need and murder.  Apparently in 2015 there were 185,000 abortions in England and Wales.  Something has to be done about it.

Range Rovers and other high performance cars

Sorry folks, your days are also numbered unless you're willing to pay through the nose for your gas guzzlers and status symbols.  While you're doing this everyone will think you have more money than sense. I think I'd do this through VAT in purchasing the car in the first place and then the annual road tax.  If it costs £500 a year to keep a Range Rover taxed, well I'd make it £5,000.  As for cars with blacked out windows, you have it coming as well.

Private education

As someone who has put his own children through a private school, you might be surprised to know I would charge VAT on the fees but introduce it over a period of years.

Cycling

It will come as little surprise that I'd spend more money on making life easier for the cyclist who, in the UK, puts up with a lot.  Dreadful roads, poor junction layouts, potholes, few cycle lanes and the list goes on.

Health issues continue

Well this raised blood pressure lark isn't really going to plan and I'm a bit perplexed, so these health issues continue somewhat.

In spite of taking one of the tablets each day, as per prescription, I have not noticed any difference at all and it has been over a week now - my blood pressure is STILL around 150/100.

What's more, I have been having a dose each day of BeetActive which I acquired as a free sample at the London Bike Show.  Having become a real genuine fan of the company's CheeryActive drink I guess I was naturally assuming the BeetActive would do the trick in a similar way.  It hasn't as yet, or perhaps I'm not being as disciplined about it as I should be.

You see I take the medication at night and then have a glass of BeetActive in the morning, just after I have taken my blood pressure reading.  I think there's a chance I'm not giving it much of a chance because:

• some "treatments" take time to take effect and are more accumulative over a period of time.  We're not talking about simple headache pills here - I only take a paracetamol once a year, if that, and then I'm completely better in 20 minutes.  Seems different now.
• the effect might only be short-lived.  If I have a glass of BeetActive, it could well reduce my blood pressure for a while but not for a steady 24/7 period

For once I'm actually looking forward to returning to the Doctor.  Not just because I might be lucky and have another easy-going conversation about juicing but because I seriously want to get this solved.  As a reminder there are no real drivers for my blood pressure to be on the high side - vegetarian, enough exercise, good weight, teetotal, smoke free, caffeine free and so on.   There are a couple of possible drivers which haven't really been considered much by either me or my Doctor:

• salt intake.  Although I hardly ever add any salt to a meal, salt can lead to raised blood pressure and there does seem to be quite a bit of salt in the foods I enjoy.  These include peanut butter and bread.
• me.  I do wonder if I'm a bit highly strung and simply winding up by blood pressure because that's who I am.  By that I mean I'm a bit of a Type A personality and rather critical of myself

I did find this article on BeetActive as a way of lowering blood pressure.  It's no panacea but according to the article it does have a part to play.  Otherwise beetroots are certainly a healthy addition to the diet which I do like in any event.

As for the BeetActive itself, I'm sorry I don't care for th e taste too much, perhaps a personal thing.  I wouldn't drink it out of choice and therefore I tend to mix up a glass and drink it all in one go and as quickly as I can.

Health issues 2

Health issues 2.

I hadn't even sat down in the Doctor's waiting room before I got called in.  It was a different Doctor this time who was tall, lean, possibly foreign and seemed to have a gentle manner about him.  This, I thought, was looking promising.

"How can I help you today?"

"Your colleague has asked for some blood tests as I appear to have high blood pressure"

"Ah yes I see [reading the computer screen] they are indeed high.  And I see this might be having an impact on your kidney function.  There's no need to worry, we can get this sorted out and it's good you've come to us in plenty of time about this, some men ignore any symptoms until things are serious".

A conversation took place about my lifestyle.  Keeping fit, teetotal, vegetarian, smoke free, good weight and so on.  My cholesterol was a really good score apparently along with a number of other measurements.  He went onto say my cholesterol reading would be the envy of many of his colleagues.  He was perplexed: "I don't really understand why your blood pressure is raised as you appear to be doing everything right.  Nevertheless we have to deal with it and I'll prescribed some tablets to make your blood vessels a little softer and more flexible to allow the pressure to come down".

"Thank you" I said "that's fine but I wish there was a way of dealing with this issue without taking tablets".

"Sorry, what do you mean?"

"I've made it this far without having to be treated for anything and I'd like to continue this way if I can.  If only it was as simple as having an extra apple each day". I mentioned my eyesight problems which he was understanding about.

Then a lengthy conversation took place which I was, in hindsight, amazed at.  The Doctor started talking about the benefits of being vegetarian as apparently it is kinder on our kidneys and other things.  He went onto say beetroot can help with blood pressure, in particular beetroot juice.

"Actually if you're interested, you can get some pretty good juicers these days and I've bought one myself!"

The Doctor then explained the different between different machines.  Some are brilliant and extremely efficient at extracting the juice from vegetables and fruit.  Others are less good and extracting the juice but are a lot easier to clean and are cheaper - this is the type he bought recently - a Bosch model.

The conversation was concluded by:

• start taking the tablets. One a day, 5mg.  Avoid grapefruit.
• go and look into juicing, especially beetroot.
• carry on running, cycling, doing weights in the gym.
• keep my heart rate to about 150bpm when doing cardio.  Any further blasts to be done sparingly and limited in time as he doesn't want me to have a stroke.
• see me again in a month.

I thought that was a pretty amazingly consultation with my Doctor.  Must have been a maximum of 5 minutes going through the results and deciding what medication to prescribe (standard stuff I guess).  This was followed by at least 10 minutes talking about the benefits of juicing, being a vegetarian and being a runner.

This Doctor was cool and I like him!

Health issues

MK Marathon, PB well under 4 hours

A couple of health issues have cropped up recently and these have got me a bit concerned.  This post will probably be a bit personal.

Yesterday I went over to my favourite health food shop as it was about time we stocked up on some more nuts and seeds.  I always spend more than I plan (£77 this time) but Rachel never minds at all.  As normal I got chatting to Neil, the shop's proprietor and a  really nice chap.  He shocked me by saying he'd had a heart attack in January.

Neil's a little younger than me.  It seems bizarre that someone of that age should have a heart attack - and he runs a vegetarian whole food shop! The story goes that he went for a bike ride on a really cold day and returned with a bit of a tight chest, which he explained to himself as the effect of the cold air.  A few days later he was taking his dog for a walk and again had this tight chest feeling which he thought might have been indigestion and when he got home promptly took a couple of Rennie tablets.

The pain wasn't improving and he started to think the worse.  He called his wife who simply told him to call an ambulance.  Within a few minutes the paramedics arrived, diagnosed a heart attack and he was then rushed into hospital.  A while later he found himself in the operating theatre having a stent installed.

Thankfully he's on the mend, starting to increase his activity levels.  It also sounds like he's having good care from his local Doctor and hospital staff.  Here's sending you all good wishes Neil!

And myself...

You might remember me saying my blood pressure was on the high side.  The Doctor was concerned about this and has ordered some blood tests as it is now two years since my last annual check-up.  Last Wednesday I attended the surgery to have the blood samples taken and hand in my urine sample.  All these tests were following a 12 hour fast.

When the nurse took the blood samples, she said it would take 10 days for the results to come through.  So I was then very surprised when on Friday (just 48 hours later) the surgery got in touch with me and said I urgently needed to arrange to give some further samples as there were some abnormal readings.

It is always difficult trying to have much of a conversation with a receptionist, for perfectly understandable reasons.  Notwithstanding this she did say one of the tests would be for creatine (or something like that) where the normal range was a reading of 60-110.  Mine was abnormally high at 160.  I asked what this was to do with and she simply said "it's renal stuff" which I take as kidneys.  From what I previously understood, kidney damage can be caused by high blood pressure, so maybe that's what's going on. (If you're reading this and can explain more about what this means, please do so!)

Also on Friday I was in a training event-come-conference in London.  I was sitting in a room with about 150 other people and I could feel a headache coming on, quite quickly.  Then my left arm felt a little different, perhaps a bit numb, or weak.  While I was figuring out what to do it returned to normal and then my head cleared 15 minutes later.  I remembered the coffee I'd be given on arrival was probably with caffeine and so I wondered if there was a connection.

Later on I wondered if I'd had an early warning of a stroke.  I don't know and I'm almost afraid to google this.  Nevertheless I'm having my repeat blood tests again tomorrow, so I'll ask the nurse.

I woke early this morning, feeling worried about my health.  All kinds of things were rushing through my thoughts.  Was I looking at some terrible incidence like a stroke or a heart attack?  Why could that happen, I'm still in pretty good shape?  But it happened to Neil and he's younger than me!  Thank the Lord I have critical illness insurance, is it enough?  But I have been meaning to update my will; heck is there time?  I can't possible have something happen or even die, what about my family?  There's just so much I want to do, places to travel to, things to achieve, books to read, paintings to paint, photographs to take, people to meet, conversations to have and the list goes on and on.  I'm hoping to retire in five years so I can do all of these things!

And then I thought of my eyesight.  Completely independently of all this I had my annual check up with my optician who is pretty thorough.  To cut a long story short, he's referring me to Moorfields eye hospital as my central serous retinopathy is a lot worse that it was last year (which I could have told him!).  My appointment is in May.

In the cold light of day things are more easily seen in perspective.  My faith is of course reassuring but I'm not ready to go anytime soon.  And yes I know I worry about these things.  I know I worry about work related things more than I should.  I know I'm my worst critic and probably a Type A personality.  I'm thankful these things have, perhaps, been spotted and so there's time and steps to be taken to solve these issues, whatever they are.

I see this as a heck of a nudge to get me back to tip top health.  While I'm still pretty fit (I ran 10k a few days ago in under 50 minutes) I know I could be in better shape and a little lighter; my strict only-good-food diet has slipped over the last 18 months and it's now time to resume that.

Strokes in middle age

At forty three years old Simon Hall was not exactly a candidate for having a stroke.  Far from it as he was a non-smoker, sensible weight, he took regular exercise as a kayaker and enjoyed good all-round health.  And yet this all changed one ordinary morning in 2013 when, completely unexpectedly and without any warning, he had a stroke.   Happily Simon Hall has recovered and it appears has been helped through regular kayaking.

“It was an ordinary day when I was getting ready for work and I simply dropped my socks on the floor.  My arm started flapping around uncontrollably and I had no idea what was happening” explained Simon.  

He quickly found himself in hospital.  Although he was initially sent home as they’d believed he’s simply had a “minor” stroke, he was rushed back a couple of hours later as it was clear the stroke was far from being minor.  

“The NHS treatment then was brilliant.  They invested a great deal in trying to find out why the stroke had happened but concluded it was ‘cryptic’ which means there is no obvious reason.  They did all sorts of tests on me to try and find out why I’d had a stroke.  This included looking at my heart to see if there was anything abnormal like a wide opening in the heart or an area where the blood is pooling but nothing was found; there was no reason why I’d had a stroke".

"Having a stroke was incredibly debilitating for me, I had almost three months off work.  The immediate impact on me was chronic tiredness and fatigue.  The Doctor I saw at the hospital recommended I sat at home, rested and pottered around”.    This is exactly what Simon did but soon became restless.

"After being in the house for a week or so, I leapt at the opportunity to go shopping with my wife Elizabeth to nearby Milton Keynes.  When we got there we went to a cafe which was only 50 years away, I couldn’t even make it that far and had to go back to the car for a sleep.  This is because my brain was working so hard to repair itself, that is why I was so exhausted. People tend to look at the physical effects but it is actually a brain injury and it takes a long time to heal".

"Then there was a period of recovery and it was the canoeing which I missed so desperately.  Even when I was in hospital I remember thinking how I’d miss canoeing for my own sanity and sense of well-being.  I became despondent after a couple of months, I was wondering if I’d ever be able to go canoeing again".  

The Doctors couldn't tell Simon how precisely his recovery would go as the impact of every stroke is different.  After three months there was enough improvement to allow Simon to return to work on a part time basis.  The turning point was when his own GP recommended he continued kayaking having recognised the benefits (other health professionals had suggested exchanging his canoe for a set of golf clubs).  Something like kayaking his a non-contact sport and therefore relatively safe for someone in Simon’s position.

Simon was greatly encouraged by one of the other club members to pick up kayaking again in a K2.  This was a helpful way of easing back into the sport and it was reassuring to know someone was always close at hand for Simon.  Gradually Simon regained some of his strength and fitness.   He believes the regular pattern of paddling as been helpful in his recovery, having to co-ordinate the left-right-left-right rhythm.  

Now it is three years on from his stroke.  Simon describes his recovery as being almost complete.  He says the grip in his left hand is not being quite as strong but otherwise he’s regained his strength, fitness and confidence.   Although very modest and unassuming, Simon is clear that he owes so much to kayaking.  His stroke could not have been predicted; he was fit, healthy and ordinarily far too young for a stroke.   Simon believes it was his underlying all round level of fitness that helped him recover and, most importantly, provide a focus for his rehabilitation.  

Drastically improved eyesight

If you're a regular here you might have clocked I have an eyesight problem - central serous retinopathy.  The fantastic and remarkable thing is, it has now drastically improved.

You see, the problem is mostly in my left eye, where a tiny leak occurred and the back of my eye, causing the retina to budge forward and this in turn causes distorted vision near the middle of my retina.   You can see in the above photo there is a darkish area in the middle and a few white-ish spots.  As if this was't bad enough, because the retina has been starved of nutrients (explained my Doctor, a dullness had set in for a few years.  This was like viewing the world through the lens of a grey pair of sunglasses.

The Doctor said this was not reversible and yet I now think there is little colour vision difference between the two eyes!  I think this is remarkable, having put up with everything looking greyish and with muted colours for several years, everything now seems so much brighter and more colourful.

I noticed this yesterday when I was driving back across the Cotswold Hills on a bright sunny day.  I found myself enjoying the lovely colours and September sun across the stunning landscape.  I also remember thinking "these colours will look pretty dull through my left eye".  So my astonishment was an almost complete colour restoration.  That you God.

The details I see, however, is still well short of my "good eye".  The distortion comes and goes but it is always noticeable.  An example of this is when I look at the toolbar of my computer screen, it is wavy and certainly not straight.

This is all very wonderful and I'm not quite sure why this has happened.  Most likely it is my excellent diet and through being a regular runner!

Related:
Posts about eyesight

Catching up with myself: health checks

Yet again time flies and blogging gets left behind.  So here's a quiet Sunday morning and my favourite time in the week.  My family are slumbering upstairs, I'm sitting at the dining room table having emptied the dishwasher from its overnight run, laid out everything we need for breakfast, brewed some (decaf) coffee and sitting down with my Mac.  Here goes.

Health checks

Left eye, July 2015

Right eye, July 2015

As you know I always like to make sure my body is in tip top condition.  I ensure I have an annual check at the Doctor's surgery covering blood pressure, cholesterol, liver function, kidney function, PSA levels and so on.  That's always okay.  At the dentist I quite often get caught with a little decay or something needing attention on an x-ray.  And then I go to the optician as well.

It is always interesting at the opticians as I can tell my eyes are deteriorating in terms of becoming longer sighted.  I still hate the time when I was told, in my mid forties "well you're middle-aged now, most people become long sited and need glasses.  You're no different".  So I have glasses for reading and using a computer - for that reason my employer kindly allows me to claim £15 for an annual test and £40 towards the cost of glasses.

This check up revealed I needed slightly stronger lenses owing to continuing to become more long sighted.  "This is all fairly routine" explains the optician every year.  She went onto explain that if I follow the normal pattern my long-sited vision will level out soon and not change too much of the rest of my life.  That sounds good as I do need my glasses more and more for anything under one metre and also to expect things to be in focus.

There are always two things which provide interest to the conversation.  Firstly she says "what lovely blood vessels you have at the back of your eyes Doug".  No sign of diabetes or anything like that.  You had better keep up your veggie diet and keep running.

Secondly she's always interested in the dark patch in my left eye.  Actually it is more textured in real life than the photo shows.  This is a Central Serous Retinopathy and this is a tiny leak causing the retina to bulge and this leads to distorted vision.  It has been there for many years and comes and goes a little.  It also features a little in my right eye, although considerably less.  Apparently there are further signs of this happening away from the centre of my vision but I'm less aware of this.  The long term effect of this is to deprive the retina with certain nutrients and my vision has become dull and the world appears as if viewed from a bit of grey, uneven glass.

On a positive note, my brain adapts and this is an example of our wonderfully designed bodies.  I tend to see more from my right eye, so I hope this eye doesn't deteriorate any further.

You might wonder what causes this.  Well, Central Serous Retinopathy is still a bit of a mystery to the medical profession.  It does appear to affect men more than women and the age group is generally 30 - 50 years.  Men who suffer from a Central Serous Retinopathy are often high achievers, high flyers.  Additionally they expect a lot of themselves and put themselves under a lot of pressure.  In other words these are Type A personality traits.  Now I am NOT a high flyer but I do expect a lot of myself.  I am, perhaps, my hardest critic and often known to give myself a hard time over some things.

As a release from this, I find so much solace in my faith (I'm a Christian) and of course running has a brilliant effect on me.  Although I became a runner about eight years ago and at a time of considerable stress, I do find this helps me deal with the challenges of life, especially my work.  Having faith and becoming a runner doesn't solve everything but they are brilliant ways of accepting situations and thinking them through.  I digress.

Back to health checks.  These are so important and I'm pleased those public health folk take it seriously and the Government fund it.  It always amazes me how some people spend far more time and money on maintaining their cars than their own bodies.  Cars are expensive things, sure.  Cars are also very transitory objects and unimportant in the great scheme of things - having a nice car won't allow you to live a minute longer or be a better person.  Taking the time and trouble to have regular health checks at the doctor, dentist and optician is a great way of spotting any problems as they emerge and as we should all know, early diagnosis is very important.  Also important are steps which can prevent illnesses in the first place.

So there you are.  Make sure you get a check-up once a year, especially if you are anywhere near the dreaded "middle age".

Related
Type A personality tag
Staying active in old age

Cycling, running and cramp

If you ever listen to the excellent Radio 4 programme Inside Health, presented by Dr Mark Porter MBE, you might know he sometimes invites listeners to get in touch with health queries.  Here's mine.....

Dear Dr Mark,

From time to time I get bouts of cramp, mainly in my legs and feet.  When I get cramp it is often at night and a muscle seems to go into a kind of stiff spasm and be very taught.  I can tell you, it can be dramatic waking up at night with an agonising pain in either my left or right leg.  It scares the living daylights out of my wife who will often wake up as well, very startled at me leaping and hopping around the bedroom.  

It seems to generally affect one muscle at a time, either in the upper or lower part of my leg.  It's the same with my feet but that's not quite so painful as I guess the muscles are smaller.

While I get cramp mostly at night, it sometimes happens when I cycle and believe me, this is a little disconcerting when you have both feet clipped into the pedals.  Like many other cyclists, I use a clipless pedal where your cycling shoes are locked to the pedal.  Releasing your feet is done by twisting the heel outwards and then the shoe springs out.

Me, my health

I am in my mid fifties and have no health issues.  I'm pretty active and fit with running (I average over 20 miles each week) and cycling.  My BMI is 22.5 and I'm in pretty good shape.  I'm tee total, don't smoke and I'm a vegetarian.  I reckon my diet is pretty good generally; I especially eat lots of fruit (as many different kinds as I can over the course of a week).

My own Doctor

Every year I make sure I get a health check covering the usual things such as blood pressure, cholesterol, liver and kidney function etc.  These are all fine and my Doctor says "well done, keep it up".

I did mention the issue of cramp to my Doctor.  She said that she wasn't very knowledgeable about it and flicked through my notes and said there was no obvious reason.  She felt behind my knees and then held my feet in her hands and commented they were colder than she expected, although it was a chilly day.  Other than that there was nothing to say or do apart from "I could suggest you give up running any cycling but I doubt if you'd think that was a good idea!".

Electrolytes

Some people suggest sports drinks to be a solution and yet there are many different types around.  I have tried taking some electrolyte drinks which might help but I cannot be sure, there's no regular pattern.

Any suggestions?  

Goes without saying I'm hoping you can cover this on Inside Health, I'm happy to be interviewed or provide some further information if that would be helpful.

Links:
Radio 4 Inside Health
Electrolyte drinks - do we need them?

Life without caffeine

It is now about five weeks since I decided to try life without caffeine and its been an interesting experience.  At first I was a little apprehensive and wondered how I would get on.  To be completely honest, in the first few days it was noticeable something was missing but happily things have settled down now.

I remember feeling a little different, a kind of light headiness perhaps.  I also thought my sense of balance had been affected.  Also I remember really missing a nice cuppa at different times in the day when ordinarily I would enjoy a cup of tea or a coffee.  With this in mind Rachel suggested decaf and went rummaging in the kitchen before finding a box of seldom used decaf teabags.  I tried a cup and it wasn’t bad but of course it wasn’t quite the same as the tea I was used to.  I have progressed on to having some decaf coffee too.  Mind you, I still can’t stand the thought of ‘instant’ coffee.

The strange thing about life without caffeine nowadays is people’s surprise when I decline a drink unless it’s decaf. This has occurred mostly at work as a few of us have a good system going on to ensure we’re all supplied with regular cups of tea or coffee.  There have, however, been a few times when I’ve not had decaf and the results have been interesting; this is right from the diuretic effect happening with a made dash to the toilet through to absolutely no effect at all.

I do miss a decent cup of tea or coffee but there are no real worries.  I miss how I used to enjoy it and think I can gradually have some more soon.  What either concerns, or amuses me, is thinking of how many years ago I gave up smoking and drinking.  Several years ago I gave up eating meat by becoming a vegetarian and knocking caffeine out seems a radical step, possibly a step too far to be completely caffeine free?

Caffeine withdrawal

Caffeine withdrawal and how it started…..

Eager beaver readers will know I like to have a check-up at the Doctors once a year.  This appears to be one of the benefits of being in my age group as potentially serious health conditions can be picked up early and dealt with while there is time to benefit from early treatment. I dutifully took in my ‘specimen’ when I arrived for my 12 hour fasting blood test which includes:

• Blood count (which I imagine to be haemoglobin / anaemia)
• Glucose levels
• Cholesterol
• Liver function
• Kidney function
• PSA (checking for prostate cancer)
• and three others which I can’t quite remember

When I went to see the Doctor for the results she said “well done, they’re all fine” followed by “is there anything else?”.  I then explained I had occasionally found bladder control more difficult these days.

“Well” she explained “you can expect this kind of thing, it is a common middle age problem for men and women.  At least we can rule out prostate cancer or anything like that”.

Naturally that was good to hear, so the next part of the conversation was being asked a few more details and then being offered a prescription.

“But I like to avoid medication” and I pointed out I’ve really only had the occasional antibiotic every few years for some kind of infection I might have picked up.  I went onto explain that I’d prefer to avoid medication if I possibly can for as long as possible as I think of it as being a slippery slope.  This was dismissed as being silly.  “Take it or leave it” the Doctor said in a slightly stern way.

“Is there any other solution?”

“No not really, besides the side effects aren’t bad with this and we can always switch you to something else”

“How long will I have to take them for?”

“For the rest of your life but don’t worry, once we know they suit you I’ll prescribe a larger supply for you, so they won’t be too expensive”.

This was all sounding awful and the conversation was not going the way I wanted it to go! “Is there really no other solution?” I asked again.

She went onto say there wasn’t, although she did say “lifestyle” to which I stopped her and asked what she meant.  I was concerned as she had just congratulated me on my excellent blood test results.  The word caffeine got mentioned and explored no further, not wanting to ask me how many cups of tea or coffee I get through in a day.

I had the prescription made up and started taking my two tablets a day.  The first night I had a terrible dream and in the morning I was wracking my brains trying to remember if the Doctor had said anything about dreams being in the side effects.  I couldn’t remember anything but when I read the Patient Information leaflet it mentioned nightmares, along with a whole load of other possible side effects.

Over the next few days I grew increasingly uncomfortable with taking these tablets, even with them being low dose.  I decided to quit tea and coffee to see if that made a difference.  Well I can tell you I certainly missed a regular cuppa at various times of the day and for the first 24 hours I was feeling slightly light-headed and yearning for a nice coffee.  I knew I was withdrawing.

Now a week later I’m not taking the tablets, avoiding all caffeine and doing fine. I have solved the problem.  Yippee, so to speak.

Follow up appointment with the Doctor 

Now at this point I am due to make a follow up appointment with my Doctor.  She will be expecting me to say that I have been fine with the tablets and take up the offer of a longer term prescription which will be repeated of the rest of my days.  After all, I haven’t been back sooner to complain of horrible side effects.

Instead I’m going to report that I have solved the problem through avoiding caffeine but this now gives me a dilemma.  I really do like a nice cup of tea, or a cup of ground filter coffee of some description.  Should I abstain completely from tea or coffee?  Switch to de-caff?  Isn’t tea and coffee de-caffed through some horrible chemical process?  Have the occasional coffee, to be polite etc?

Decisions, decisions……

Taking care of my knees

Back in April one of my blog readers asked about taking care of knees.  This was from the perspective of many runners having injuries with knees.

Naturally it isn't just runners who occasionally have knee problems; injuries can be common in many sports as well as the general population.  Knees are complicated joints and have to be strong in taking a lot of punishment over the years.  I also come across many people who often say they would love to become a runner but their knees aren't up to the job.

With this in mind, here are my top tips for taking care of knees:

Correct shoes
I have blogged many times before about the need to have the correct running shoe.  This does not mean simply paying a lot of money for the latest in fashionable trainers.  No.  It means getting shoes which are the correct size and are suitable in terms of whether you over or under pronate as you run.

To achieve this I recommend ALL runners starting out have a proper gait analysis done at a running shop.  This is either done on a treadmill and you're filmed in slow motion to see how your feet land and roll forward, or you simply run around the shop and you're observed by an expert eye.

Getting the right shoes not only benefits your feet but your whole position as you run, this includes how your knees perform.

Correct saddle height
This applies if you're a cyclist.  Many cyclists ride with the saddle too low, especially on these horrid Bike Shaped Objects which people buy from supermarkets for £99.  These heaps of junk do more harm than good.

By making sure your saddle is at the correct height in stretching your leg nicely - but not completely - when you turn those pedals will make your ride more efficient, comfortable and less likely to cause injuries.

When you're exercising

I mentioned above that knees are complicated joints, therefore it's important to take note of any discomfort or pain when you are exercising or training.  This is especially relevant to all runners, as the constant pounding our knees and ankles take can be considerable.  Also this applies equally to people who have had replacement knees as well as those who haven't.

I have heard some runners say they run through the pain.  That's all very well but when joints, such as knees, become painful it is because something is wrong and it is important not to make things worse. There's simply no point in being "tough" and regretting it later on.  Beware of any twists or strains, which can happen with sudden changes in direction, or trips and falls.  If you notice any kind of restricted movement or instability, a pain that won't go away etc. it could be time to visit your Doctor.

Take the stairs
In my office we have stairs and a lift serving all three floors.  I always take the stairs to get a little exercise whenever I need to move around the building.  Sometimes I simply walk up one stair at a time, usually I go two steps at a time.

Last week I had a large box delivered which was too heavy to carry and I used the office trolley to collect it from reception.  I popped it into the lift, pressed the 2nd floor button and raced the lift.  Beating the lift is actually easy as it's not fast at all.  When I got to the 2nd floor some of my colleagues were there waiting for the lift and were amazed, puzzled and completely unsure of why I had raced the lift.  But then, you take a look at them and you can see what I mean (use your imagination here....).

Gaining down the stairs I always take care not to "jar" my knees by landing all my weight onto a completely straight and rigid leg.  The foot and knee is designed to absorb such shocks and it's important we allow that to happen.  This also applies when running and I take care to land softly when coming down hill (by the way, including a few hills is brilliant running for me - love them!).

Keeping your weight right
Many people with knee problems are overweight.  I believe for many people who are a little overweight, problems with knees and ankles can become a vicious circle and this is where expert help is required.  After all there's no point in soldiering on trying to lose weight while causing further injuries in the process.  A Doctor or Sports Physiotherapist will be able to advise.  For some non-weight bearing exercise might be appropriate to strengthen knee joints i.e. swimming, cycling and other non-weight bearing exercises.

Running form
This connects to having the right shoes.  When I run, I often try to be aware of my "form"; this is how my body is working and how my legs, feet, knees, hips, arms etc are all working together to run well. Getting this right is a wonderful thing and for most runners it takes some doing.

Sometimes when I run, there's a certain magic when everything comes together to make a particular run so perfect.  Many other runners describe the same and I recommend any runner takes time to concentrate on achieving this.  Once you've got it, you know your body has worked well and it feels good.  When you run, you become aware of all of the many parts of your body working well with each other and your own control is as close to perfection as you can possibly achieve.

Eating the right foods
A sensible diet brings many benefits as we all know these days.  Going a little further there are some foods which will protect against diseases such as rheumatoid arthritis, which is relevant here.  Foods such as beetroot, various berries, curly kale, mango, nuts and sunflower seeds or oil are all beneficial.

Related:
How to look after your feet

Recovery run

A Recovery Run is a good step to take after a major run, such as a marathon and one which I had been longing for all week.

The purpose of a Recovery Run, put simply, is to stop a runner from seizing up.  It is helpful in keeping joints moving and as a reminder about still being a runner.  It is also part of a healing process, should this be necessary.

There's no set formula as to what the length should be, or the intensity or speed but generally it is best for them to be gentle, easy going and comfortable.  A Recovery Run is not the place for seeking a high pace.  If anything starts to hurt (i.e. joints, muscles etc) it is better not to run at all, or at least make it a gentle jog.  The last thing you want to do is aggravate anything and delay the healing process.

And then there is the mental health side of a Recover Run, which should not be underestimated.  This is relevant where a runner has put everything into training and the race itself was emotional; this can happen.  Some runners may feel a sense of real achievement, others might be disappointed and therefore this needs to be processed and dealt with.  Therefore the Recovery Run can be helpful in putting everything in perspective.

Yesterday I had a Recover Run, following the MK Marathon a few days ago and I had been seriously looking forward to the run; here's the features:

• Distance: I did exactly 7.5 miles over my favourite hilly route.  I decided to do it in reverse as I was not wanting to chase any time over any Strava segments or anything like that.

• I was running for enjoyment, not for event training or improving my fitness.  I had nothing to prove, it was simply for the joy of running.  Arguably there is no better reason to run.

• The conditions were perfect; temperature, scenery and my mood.  Just right.

• There were a few spots of rain in the first mile.  My first reaction was wishing I was wearing an extra layer, possibly a light rain jacket.  Then I figured I'd simply enjoy it (at that point the rain stopped!).

• I could feel a little ache or two in my legs but there wasn't much to it.  Just as well I wasn't pushing myself.

• I ran up the shortest and steepest hill I know around here with comparative ease (at 1:4 it will never be easy)

• I was feeling thankful I could do this run.  Thankful because I pulled myself away from being an overweight couch potato and lazy slob all those years ago, even thankful for all the stress and worry which drove me to it in the first place. Thankful because I have been given a good pair of legs, lungs and heart to allow me to do this.  

MK Marathon countdown

This time tomorrow I will be nervously having my breakfast before setting off to Milton Keynes for the marathon.  This is the third time I will have completed this race and, as I have such good memories, I am really looking forward to it.

In getting the negatives out of the way, I am still being dogged by an annoying injury which probably ranks amongst the most avoidable injuries a runner could get.  I have a dose of shin-splints.  This is tenderness and some pain on the front of my shin bone (where various tendons join the bone).  I put this down to over-use.  The second injury (same leg) is one of the calf muscles is sore and has been for a few weeks.  Lately I have been having some short runs of only a few miles in order to remain supple but not to aggravate anything.

The solution to all of this is taking some Ibuprofen on the day and continued gently stretching, which does seem to be helping.  Having said that, I am prepared to pull out on the day if it's too painful and right now I'm thinking this could be a possibility, although this is something I have never done before.  Even if the race goes well, I dare say I will hobble around afterwards and it does seem to be affecting my hip after a run.  All this is another reminder of how fantastic our bodies are in terms of the complex design and how everything works together but we aren't made to carry on forever.

My checklist:

• Race number
• Safety pins x4
• Shorts (I have treated myself to some new Ron Hill shorts!)
• Shirt (haven't decided which to wear, depends on the weather forecast!)
• Socks (again I have treated myself to some new ones: X-Socks)
• iPhone, charged up
• Small ruck sack, with bag tag
• Running shoes
• Timing chip
• Sort out where to park
• Plasters on the ball of each foot (a blister spot after 20 miles)
• Trim toe nails
• Hydration starts today
• Don't eat too much this evening
• Something to wear before / after
• Some cash
• Read through the race guide

Remind myself

Yep I need to remind myself why I do this.  This is a bit of "self talk" now and something I encourage other people to do themselves.  

Running is a fantastic sport and something I can do alright.  I will never be a medal winner but my performance isn't too bad.

It helps me stay in good shape physically and keeps my weight nicely under control.  I weigh the same as I did two years ago, albeit a tad higher than I have been in recent years.  My BMI is 22.  I have also had the results back from some blood tests; I like to have a check-up once a year to cover the usual things such as cholesterol, glucose, liver and kidney function, PSA and so on.  Besides I am apparently of an age where this is more cost effective for the NHS to make sure I am in good shape as it's a prime time for diabetes, strokes and other heart issues to emerge as problems which could be dealt with.  Nine tests altogether.  Happily these are said to be "absolutely normal, the Doctor doesn't need to see you about anything".

I need to prove to myself I can still do this.  If it wasn't for being injured, I think I could match my previous time of a whisker under 4 hours as otherwise I feel pretty fit.

Also I need to do this for the satisfaction of doing it.  There are many challenges along the way in terms of training and the actual day itself.  I need to prove to myself I can do it, not to give up and make a good time if at all possible.

Can't wait.

Raspberry smoothie recipe

Raspberry smoothie

My Mother-in-Law is a bit of a hoarder at times and this applies to her stash of frozen raspberries, as well as 40 year old home made mead in her cellar.   So I'm thankful for a couple of things: firstly that she doesn't read my blog, secondly she's happy for me to work my way through her frozen raspberries.  They are now mainly of 2008 vintage, as the younger ones have now been consumed.

I do like raspberries, one of my favourite fruits and they do remind me of summer so much.   Below I will expand on their health properties along with the other fruit.  Firstly, here's my recipe for one of my favourite smoothies:

4oz Raspberries

1 Pomegranate

Quarter of a pink or red grapefruit

Apple juice and/or water for preferred consistency

Method

Couldn't be easier.  Wash or defrost the raspberries.  I normally check them over as raspberries are a soft and delicate fruit, so avoid any bruised or damaged fruit.  With the pomegranate, cut into quarters and spoon out the pink flesh, discarding the skin as best you can.  Pink or red grapefruit is best and use about one quarter, peeled and cut into small slices.

Put all of the fruit into a glass jug, add some juice or water gradually and then use a sharp hand blender to whizz them all together into a scrummy smoothie.  I don't mind having a slightly thicker, soup-like smoothie but I imagine many prefer a more liquid consistency.

Why this smoothie is so good

Above all else, this is a kind of "cleansing" smoothie and delicious.  This is why:

Rasperries contain Vitamins C and B3, folate, biotin, folate, manganese, citric acis, fibre and some sugars.  Also, according to Eating for Immunity by KirstenHartvig, raspberries activate the body's natural self cleansing ability and improve the health of the skin, hair, sweat glands, nerves, liver, bone marrow and mucous membranes.  Actually their usefulness for the body goes much further and at least this will give you an idea about their precious health-giving qualities.

Grapefruit is a very powerful detoxifying fruit, even on its own and helps to remove harmful microbes and strengthen the immune system.  It also has Vitamins A and C, potassium (helps deal with my frequent cramp) and a number of other nutrients.  Of course, grapefruit is not to everyone's taste; I will have it because I know it's good for me and it's quite nice and refreshing on its own.

Pomegranate is a funny kind of fruit that takes a bit of work to get the edible flesh out.  I think it tastes quite nice, sweet but not overly sweet or sickly.  I always had it in the back of my mind that pomegranate was a protective fruit benefitting the prostate gland.  From this NHS article it appears this might be the case but research is not viewed as conclusive at present.

Water and a dash of apple juice helps make the smoothie the right consistency and sweetens it a little.  I hope you like my raspberry smoothie recipe - let me know!

Concluding 2014...

To sum up this run, it was a truly magical, inspirational and a fantastic way of rounding 2014 off.

Bloggers, sporty types and the like will often review their year by looking back at the achievements, race wins, PBs, Strava Course Records, Strava King of the Mountains and all kinds of other indicators.  I would have to search hard to find more than one or two of those.  Instead I just wanted to reflect on a few things that occurred to me during my #ChristmasRun earlier this afternoon.

The run itself was over very familiar terrain and was a little over 10 miles and took a shade under 1.5 hours.  Soft winter sunshine lit the rolling Bedfordshire countryside around the Downs in a beautiful way.  I crunched through a few icy bits here and there, although happily the temperature has risen a few degrees today - but I'm still needing to remember how to ice skate though.  

I was greatly encouraged by:

• seeing a couple of other runners and having two cyclists greet me in a friendly way
• finishing another year in good shape
• running up a few hills and having a rush of endorphins to fuel me along as I panted my way up.    I wasn't quite at full capacity but not far off.  It's these hills I love these days, although I do just about remember avoiding them like the plague when I started running a few years back!  In fact I reckon these hills, on their own, have made a huge difference with my running ability and my cardiovascular health.  Not so sure about running down them though, that's something I don't do too well
• God's undeserved grace towards me. 
• Thoughts of doing this kind of run in my 60s and 70s

I started 2014 by cycling every day, instead of running.  That was also a brilliant thing to do and all part of trying to be in good shape for the 150 mile Coast to Coast in a Day in June.  You know, as much as I love cycling, I don't think I'm very good at it.  Sure I completed the event in 11 hours and ?20 minutes with bucket loads of satisfaction and memories and huge respect for my friends Andrew, Robin, Josh and Jeremy who did it with me.

My family.  Yes my family who continue to be so tolerant of me as I disappear for runs, bike rides and the like at all those totally inconvenient times.  Plus all those stinky HH tops and socks, not to mention the trail of muddy footprints through the house and the sight of me "resting my eyes" watching an evening TV programme (really, as if......?).

Looking to 2015....

These are some of the many thoughts whirring around in my mind and I finally feel that I'm actually on holiday and away from work.  This has taken me almost two weeks to get to this stage and I'm only just getting there (I unfortunately managed to remember my computer password for work, which means I still have a little way to go).  Amongst those thoughts were plenty of family thoughts and where our journeys may take us; this includes Hannah who has taken to kayaking really well this year.  I'm actually very impressed with her determination and grit plus the encouragement at all the coaches and members in the Leighton Buzzard Canoe Club.

With health, running and staying in good shape I am kicking around a few of these:

• Running 1000 miles in 2015
• Doing the Chiltern 100 cycle sportive in May
• I have entered the draw for the Prudential Ride London 100 cycle sportive
• Focussing more on writing health related articles for other people and increasing my income from this and rely less on my criminal justice work
• Getting my act together and getting my e-book published
• Being more proactive in giving a few more talks
• Really getting to grips with stretching, being more supple and flexible
• Let's look at doing some podcasts and YouTube pieces on healthy living
• Did I ought to do something really radical that pushes me to the absolute limit?????