who only by moving can balance

Slightly to my surprise, earlier today I got a text from my GP saying approximately "yes your serum ferritin is now 'normal', but also, uh, by this we mean '15, with a reference range of 13-150, after six weeks of supplements', so... keep taking the supplements and we'll retest in six weeks!!!"

It is possible that the reason this actually got flagged at all was in fact that I've got a slightly elevated white cell count, and had I just had normal serum ferritin I'd have had to submit the "uhhh sooooo..." eConsult. Which I'd been gearing up to do, because the serum ferritin result showed up in the NHS app sooner than anything else!

Unfortunately, I had been working myself up to mentioning some Possible Additional Signs Of Concern in said eConsult (the various unimportant bleeding, like "there is usually old blood when I blow my nose BUT/AND I am very much using a steroid nasal spray every day") and I now have a solid excuse to keep putting it off for another six weeks, but hey. No longer officially anaemic! Pity about what's going to happen when I run out of supplementary iron, huh!

[cn time-restricted eating.]

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In brief: book is the least I've been annoyed by any such book I have yet read, which is fairly impressive going, especially since the copy in the BL's collection is the first edition originally published in 2003 rather than the second edition updated in 2013; more notes possibly to follow (subject to reaching a decision about whether I want to hold out for getting my hands on a copy of the second edition before talking about it in public).

Entertainment: shortly after I finally settled myself down in my nice corner desk against a window with my back to the wall and a whole enclosed-in-glass booth between me and Any Other Readers... my watch buzzed to let me know that I'd just finished a Period Of High Stress. The high stress was, obviously, sitting quietly wedged into a corner on public transport while reading a relaxing book. I did know public transport was exhausting! I have been saying! I'm still kind of impressed at the watch Earnestly Informing Me, In Case I Didn't? Know? and mildly regretting that I'm planning to do the same-ish again tomorrow, and also also I am reassessing A Lot of my wheelchair use in light of this...

Related entertainment: how much my hypervigilance kicked up when I returned from lunch to discover that neatly leaving my notebook and reading-book in a stack on my desk had not had sufficient inhibitory effect, and a Noisy Person had decided to sit diagonally across from me, in my Space, being Noisy. The amount I relaxed when they (temporarily) fucked off is another one for the "yep I can see how not leaving the house for over a year and then staying Hyper Local has added up to me looking much more functional" files...

Today was Lower Limb Class #2, as ongoing follow-up for the most recent ankle reinjury. (On which status is: still a biiiit weaker when I'm pushing to limits, but not really noticeable in day-to-day life, e.g. I'm no longer regularly wincing when I jar it getting off a bike; definitely still feeling the work up the outside of my right leg when doing e.g. isometric holds on double heel raises.)

I am very amused by how "???!!!" the physios got when I tried to faint from things that "shouldn't" have been significant cardio and indeed aren't by my standards for cardio but crucially involved a lot of moving around and position changes while upright: sit-to-stand, lunges, crab-walking with knees bent. Apparently I have carefully selected for exercise done while seated or prone for really solid reasons, i.e. that would be the orthostatic hypotension. Which I apparently hadn't told the physios about as its own thing. ...whoops.

( notes )

Two things:

1. I keep (especially post-surgery, cotemporal with relearning how to walk) finding more small ways that how I've been doing my various physio exercises isn't quite right. This is a good thing! Isn't it fascinating to be learning more about embodiment and how my body works and how I can best deploy my various muscles!

2. Up until the hypermobility clinic, all the physio I was ever prescribed made me worse, not better.

It abruptly dawned on me, all at once, that the subtlety of the changes I'm making with adjusting how I'm shifting my weight around and so on and so forth? Are almost certainly not actually externally visible. Like, yes, people not understanding hypermobility and problems with it was also Definitely A Problem, but -- the part where I'm still, mm, not necessarily fixing things but certainly developing them, finding places where even with What The Hypermobility Clinic Told Me To Do I wasn't getting quite right... well, the hypermobility specialists clearly went "eh, good enough", and in terms of the effects on my ability to Things I think they were clearly demonstrably provable correct, but -- yeah, okay, sudden understanding of some of just how difficult it would have been to correct some of this stuff.

(I'm very sure that all my various epiphanies will turn out to be about things that still aren't quite right, that I can still refine further -- I'm having an extended phase of that with Pilates right now -- but this is a good thing, actually. It's really nice to have such clear evidence that I'm getting to know and understand myself better.)

In Which I Have Adventures In Menstruation.

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• the Lincoln Ostomy Output Consistency Scale (and, relatedly, the Bristol Stool Chart chocolate cake [nb FB link])
• a selection of Journal for Minimally Invasive Gynecology papers (feat. videos of the kind of surgery I'm likely to be having) (which I have not yet watched because logging in is Difficult) [ 1 | 2 ]
• the role of CGRP in hunger signalling (awake at 4 a.m.; had moment of INSIGHT or, well, potential insight)
• the part where heart rate is affected by CGRP, and varies over the course of the menstrual cycle, and unshockingly Does Things during migraine, and I have Fitbit-provided heart rate data since a few weeks before I started having regular migraine attacks, for the purpose of Writing Myself Up...
• thenatureofpaper (WHICH flowers do I want to buy myself. HOW long will I be inpatient. HOW many decorative things is it reasonable for me to take.)
• and, completely unrelatedly, British stick insect populations

I have been intermittently mentioning Issues With Reflux. When last heard from, in early September, I was... working my way up to doing something about it? Working my way up to Doing Something about it.

At the end of September, I got officially bumped up from 20mg omeprazole to 40 mg omeprazole, having merrily done this unsupervised for the week I was at Admin: the LRP, and established that I miraculously did not have symptoms. At that point the conclusion was, okay, bump me up to 40 mg, with the intention of dropping me back down to 20 mg somewhere in the vicinity of four weeks after surgery, with onward referral for endoscopy if that didn't... work.

Then, obviously, surgery was... postponed.

And then! On Monday afternoon I hit the point of "no, this is bad enough I need to go back to the sodding GP", and yesterday morning I filled out an eConsult, and yesterday afternoon I was informed I had been booked a phone appointment for... today. Which, er, is much sooner than I was expecting.

... and it was amazing. I had an absolutely classic Let The Doctors Do Their Damn Job moment: GP expressed Some Concerned Frustration that it was Bizarre that the increased dose had initially worked and then stopped, and hit the point of going "When exactly did you start noticing symptoms again?"

So I told him that it was a few days ago![1] Four or five? And I couldn't think of anything I'd changed -- I was still cutting way back on chilli, still not consuming alcohol, etc etc etc -- the only thing I could even vaguely think of on that timescale, I said, offhandedly, was that I was recovering from my first confirmed case of COVID but couldn't imagine that was relevant --

....... I think I remember reading something about that, says the GP. Let me just go check with Doctor Google...

(Yes. Verbatim. I was DELIGHTED.)

And: BINGO. Apparently there's a study that found increased acidity (lower pH) in the stomach post-COVID infection, getting back to normal for about 98% of people it shows up in around 6-8 weeks post-infection. Higher acidity is, shockingly, associated with more by way of pain and discomfort and General Symptoms.[2]

In the context of I Contain Multitudes, and all the ways our immune systems interact with our biota, and the fact that "hypochlorhydria" ("low stomach acid") lets SARS-CoV-2 pass through the stomach Still Intact, I am now vaguely wondering about the extent to which this constitutes An Immune Response, but I should really attempt to not fall down that particular rabbit hole, at least not tonight...

(Next steps: bump the omeprazole dose up again for a week to try to get things under control; referral for endoscopy being made; please go get these bloods done ASAP because they'll want to see the results. No idea on wait times. And all of this after I'd said "oh! okay then, I'm totally happy to leave it for now and come back in the new year if it's still a problem!" so, like, I'd like to keep this one, thanks, I like this GP.)

[1] In fact I double-checked my notebook after the appointment and discovered that I first noted An Unpleasant And Unwelcome Resurgence Of Reflux on.... 07/10/2024.

[2] So far I've failed to track down the paper -- I think the journal was "BMU" and it was published probably around 2021? But I was absolutely getting Stats, Clearly From An Abstract quoted at me...

[Passing references to nudity.]

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Uncheerfully: I have spent a lot of time hanging around waiting for DHL to maybe consider being less cryptic and more, you know, of a delivery service. Alas the big box of ice cream did not arrive today, and is now marked as returned to sender. What's going to happen next? Who knows! But:

1. I brought home some mulberries, and have Plans for getting more. (Also I ate some plus a custard tart while sat on a bench underneath the tree.)
2. The Child (who I think I have not previously mentioned) asked of its own accord if we were coming to visit today. I am delighted. (We drew trains.)
3. Have Made Arrangements for the Zoladex due to be administered while I am In A Field, so as not to require any of arriving late/leaving site/delaying dose, all of which would be suboptimal.
4. Did a thing with the laptop that would prior to yesterday very definitely have caused it to fall over. It merely thought quite hard. (I am baffled that old laptop Coped Better and need to have a poke around to see what it even contains, then.)
5. Cycled up hill entirely in middle gear for First Time Ever, which I am Very Proud Of, and which continues to convince me that whatever it is that is Wrong in my hips probably involves the gluteus medius. Which means I can work on improving it.