Anytimeisteatime

To add to OP's explanation of why his RBCs are going and staying low, you can transfuse people with blood to replace it, but it's not ideal to do it repeatedly for a couple of reasons:

• if your kidneys aren't great, a bag of RBCs is also a bag with quite a lot of fluid in it, so you have to go slow so the kidneys have time to kick out that extra fluid, or it will find its own place to go (like your lungs) or hang around making your heart have to work harder
• other people's blood has other people's proteins on it; every time you meet transfused blood, there is a chance you'll form antibodies to some of the foreign proteins their blood has and your doesn't have. So blood that used to be OK to you, now in the future isn't OK to you and you'll reject it. This is dangerous in itself- like massive anaphylaxis but to blood. Not ideal. But also...
• ... patients with chronic illnesses like cancer or kidney failure are at risk of urgently needing transfusions one day- say they get sick and their RBC count drops abruptly, they have a bleed, they have surgery, etc. You don't want to make it really hard to find blood that their immune system will accept one day down the line.

If you can, it's better to try to keep nudging the RBC count up with alternative treatments: iron supplements or even iron transfusions, treating the problem that's causing the anaemia in the first place, or trying to wait it out.

How come your justgiving page for climbing Kili says you left clinical medicine in 2012 and there's no one on the GMC register who fits your name with the middle initial given in an article about the KAT centre? And you're listed as Mr rather than Dr on the KAT website..? And no S Davies registered with the RCVS, though guess you wouldn't need to be registered in UK for veterinary practice in Nepal. But you would need GMC registration to work for MyWellness etc for UK patients.

Genuinely was just curious as have always wanted to become dual qualified vet/human med and know there are only a few around but hadn't come across you before, so went to Google where you studied and couldn't find anything. Plus you look super youthful for ~39 (minimum to do both degrees and GP training in UK before working at KAT in 2014).

Hoping there's a simple explanation for the above as your charity seems really cool and dual qualified vet/human med is also very cool.

Not OP, but as a med student, the first operation I ever saw was a oesophagogastrectomy- an operation cutting cancerous parts of the lower oesophagus and upper stomach out, pulling the stomach through the diaphragm and attaching it to the remainder of the oesophagus. To get access, they have to make a large abdominal incision, and also a large lateral chest incision, and deflate the left lung.

I was scrubbed so I could stand close enough to see the anatomy as the surgeon quizzed me on it. He casually asked me if I'd ever felt a fistula- the arterio-venous connection created for patients needing dialysis, which have what's called a thrill, a palpable vibration. I said no, and he took my hand and placed it on the patient's heart. "That's what they feel like," he said.

Luckily, I was wearing a surgical mask and he had his back to me, because my face was like Σ(゜o ゜) and I think I stopped breathing. I had my hand on a man's beating heart.

I've seen plenty of surgery since and sometimes it's pretty boring, but that was a great first experience in the operating theatre.

Ah, so you're not a doctor but work in public health? LSHTM don't do primary medical qualifications. How can you work for MyWellness etc?

Sounds like you've found an awesome niche to pursue your passions.