Tag: anemia

Not anaemic

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It turns out that my iron levels are fine. Haemoglobin is 139 g/L and serum ferritin is 74 ng/mL. The haemoglobin reading is subject to ‘sports anaemia’ which is when your haemoglobin concentration reading is a bit lower because you really have more plasma, not because you actually have less haemoglobin. Or something. There is a lot of disagreement about what a low ferritin level is, some people say 10-15, some 20, some people say that under 50 is going to impact athletic performance. But 74 is good. That’s the highest it’s ever been on a blood test.

So really, I have no excuse for my rubbish running performance lately. Since I started running after work my average easy paces have improved though. Then last week on Parkrun I ran 21:15 and this week I ran 20:55, which is a post-lockdown PB and the first time post-lockdown I’ve gone sub 21. I pretty much just threw myself at it straight from the start. I usually try to run even or negative splits but sometimes I think you just need to go out faster than comfortable and then just try to hang on when it starts getting tough. Then next week you’ll probably be able to go a bit longer before you start questioning all your life choices that led you up to the point of wanting to die somewhere in the third kilometre of a 5km run. It also helps to have a running nemesis who is slightly faster than you. Next step: sub 20?

I have to be a little bit careful with this though because I spent all of Tuesday last week feeling slightly tired, slightly irritable and slightly hungry and I’m pretty sure it was just from running a bit further and a bit faster than usual last weekend and Monday.

So I think the reason I was feeling tired before was actually just because I have a crazy adolescent dog.

Energy

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I started running after work this week and it actually does feel a lot better! I’m running faster and further with what feels like the same effort. And I don’t know if it’s because of not running in the morning or because I’ve been taking iron for about 3 weeks now, but I’ve been feeling a lot less tired this week, particularly in the afternoons. I’m pretty sure that if it wasn’t for work then I’d have been having frequent post lunch naps for a few months now.

So I’m pleased about this and I’m hoping that my Parkrun times start moving in the right direction… It was a bit underwhelming today, but it was quite hot this morning and I really, really wasn’t feeling it when I started my warm up before hand.

I’ve also been reading up more on iron. The problem with iron isn’t eating it, it’s absorbing it. I already knew that things like tea, coffee, dairy, etc lower absorption. I was also vaguely aware that running is bad for iron levels because the physical impact destroys red blood cells. But what I didn’t know was that workouts cause the release of something called hepcidin, which lowers iron absorption. The hepcidin levels are highest around 3-6 hours after a workout. So on top of dietary iron blockers, you also have to time iron intake around this.

Anyway I have my doctor’s appointment on Tuesday so hopefully I’ll get a blood test to see exactly what my iron levels are.

Progress

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Despite my lacklustre half marathon performance on Sunday and my suspicion that I might need to take some time off for my hip, I ran down to the doctors yesterday to enquire about my blood test. It turns out that blood test forms expire after 3 months, so the one I had from last August was definitely out. So I have booked a GP appointment (again!) in a couple of weeks and I’ll see about getting another one, and actually having it done this time. Of course by the time it happens I’ll have been on iron tablets for four weeks, but I’ll just have to tell them that when they interpret the results.

So overall, going into the surgery worked a lot better than trying to phone them up. A few years ago I booked a lot of appointments over a period of about 12 months, and usually I would just do it at work by disappearing into the corridor for a couple of minutes. Or I could use the online booking… which is now disabled “because of COVID” (?????). Whereas now it’s at least 30 minutes on hold. I could understand if they had a GP shortage and couldn’t provide enough appointments, because a GP shortage is a hard problem to solve. But I am pretty sure that a shortage of people to answer the phones is not a hard problem to solve. This has been going on for a couple of years now, and every so often the local newspaper picks up on it and prints a scathing article… and nothing changes.

Anyway the running was OK. I was achy but that’s hardly surprising. Then today I went out again and did a 10km tempo, which was neither terrible nor great. My pace was a bit faster than the HM on Sunday, and it was really hot and I’m probably not recovered from Sunday yet, so overall it wasn’t bad, but my energy levels dipped quite a lot around the 8km mark.

I’ve been off work this week so I’ve been entertaining Monty. I took him to the town centre on Tuesday and sat in the square with a drink while he watched everyone walk past. Today we went into a dog friendly cafe and had a drink. He was quite stressed, or maybe just really excited. He was whimpering a bit to start with so I had him sat in my lap and I could feel him panting heavily almost the whole time. It’s funny how he’s so confident and boisterous in his comfort zone, but as soon as you put him in a new situation he’s quite timid. Before we got him, I had no idea dogs could be so expressive with the sounds they make.

Health and things

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Citalopram days 7-10: I think it’s day 10 anyway. I’ve lost count. Nothing to report, really. I had some more nausea when I went up to 20mg but nothing much. I have felt pretty tired at times; mid-afternoon at my desk is a bit of a struggle some days. If it doesn’t wear off I might try taking it in the evening instead of morning.

Other health: I have been prescribed iron tablets again because my iron levels have dropped a lot and are approaching anaemia since I finished the previous course. But maybe that’s why I’m getting tired?

Having to take two sets of pills is not making my stomach happy though.

Mentally I’m feeling a bit lighter on average, which is promising as it’s still a few weeks before we really expect full effectiveness from the antidepressants. This morning at work there were things happening that would usually have bothered me, but they just washed over me. This afternoon wasn’t so easy though; I felt angsty and frustrated and went home feeling drained.

Things should get a bit easier now anyway because Becky is on holiday next week and then I have two weeks off. I have had a hard time switching off from the weird rudeness I get from her, which increases my anxiety a lot because I end up anticipating it and feeling that I have to be prepared for it so I don’t overreact. In reality, I don’t know why I even feel that way. I’m not a reactive person. She’s rude to me and I just ignore it at the time. It reflects badly on her, not on me. It upsets me later, but at the time, it just happens and the moment passes. Sometimes afterwards I feel like marching up to her desk and confronting her, but it’s not like I’d do that.

My counsellor told me I was feeling guilty about things I haven’t done (i.e. my fear of reacting), and she’s right. She came up with an interesting idea that I should reward myself whenever Becky is rude to me so that I stop dreading it. I think it might help reframe it. I’ve started carrying around some Fruit Pastilles in my bag, which are as yet unopened.

Health bits

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I got more of my blood test results back today. My iron levels are borderline anaemic, and they’ve dropped a lot since January. I think I need to be on iron tablets again.

I wonder if this has affected how I’m feeling mentally. When my iron levels were low last year I ended up having a breakdown. I don’t think that’s a coincidence. I also don’t feel I’ve ever really recovered from it. I don’t want to repeat that, so I will be back at my GP the first appointment I can get.

Work was tough today. I didn’t work hard at all and spent probably two hours in the kitchen chatting to people today, which should have made it an enjoyable day… but… the reason I did that was because I was struggling. I was in the kitchen alone early in the morning when Becky came in. She got part way through the door, saw I was in there, then made a huffing noise and turned around and walked out again. We always have to have the amateur dramatics with her. She always seems to want me to notice her. I know it reflects badly on her and not at all on me, but it upsets me. I was feeling unsettled anyway and this just pushed me over.

I don’t even know why she’s taken offense to me again; I haven’t spoken to her for months. I think that might be the problem. I think she wants a better relationship but doesn’t know how to achieve it, so she gets frustrated and goes out of her way to make me notice her being rude to me in the hope that I’ll do something differently and then via some magical process which requires no change or effort or communication on her part everything improves. Or maybe I’m just projecting because I thought about doing that too, but then I remembered I’m not 5 years old and it would look a lot like bullying.

But I’m not playing stupid games, so here we are.

I wish I’d seen my counsellor this week.

Medical stuff

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Today was a bit different because I had some medical appointments. The blood test I had done in July showed my haemoglobin level at 140, which is the highest I’ve ever seen it. I noted to the GP that I’ve had two instances of bleeding since then so that reading might be out of date. She decided to repeat it, and, amazingly, the results are already available – it’s now 137, which is good. Not as good as 140, but it means I didn’t lose much blood.

I feel kind of insecure about it though. Even as I’m writing this, I’m thinking “it was 137 this afternoon… but I could easily find out tomorrow morning that I’ve been bleeding more”.

I have been referred to a dietitian for my weight loss, but she told me it was probably my anxiety and spent quite a while trying to convince me I should be on anti-depressants. Well. Maybe.

I went through the food side of things a bit with my counsellor this week. I said to her that if anyone else ate nearly as much as me, they’d put on a huge amount of weight very quickly, whereas I’m really struggling to keep my BMI above 19. She had me keep a list of what I was eating every day (because I don’t think she really believed that I ate much). She looked at it and her reaction was “hmm, that is a lot of food”.

Sleep is important

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I slept about 3 hours last night because of the heat/thunderstorms/work stress, but I felt today OK until I left work. I didn’t have any anxiety incidents. I crashed when I got home and felt really, really hungry, which probably isn’t good (hello, anaemia).

Work was OK. Becky was ignore-able. She sent me an email this afternoon following up some kind of review she’s supposed to be doing. She had asked everyone to reply and answer a few questions about the software installed on their computer. She sent it when I was off sick and I ignored it. She sent it again to me but also asked me to do it for another computer, which is… uh, how about do that one yourself?

I didn’t even consider replying and I wondered later why that was. I think I find it irritating that she expects a frictionless professional relationship to exist between us when she wants something from me, without her having to invest any effort in rebuilding it. But if I don’t reply will she complain… or will she send it again and CC my boss…

I’ve booked off some holiday for the start of September and I’ve set a soft date of 7th August for giving my one month notice, if I’ve seen no reason to think things will improve by then.

Citalopram day zero

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Trigger warning: suicide, down at the bottom.

LIFE updates!

Phone call with IAPT (Improving Access to Psychological Therapy) was fine and I’m on the CBT waiting list, which is going to be a few months.

Gastroenterology appointment was OK. He was concerned my haemoglobin levels had dipped at my last blood test (March) and had me do another one today. He mentioned the possibility of long term iron supplementation, dependent upon the results. I think they’ll be OK. In the words of David Lee Roth, I don’t feel anaemic.

He (the doctor, not David Lee Roth) is drawing a blank on the cause of the bleeding but suggested that if/when I next have active bleeding I could go to A+E and they might be able to do some kind of immediate test. He called it a ‘scan’, which sounds a lot less mechanically intrusive than jamming a camera down my throat.

I asked him about the SSRIs and he said it would likely be fine.

So I’ve decided to start taking them… tonight. On the way back from the appointment I was coming up with excuses why I shouldn’t, but the fact is that I’m not OK and I need to admit this. For the past couple of weeks I’ve felt dreadful. At the moment I feel light headed, spaced out, my stomach is very unhappy and I had so much nausea this morning when minor things at work stressed me. I feel like I’m actually physically ill when at work, and magically better over the weekends. I’m still worried about side effects, but let’s just rephrase that a moment – I am anxious about side effects. That comes with the territory, doesn’t it?

The hospital itself was a strange experience. Firstly, my mum met me from work and we went over there on the bus, but before getting on the bus I took her on a tour of the graffiti near my workplace. The graffiti is of the extremely talented street-art variety, not just random tags. That was fine. What wasn’t fine was running into Becky. I felt like… I’d left work for the day, I was with my mother, it was personal time. Why you are here, Becky? Your presence is intrusive to my personal life. That’s how I felt when I saw her face on my phone when it notified me she was looking at my social media. Why does it always have to be you? Why is it never James or any other random colleague? It’s always you.

So that was uncomfortable. We just ignored each other, because why would you say hello to someone when you can just stalk their LinkedIn profile instead.

And the hospital itself…

The last time I was at that particular hospital was December. I felt dreadful at the time. I was anaemic, work seemed to be imploding around me, and I had the other issue in the background. I felt absolutely awful that day, everything was getting too much, and the day after, I decided to kill myself (and suddenly felt a lot happier). Obviously, I didn’t do that, but this was how I felt during that period of my life. I remember after the appointment going through the car park feeling that life as I knew it just seemed to be drifting away from me. Wandering through the car park today was a bit of a surreal experience. I didn’t remember it until I was there.

Not bleeding

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There was no sign of bleeding today, which is good. In the past it’s usually been visible for two days so the fact it’s back to normal after one this time is nice. I have felt a bit weird today with some nausea while I was walking and my stomach has been very unhappy, but I don’t know if it’s related. Other candidates include the heat and anxiety because…

…I had another phone interview this evening. This time for a job that seems more promising, at least by location. I felt it went well, much better than the previous one. I felt a lot happier afterwards so maybe it was just anxiety.

To be honest though, work is going OK. The project I’m on is coming to an end, but that’s OK, I think. It’s become very bitty and not engaging. I’ve been directed towards another project which will involve learning a new technology, which will be a bit more interesting.

Becky hasn’t annoyed me lately, though I did have a strange conversation with my boss the other day where he said “Becky told me you said to her you would be happy to look after some plants for the office if we got some in”. He looked very confused when I just said “I did not say that”. I don’t understand her, fundamentally. I mean, why would she say this? What was she thinking would happen? I still have radio silence from HR lady but when she surfaces I will mention this and ask her if she can offer an explanation. To me it looks like Becky wants attention, so every so often she does something weird, but I don’t know… she’s a 45 year old, not a 5 year old.

Bleeding…

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I’m feeling really down because I have internal bleeding again. It’s such a bizarre thing to experience. If you Google variants on “why is my poop black” (TMI, sorry not sorry), you’ll be told in no uncertain terms that you should go to a hospital urgently because it’s probably blood, and gastrointestinal bleeding can get really serious really quickly. It never has for me; it’s never become a continual bleed, but I’m sat here thinking “well, how do I know it’s actually stopped now?”.

I don’t know if it’s the emotional hit to my sense of safety or whether it’s just the physiological effect of suddenly having less blood, but it upset me a lot. I ended up crying in the toilets at work, which hasn’t happened for a long time. I didn’t even know what I was crying about. I felt angry and angsty and frustrated about work in general. Today wasn’t a good day.

I will be seeing my GP next week, but I’ve been anaemic before due to this and I’ve had a lot of cameras inside me, which didn’t show anything.

I don’t know if it’s just because I’m aware of the bleeding, but I also feel a bit… unwell. It’s probably my imagination. It always took a few incidents before I started to feel unwell before.