Wednesday, 4 June 2014

Anaemia joins the Journey of UCTD



I have been so very very lazy in doing the next instalment of my Journey of UCTD. Well this time the delay was not due to ill health but because I was a little better and was catching up on chores and also spend a few hours on a beach. It was so nice to feel the warmth of the late autumn sun with wide blue skies and rolling waves. I had heard about Curl Curl beach from a friend so we decided to visit the place and also the nearby Dee Why beach. Of course one cannot go to the beach and not walk at the edge of the water, wet our feet and have hot hot chips, even if it meant resting for the next day or so.
Well the weather has turned wintery now and am desperately trying to keep warm. So time has come to continue writing. What shall I tackle next? I want to talk about the specific drugs as a separate single blog so maybe I should continue with other symptoms. Oh yes! Just like vitamin D deficiency was identified by chance so was the lowered Hb (haemoglobin). Normally I have an Hb of 12 and suddenly it was down to 9. I was feeling tired and run down, getting breathless with walking any distance and of course the stairs in the house needed girding of the loins to use. But I had not paid any specific attention as by now I was not even able to distinguish symptoms from different issues. Anyway why would I get anaemic?
Well if I had bothered to look a little more closely at the side effects literature for ibuprofen I would have seen that it can lead to anaemia. Of course my GP wants to give me oral iron tablets. I pointed out that my stomach cannot handle the usual iron pills. I get sever gripping pain, sinking feeling and nausea within minutes of taking the tablet. So it was decided that I should have some liquid iron preparation. Now I cannot remember the brand name of the first one I tried. 2 teaspoons every day was the prescribed dose and I found that after taking it for 2 days my stomach started hurting. I took a 1 teaspoon a day and even so it was not a nice experience.
Went back to the GP and complained so I was given another brand to try. This one was even worse. It felt as if I was drinking paint stripper……. I could feel the mucous membrane burn as the liquid touched it. So went back to the GP as there was no way I could take this preparation. I even suggested that injections would be better. But for some reason only known to himself, he refused that and said just take the earlier prescribed liquid iron preparation as and when I could. I am not sure how helpful a teaspoon every couple of days would do to raise the iron levels. The drip feed raised the Hb to 10.5. Oh yea I had 5 vitamin B injections just in case the iron was not being absorbed.
When I came to Australia and settled into life here, my new rheumatologist got the whole blood panel done and found that my Hb was lower than my normal but the ferritin stores were much depleted. (I do not think my ferritin levels were checked in UK) Again the same conversation re oral iron prescriptions….. ahhhhhhhhhhhhhh. This time I refused to even try any oral medication. He said well it will have to be injection and they are painful. They can cause staining of the skin around the injection site. I said that will be minor discomfort compared to the agony of drinking acid.
So I had 10 X 5 ml injections over a period of year and brought back the levels to normal. Now it gets regularly monitored to make sure the levels do not deplete. There was some concern that the problem lack of iron could be due to poor intake and or poor absorption of it in the small intestine. The Gut men just wanted to go on a fishing expedition in my lower GIT and I said no way. This was in UK and I asked how it was supposed to go up if I am not able to take the medication. How can they even begin to suspect a problem in that case? Well the other one they mumbled about was … oh you might have a GI bleed….. I firmly refused saying give me the medication and if the levels do not rise I will agree to further investigation. Thankfully with the injections the story took a positive turn for this aspect.

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