Lessons I Learned While Warded in the Hospitals! Part 6: What Is Wrong with Me Doc.? I am confused!

My Overall Health Based on Blood Test Results

After being discharged from hospital C, I did a more detailed blood tests in a private clinic. This is to give me an idea of what other problems I could have. Below are the results:

16 June 2024

Cardiac Profile:          Creatine Kinase   35   U/L  (46-171)

• Creatine kinase (CK) is an enzyme that’s found in the skeletal muscle, heart muscle and brain. When any of these tissues are damaged, they leak creatine kinase into the bloodstream. Elevated CK levels may indicate muscle injury or disease (from Cleveland Clinic).

Liver Profile:     Alkaline phosphatase, Total bilirubin, SGPT(ALT), SGOT(AST), GGT – all of these are within normal limits. My liver is healthy.

Renal Profile:

	16 June	23 June	13 July	Normal range
Urea	10 mg/dL	14	18	9.23
Creatinine	0.55 mg/dL	0.62	0.70	0.70 – 1.30
Sodium	127 mmol/L	130	133	134 -145
Potassium	3.4 mmol/L	3.7	3.9	3.5 – 5.1
Chloride	93  mmol/L	96	100	89 -108
Bicarbonate	22 mL/min	23	24	20 – 31
eGFR	94.5 mL/min	97.2	93.7	> 90

• Creatinine is a reliable indicator of kidney function. Elevated creatinine level signifies impaired kidney function or kidney disease.
• Normal sodium levels are usually between 136 and 145 mmol/L Blood sodium levels below 136 mmol/L means hyponatremia, i.e. low blood sodium. Blood sodium levels greater than 145 mmol/L means hypernatremia – highblood sodium levels.

Hypernatremia typically causes thirst. Severe hypernatremia can lead to confusion, muscle twitching, seizures, coma, and death.

Symptoms of hyponatremia include: weakness, fatigue, confusion, seizures. Without treatment, extremely low levels of sodium may lead to a coma and become life threatening.

• eGFR (glomerular filtration rate) measures the level of kidney function and determines how well the kidneys are working. In adults, the normal eGFR number is more than 90.

Lipid Profile 13 July:         Cholesterol     323  mg/dL     (up to 200)

                                              Triglycerides   282 mg/dL      (up to 200)

                                              HDL cholesterol  48 mg/dL    (39 – 58)

                                              LDL cholesterol   219 mg/L    <130

• LDL (“bad”) cholesterol can contribute to the formation of plaque buildup in the arteries (atherosclerosis). This is linked to higher risk for heart attack and stroke.
• High cholesterol has no symptoms. A blood test is the only way to detect if you have it.
• Because of my high cholesterol level, I was started on a low dose cholesterol drug, Rosuvastatin starting 17 July 2024.

Rosuvastatin works by blocking an enzyme that is needed by the body to make cholesterol, thus reduces the amount of cholesterol in the blood.

What are the most common side effects of rosuvastatin? The most common side effects are: headache, nausea, muscle aches and pain, weakness, constipation, stomach pain

Other more serious side effects of rosuvastatin are: low energy levels or feeling easily tired, especially with activity, dark coloured urine, fever, liver damage or hepatotoxicity, severe allergic reactions. 

Am I really a sick man?

For decades, since I started CA Care, I have been asking patients to take care of their health mainly by taking care of their diet. Eat healthy food. Diet is very important for your healing and for you to stay healthy all your life! That was what I taught my cancer patients and that was what I personally believe and practise at home. Indeed, I was well and healthy (looking from the outside). Everyone who met me had expressed the same opinion – you look healthy and strong! But in early June 2024, this turned to be a myth

Based on medical reports:

1. I am a diabetic. My Hemoglobin A1c was at 13.6%, which was a very high value indeed. An ideal HbA1c level is not more than 6.5%. My glucose was at 20.5 mmol/L. The healthy range is 3.9 – 5.8 mmol/L.
2. My cholesterol was 323 mg/dL The maximum level for a healthy person is 200 mg/dL.
3. My blood sodium was 133 mmol/L which was critically low. Normal range is 138-146 mmol/L. I have a condition called hyponatremia.
4. Blood tests on 17 July 2024 confirmed that my PSA was at 7.35 ng/ml. Healthy person should have a value not more than 4.0.

If you were to ask me (before my fall in June 2024) if was going to end up a diabetic or a person with high cholesterol, my reply was probably — You must me joking! I am a healthy man!

For the past 25 years I have been on healthy diet.  I rarely eat meat. I rarely eat the famous Penang hawkers’ food. I prefer home-cooked food. There is NOT a grain of sugar in my house because we never buy such stuff.

We minimize our intake of oil in our cooking. We also reduce / avoid fats and meat in our daily food intake. Our diet consists mainly of rice, fish, vegetables, soup, etc. About 30% of my diet consists of a variety of fruits – papaya, apples, grapes, bananas, etc. I don’t drink any alcohol. I don’t smoke either.

Almost every day my wife and I spent about an hour walking in the park, besides doing tai chi.

That leads me to wonder, where does the cholesterol come from?

The website of Johns Hopkins posted the following:

• The cholesterol in your blood comes from two sources:
• The food that you eat.
• Your liver makes all the cholesterol your body needs.

According to Mayo Clinic website the factors that can increase the risk of unhealthy cholesterol levels are:

• Poor diet. Eating too much saturated fat or trans fats can result in unhealthy cholesterol levels. Saturated fats are found in fatty cuts of meat and full-fat dairy products. Trans fats are often found in packaged snacks or desserts.
• Obesity. Having a body mass index (BMI) of 30 or greater puts you at risk of high cholesterol.
• Lack of exercise. Exercise helps boost your body’s HDL, the “good,” cholesterol.
• Smoking. Cigarette smoking may lower your level of HDL, the “good,” cholesterol.
• Alcohol. Drinking too much alcohol can increase your total cholesterol level.

You may want to ask, where do I go wrong here? I learned from this June episode that what I did all these years was right, there is nothing wrong.

According to Singapore Heart Foundation (https://www.myheart.org.sg/health/risk-factors/familial-hypercholesterolemia/)

• Familial Hypercholesterolemia (FH) is a genetic condition in which high LDL cholesterol levels are passed down in families, increasing the risk of premature heartdisease (i.e. chest pain, heart attacks, strokes) by up to 20 times over people without the condition.

So my condition is a genetic problem, inherited from either farther or mother. My brothers and sister also had this condition. My two sons also have familial hypercholesterolemia.

What do I do now?

According to Health Department of Victoria State, Australia https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/genetic-factors-and-cholesterol

• There is no cure for familial hypercholesterolaemia.
• Treatment aims to reduce the person’s risk of coronary artery disease and heart attack, and may include (a protocol which I have practising for years):
• Dietary changes – recommended dietary changes include reduced intake of saturated fats and cholesterol-rich foods, and increased intake of fibre.
• Plant sterols and stanols – corn, rice, vegetable oils and nuts – can substantially reduce blood cholesterol. These substances are structurally similar to cholesterol, but aren’t absorbed by the cells.
• Exercise – regular exercise has been shown to reduce blood cholesterol levels.
• Weight loss – obesity is a risk factor.
• Avoid smoking. 

Do I have prostate cancer?

The website of the National Cancer Institute (

https://www.cancer.gov/types/prostate/psa-fact-sheet#:~:text=There%20is%20no%20specific%20normal,have%20prostate%20cancer%20(1)) had this message:

• There is no specific normal or abnormal level of PSA in the blood.
• In the past, PSA levels of 4.0 ng/mL and lower were considered normal. However, some individuals with PSA levels below 4.0 ng/mL have prostate cancer and many with higher PSA levels between 4 and 10 ng/mL do not have prostate cancer. 

Mayo Clinic issued this statement:

• Misleading results. The (PSA) test doesn’t always provide an accurate result. An elevated PSA level doesn’t necessarily mean you have cancer. And it’s possible to have prostate cancer when you have a normal PSA level.
• Overdiagnosis. Some prostate cancers detected by PSA tests will never cause symptoms or lead to death. These symptom-free cancers are considered overdiagnoses — identification of cancer not likely to cause poor health or to present a risk of death.

Despite the negative data against me, I don’t panic but at the same time I would not ignore my elevated PSA test result. When I am home in Penang I shall start taking my herbal tea for Prostate. I shall keep you posted in the months to come. Let the truth be told!

There are 2 more issues to be addressed.

• My blood sodium was 133 mmol/L which was critically low. Normal range is 138 – 146 mmol/L. I have a condition called hyponatremia.

After undergoing intravenous (IV) sodium solution and taking sodium chloride pills I believe the problem is almost resolved. It is almost back to normal.

• My glucose was at 20.5 mmol/L – frightening high!

After receiving treatment in the hospital C and at home (without medical drugs) I am inclined to believe that I don’t have this problem anymore. I have written what I did in Part 3 of this story.

Let me give you an example of how my glucose levels fluctuate each day. This case was recorded on 10 June Wednesday to 11 June Thursday. The average glucose of the day was 7.3 mmol/L. The previous day was 6.2 indicating that I was normal.

However,  I need to remind myself that even though “blood wise” I have almost overcome my problems, I need to be careful and need to monitor my situation every day. Things may turn worse instead of better.

In general, food that cause blood sugar level to rise are those that are high in carbohydrates, such as rice, bread, fruits and sugar – which are quickly converted into energy,  Next are foods high in protein, such as meats, fish eggs, milk and dairy products, and oily foods.
(https://www.otsuka.co.jp/en/health-and-illness/glycemic-index/glucose-level/#:~:text=In%20general%2C%20foods%20that%20cause,dairy%20products%2C%20and%20oily%20foods.0).

• Glucose levels vary throughout the day. They tend to be lower before eating (A, C) and after exercise and are higher (B,D) an hour or so after meals.
• A blood sugar level less than 7.8 mmol/L is normal.
• A reading of more than 11.1 mmol/L after two hours means you have diabetes.
• A reading between 7.8 mmol/L and 11.0 mmol/L means you have prediabetes.