‘If not for you…’

I was busy planning my next blog – some b****cks about stoicism or something equally poncey, when events kind of took over and spared any readers I have left from further attrition. So far I have been writing about the life of someone who, diagnosed with cirrhosis of the liver, experiences the increasing impact of symptoms, the amount of visits to hospital and most of all, the contemplation of the workings of the liver transplant list which fundamentally provides the only realistic prospect for survival. I didn’t really think beyond that at first, but I suppose deep down, I wondered whether one day maybe I’d get the chance to write the following. So here goes…

Thursday evening and the usual chaos of family life. Just finished tea  (nice curry – you’re welcome) and we were laughing at embarrassing photos of our son at his prom when the phone rang. It was the land line – I missed the meeting when it was agreed that only I am able to answer this ancient piece of technology – so by the time I got to the handset it had rung off. As I was about to call back my mobile rang – the same number. A pleasant lady answered who introduced herself as one of the Transplant Coordinators and informed me that a donated liver was about to become available and that it had been allocated to me. I was conscious that the hubbub around me subsided as the subject of the phone call became apparent. I took the information in and relayed it – my wife had already shot upstairs to pack the overnight bag she had been meaning to pack for weeks and was already contemplating what to wear – and after agreeing to get to the hospital by 10:45pm, made myself a cup of tea. So. Very. British.

A few phone calls later, a quick jaunt over the Pennines and we were being introduced to the pre-op process. Lots of tests and forms, a shower, a change into gowns and at 3am a conversation with one of the surgeons about potential issues with the viability of the liver. One of the little know facts about transplantation is that only 50% of such calls result in a successful operation taking place. In many cases the donated organ is not viable owing to a number of factors. The good doctor concluded by telling us if we see him again tonight it would mean the operation won’t be going ahead, but if someone else comes for me, we’re on. What followed was two very strange hours, just me and my wife in a side ward, the conversation fluctuating from what shall we get to eat if we are sent home (McDonalds) to all kinds of ‘if things don’t go well’ scenarios (potential ashes scattering locations and what to have for the buffet etc). Then at 5am a nurse came and informed us we were, in fact, on. I sauntered into the operating theatre, filled with ‘faith, hope and love.’ I said ‘Hi’ to the team, lay down on the table, Vivaldi was playing and the air conditioning was blowing cold. The anaesthetist told me I was going to sleep, and thankfully, he was not wrong.

I woke up sometime on Fridayafternoon, conscious of the presence of my wife, her sister an anaesthetist, a nurse and what I believe The Black Knight would refer to as ‘just a flesh wound,’ the result of which was pain that I really cannot decribe, except to say it smarted a bit. This was soon exacerbated by the requirement to be turned whilst I had the rather large tubes currently residing DOWN MY THROAT removed. That was fun. I was fairly alert straight away and became more used to the situation. I was a tangled web of lines and drains protruding from various bits of me, and I was really, really thirsty, which I mention purely because I was ‘nil by mouth’ and it would be several hours before I could drink.

Fate soon lent a hand. My previous experience of nursing had been pretty much based on that displayed by my wife and covers three archetypes.  First, the Barbara Windsor – bubbly, busty and above all predisposed to be nice to you. In my experience this is a mythical creature up there with Unicorns and friendly tube commuters. Then, there’s the Nurse Ratchett – true to her One Flew Over The Cuckoo’s Nest inspiration,  clinical and lacking compassion to the point of cruelty. Finally, and this is the experience I am most familiar with, the Kathy Bates off Misery. You think they’re a fan but step out of line and out comes the sledgehammer. So imagine my surprise when the nurse who was assigned to care for me seemed to be nothing of the sort. She was everything I wanted in a nurse, sarcastic to a level I could only admire and disparaging of any fools that crossed her path (that would be me then). It’s a novel approach – taking your mind of the physical pain by constant emotional and psychological assault, but it did work. I am forever grateful to my Intensive Nurse for getting me through my toughest night ever with her pointed barbs, casual put downs and wicked tongue.

As the days passed I was transferred from ICU to the liver unit itself. During that time the process of rehabilitation and recovery was progressed. As every tube and line was removed, I felt a little but more human. I was still very delicate but tried to keep mobile and as independent as possible. There was a lot to get my head around. A lot of tablets to learn about – what they did, when to take, what to do if you forget etc. A whole new diet which is a bit like a hard core version of a pregnant lady diet – no unpasteurised produce, everything well cooked, no soft cheese or shellfish etc. Some things like going to the toilet and having a shower that once were habitual now became huge challenges to be overcome. A fellow transplantee cut to the chase when she first saw me and asked the obvious first question when seeing someone who has just had major surgery – ‘how long did it take you to have a shit?’ I had to clarify her question – did she mean how long after the operation did I first manage the task, or how long did it actually take once embarked upon? Ironically however the answer to both is the same – about three days.

By Wednesday the consultants who came by every morning started laying plans for discharge. Provided they were happy with all the functions they were monitoring, and that I was mobile and comfortable in self medication, I was to be released the following Saturday. That meant 8 days after the operation I would be back home, which seemed remarkably quick given how daunting the experience had been. Without being too graphic I have a scar that begins in the middle of my chest, descends for 8 inches and the veers off to the right just above my navel for another 6 inches. It’s quite impressive. During the 6 hour operation my stomach muscles were separated, my ribs manipulated, all my internal organs shifted about and of course a very diseased liver was replaced by a fully functioning one. I felt vulnerable despite putting a brave face on, and was worried about everyone making a fuss. Well, the dog making a fuss anyway. Saturday arrived and after gingerly hugging the wonderful nurses who had looked after me, I was whisked home. After a slight detour caused by forgetting half my medication and returning to hospital 30 minutes later via the roughest estate in Leeds, traffic calming measures accelerated over by a wife who clearly missed her calling as a tank commander,  and my mortality compromised far more effectively than cirrhosis could ever manage, I made it.

So now I am at home recuperating and reflecting. I am well and becoming more mobile every day. All the indications so far are that the procedure has been a complete success. I don’t know what the future holds but I have every reason to be confident that I will see what happens at the end of Game of Thrones. The physical challenge is ebbing away but the emotional heft takes longer to discharge. Overall I am in awestruck gratitude. I have had so much love and support from so many people, particularly over the past few weeks, and especially from my family, with my wife playing a starring role. The staff at St James’ Hospital in Leeds are amazingly skilled, endlessly compassionate and wonderfully talented paragons of their professions. By an interesting coincidence I was in hospital during the conservative party conference where one of the less well remembered portions of a fairly calamitous speech by the prime minister was the announcement of a reversal of the organ donation policy, effectively making it an ‘opt out’ rather than an ‘opt in’ scheme. There are two things to bear in mind here – the government may take some time to get the legislation through given the complexities faced currently, and in any case research demonstrates that changing the law is not enough. In either event, if you intend to donate organs, still continue to register at the moment, but just as important, have a conversation with your kin, so that if they are approached by a doctor at a time they may be in despair, they know precisely what your intentions are. In late September of this year, somewhere in the north of England, just such a conversation was being held. Owing to the outcome of the conversation the above chain of events were set in motion. So no matter how much I am indebted to everyone else for their kindness and care, it is nothing compared to what I feel for the people who I may never know, my donor and family, who in a moment of grief, provided me with the gift of renewed life. Nothing I can write or say would ever express my depth of gratitude to them.

‘I’d be lost if not for you.’

https://www.organdonation.nhs.uk/register-to-donate/

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The curious illness of Benjamin Button

I meet two of my friends on a fairly regular basis to go for a curry. We go to a variety of places but tend to gravitate to one in particular which serves reasonable food, at a reasonable price with reasonable service. In fact the staff know us pretty well and therefore tend to make a bit of a fuss when we arrive. So when we got there a couple of weeks ago, we got the usual friendly welcome, hands shaken and ushered to our table where our poppadum awaited. One of the waiters then turned to me and said – ‘hey you’re looking really well.’

This is a fairly regular occurrence at the moment. Despite having what I think we can safely term an illness that ranks high on the poorly scale, my outward appearance is still pretty good. I am not suffering from the more debilitating symptoms that are associated with cirrhosis.  Added to which I am determined to be as fit as possible for as long as possible, which means our dog is as fit as…well you know. We tend to walk 3-4 miles per day in the fresh air which, added to the relatively healthy diet, sans alcohol, and the absence of the stress of working like a dog (2 doggie similes in one paragraph!) has contributed to an apparent impression of wellbeing. All this despite my liver malfunctions slowly increasing.  Like Benjamin Button, my appearance is deceptive. For the time being at least, the iller I am, the better I look.

That is probably a good thing because, despite assiduously refusing all offers of travel outside the West Yorkshire massif, I am realistically unlikely to be called for a transplant any time soon. The last couple of days have seen a flurry of activity in the media as well as on Prime Ministers Questions, where calls for an opt out rather than an opt in for organ donation have again been made. The success of this approach elsewhere is a matter of record, and I have met many wonderful people who have had there lives transformed by the gift of donation. These people have gone on to live useful lives, and contribute to our social fabric in many ways, who otherwise would not have recovered. I am fairly content that as long as, other than being dog tired (*sigh*), my Indian restaurant waiter continues to complement my healthy visage, I can avoid the transplant surgeons for a reasonable time yet. At the start of the Godfather, Marlon Brando mumbles this:

‘one day, and that day may never come, I shall call upon you to do a service.’

Admittedly he was talking to his undertaker, not his Liver Surgeon, but you get the general idea.

‘You’ve just made the list’ (Chris Jericho, WWE wrestler)

Lets start with a piece of trivia. What have the following fairly famous people got in common:

Eric Abidal the Barcelona footballer, Dave Crosby and Jack Bruce, rock musicians, Larry Hagman, actor in some fairly terrible American TV, Linda Lovelace, actor in some fantastic American pornographic films, so I’m told, Evel Knievel, stunt performer and Steve Jobs, that bloke from Apple.

The answer  is that they are amongst the list of people who have been successfully transplanted liver patients. Steve Jobs sadly died 2 years after his operation but the others are either still alive today or went on to live many years after their transplant. For this to happen of course, they needed the skills of the medical professionals that cared for them, and the generosity of donors either living or dead and their families, who chose to bequeath the most precious legacy.

Last month I saw two sides of this process in action. I pitched up in Leeds to sign up for the list itself and was told all the whys and wherefores of what to expect during the wait for the call, what happens when you get it, and what happens if and when you make it to the operating theatre. Sparing a lot of detail, you wait, in my case, probably quite a long time, you may get a false alarm, but eventually get the green light and are whisked off for  essentially, a bit of a plumbing job. You wake up after a stint on ICU and hopefully can get home pretty quickly after that, complications permitting. A couple of weeks later I was lucky enough to meet a number of people who don’t figure in the list of famous people above but have benefitted from the same remarkable generosity. I attended a transplant support group where I reckon I was the only pre-transplant patient. Everyone else had been through the operation, some more than once, some many year’s previously, some very recently. What bound them together was their willingness to share their experiences in a humbling display of mutual support, and their understanding that without someone, somewhere making a courageous decision they would not be alive today. The post operative life is not without its challenges, that is clear. A lifetime of hard core medication, sunblock and no shellfish are pre-requisites. I imagine they are a small price to pay though.

As I inferred before, the expectation is that my wait will be fairly lengthy. Though my liver is damaged enough to justify transplant, my relative good health means that people far poorlier than me will rightly get first dibs. It’s a bit like Catch 22.

“There was only one catch and that was Catch-22, which specified that a concern for one’s safety in the face of dangers that were real and immediate was the process of a rational mind. Orr was crazy and could be grounded. All he had to do was ask; and as soon as he did, he would no longer be crazy and would have to fly more missions. Orr would be crazy to fly more missions and sane if he didn’t, but if he was sane he had to fly them. If he flew them he was crazy and didn’t have to; but if he didn’t want to he was sane and had to.”

In my case I’m ill enough to be on the transplant list but too well to have one. If I was iller I would qualify but by then I might not be well enough to get the operation. I would be crazy to want to become more poorly and get the operation quicker but sane if I don’t and have to wait longer. When I’m well I can have one but mightn’t get one; when I’m ill I can get one but might not have one.

Thankfully liver transplant surgery allocation is not quite as chaotic as the satirical depiction of World War 2 allied operations and I have enough confidence in the team that are responsible for my care that at the right time I will make my way to Leeds where a new liver and a new life awaits. In fact I’m so confident I have booked tickets to go and see Bob Dylan next May, even though that is 6 months away, and as a further test of my resolve he is playing in Liverpool. By the time he walks on stage he will be just a couple of weeks away from his 76th birthday, me a couple of days before my 52nd. The question is, who will look the worse for wear?

As the new year beckons I can’t help wonder whether this time next year I will be in the same position – poorly enough to be on the list but not so chronic as to have the transplant. In the final reckoning it really does not matter though – that someone has to die to save a wretch like me is sobering enough a thought, so all I can do in the meantime is keep healthy and keep happy.

 

 

 

 

 

 

 

Time

It’s been a while since I posted anything, much to my readers’ relief, but I thought it was about time for an update. Literally. This post is about time.

Depending on your perspective, time flies by ‘when you’re the driver of a train’ (in Chigley), it ‘goes by so slowly’ (if you’re Bob Dylan) or rather than being a strict progression of cause to effect, as people assume, it is ‘actually from a non-linear, non-subjective viewpoint – more like a big ball of wibbly wobbly… time-y wimey… stuff.’ if you’re Dr Who and therefore a time lord and therefore know your stuff.

For me time is slowing down and speeding up at the same time.

It feels slow because when you are in the midst of a number of complex medical processes your life begins to become structured around appointments, waiting rooms, waiting for results, waiting for some numbers to reduce and others to increase that might give you a clue as to what the next steps might be. You end up just wanting to crack on with things.

It feels fast because, if you are expecting an average lifespan of 80 – odd years and you suddenly find out that might not be the case, you become very aware that you may have less time than you thought, and you end up just wanting to crack on with things.

Stuck in the middle of these abstract perceptions are some realties however. The first one is that my synthetic liver function is showing signs of decline through the almost imperceptible blood measures that the experts look at. I don’t look any iller and one thing I get told all the time is how well I look. I do feel a bit more under the weather though, with fatigue meaning I ache constantly. Not a thing to complain about really, just a thing.

As a consequence of this the consultants in St James’ Hospital Leeds have concluded that my condition has reached a stage whereby a liver transplant offers me the best chance of – in my case – maintaining a sarcastic presence and annoying my children for a bit longer. So in early October I will be ‘inducted’ onto the programme and join what the British people love more than anything else, a queue.

As far as I can make out the rules of the queue are as follows:

  1. You can push in. If you are more poorly you might be prioritised, although I don’t think my currently bothersome achy knee qualifies.
  2. You can’t travel too far from your transplant centre. It is unlikely therefore I will be wintering in Mustique, seeing Paris in the spring and even Chelsea (away) might be a push. Thankfully Rotherham is a ‘go to’ destination this autumn where Jamie Oliver’s culinary legacy will no doubt have flourished since his TV series attempting to wean the population off their diet of chips, kebabs and aggressive alcoholic consumption.
  3. You have to pack an ‘overnight’ bag. This is similar to the one expectant mothers pack in the first couple of weeks following conception that contains recordings of whale songs, essential oils to massage into the temples and a do it yourself vasectomy kit for the man in your life, to be pressed into use in the immediate aftermath of the birth. The one I’m packing however is a bit more practical:
    • A bullet. To bite on. In case the anaesthetic doesn’t work and we have to do things ‘the old fashioned way.’
    • A Swiss Army Knife. In case the surgeon gets a bit flaky. I’ve seen 127 hours and spent a lot of my formative years with medical students who got great A Levels but could hardly read or write.  How hard can transplantation be? It’s not rocket science – it’s liver surgery.
    • Needle and thread. I’ve been practicing my needlepoint to put some fancy embroidering on my post – operative torso to impress the nurses.

One thing that is not clear is how long do you wait on a waiting list? How long is a piece of elastic? It could be quite soon but thanks to my relatively healthy disposition it is likely to be some time yet. Yet for the first time since my diagnosis, I at least have some clarity about a way forward. Currently, I feel that, as the Rolling Stones would put it, ‘Time is on my side.’

 

 

Resource planning

No sooner is dry January over than we have Lent, and another opportunity for those fearlessly contemplating a limited time to abstain from alcohol to publish their travails over the internet. ‘Day 3 – I’m over the worse of the shakes…this headache must be the toxins leaving the body…’ Laudable as these displays of self restraint are and the British Liver Trust does seem to think that periods of RnR for the body may have some benefit, enough already! I’m fast approaching my 1 year ‘goodbye to Guinness’ anniversary so can you please leave my bandwagon.

Speaking of which, hoving into view along with the new year were some other Liver illness thunder stealers. An honourable mention to David Bowie who succumbed to Liver cancer and left this mortal coil with tremendous dignity and a legacy that warranted the outpouring of tributes that kept the media saturated for days. Between Christmas and New Year, my father in law turned a brighter shade of yellow in what, it turned out, was a bile duct problem necessitating a prolonged stay in hospital and a worrying time for all those who know and love him. As I write he is out of the hospital but not out of the woods however he does not have any of the graver liver injuries that might have been supposed given his symptoms, so we are hopeful he will get better over time. My new found pretend liver specialist status was not much help, no real Hepatological consultant will be surprised to discover,  but if faith means anything to anyone these days, hopefully my prayers are.

I eagerly await 3 consultant appointments in three days next week to find out how much my iron saturation has reduced (Haematology), what impact my cirrhosis has had on my general wellbeing (Gastroenterology) and the status of the cirrhosis itself (Liver Transplant Hepotology). During the 3 appointments I will be dealt with by a number of medical professionals who use their skill, experience and care on a hopeless case like me. I can guarantee that not all of them will have been born or educated in the UK but that, like many of their colleagues, they maintain the exceptional service that is provided to UK citizens through the National Health Service.

There has been a lively debate about the future of the NHS as for long as I can remember. The recent flurry of activity does fill me with despair however given the nature of the main protagonist, Jeremy Hunt, who, whilst I am sure does have some redeeming features somewhere in his hinterland, does not appear to possess the capability to fulfil the requirements of this particularly important role. An ability to engage the people who rely on your custodianship, for example, seems to be strangely absent. An authenticity that will enable the same people (the ones who do the work) to trust you, is similarly invisible. We aren’t talking about British Leyland in the 1970s under Red Robbo, don’t forget. These are the diligent, top of the class, articulate, compassionate and dutiful people who will look after you when you are at your lowest ebb, from cradle to grave. I was once told about what a proper ‘open door management style’ should mean. It isn’t ‘my door is always open so you can talk to me about your problems  whenever you want.’ It is ‘the door is always open so you can leave at any time. My job is to make sure you are rewarded and valued so you don’t ever want to leave.’ Given the numbers of expensively trained medics leaving the NHS every year, Jeremy might take note of this. Or he could do worse than look at what is happening in football at the moment. Manchester United are currently enduring what is, for them, a real Mid-Staffordshire Hospital Trust of a season. Elsewhere, Paul Pogba of Juventus is rated the best young midfield player in the world, and Danny Drinkwater recognised as the ‘unsung hero’ of Leicester City’s unlikely table topping exploits, and both were former alumni of the Manchester United academy, as was Danny Welbeck who scored the winner for Arsenal last Sunday, all permitted to leave whilst more expensive recruits are being sought who may not or have not performed to the same level.

A few years ago, we had a skills shortage in trades like plumbing. Amusingly there were stories of stockbrokers retraining as they thought they could earn more money fitting radiators that dealing in equities. At the same time, the government rang Poland and asked them to send over their plumbers to unblock the nation’s U-bends. After checking to see if they could ‘squeeze us in as they had a big bathroom to fit’ over they came to save us from becoming a land without heated towel rails. The thing about resource planning though is its not just a numbers game. Plumbing is actually a highly specialised skill even if you haven’t attempted CORGI registration. The skills and behaviours required to be a medical professional are even more complex and gaps cannot be filled like cells on a pixelated excel spreadsheet. Trying to solve problems like employee engagement, attrition and under-resourcing cannot be solved sustainably by ‘ringing up the temp agency.’ The current manager of Manchester United hangs onto his job at the moment protected by an exceptional CV with a proven track record that has bought him some time. I do not think that Jeremy Hunt can validate his capability like Louis Van Gaal can, with his championships and European Cups. An expensively procured PPE at Oxford really does not hold a candle to the qualifications, both academic and professional, that the people hold I will be seeing next week.

Advent – tis the season to be jolly

It seemed that last weekend pretty much everyone in my social orbit (aka Facebook) had some kind of office party. My timeline was filled with an alcoholic advent calendar, each window opening on a new close up of a cocktail, a  panorama of prosecco, a selfy with Staropramen. Those not ‘happy in the haze of a drunken hour’ were in the McDonald recovery suite hoping that carbohydrates would repair the damage done to their equilibrium.

I have a complex but fairly non-judgmental view of this festive bacchanal, where preparing for the arrival of the saviour has been replaced with preparing for the arrival of the hangover. As a sober observer who has in the past been first amongst equals into the fray, but now stands like a conscientious objector observing the carnage, I cannot confess to any feelings of personal loss. I worry about some of the more enthusiastic participants as, although a long way from expert status, I have gathered enough knowledge about liver damage to understand – SPOILER ALERT  – that prolonged heavy drinking is not a good idea. I suppose I winged it myself through what Bob Dylan called ‘those long and wasted years’ (before he became an X Factor star by proxy), my Guinness absorption capabilities becoming legendary along the way. That my liver diagnosis is due to another condition rather than alcohol abuse is a matter of record, although ironically (there’s that iron based pun again – I promise I won’t do it again) my liver might repair more readily had it been damaged by alcohol rather than the iron that still courses my veins at levels so ridiculous I was worried that in the recent downpours I might be a rust risk. Incidentally, ‘the liver will repair’ is a fool’s errand. If you cut your knee it will heal. If you do a knee slide across a gravel path every day it won’t.

That is why, in early March, and in advance of formal diagnosis I had the following conversation with the alcoholic beverage community:

‘I’ve been thinking – I don’t think it’s working any more. It’s not you – it’s me. I want to move on. I’m not sure whether this relationship is healthy. You’ll find someone else. Don’t call me – it’s best we have a clean break.’

That weekend my oldest friend was celebrating his 50th birthday. His mum and mine met in the ante-natal clinic and so we began what was literally an embryonic relationship. That’s why I’m confident in saying he is definitely my oldest friend. It was there, with the sounds of an exceptional band ringing in my ears (The Extras from Southport – check them out) that I downed my last pint. Will I ever have another? Some interesting ‘when to fall off the wagon’ conversations have been held mostly revolving around United and the European Cup Final. I can only assume that Louis Van Gaal, respectful of my health status, is doing his best to ensure it will be a long time before I have to encounter that dilemma. I really don’t think I will ever want to have another drink though. The adjustment was not a problem – I was never dependent and so choosing not to drink alcohol has been easy in comparison to adjusting to other elements of my diagnosis. I am focussed on looking after my liver in its poorly state. If I can do that, I will be able to look after everyone else I care about that bit longer. If advent means anything to me it is that the gift I treasure most does not come in a barrel or a bottle. This weekend in a decision I have to confess I have been a bit animated about, after denouncing Bob Dylan a few years ago, Simon Cowell has committed the ultimate crime against music by electing to use ‘Forever Young’ as the X Factor Christmas Single. The lady singing it has a bash but the potency of the lyrics is lost in the over-production. Nonetheless, on Christmas Day this year, instead of the wine or port or advocaat, my indulgence will be to remember the lines ‘may your heart always be joyful, may your song always be sung…’ Unfortunately for my nearest and dearest, it is my intention to be singing it tunelessly for a few more Christmases to come.

 

Iron man

Iron is a chemical element with a symbol Fe from the Latin Ferrum and an atomic number of 26. My wife was born on the 26th. That’s two elements that have caused havoc with my life sharing the same number. Co-incidence? It is by mass the most common element on Earth according to Wikipedia  (to clarify, I’m back on iron here, NOT my wife) , and has played a significant part in human history. It has an Age named after it, and later in history, was refined to produce steel. It also plays an important role in biology helping to form the molecular structures that help transfer oxygen which is why, in short, Guinness is good for you.

Like much of the elemental nutrition we introduce to our body, you can get too much of a good thing. Iron is particularly problematic if we absorb too much, as we have no real means of processing and excreting it. So as appealing as a sprout and Guinness only diet might appear, it would not be recommended as it would lead to potential health complications and unless you had a particularly understanding social circle, being completely ostracised from any human contact.

For most people, eating iron rich food as part of a balanced diet is beneficial. If you are anaemic for example, you are encouraged to eat an iron rich diet and to aid iron absorption by drinking fruit juice. If however, you have a slight genetic malfunction, you can unwittingly absorb too much iron from whatever food you eat, which, because it has nowhere else to go, ends up in vital organs, especially the liver, where it begins to take its toll. My smoking gun, my Achilles heel, the petard upon which I am hoisted, is just that. Or to use its posh medical name, Genetic Hemochromatosis.

GH is fairly rare in the sense that there is a requirement for both parents to be carriers to become a sufferer. My children have been confirmed as carriers but have not got the disease. My sister is neither a sufferer nor a carrier. That’s the way the genetic cookie crumbles. It is more prevalent amongst white northern Europeans, particularly Celtic descendants and is sometimes known as the ‘Celtic Curse.’ Other than liking the music, drinking Guinness and quoting W B Yeats, I have not really embraced my remote emerald  heritage in the way I see quite often living where I do, in a community where Irish dancing and having children with names that are difficult to spell are still the norm. It seems that my heritage has sought me out nonetheless. The iron-y!

My brilliant haematologist imparted all this information to me (not the Guinness bit, the bit about iron) over the course of a number of appointments in the spring of 2015, A routine blood test had indicated low platelet count, which was potentially indicative of liver malfunction. After a whole raft of further tests, it was found that the level of iron in my blood was 8 or 9 times higher than normal. The tests also indicated my liver was not functioning properly in many ways, and a scan depicted the scarring and lesions consistent with cirrhosis. So despite having no symptoms, I suddenly found I had this relentless condition that was slowly destroying my liver. Thankfully, the biochemical evidence is so fiendishly complex to the layman that I was too busy learning about the condition so I could appear clever, to ever get particularly concerned about the actual impact. What was apparent was that, whatever treatment regime I was put under, and before all the various diagnoses were actually confirmed, a priority for me was to give up drinking alcohol. SPOILER ALERT: Guinness does have a bit of iron in it but nowhere near enough to damage your liver. It’s alcohol that does that.

There is a treatment for GH. It isn’t a curable disease but the excess iron can be removed from your body over time to reduce it back to normal levels. Every fortnight I go to Oldham Royal Hospital Haematology Ward to meet the vampire girls. They carefully introduce a knitting needle gauged conduit into my arm and remove a pint of blood. This means that the body will produce another pint of blood to replace the one that is removed. As the new blood is unadulterated, over time the iron levels will gradually reduce to manageable levels that will stop any further damage occurring. This will take between one and two years providing I can manage to continue the process. It was either this, or leaches. There are two disappointing elements to this process. Firstly, none of the gallon and a half of blood I have so far rendered can be used for blood donation owing to the high iron content. That makes me sad as I used to be a blood donor. That means that someone reading this should step into the breach and replace me! Its simple, painless and greatly needed. Go online to http://www.blood.co.uk/ and sort it out. The other disappointment is that, owing to the number of times I go, I can’t get away with quoting extensively from Tony Hancock’s ‘The Blood Donor’ (‘A pint? That’s practically an armful!’). You can watch some of it here:

I doubt that the wonderful Haematology nurses who look after me every fortnight (they don’t really resemble vampires at all) would be quite as careful with their needles if they had to put up with me trying to be funny. It doesn’t go down well any where else in the world – why should it work there?

This morning I went to Bury Market. The Borough Market in London, the Boqueria in Barcelona, and the Grand Bazaar in Istanbul grab the headlines in the glossies, but Bury Market is every bit the equal of them. Its most famous produce is what the French call Boudin Noir, the Spanish call Morcilla, and we call Black Pudding. Whistfully, I looked at the steaming vats, simmering within the regal delicacy of onion, oats, herbs and blood first combined by Alexander the Great to feed his troops that would conquer the known world. If you want to consume something that will give you Iron in the Soul, have a bash at one of these. Once my blood is down to an acceptable level of Ferritin Saturation I will join you.