mise à jour très tardive - surtout la santé

Very Late Update - mostly health

I knew I’d fallen out of the habit of regular posts on here, but jeez, over a year? Sorry about that. It has been quite a challenging year mind, for a few reasons, mostly health related, which you’ll have seen on FB if you are connected to me there. Long explanation below if you can be arsed.

TL:DR / summary is that my Chronic Kidney Disease, which I’ve had since 2008, after a bad reaction to mesalazine, a drug I was prescribed for Crohn’s Disease, which I got in 2007 after I got food poisoning from a pizza on holiday in Spain took a dip last year, and I am now being prepped for dialysis at some point in the next year or three maybe and for going onto the kidney transplant list.

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There is a measure called eGFR, which can be just taken as ‘percentage of full kidney function’. When you’re young and healthy it’s very high, and it goes down a little as you get older, but if you are a healthy person, chances are it’s pretty high still, like 80% or more. The dodgy thing is it can go very low before you notice any symptoms, though many things you might go see your doc about where they test your blood, they might include that perhaps as it’s a fairly standard test.

What to watch our for? Well, foamy urine, peeing in the night (Other reasons for that of course, diabetes, prostate in men etc, still go see a GP), tiredness, itching, but those things more likely when it’s already pretty bad.

How to avoid it? As I’ve learned from groups and things there are many, many ways to get it, even persistent UTIs can creep into kidneys and damage them but high blood pressure and type 2 diabetes probably most common, especially in US, and no doubt will be in the UK more and more. Usual things, eat a good variety of veg, avoid processed food, especially watch salt content, exercise every day even if just walking, drink plenty water etc. The stuff we all know, but often don’t practice. If you are put on some med, ask if kidney problems are a possibility, and make sure by checking yourself online, if worried hassle them to test your blood before and after. My advice is always treat doctors like accountants, trusted advisers and if you are not sure ask another. HMRC don’t care what you’re accountant said, it’s your responsibilty, likewise with your health, own it.

Once you’ve got CKD, for me, as with anyone with, there was an almost inevitable decline, and mine went from 42% in 2008, to 24% in 2010 and after that, when I took up running as much as 20K a week, it improved a little, and longer term, the decline smoothed out and slowed, and it hovered around 20% for some years. I also stopped eating meat in 2019, now more pescatarian but not daily: I’ve always tried to do all I can with lifestyle to slow it as much as possible, again, it’s your health, own it.

In 2022, I hit 14% and then in summer last year a sudden dip to 10%. Back when I started running it was headed that way too, the trend matters more than the absolute number with CKD, and that triggered NHS Scotland to start talking to me about dialysis options, talking to potential live donors and preparing to go on the transplant list

The good news is that I have bounced back a bit since then to 12 or 14%, and the nephrologue here is less concerned about urgency for dialysis/transplant, but at that time last summer, they were and the same processes kicked in here, but with more rapidity. So the last year has seen me make a lot of use of the French healthcare system, and it has been very good overall I’d say. I’ve been to probably 5 different facilities here, local to 2 hours drive away, had CTs, ultrasounds, seen a cariologist, had a heart stress test, got a document from the dentist to show I had no tooth infections (Can’t have an infection if you are going to get transplanted and bad teeth problems can infect your heart, if you are not aware), been twice to Poitiers where the tranplant centre is at the Univeristy Hospital (One in Bordeaux too but much worse traffic there of course and same drive more or less) and now I have hopefully just 2 MRIs, and perhaps a biopsy and then onto the transplant list (Before you ask, I am blood type O, and they say 1-3 years of wait, I also can’t be more than 4 hours from Poitiers whilst waiting for the call).

Poitiers CHU:

Centre Hospitalier d'Angoulême:

I also had a colonoscopy, which I’ve had many times for Crohn’s since 2007, probably my 7th maybe? (They do that differently here too, proper general knock out and not sedative only and you have your own wee room before and after with toilet and shower). That ‘scope showed, as I knew, it was still active, much as it wasn’t bothering me too badly, but because the easiest form of dialysis, Peritoneal Dialysis requires you to have no inflammation in your gut (Infection risk again), it has to be calmed the f*ck doon for that to be an option. The proper term for auto-immune dieases is ‘remission’, kind of like cancer, which is also an immune system problem when you think about it, it can’t really be cured, just shut the hell up for as long as possible.

So, me and the gastro-entérologue had a negotiation, which I tried to do in Scotland but the GI there was having none of it, about Azathioprine treatment, which I have refused since 2008 after my bad experience with mesalazine Thankfully, here the doctor was more amenable and agreed to try a short course of Prednisolone corticosteroid with a follow up colonoscopy, to see if I could manage to attain and retain remission. Fact is, once I get a transplant I will have to go on azathioprine anyway, as you are on a set of immunosuppresive and other drugs for life then in order to prevent rejection of the transplanted organ. My general impression of consultants here is they are less arrogant and dictating than ones I’ve had back in Scotland to be honest, more of a two way conversation.

So for a week or so now I have been on steroids and it has been transformational, way more energy; I was feeling like I had a bad hangover every single day due to the CKD/Crohn’s combo and more importantly, my head cleared of brain fog, something I am sure more people will be familar with now after having had Covid as everyone seems to have had a dose by now. It makes my work really, really hard. I knew it was affecting me, but the steroids have made me realise just how much it has.

This pleasant respite is unlikely to last of course, but I am making the most of my energetic and productive summer to get shit done, so there will be more posts here. Will probably save them up and try to get one a week out. After that, if it’s monthly or less, you’ll know I am back in knackered and brain fog land once again I’m afraid!

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Nothing much about France here, sorry, just the healthcare, but happy to answer questions on that or CKD/Crohn’s if anyone is curious.

I will say though that, much as I have said before, there are plusses and minuses about coming here, I feel given the state of the NHS in the UK post-austerity and Brexit etc, I am much better in my state of health, being looked after here, as is my partner.

It really is a much better system, not just in the level of funding, and I think there needs to be a proper grown up debate in the UK about adopting a more France/Germany style system with mutual insurance. I think, as ever UK folks are too aligned with the US in thinking, something I thought Brexit was often about, and the minute insurance and private involvement comes into the discussion, us UK folks’ hackles go up and we think US style costs, outcomes and healthcare debt bankruptcies - it does not have to be like the NHS now, nor does it have to be like the US system, there are ways of doing it better without funnelling all the gains to private companies - There is just way too much of that tolerated already in the UK IMHO and it needs to be pushed back on. Keep Calm and Carry On? Fuck that, get angry like the French and make politicians fear you and not patronise you.

End of small politics rant.

à bientôt!