Monday, January 31, 2011

I had been feeling quite poorly...

This post is for family and friends to explain some recent endocrinological events in my life ...

For a while of late I had been feeling quite poorly: fatigued, poor concentration, low mood, pins and needles in my hands and feet, a sore tongue (!) (weird huh), quite severe pitting edema in my legs, and a number of other obscure ailments such as occasional bouts of angioedema.

It all came on quite slowly and I put it down to general malaise after the severe flu I had last semester, and some poor lifestyle choices among the many insiduously entrenched in our western society (processed food, alcohol, lack of exercise). I resolved to pull up my proverbial socks, exercise more, make more healthy choices and fewer unhealthy ones ... but it didn't seem to help and I felt I was losing ground, it was getting harder and harder. When I got to the stage that I could not keep up with my weekly jazz dance class, my concentration was shot, and walking down to feed the hens became something I started to worry about, I knew something had to be done.

So I drew a picture of my body and drew arrows pointing to various areas of my body, outlining my problems both mental and physical, and gave that to my good GP doctor Dr Marcus at our excellent Bangalow Medical Centre. Marcus quickly surmised (correctly) that I was experiencing hypothyroidism due to a too-low dose prescribed by a previous doctor (I had Hashimoto syndrome as a teenager and lost my thyroid function) . And he ordered a full blood count too.

He was right about the hypothyroidism, but what we found to our surprise was that my free Vitamin B12 levels - which should be over 250 (and up to around 600 or so), were down to a paltry 3. Three! Insane. "Your B12 levels are in your boots", Marcus said, and promptly ordered thrice-weekly injections for me. His colleague Dr Graham came to see me as well and said he'd never met anyone with a B12 level so low.

But why so low? My diet is not really poor, even if I berate myself for not eating healthily. We actually have a great diet with lots of fresh vegetables, lean meat, fish, and so on (and John's an absolutely awesome cook who makes fantastically healthy tasty meals). More tests were done, and it turns out that autoimmune antibodies against parietal cells that I had been carrying around (dormant) for years had finally kicked in. And thus I can no longer produce intrinsic factor, a glycoprotein which processes B12. Without this protein, you can't absorb B12, no matter how much vegemite you eat. This results in what is called pernicious anemia, a condition once fatal but now (happily) easily treated by intramuscular injections of B12.

"Pernicious anaemia:
Pernicious anaemia is the classical symptom of B12 deficiency, but it is actually the end-stage of an autoimmune inflammation of the stomach, resulting in destruction of stomach cells by the body’s own antibodies. Anaemia is a condition in which red blood cells do not provide adequate oxygen to body tissues. Pernicious anaemia is a type of megaloblastic anaemia."

I've had four injections. I probably need about 20 to get my levels to where they should be and from then on a maintenance dose of once a month or so for the rest of my life.

I'm cool with that. At least I'll be able to scamper down the hill and feed the chooks with aplomb, I will once again enjoy John's curries without a sore tongue, I can get back to fitness classes, I can concentrate on things with more focus than a chaffinch, and my ankles won't look like marshmallow puffs.

Yay for modern medicine and the good doctors at Bangalow Medical Centre.

"I don't eat Aplomb. I like Darling Down Best Layer Mash, thank you very much."



Louise said...

Sorry to hear that you've been feeling so poorly, but glad that it's on the way to being fixed- I hope the injections work their miracles soon.

Anonymous said...

Dear Mieke,

Completely agree with the previous speaker! Hope you'll be on top of the mountain again soon...


Anonymous said...

And to think you managed to take Imogen horseriding and you only stopped once coming back up the hill. Imagine with what alacrity you'll bound up the hill once your iron levels are back to normal. You'll be like Julie Andrews, climbing every mountain!

Take care my friend