My killer dinner: How a vegetable diet lead to organ malfunction
Nick Kettles lay critically ill, his organs failing. Then doctors discovered the cause of his illness - a plate of broad beans
Tuesday 22 May 2007
At first, I dismissed my pale, red urine as the result of a large beetroot salad I had eaten the night before. Nevertheless, as my pee turned steadily darker throughout the day, until it looked like strong Ribena, I began to wonder if I should seek medical advice.
Being a staunch vegetarian and advocate of all forms of complementary medicine, I was stubborn about seeking advice from a system that I believed was more concerned with sickness than wellbeing. It wasn't neat blood I was peeing, so surely there must be some innocent explanation. I would sleep on it, I thought.
Perhaps the fact that the short walk to the toilet was leaving me progressively breathless should have been the red flag; or, maybe, the entry in my book on homeopathy, which said "call 999" beside the description of dark red urine. But, then, these things are easy to ignore when you're short on oxygen and delirious.
After another half-pint of Ribena pee the following morning, and the insistence of my partner on how frightening my now yellow, jaundiced face looked, finally persuaded me to see a GP at the local hospital.
It's lucky I did. Little did I know that without treatment I was heading for major organ failure, a heart attack for example, within 24-48 hours.
Laying back onto the soft mattress of the porter's trolley, and breathing deeply from the oxygen mask clasped to my face, I watched the ceiling lights roll by above my head as we made our way to casualty. The thinly curtained cubicle did little to block out the constant noise and chaos of casualty; but I distracted myself by watching my little daughter's fascination with the "stats" machine I was being plugged into.
"What's the 89 per cent stand for?" I asked the staff nurse, as she took a blood sample. "That's how saturated your blood is with oxygen, my dear," she said.
"Oh, is that good?"
"No, you really need to get it up into the mid-nineties," she replied.
"Oh, so I've not got far to go then," I said, hopeful of a quick discharge.
The nurse paused to make sure she had my full attention, before adding, "You need to get there without the oxygen mask. That's what's keeping you alive. "
My partner held my hand tighter, as my mind swirled with this thought and more doctors and nurses poked their heads round the curtain to look at me curiously. "It's your face, darling," my partner said. "It's very yellow."
"But what's wrong with me?"
"They said you're very ill. They've got an ambulance on standby to take you to another hospital for kidney dialysis."
My jaw dropped as I took in the gravity of my condition for the first time.
A junior doctor then appeared and started flipping through a reference book in front of me, searching for a diagnosis. "Oh God," I thought, "I'm facing major organ failure, and they send a trainee.
"Does your lower back hurt?" she asked. I nodded sheepishly. It felt like my kidneys were racing. The thought of being wired up to a dialysis machine for life raced through my mind.
My partner was close to tears by now, and she scrambled through her handbag to find a pen and paper. "Where are you going?" I wheezed, as she pressed them into my hand and got up to leave. "The baby's nappy has leaked, I need to go home and change her clothes," she replied. " But, if you think you're going to, y'know, write me something."
The chaos of casualty swirled around my mind, for what might have been a minute or an hour. Finally, my urine test results came back. My kidneys were fine, but my urine was still dark red, with my blood count falling closer to half the normal amount. "This one's critical. Priority for the next bed, " the house doctor said.
Still uncertain whether I would recover, or lose more blood, I drifted in and out of consciousness, waiting for my first blood transfusion. There was no near death experience to report, but this experience was just as galvanising. I remember determining to live life fully, and not miss the opportunities to spend more time with my partner and daughter. If I pulled through, I would truly savour life.
Shortly after my first blood transfusion the following morning, the consultant haematologist arrived with five trainee doctors in tow, to goggle at my glowing, yellow face. "Would you send them out, please?" I cried. My partner had not yet arrived to visit me, and I really just wanted to be held, not stared at. The haematologist ushered them out.
At first he looked as baffled as the casualty doctors had been the previous day. With that magical sparkle in his eyes only expert consultants are able to muster, he said: "You haven't eaten broad beans recently, have you?"
"Oh, you mean the pound of sumptuous, steamed, fresh organic ones I ate with the beetroot salad two nights ago?" I replied.
"That would be the ones," he said with a wry smile. "It's possible they may have triggered this haemolytic crisis you're having."
"BROAD BEANS?" I thought to myself. "A vegetable has caused this?"
And a blood test confirmed I had favism - a simple enzyme deficiency. The broad or fava bean is the primary food that can cause a haemolytic crisis in people deficient in glucose-6-phosphate dehydrogenase (G6PD) enzyme.
In native Brits, this deficiency is relatively rare, but it's much more widespread in Africa (20 per cent of people) and around the Mediterranean (4-30 per cent). G6PD deficient people are more susceptible to the " oxidative stress", triggered by the high level of certain oxidants in broad beans and the subsequent haemolysis (abnormal break down) of haemoglobin that can cause.
I was very relieved, but also very embarrassed. Following the high drama of the previous two days, I felt like I had been unwittingly cast in a cheap 1950s B-Movie: "Revenge of the Killer Broad Bean". Was this some kind of karmic retribution for my vegetarian zeal? To be sure, I had never hesitated to remind my family about the risks they were taking by eating meat.
Thankfully, the cure is a simple one; the transfusion of G6PD enzyme rich blood, to stop the break down of haemoglobin. After receiving four more units of lovingly donated blood over the next two days, my urine and respiration returned to normal.
I was eventually discharged with a warning to avoid broad beans, certain other foods, and a very long list of both prescription and over the counter drugs. It was as simple as that.
At first, I returned to my normal vegetarian diet, sans broad beans of course. However, about a stone and a half lighter, and suddenly quite anaemic, I just couldn't seem to regain the good health that I had enjoyed before.
"Perhaps you should just lighten up about your diet," my partner suggested. "After all, meat is a good source of iron."
I feel a little hesitancy in sharing that I have taken her advice. The idealist in me feels like I'm letting the side down. To be sure, I'm no fast food meat head. I try only to eat meat that has been organically and humanely reared, but meat it is, and meat is what I now recognise my body needs.
Finding a balance between what we want to eat, our ideals, and what our body really needs, is not easy. As my experience shows, one man or woman's health regime, can easily be another's horror B-movie.
A cautionary tale for ambitious would-be authors.
X Factor judge will appear in court later this month
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