Top and tail

It's dawned on me that I'm coming to that age where suddenly, I qualify for a new set of health checks. A new set of concerns that "people at my age" need to be "aware of", and "checking for". What this means is that there are new scans, or probes or fingers that were never part of the medical interactions. If 2020 was the year of mental health, then 2021 the year of physical health.  

I've now seen a Cardiologist, for the Premature Ventricular Contractions. A Haematologist, for errant low White Blood Cell counts (this proved to be nothing to be concerned of). Most recently I have no added a Gastroenterologist to the list because I've been spooked with all the cancer talk of late and the hereditary concern of colon cancer. Warning, this post is not fun.

The thing about a Gastroenterologist, is that for any diagnosis to be given, they kind of need to put a camera into your stomach (Gastroscopy/endoscopy), and/or the same for your colon (colonoscopy). The problem then lies with the state of the internals for them to get a "clear picture", your insides also need to be "clear" or "clean". What this essentially means is medical grade laxatives to clear the pipes so that the specialist can go in and inspect the innards without obfuscation from food, or waste. So what does this look like?

For the days before the procedure, you are prescribed a low residual diet, that contains minimal fibre and with food that is easily digestible. I interpret this as no consumption of fruit and vegetables but lots of white rice and white carbs. Essentially this translates to toast and congee for 2 days. I'm given a "loosener" and half doses of Picoprep to start the clearing out 3 and 2 days before the eve of. Then for the 24 hours before the procedure, it's a liquid-only diet followed by a night-before purge courtesy of Klean-Prep. The Picoprep is gentle, 125 mls of solution. The Klean-prep is aggressive, 4 litres over 2 hours (6-8 pm). Initially my bowels don't feel like they're responding, then at around 9, it kicks in. My bowels calm down around 11, and I'm exhausted and ready for bed.

This isn't the first time I've experienced laxative, think Peru. However, I will say the low fibre diet definitely makes it more bearable (not entirely sure, why this wasn't prescribed in the Andes), but still, I'm glad this is something that isn't part of the annual health checks. No water from now until the end of the procedure.

I check in to Adventist hospital at 7 am. I'm "upgraded" from a "semi-private room" to a "private room" and for a moment there's a flutter of what it feels like to be upgraded for a flight, or a hotel room. Reality settles in. Second time in 12 months I've been at this hospital. I meet the Specialist and the Anaesthesiologist, the procedure is explained to me and within moments I'm lying on my side, drinking a solution and biting on a mouth guard before drifting off to sleep. After 40 minutes I'm being woken up. Other than being thirsty, I think that went pretty fast. The hardest part was the prep. That was less than easy. 

I'm made to drink some water, have some food and go bathroom, after 2 hours I'm discharged with a bill and a small coloured sample. I've been given a sample for Helicobacter pylori (H. pylori) test. I'm supposed to see if this changes colour from orange to pink after 24 hours indicating a presence of this bacteria in my gut.

Update: this did not change colour.

Health Check: The Results

Long story short. There are two things that stand out from my health check. 1) Super high total testosterone count and 2). Exercise induced Arrhythmia. Point number #1, I'm not too worried about, I've been mucking around with 3′-Diindolylmethane and Pine Pollen, so I'll cut that down and to a re-test shortly. #2 however, seemed to have caused the GP great consternation. "Do you ever feel tightness in the chest or dizziness?" - I answer no. The GP mentions something about irregular heart beats and urged that I go see a cardiologist for further diagnosis.

Here are my ECG results. Those squiggly lines at the bottom are apparently, ventricular arrhythmia. This is supposedly common in patients, and normally occur in couplets or triplets. Apparently anything under three is normal. Me, I of course clock up four, whilst on the treadmill, which is why I'm seeing the specialist. I manage to take the morning off work and head to Adventist, Google tells me they have a decent cardiology unit specialising in Cardiac electrophysiology. They have me perform the tests again. Geez. More blood. Another treadmill test, this time in my work clothes while the Cardiologist supervises. He looks at me "Now, you have six!", the test stops "when you stop exercising, your heart rate stablises straight away. Do you ever feel tightness in the chest or dizziness?" - again, I answer no.

So what does that mean? I have exercise induced ventricular tachycardia, which could lead to ventricular fibrillation which is the leading cause of Cardiac Arrest. All this heart talk is really freaking me out. The tests that proceed, a heart ultrasound and 24 hour ECGs to monitor daily heart rate. This hospital is super depressing.

Annual Healthcheck

Every year, right before my medical insurance expires, I book an annual health check up. There's always anxiety and curiosity around this time of the year. The curiosity manifests itself from the fact that my body is ageing and that a clean bill of health is something indirectly correlated with age and the Hong Kong lifestyle. That and the fact that I've been aggressively trying to eat more plant-based over the last few months, makes me curious as to whether this has had an impact on my innards.

The anxiety, stems more from the logistics on providing the samples to analyse. This includes, a stool sample (you have the prepare this beforehand), a urine sample (you to drink enough water to pee on demand), a fasted blood sample (don't worry, the nurse helps here), toe nail clippings and a loch of right armpit hair (actually, the last two aren't really required). In addition, they scan your lungs, check the lung capacity, take your height/weight, ultrasound your abdomen, test your eyesight and monitor your cardiovascular capacity on a treadmill. After three hours, the collection process is over.