Category: Musings

What is your diagnosis, Bob?

~ quantumdreamer ~ Leave a comment

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I had a difficult night last night with a lot of pain. This usually happens after I visit Torquemada the physiotherapist. It settles down over the next few days and is generally much better because of his ministrations. He said, “let’s hope you don’t have even more pathologies.”

Some more blood tests results are due and I am sanguine about them. It took many months of rapidly worsening health for the wife’s Myeloma diagnosis. This after a very scary mis-diagnosis which had me contacting people assuming a strict time pressure.

My list of ills is relatively long and we could use Bob’s simple diagnosis. It is unlikely that there will be some overarching diagnosis which explains everything.

We can’t turn back time. And there are many things in life which cannot be fixed, solved or otherwise put right. Social conditioning suggests that an apology can make things better. An apology does not alter Karma and forced begrudging “false” apology makes things worse karmically speaking. If there is some genuine acceptance then that might take the sting out of the accrued karma, a little. What our parents tell us in kindergarten does not really work, “say sorry to Sally for nicking her Maltesers!!” It is a pretence often.

During the night I had a brief dreaming segment concerning Myeloma UK. It had occurred to me if we move back to get involved there. I have probably read more medical-disease-epidemiology papers than most. When I have interacted from here, I have come across a UK based parochialism, “that is the way we do things here!”  Best clinical practice in France, Europe and the USA is not followed due to the accountants at NICE. In a real sense if you do it well first time, it saves money instead of doing multiple rounds of cheaper less effective treatments.

Luckily the patent on Revlimid has expired.

There is a well paid career path in charity management and I am not entirely convinced that the high salaries are justified. I find the heavily PR oriented and sanitised Web presences a little unreal. I understand that they want to give hope, but they do airbrush reality. I understand that they are not aimed at the likes of me. They are often not very real and people revert to blogs and video from genuine human beings. Things need a human face not some corporate blah.

When I was looking for a job, I got interviewed for several board positions. Because I was a bit young and not one of the gang and all praising, I did not get the job. I was asked what I could bring. I said new ways of thinking, some energy and something fresh. Comfortable places with cobwebs don’t like that sort of thing. People in power although they like the theoretical idea of a functioning challenging board, do not really.  Itchy back disease is prevalent. I am more than 90% sure that I would have brought, eventually, positive change. I am very organised and good at process.

Apple carts do not like to be upset.

Sometime gatekeepers keep useful people at bay.

Anyway, only my alpha-globulins have come back low. Low alpha 1 can mean alpha-1 antitrypsin deficiency which can cause lung problems like COPD and wheezing!! This can be genetic…

Both alpha 1 and alpha 2 low can mean liver problems.

What do you reckon Bob?

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Serum Protein Electrophoresis (SPEP) Test

~ quantumdreamer ~ Leave a comment

I have been looking at results from these since December 2021 when the wife had her Myeloma diagnosis. There was a large monoclonal peak in the gamma globulin area, a characteristic “finger print”. I have seen dozens of these electrophoresis traces. Her therapy quickly reduced the monoclonal peak below the detection thresholds. The technique is key to the diagnosis of Myeloma and smouldering Myeloma.

My blood is having one of these tests done today. I have found that Canadian healthcare web sites have a nice balance of detail and not treating you as a numpty.

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South Tees Hospital Pathology

“Serum electrophoresis is essential in the investigation of suspected paraproteinaemia and immune deficiency. Characteristic patterns are also seen in the presence of an acute phase response, nephrotic syndrome, alpha 1 antitrypsin deficiency, inflammatory and infective disorders. SPE is performed on all specimens submitted for immunoglobulin quantitation to check whether the immunoglobulins are polyclonal or monoclonal proteins. Polyclonal increases are due to and increased activity of numerous different lymphocytes and are associated with a wide range of infectious and inflammatory diseases including liver disease. The main value in serum electrophoresis is detection of monoclonal immunoglobulins associated with lymphoid malignancy, myeloma or related haematological disorders. Since quantitative immunoglobulin measurements cannot differentiate between monoclonal and polyclonal immunoglobulins, paraprotein determination (monoclonal protein) must be carried out by quantitation of bands obtained on electrophoresis.”

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From https://myhealth.alberta.ca

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“The serum protein electrophoresis (SPEP) test measures specific proteins in the blood to help identify some diseases. Proteins are substances made up of smaller building blocks called amino acids. Proteins carry a positive or a negative electrical charge, and they move in fluid when placed in an electrical field. Serum protein electrophoresis uses an electrical field to separate the proteins in the blood serum into groups of similar size, shape, and charge.

Blood serum contains two major protein groups: albumin and globulin. Both albumin and globulin carry substances through the bloodstream. Using protein electrophoresis, these two groups can be separated into five smaller groups (fractions):

  • Albumin. Albumin proteins keep the blood from leaking out of blood vessels. Albumin also helps carry some medicines and other substances through the blood and is important for tissue growth and healing. More than half of the protein in blood serum is albumin.
  • Alpha-1 globulin. High-density lipoprotein (HDL), the “good” type of cholesterol, is included in this fraction.
  • Alpha-2 globulin. A protein called haptoglobin, which binds with hemoglobin, is included in the alpha-2 globulin fraction.
  • Beta globulin. Beta globulin proteins help carry substances, such as iron, through the bloodstream and help fight infection.
  • Gamma globulin. These proteins are also called antibodies. They help prevent and fight infection. Gamma globulins bind to foreign substances, such as bacteria or viruses, causing them to be destroyed by the immune system.

Each of these five protein groups moves at a different rate in an electrical field and together form a specific pattern. This pattern helps identify some diseases.

Serum protein electrophoresis is most often done to help diagnose and monitor a wide variety of conditions. These include:

  • Some forms of cancer.
  • Problems with the kidneys or liver.
  • Problems with the immune system.
  • Conditions that lead to poor nutrition.

High values

High values may be caused by many conditions. Some of the most common are shown here.

  • High albumin: Dehydration
  • High alpha-1 globulin: Infection; inflammation
  • High alpha-2 globulin: Inflammation; kidney disease
  • High beta globulin: Very high cholesterol; low iron (iron-deficiency anemia)
  • High gamma globulin: Inflammation; infection; liver disease; some forms of cancer

Low values

Low values may be caused by many conditions. Some of the most common are shown here.

  • Low albumin: Poor nutrition; inflammation; liver disease; kidney disease
  • Low alpha-1 globulin: Some genetic problems
  • Low alpha-2 globulin: Kidney disease; some cancers
  • Low beta globulin: Poor nutrition
  • Low gamma globulin: Problems with the immune system “

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Given the high levels of ferritin yet normal levels of transferrin in my blood, the primary screen has to be for liver disease. But the bullet point for cancer above has quite a list behind it. I guess that the beta globulins may be abnormal in some way because of Iron. Anything weird in the gamma region means more tests…There are rheumatological factors. The tests show inflammation. I don’t think at 100kg I class a malnourished.

Anything non-standard will mean more tests [probably].

I’ll speculate that more tests are somehow “on the cards”.

Social Blurring and Status Problems

~ quantumdreamer ~ Leave a comment

During the night I came up with this term “social blurring” to try to verbalize something which has seemed difficult to / with me in my social interactions. That is behaviour within the common social-conditioned view of the world. It is surprisingly difficult to put into words.

One could say that I do not have the “proper” respect for social position and authority. Nevertheless, I am law abiding, these days. I am pretty sure that I have put noses out of joint among those who consider themselves higher, better, more powerful than me.  I am not prone to arse licking or sycophancy. I do not play the itchy back game in a transactional sense.  I do not curry favour nor do I butter up. It is possible that this has been noted. People have gotten hoity-toity with me when I have not shown enough respect “due” to their position in society. In some cases, this has caused a punitive response, particularly when I was a precocious graduate student. I have reason to believe that this detrimentally affected my career. To me it is no big deal if someone is a famous Prof, a CEO or a King. I see the person and not the status.

Clearly there are social “problems” inherent in this attitude. A mere pleb did not ought to think like this and perhaps needs reminded of their position on the ladder of life. I do not appreciate my position in “the” pecking order as a serf.

Various people have said things to me which made little or no sense to me but seemed to make sense to them.

My mother, from the Rhondda valley, said that I behaved “to the manor born”. Which meant that I was a bit posh and at ease in posh places like expensive hotels and restaurants. Nchanga Consolidated Copper Mines paid for four years at an English private preparatory school. I had an itinerant childhood and thus became an adept chameleon. I never had a sense of not belonging in a posh place. I can walk into the Ritz and feel at ease. I have been on stage at The Royal Albert Hall. I can walk into expensive private homes and not feel at awe.

Twenty odd years ago Théun Mares said that I was an alpha male. I thought to myself what the fuck is he on about. He kept banging on about this and some wolf pack interpretation of status. It had never occurred to me that I am in any way alpha nor dominant. I have no desire to assert position nor have underlings. I do not need nor want to snarl to keep a pack in line. In this weird world view I am a lone wolf not a pack animal. I clearly do not exert or exude the boundaries others anticipate. I am not interested in being top dog nor will I be overly submissive either. I don’t get excited by the intrigue of power struggles, nor can I be arsed with them. As a consequence of not snarling people can take the piss. The boundaries are blurred. Some, so I am told, like clear boundaries and definition of position in pecking order.

When I was a lecturer, it never occurred to me that I had status and position, in that context. I saw myself as no better than the students and definitely not a font of all wisdom. I interacted in a manner similar to a third year graduate student with a first year graduate student. It was more working together than professing. When I left my job, it became abundantly obvious that there were elements of social positional power associated with that role and the institution in which I had been institutionalised. It was a big deal for some, whereas for me it was bog standard. The lines between staff and student were accidentally blurred. I saw them more as equals than underlings.

In a weird sense I am used to being listened to irrespective of social position, there may even be some residual expectation of that. This expectation is rarely met. I have mostly gotten used to it, though on occasion it can flare up particularly if the other person concerned is ignorant and yet adamant in their ignorance. Sometimes I fail to hold my tongue and I do not care what their social standing may be.

In general, I am not awed by social positions but may be socially awkward when in numbers. I just find the ritual sniffing or normal social interaction boring and pointless. This means that I do not satisfy apparent needs / requirements of others. I can seem like an odd fish. I have no need to brag and claim social ladder rung in consversation..

When I have had “power” I have not wielded it. Nor have I taken advantage of that power when I might have. Being a young man with a paper share value of £ 2 million has an impact on knicker elastic. I feel pretty sure in my self that I have been tempted by power and come out the other side relatively unscathed. I did not turn into a power crazed arsehole.

I keep coming back to a perception that somehow, I do not fit what others expect.

I do not see others as better than, higher than me. Nor do I see others as beneath me. I am no better. I may be more experienced and intelligent, but I am not above. It is a kind of egalitarianism which can make people uncomfortable. There are some who have deferred to me and others who are perennially spoiling for a fight as if to assert position in pecking order. A fight I have no interest in partaking in. It has been my perception that people who have thus engaged have failed to learn whatever it is that I might have taught them. The immediacy of perceived status and competition for it has blinded them. Some people want to bring me down, teach me a lesson.

Perhaps the overarching weirdness in this life has been the number of people who want to tell me something, argue the toss, try to convince me they are right and otherwise teach me.

“That’ll learn ‘im!”

It remains an unsolved mystery as to how and why others feel the burning pressing need to educate me.

Because I do not have strong demands or wants, I have been pliable and subject to manipulation. I rarely have an agenda in contrast to many.

On occasion people have looked to me to provide a lead, only later to undermine me when that lead has not been to their liking. I have come around to the idea that I like planning and envisioning way more than execution. I am certain that I am not cut out to provide any ongoing leadership role in a socio-political sense because I cannot be bothered with the social “niceties” and tedious transactional negotiations. I am not a sycophant nor am I prone to sycophancy. In terms of leadership, I can sustain that for very short terms only. Sooner or later its will go pear shaped because I am unwilling to play the “normal” games.

Quite how and why I was born with this set of self-perceptions may be due to prior incarnations, prior learned inclinations. The more I have meditated the less impressed with socio-political status and imagined kudos I become. The whole notion of “advancement” “position” and social rank escapes me. Even though for others I once had a little.

As far as I can tell my beingness and how I am interpreted by others do not match. There is nothing I can do about that. I have to reel myself in because if I let it go, fully, people might struggle.

I am socially a bit of an oddball. At first pass I seem OK, normal-ish. There is some blurring where social perception and shoe-horn expectation does not fit. My behaviour has been “status” inappropriate not in a criminal way, rather something which is mildly unsettling for others.

I don’t fit the social conditioned mould as well as a I might.

Big Cheeses and Kudos

~ quantumdreamer ~ Leave a comment

I’ll speculate that Herr Trump sees himself as a big cheese and wants people to kiss his ring. The orange don, Donald, has a big army, navy and air force. I doubt anyone looks forward with unbridled glee at the notion of a public meeting with him. These meetings are a necessary evil. He is not a pleasant man. In societal terms he is a high kudos being, though some may not wish to brag about their associations with him. He is not universally good PR. He can be bad for business. He has a lot of power.

Kudos is context specific. To a MAGA wannabe an endorsement from the “don” is manna from heaven.

We are watching recorded University Challenges on YouTube. Quite often there are questions on Nobel Prizes and Laureates. These prizes are high kudos and should you win one it will boost an academic salary and secure your job. Universities like the kudos of bragging about Nobel Laureates.

“Look at us we are special!”

Even though I was recently incarnated as a scientist I struggle to recall who won, with whom and for what. I have even met a few of these winners.

According to Professor Google there are / have been around one thousand Nobel Laureates. This means that England football captains are less common and world cup winning England football captains a positive rarity. In some {most} contexts football is more important and more significant than someone boffinacious. Aside from a few like Einstein, people know the faces of Beckham and Lineker better.

Lhamo Thondup the Tibetan tulku also known as Jetsun Jamphel Ngawang Lobsang Yeshe Tenzin Gyatso or H.H. Dalai Lama is one of only 14 reincarnations. To many in the world he is a high kudos being and his face is easily recognised. He has met Bush, Obama, Cameron and Merkel inter alia. It is good PR to be seen in his presence. He is a spiritual big cheese. He gets invites.

People can speak in awe of people like Friedrich Nietzsche. You must be brainy to read him. Strangely he played a big part in my interest in Buddhism

“Goodreads” attributes the following quotations to Nietzsche.

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“Sometimes people don’t want to hear the truth because they don’t want their illusions destroyed.”

“Truths are illusions which we have forgotten are illusions.”


― Friedrich Nietzsche

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In academic circles it is more accepted to quote him than Padmasambhava. The latter is a very high kudos figure in Tibetan Buddhism, a supposed Nirmanakaya of Buddha.

Many big cheese are also legends in their own lunchtimes, others are not, they are humbler than that. In the UK, research assessment exercises have sought to measure peer esteem or kudos. This is such a subjective thing and wholly non scientific yet those keen to get research grants played along with something close to a convenient heresy.

The ascribing of kudos is a very personal and hence subjective thing too. We have the phenomenon of fans who attach much kudos to their heroines or heroes. They may even pay for used clothing or bath water. Kudos is attached to corporeal relics of saints and Buddhas. The essence which may have once imbued the relic is long departed. Perhaps saints have way more than eight fingers and two thumbs so everyone can get a relic.

Despite the positional power which kudos affords in a socio-political sense it is not real. You cannot measure it with a laser and a detector. When you die you can’t take it with you.

People can make huge faux pas dancing upon the minefield of kudos. Kudos is another word for something we desire in a social-construct sense. We may seek recognition or affirmation from the herd, the shoal. Even if we are awarded with a measurable trinket, kudos is impermanent. One can fall from grace off one’s glittery platform shoes like Gary did. A fall from the lofty heights of kudos is difficult to bear.

We may hold things important which others do not. We may fail to attach importance to something revered by others. We may be arrogant in our notions of what is significant and to which we ascribe our personal kudos.

Trying saying kudos, kudos, over and over!! Very quickly is starts to sound silly.

Some people want to become important, significant big cheeses. Some imagine they already are. Many have a sense of grandiose entitlement.

Just as some want to be top dog others want to be a big cheese.

“If you thought $30 for a pound of blue cheese was expensive, wait till you hear how much this Spanish blue cheese just sold for.

Clocking in at $6,682 per pound, a wheel of Cabrales blue cheese from northern Spain earned the title of the world’s most expensive cheese after a 2.2 kg (4.85 lb) wheel was sold at auction for €30,000 ($32,408.10).

The auction took place at the 51st annual Cabrales Cheese Competition held in the Principality of Asturias. Bidding started at €3,000 and quickly rose as passionate turophiles battled for the right to own the first-place cheese.

In the end, restauranteur Iván Suárez won the prized wheel. Suárez told Spanish news outlet EFE that “the passion for the land” and “recognizing the work of all the cheesemakers” made him buy the cheese.”

New Record for World’s Most Expensive Cheese Josie Krogh | August 29, 2023

Faux Pas and Extracurricular Activities

~ quantumdreamer ~ Leave a comment

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Faux Pas: a significant or embarrassing error or mistake: blunder

especially a socially awkward or improper act or remark

: an embarrassing social mistake

A faux pas literally means “wrong step” in French.

You could just use the term “fuck things up” instead, but if you wanna look classy, use “faux pas”.

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There is in human thinking the notion of social hierarchy where status and kudos are important. It is easy to misread these often unwritten pecking orders and clues. One can get things wrong. Some cultures are more sensitive than others to such mistakes. When pecking orders abut things can be indeterminate and the possibility for miscalculations high. To prevent error some societies, start with the concept of humility and perhaps “lower” themselves until the minefield is better understood and thereby negotiated.

A big cheese in one system is small fry in another. I found that in “business” and “industry”, for example, academics are not held in very high regard. A VC said to me that from time to time they do invest in a “prof in his garage” but that such things were very risky, early stage. A young Ph.D. student might see Prof. X, in his garage, as being near deity perhaps having aspiration to emulate and to join the Gods. Working across hierarchies and socially invented pecking orders can be tricky. Some prefer Stilton others Emmenthal. It takes all sorts.

Apparent power can be gained by association. A long time ago when on business selling some science ideas in Tokyo, I was on a mission from my then Sensei to hunt down any video / film footage of various “obscure” old-school Iaidō masters. I was given some text in Japanese and the addresses of various martial arts shops dotted around Tokyo. Sensei was an advanced practitioner of various Ryu and Japanese trained. These shops were well off the beaten track and some had a dōjō associated. On a number of occasions on furnishing the Japanese text the shopkeeper called into the back and an older Japanese man came out to help me. They took the task very seriously and furnished me with more “leads”. It was obvious that I had kudos / respect by association even though I was a low grade student. It was the Ryu and his mastery that conferred. I was ultra polite and very careful so as not to bring disrespect and dishonour. They were very keen to help and found it interesting that Sensei was teaching in a small classical dōjō in London. I knew that disrespect might, if gotten out of hand, prove fatal. It was all very good natured and fun. No faux pas was made and allowance was made for my gaijin degrees of gauche.

At the time I was a lecturer in physical chemistry and soon to be start-up co-founder. Nobody where I worked could possibly have understood all the subtleties of what my major extracurricular activity was. This was more important to me, in some senses, than my job!!

We really do not know what is going on for others. There is a back story for most about which we are very largely ignorant and unaware. It is easy to barge around like a bull, on amphetamines, in a China shop and make huge fuck ups. The more arrogant and know-it-all we are the more likely it is.

Like a frog in the bottom of a well people can be a big-Gouda in their silo unaware that there are oceans out there. People are blind and blinkered in their silos. You can try to tell a well dweller about life outside the well but they may not accept that such a thing exists. In the absence of six-sigma proof they will deem extra-well existence impossible and mere conjecture, pseudoscience even. Because they have not seen an ocean, they will not accept your stories about them. Their adamant insistence means that they will probably never have the experience. They will go to their “graves” saying “I told you so. I am right. Oceans are figments of imagination!”

If someone unaccustomed to an ocean goes swimming therein, it is easy for them to get out of their depth. They may not have had this experience before and the notion of being out of their depth is alien to their omniscience. If you say, “careful you are out of your depth”, they are likely to pooh-pooh and disregard. When they get tired and can no longer swim, panic can set in. Being out of their depth they do not know how to proceed.

In general, I have found that trying to warn people that they are stepping into something they do not understand is fruitless. You warn, are assumed weird and a numpty. They disregard the warning and proceed full steam ahead into clusterfuck territory. There is nothing you can do, if an arrogant person needs that experience, who am I to rob them of it? By definition it is impossible to teach a self-diagnosed omniscient or know-it-all, anything.

People in silos or wells are ignorant of life outside the well but they don’t know it nor will they accept it.

If for example you were a skilled physical chemist accustomed to using synchrotron radiation to elucidate the properties of lipid membranes and you were thrust into the midst of a Vajrayana demon banishing ritual it is unlikely that you would take it seriously and believe. You might think it quaint and an indigenous ritual. You would not feel nor note the exorcism. After all synchrotrons are more real and more important than Vajrayana magic.

Maybe one day you might on a whim play with a Ouija board. Because you know best there would be no danger of you opening a portal and allowing a demon in, to feed off your aura and possess you.

People do not understand that “expertise” does not travel well between contexts and worlds. And if you are sufficiently ignorant to make the faux pas of pissing off a demon, there could be hell to pay, literally.

But of course, outside of your well, demons do not and cannot exist, you are adamantly correct about this, are you not?

Squeamish About Death – Place Your Bets

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I think it fair to speculate that many are afraid of death and the concept of dying. Opinions differ on the nature of afterlife, if there is one, and although reincarnation is a widely held concept there is no direct physical proof, rather circumstantial evidence. People are curious about what happens when you die. If one is simply extinguished then death is not to be feared whereas loss of life might be.  Time wasted is regretted.

People say “it is tragic that so and so was taken from us” when in fact death is a wholly natural process, at least on our planet. Few say, “it is natural that he passed away.” There is much social conditioning around death.

Humanity has a hang up about death.

I saw my first deaths up close in the Zambezi River aged ~11. One man died by drowning the other by crocodile. I had to write the account for the local police because they, grown men, were unable to write. Somewhere that report of death in my scruffy childish handwriting may still exist.

No matter how strong your faith, what your teachers tell you, nor whatever is written in books, from a philosophical point of view, whatever your opinion about death is, is simply that, opinion. There may be aspiration or wish. In effect you are placing your bets on what may or may not happen. This may be conscious or simple laziness. People can drift sleepwalking towards their death. Some contemplate it up close and personal. I’ll speculate that it is better to be prepared.

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To think about death can be seen to be morbid. On the other hand it might be wise to take advice from the inevitability of death and change your actions accordingly. No matter how squeamish you may be about death, dying and the death process, it awaits you. Your allotted time, your length of planetary sejour are finite.

If you are placing your bets on there being no heaven or hell, then you could be in for a surprise when you find “yourself” conscious therein. If you are shit-scared of dying then the process for you will be very uncomfortable. If you are relaxed and ready, then whatever happens will be more facile.

According to religious theory you cannot get away with placing a spread bet, covering all options. You need to choose, decide and commit.

If you are somehow still conscious after death and visit your old “haunts” to see what is transpiring, you could be in for a surprise. If you came to check up on me, to say hi. That might be a surprise for you. What might you say? If I was less surprised than you, would that be surprising for you?

If the light simply goes out there is nothing left to worry about.

At the end of the day, literally, how you approach death depends upon where you have placed your bets in life, what your opinions, points of view and actions have been.

Death although it can be in a public space with people, is largely personal. I don’t believe that you can bullshit death. You may try to be in denial, but death will not care. You are effectively alone on your own when you die. That may not be brain consciousness as we know it. But there is nobody “there” with you on the “inside”.

I don’t think that being squeamish about death and dying is wise.

Genetic Counsellors and Cans of Worms

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I learned a new phrase today “genetic counsellor”. Apparently, at least in Canada, such things exist. I have been recommended to have the HFE gene test to see if I have hereditary haemochromatosis (HH). This for completion. Back in 1994 I visited this high haemoglobin “space” and was bled regularly at St Thomas’. Retrospect suggests that I may have had an ongoing health condition which was missed back then.

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They took an armful each time. 

This HFE mutation would provide a benign explanation for my raised haem and ferritin levels. My ferritin levels have been increasing with time over the last four years. I don’t really have many of the symptoms associated with the genetic disease. It is linked with the less benign polycythaemia. Which would require a wider more substantive gene panel test, so-called molecular oncology. The authorisation for this testing is probably reserved for specialists. Iron overload is not without consequences. It can “cause” cancer or be correlated with it. Medical literature often blurs correlation with cause.

The problem with all this new-fangled gene testing is that it can open a can of worms

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Needless to say, the genetics are complex.

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I would be a mutant of sorts…

The next stages are Iron MRI and/or liver biopsy. The latter does not sound like much fun!!

Liver disease is possible maybe even likely, but I am largely asymptomatic. My enzyme work was ok.

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The next stage of inquiry would be to look for myeloproliferative neoplasms which are rare, not lottery winning rare, but rare enough. Search of JAK 2 and other related things starts increasing the price. JAK 2 can mutate.

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“Mutations in JAK2 have been implicated in polycythemia vera, essential thrombocythemia, and myelofibrosis as well as other myeloproliferative disorders. This mutation (V617F), a change of valine to phenylalanine at the 617 position, appears to render hematopoietic cells more sensitive to growth factors such as erythropoietin and thrombopoietin, because the receptors for these growth factors require JAK2 for signal transduction. JAK2 mutation, when demonstrable, is one of the methods of diagnosing polycythemia vera.”

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The thing is looking closely at most people my age the chances are that you will find something which has gone wrong.

The French sites suggest that some kind of follow up is warranted because of my Iron status.

Not sure what if anything the GP will recommend….

The osteoporosis situation seems simpler to treat with some pills, supplements and vitamins. But could have an Iron cause.

Given that the haemoglobin situation has been ongoing for, perhaps, thirty years it seems unlikely that any new unpleasant things have suddenly taken hold. But the ferritin level has doubled since 2021.

There is part of me that thinks that I just let this all drop…The osteoporosis might have enabled the fracture of my femoral neck six years ago. I have perhaps been living with it since. Simple answer is to not fall over.

A few more pills is no big deal however…

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hereditary haemochromatosis – regularly being bled.

Not HH – Iron MRI / Liver biopsy —

Liver disease – it depends on what – treatments in absence of virus are usually diet and no booze.

Something fancy and esoteric – myeloproliferative neoplasms – massive complex can of worms

The French sites suggest that some kind of follow up is warranted because of my Iron status.

What is inside the can…?

Stuck, On Hold and In Limbo

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While the world is caught up in a Bruce Springsteen “Glory Days” rose-tinted-sepia version {drama} of what America might once again become, not much is moving forward. The capitalist evangelist nation has admitted it is no longer competitive and is thinking sanctions to protect its internal markets. Your average American is unwilling to work for the same pay as someone less corpulent.

The war in Ukraine and the barbarity in Gaza continue apace. The world watches, sits on its hands and talks but does not. Humanity is very stuck and harping on about the Glory Days will not help no matter how many Bud Lights you refuse to drink. There has been no genuine lead from the USA for near a decade. Unsurprisingly the economic miracle foreseen by the Brexit soap-boxers has not propelled the UK into becoming a world economic superpower. Cunning plans may not be well thought out.

There is a huge leadership vacuum in the world today.

In my opinion humanity is need of an almighty wake up call to re-start the “save the planet” agenda and to overcome the for profit climate change nay-sayers. The equation is simple choose to be “comfortable” now and do fuck all, then pay very dearly later. This manifesto will get you elected in a “popularist” sense.

Here we have decided to see if it is possible to get anything done to ameliorate my hips. We have decided not to attempt to sell and move. The idea being that two new hips is about a year if the waiting time is a few months. I can’t find data on French wait times. Nor do I know if it is even possible. At the end of the month, we shall have a little more information. Best guess is the earliest operation would be after the summer. If it was UK best case scenario is six months wait with up to two years possible / probable. I could spend a huge chunk of remaining life savings and get it done privately in Hampshire, near the ferry port.

At the moment we are on hold and in limbo. Things are up in the air with no answers. We share that stuck-ness with the world. The news on television is very repetitive, a daily Groundhog Day. I don’t care who is on Love Island nor what percentage of GDP the UK will devote to defence.

Humanity needs an almighty wakeup call…