Category: Personal

Failure to Piss & Moan or Whinge & Complain…

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From the Urban Dictionary:

whinge

Verb To whinge

A British/Australian/New Zealand (possibly South African and other commonwealth) English word which describes incessant complaining. A behaviour commonly associated with poms/pommes/pohms/pommies (people from England).

If you want to get anything done in this country you’ve gotta whinge till you’re blue in the face!

Aw piss off ya blardy whingin’ pommie!

Whinging pom

An joyless English person who complains incessantly.

See Piers Morgan.

That Piers Morgan is such a whinging pom oh my god.

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This morning whilst trying to go back to sleep I was reflecting on a phenomenon of non-plussed. This is when I observe other people being non-plussed when I fail to piss & moan or whinge & complain in line with their normal level of their expectations. They seem not to know what to do when I don’t bemoan my lot or plead how terrible life is and how much miserable pain I am in {poor me, pass the feather boa.}


People are accustomed to hearing high levels of whinging and moaning and therefore expect these.

I have an idea that the medical profession don’t take me as seriously as others because I am not complaining endlessly and asking of their deity for help with my suffering. They can’t gauge things on the whinge / complain / moan scale.  I am too close to the zero-whinge state to be taken seriously.

As a rule most people like to have others hear there whinges and go, “there, there, poor you”. They seek someone to join them in their misery and seek affirmation of how terrible their personal suffering is, Bless.

If you observe, a fair percentage of so-called conversation is about complaint and woe-sharing. If people stopped whinging there would be a lot less. One is supposed to offer succour to the woe-sharer. If one does not woe-share people can be non-plussed. They do not know what to do or how to behave.

A very large amount of woe-sharing comes from the notion of how unfair the world is imagined to be. It is very victim and poor me in source. It is a bit sandpit or nursery, toddler like.

Who said that life is fair? Why do people have such an expectation?

Anyway, is seems to me that my failure to piss & moan, whinge & complain sufficiently leaves people non-plussed. It is a non sequitur which does not make sense. It can cause unease.

The Holy Trinity – Fat Fags & Booze

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Brixton Prison, Jebb Avenue London S.W. 2 Inglan

it was de miggle a di rush hour
hevrybody jus a hustle and a bustle
to go home fi dem evenin shower
mi an Jim stan up waitin pon a bus
not causin no fuss

when all of a sudden a police van pull up
out jump tree policemen
de whole a dem carryin baton
dem walk straight up to me and Jim
one a dem hold on to Jim
seh dem tekin him in
Jim tell him fi leggo a him
for him nah do nutt’n
and ‘im nah t’ief, not even a but’n
Jim start to wriggle
de police start to giggle

Sonny’s Lettah – Linton Kwesi Johnson

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Isn’t it funny that when you wait a long time for a bus at the bus stop near Jebb Avenue on Brixton Hill, there are none then all of a sudden three arrive at once?

Every weekday morning for around five years I waited at that bus stop.

Last Friday I had a radio-nuclide bone scan, Tuesday I had an ECG and comprehensive cardio ultrasound, tomorrow I will have overnight monitoring for sleep apnoea, Monday I will start taking industrial grade laxatives with a colonoscopy due Tuesday afternoon and next Friday I am due a CT scan to check for diffuse idiopathic skeletal hyperostosis (DISH).

What a fun-filled and action-packed time I have.  That is quite a lot to cram in. That is a lot of buses.

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Tomorrow I will get fitted for various monitoring including cardio. Later, they may go one stage further and do a hospital admission with full electroencephalography (EEG).

Given hip pain, enlarged prostate and hot weather, I am not sure they will get a good data set.

I don’t know what gizmo I am getting tomorrow. BUT if there is an EEG it could easily generate an anomaly which they may struggle to explain. I know from before and self-test that I can flat-line a fast Fourier transform frontal lobe EEG within the S:N ratio. If this happens in a sleep study it might raise questions or get ignored. I would be an anomaly.

The hospital version has EEG. It may never happen.

As a researcher one is trained to look out for anything unusual. I have a low parathyroid hormone level which seems anomalous. It makes my research bells go ting. It does not seem so important to others.

It seems to me that the consensus is coming around to the idea that the root cause of many of my ailments is being ascribed to the Holy Trinity, fat, fags and booze. My high iron levels will get adjusted during any hip operation by blood loss, in the first instance.

In terms of the Holy Trinity I only have fat left to renounce.

Whenever I watch a medical video, say on a part of the endocrine system, I think to myself that is a whole lot of variables which you are asserting to be interrelated yet you only have very few data points. Is that not a bit of a stretch?

I suspect that I would have been a shit medical student, too many questions. I would struggle with the exams.

In a fortnight’s time I should have a few more pieces of information, including my putative diagnosis of DISH.

Looking at the bus timetable there may be a wait……after a fun-filled and action-packed week.

Touch wood, cross fingers etc.

ECG Anomalies and a CT Coronary Angiogram

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Well, more rides on the medical merry-go-round are in store. I have a patchily shaved chest to which they attached the electrodes and they found some anomalies, a slight lowering, in the ST part of my ECG trace.

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These can be due to ischaemia {low blood supply} or muscular hypertrophy. The nice young man was very thorough with a good bedside manner. He has recommended that I get a CT Coronary Angiogram, a new procedure to me. So I have just emailed the request to the radio people.

He was reassuring but you don’t fork out for fancy tests on a whim. There is a reason…

My gut feeling to get the cardio MOT done early was right. I figured there could be some twists and turns.

There are a lot of medical threads out there which hopefully we can make some global sense of {eventually}.

Luckily, I know where the radiography department is, it is near the nuclear medicine place I was at Friday and close to the coffee machines.

More loyalty card points for me…

Gandalf and Felix – Our Resident Stray Cats

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Yesterday at feeding time Felix, the old beat up neutered tom, did not show. He has been looking increasingly shabby of late, the vet suggested that he has cat AIDS. He has been with us for three or four years. He was fearful and wild. Other younger cats taught him to come close to us. Of late he has let me touch him and he rubs himself up against me at feeding time. We play picky-ups, where I pick him up with my foot and drop him gently out of the way. He keeps coming back for more. It is a game he likes. You can usually set your watch to his stomach. No sign of Felix. Gandalf was fed as per usual.

This morning again no sign of Felix. Something has unnerved Gandalf the young, spayed female. She followed me around the garden like a limpet. I was looking to find a perhaps dead or injured Felix. She was very attentive and seeking physical contact. No sign of Felix. Not in any of his usual haunts.

We understand that our care of Felix is perhaps end of life and palliative.

I just went out to feed Gandalf down by the river and with all the noise Felix arrived. He is in a bad way with what looks like a blunt force wound to his head. There is a swollen open cut like a boxer’s injury. Gandalf seemed pleased to see him and yielded the bowl to him. No contest.  I came back to the house to get another bowl and she followed me, while there was food available. She mewed and followed me back down to where Felix was feeding. It was as if she was asking me to feed them both as is the usual custom.

I put her bowl down and she was edgy, hardly snacking. She kept greeting Felix who was trying to eat. I stood there and petted Gandalf a little. She had a few mouthfuls. I was standing like presidential “security” while the two cats ate. Something bad has gone down and freaked them out. In the past when scared or injured, cats have sought me out. I have taken scaredy-cats out into the dark for a late night piss. Gandalf remembers humans and some of her memories are good. Perhaps some not. She is glued to the side of the house where she feels safe at the moment.

Felix has finished eating and is out by the greenhouse for his post feed snooze. I have been to look and his left eye is closed again like a boxer. He has some kind of injury to that side of his mouth. Looks like a car or dog or fox and not a cat inflicted wound. Gandalf was again following me like a magnet and it looked as if she was getting ready to jump up into my arms. Which would be a first. I “took” her close to Felix and she quieted down a little. She knows he is poorly. At the moment they are sat close to the house near the magnolia.

It might be wise to swing by the vets tomorrow to ask what to do. That wound could go septic, it does not look clean and Felix is not washing after eating, which is something he usually does.

The cats are clearly unsettled by some kind of trauma…

140 keV Gamma “Ray” Bone Scans…

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My rate of emission of 140 keV photons is now down to lower levels, five radioactive half lives after injection. The concentration has been reduced by biological elution and the radioactivity by decay. It was interesting to read how few suppliers there were for 99mTc. Yesterday, she only injected a few millilitres of tracer.

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I have been reading up and watching videos on the interpretation of bone scans, I can probably note metastatic lesions, depletion in tracer localisation due to prothesis, fractures (old and new), areas of bone formation and depletion. It might be interesting to see what my damaged cervical spine looks like and if my “broken” ribs from rugby can be seen.  Osteophytes are evident on my thoracic spine and near my Titanium pin. The Diffuse Idiopathic Skeletal hyperostosis (DISH) is probably still growing and could localise tracer. {I had a full body scan.} This, if seen, can be cross referenced with an upcoming CT scan.

There could be plenty in my scans for a nuclear medicine professional to discuss with her younger colleagues.

I meet some of the diagnostic criteria for polycythaemia (probably secondary). If it is the malignant form this may interfere with bone cycling in the marrow and could appear in the scintigraphy. There are a few suggestions in the literature to use nuclear medicine to detect this. But it is not common practice.

I guess the single-photon emission computed tomographic (SPECT) images might show something like this below. My hip arthritis is much worse than in the X-ray or CT images below. It does not look like a whole lot of extra knowledge comes from the SPECT data for the hip.

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Dunn’s view of (A) right and (B) left hips of a 48-year-old male patient presenting with left hip pain only. Single-photon emission computed tomographic images shown in (C) anterior and (D) posterior coronal views display more uptake (black arrow) along the superolateral aspect of the acetabular roof on the symptomatic left hip compared with the asymptomatic right hip (white arrow).

Clin Orthop Relat Res. 2008 Dec 17;467(3):676–681

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What might however be interesting is what tips up in the rest of the body scan. The pain in my lower and mid lumbar spine has been explained in different ways by different doctors.  There might be clues as to what is going on.

I guess what I do not want to see is evidence for primary bone cancer or metastatic disease. The main diagnostic differentiation of the latter is a disordered or “random” appearance of tracer localisation. Metastatic disease is incurable and often terminal.

I have joked that I could re-train as a radiographer or a nuclear medicine operator. But you know what they say about old dogs.

It is weird, I feel very up in the air, with little or no idea if/when I will get to see the data. Something which could change the direction of life is hanging ill-defined in the aether. I am in a kind of limbo.

I wonder if people who prescribe scans have ever had to wait and hang like this…

Maybe it should be a compulsory part of training…

Pandora, what does two plus two equal?

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“A bone scan or bone scintigraphy is a nuclear medicine imaging technique used to help diagnose and assess different bone diseases. These include cancer of the bone or metastasis, location of bone inflammation and fractures (that may not be visible in traditional X-ray images), and bone infection (osteomyelitis).

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The most common radiopharmaceutical for bone scintigraphy is 99mTc with methylene diphosphonate (MDP). Other bone radiopharmaceuticals include 99mTc with HDP, HMDP and DPD. MDP adsorbs onto the crystalline hydroxyapatite mineral of bone. Mineralisation occurs at osteoblasts, representing sites of bone growth, where MDP (and other diphosphates) “bind to the hydroxyapatite crystals in proportion to local blood flow and osteoblastic activity and are therefore markers of bone turnover and bone perfusion”.”

From Wikipedia

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I have not long returned from the Nuclear Medicine suite at Yves Le Foll hospital Saint Brieuc. The pretext from my bone scan was to look at where there might be inflammation in my right femoral head / neck and hip prior to an operation. The first orthopaedic surgeon, who prescribed the scan, suggested that it might be done with an Iodine radio-tracer. That is not for bones. He became a little flustered when questioned and pressed on the subject. The second orthopaedic surgeon questioned why he might even order such a test. It seemed incongruous to him.

Nobody in France has yet mentioned the C word! Looking in Pandora’s box can have unexpected results. They could be doing a “Basil Fawlty”.

At the end of my scan today the operatives in the control room were all looking intently at my images, pointing and talking animatedly. Before the scan they did not help me onto the scanner table, after it they were very helpful with the dismount. The images changed behaviour. I was not privy to my gamma ray “only fans” content which had them talking. The secretary suggested that I will get the results in a letter at some unspecified time in the future. The results will go to the first orthopaedic surgeon and my GP.

The following outcomes are possible:

1)  The results simply show osteo-arthritic frictional inflammation in the bony tissues. What I call the pepper mill effect. In which case I will get the results through the post and I can take a good scooby at them myself.

2) There is a long delay during which a conflab occurs. I do not get the results in a timely fashion, some other follow up plan is hatched. Something needing to be followed up has been found.

3) I get a telephone call to tell me bad news. I am being followed for elevated prostate specific antigen and have had colon cancer. There are anomalies in my blood work.

4) The results arrive in a tardy fashion with bad news therein, before anyone contacts me.

This is what the Canadian Cancer Society says:

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Société canadienne du cancer

La scintigraphie osseuse aide les médecins à diagnostiquer et à évaluer différentes maladies et affections osseuses. On peut y avoir recours pour:

  • trouver un cancer des os ou déterminer si un cancer présent dans une autre région s’est propagé aux os;
  • aider à diagnostiquer la cause ou à déterminer l’emplacement d’une douleur osseuse inexpliquée;
  • aider à diagnostiquer des fractures osseuses qui ne sont pas évidentes à la radiographie;
  • voir jusqu’où le cancer s’est propagé;
  • trouver des lésions osseuses causées par une infection ou d’autres affections osseuses;
  • savoir si le traitement du cancer est efficace ou pour faire un suivi.

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Obviously, they are going to have a cancer bias. My gut feeling is that people are not being 100% straightforward with me. My gut feelings are often with substance. The French can beat around the bush so to speak.

Waffle, moi?

Whatever the outcome, knowing what the data says does not change the actual physical plane reality. It does / might affect how things move on from here…

It is out of my hands; I can do nothing…

We shall see…

When Professor Google Does Not Know…

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Something weird is happening at Eurofins the lab which analyses the blood tests. On Saturday they sent me the results of my alpha-1 antitrypsin survey. This came back normal, so there is no genetics causing a suppression. Yesterday evening they resent me the results twice!! This kind of thing is not normal, so it caught my attention.

The really weird thing is the low parathyroid hormone level.

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“Hypoparathyroidism is the combination of symptoms due to inadequate parathyroid hormone production (PTH) (Hypo-parathyroid-ism).  This is a very rare condition, and almost always occurs because of damage or removal of parathyroid glands at the time of parathyroid or thyroid surgery. This bears repeating: When people have too little parathyroid hormone (PTH), it is almost always because they had thyroid or parathyroid surgery and all four parathyroid glands were removed or injured.”

Source parathyroid.com

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I have the low hormone level BUT not the reduced calcium levels. I used to get cramps and have had neuropathy in my fingers. This neuropathy being probably down to the cervical spine injury ~2008 and the hernias therein. Calcium levels are however normal.

I have asked Professor Google about the PTH low Calcium normal using different sets of key words. He/she/it does not have much to say on the subject. There was one case of a Māori woman with similar numbers. It was weird enough to ask the laboratory to check the parathyroid hormone data. It was not wrong. They made a “special” report.

The endocrinologist may yet comment.

Using the above logic it perhaps makes sense to re-test the hormone level.

Because I am asymptomatic, this does not seem like a big deal. It could be a harbinger of problems yet to come. The hormone level is low; it has not dropped the calcium yet…

Like me it is a bit of an anomaly an outlier. The question is, is it safe to ignore and chalk up as just one of those things or does it need further investigation?

When You Just Know

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I have started the process of looking around for an alternate orthopaedic surgeon. I have secured a provisional appointment. I just know that should I follow through, this it is going to open a can of worms. In principle a second opinion is “allowed”. In practice it can put noses out of joint, cause gossip and stoke rivalries. I can stop it. I am going to sleep on it. But the moment I tip up for an appointment I will have to explain myself. There will be uncomfortable feelings on both sides. It will not be smooth and I will be the problem, not anyone else. I am also a foreigner now, too. I do not have citizenship and my right to stay expires in a few months’ time, March.

Way back when I lived near Farnham, I had a GP doctor who was athletic-skinny. He had a pro-forma crib sheet for calculating BMI. It was issued by the Ministry of Truth. He calculated mine and proceeded to lecture me from his soap box about the need to lose weight. Even though I was not officially obese back then. I asked him to show me my extra body fat. He could not. He said that people can be fat on the inside. Whatever that means, those were his literal words, fat on the inside. I showed him my large biceps and claimed muscle mass but he persisted. I then said that I had recently read an article in the BMJ about how raw BMI data was often over interpreted in general practice medicine. His back was up and he was affronted.

I just knew that we would never get on and for our mutual benefit it would be better for me to have another GP. I saw him a few times before I changed practice and each meeting was fractious. He is a human being, so was I. I have rarely had a reaction like this from a woman. I concluded that possession of a penis played a role in interpersonal dynamics. I am not insecure about the average size of mine, physically and metaphorically. I don’t have a whole bag of chips on my shoulder.

The caveat here is that my perception could be skewed. I perceive that I have an uncanny knack of putting people’s back up especially when they deem themselves superior, more expert, to me. I can be more frank than some like or can handle. I am just being me. I am not trying to wind them up or belittle them. I get what I perceive of as bad reactions.

In general I know when I have the early stages of a bronchial infection. I report to a GP doctor and quite rightly because there is not enough cack in the lungs, they do not initially prescribe an antibiotic. I just know in many cases I will be back soon when the cack gets cacky enough for antibiotics. They have a process to go through to limit over prescription. I just know that I have to wait until a certain severity of illness presents. They are doing their job, that is all. It is possible that I might wait too long one day.

I had a bad clash of personalities with my cancer “care” nurse a decade ago. She had severe mother superior tendencies and I met her dogmatism head on. This made collecting my results from her an unpleasant thing which I came to dread. Rather than looking forward to her support, I would dread the meetings. I asked them to send my carcinoembryonic antigen (CEA) results by email. They refused. If anything went wrong it would have to be very wrong indeed before I would reach out to my allocated cancer care nurse. I never did. I just knew that the best thing was to switch hospital care teams. It sounded simple and I could offer the reason of enhanced proximity.

However I opened a can of worms. Every time I went for a colonoscopy or to follow up blood in the faeces, they wanted to know why I had changed teams. They kept pressing me. They seemed obsessed with gaining this information. I gave the same answer that they were closer, which was true but incomplete. On a number of occasions the chimney sweep insisted that the blood was from piles. I just knew that was not the case. So we had to have an examination for piles before he agreed to a sigmoidoscopy. I don’t particularly like having endoscopes shoved up my arse but there was no way of avoiding his adamant insistence that it was piles. I just had to let him go through his process. He had all the power and I wanted to find out if I had a new cancer or a recurrence of the old one. I was not anxious I wanted data. People can see anxious when need for data manifests.

Sometimes I just know when the best thing is to drop something and walk away. It is for everyone’s benefit. Even If I am inconvenienced it can be better just to let things lie, leave them well alone.

A while back someone trying to be clever said that I was a part of the equation as to why things were not working out. I simplified his equation by removing a variable, me. I don’t know how well the equation worked out after that…If I was a/the problem at least they had the possibility of moving forward unencumbered by me.

This feeling that I am a/the problem according to others has presented multiple times in this life and it has resulted in a walk away or a door slam on more than a few of these.

If I am the problem I want to simplify things…

I just know when people are seeing or are starting to see me as a/the problem.

Maybe they are right and it is always me…

It is just one of those things…

Narziß und Goldmund – Quantum Superposition State

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Finding “The Glass Bead Game” and Herman Hesse was a pivotal moment for me. In Knecht, the Magister Ludi, I found someone who innately sensed interconnectivity, the flow of consciousness and how one idea or theme intertwined others. His “lives” spoke direct to me. Finally I did not feel quite so absolutely weird. The scale of concept was vast and hugely refreshing. Someone on the planet was wired a little like me, though far more eloquent and expressive.

Like Magnus Pym and Bern, “The Perfect Spy”, had captured and conveyed a little of what it was like for me to have traversed life. His fiction more complex than mine. Yet I recognised the chameleon into which I once morphed for safety and to blend.

But it was with Narziß und Goldmund that I learned in the courtyard at Mariabronn of my own duality superimposed into a superposition state. There I sensed something of my monastic pasts and my reckless wild child. Initially I felt more Goldmund, later Narziß. The coefficient of the latter in my superposition sate is higher, when time averaged. I saw in this duality the autobiography of Hesse and his delicate and nuanced verbalisation. The sense of friction but not conflict, of phase and of interplay.

In a way each of my blogs are / have been by way of a glass bead game, only making sense to me. They are a way of arranging things like a sand Mandala, waiting for the brush of diaspora onto wind.

And again I am back with Narziß und Goldmund, wondering what fate may have left in store. Are there adventures left or is a retreat deeper into cloister on the cards…

Self-Diagnosis – Avoid Cannibalism

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The internet is awash with medical, pseudo-medical and dietary advice. It is very easy to ask Dr Google, Nurse Edge or Prof DuckDuckGo for advice and thereby arrive at a diagnosis. No doubt this may drive the medical profession up the wall, but on occasion it might be useful. I am able to research things thoroughly without arriving at a firm self-diagnosis. I don’t have a favourite disease, nor a goal I am aiming at. There is no bucket list of maladies. Looking through a list of rare diseases I found this one, which is quite specialised, no need for fava beans and a nice Chianti.

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Kuru

Awareness: There’s no known Kuru awareness group or dedicated day.

Discovery: Occurring at epidemic levels in the ’50s and ’60s, it was eventually discovered by Daniel Carleton Gajdusek, whose research won him the 1976 Nobel Prize in Physiology or Medicine.

Treatment: There’s no treatment for Kuru, other than the preventative measure of not committing cannibalism.

Symptoms: Tremors and muscle jerks (Kuru is the Fore tribe’s word for ‘shiver’), headaches and arm and leg pain, difficulty walking and swallowing, progressive and severe coordination problems.

Discovered only in a remote region of New Guinea among the Fore tribe and closely related to mad cow disease, Kuru is caused by prions, which is a protein that encourages build-up of abnormal brain tissue that results in irreversible brain damage. 100% lethal, it’s brought on by the consumption of human brains that contain the infection. The Fore tribes practiced cannibalism prior to the 1950’s to preserve the spirits of the dead, but it is now outlawed.

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The prophylactic advice to not commit cannibalism is not too arduous to follow. It should be within the ability of most. I read today that ~75% of Americans are obese. I just cross the threshold for obesity which means that ~70% are more weighty than me. That it is a serious arthritis epidemic in the making. Lardy, lardy.

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People can self-diagnose with all sorts of things including grandeur, omniscience and importance. They may imagine themselves angelic and incapable of the oral phase change of butter. Not all diagnoses are accurate.

Today my results for alpha-1-antitrypsin are in and the result is mid-range and very normal. Which raises a slight question about the low alpha 1 globulin data. I would like to see the error bars on reading a labelled electrophoresis result. My guess is that they could be a few percent. As a technique is does not scream highly quantitative to me.

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Alpha-1 (α1) globulins

Proteins migrating within the alpha-1 region include alpha-1-antitrypsin (constituting about 90% of the band intensity), alpha-1 lipoprotein, alpha-1-acid glycoprotein, and alpha-1 fetoprotein. A haze stain at the leading edge of this band may be due to high-density lipoprotein (HDL).

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The GP may wish further clarification. Up to her, if she thinks I need more tests. The thing making up ~90% in the electrophoresis is normal using a more quantitative method.

Logic suggests that having something iffy with my liver is possible / likely. But I am not yet yellow. One genetic problem has now been ruled out. There is a faint hint on line of some endocrine stuff implicated. We shall see what, if anything, the specialist suggests.

I may hear back from the Rheumatologist next week and it is possible something else needs investigated.

On exactly the ten year anniversary of my arse {colon} cancer operation I get to see an anaesthetist to ensure that I am OK to have a colonoscopy. Some blood / piss tests to measure creatinine may be on the cards….

Ten years ago I was in the GP’s office after a sigmoidoscopy. They has found 11 polyps in the lower part of my colon. I had read that 1 in ten polyps turn cancerous. Given that they has not looked “upstream” I said sampling the probability that often suggested that I may have colon cancer “upstream”. He looked shocked and wanted to reassure me. I was calm and knew the reason behind my statement. A few days later they found more polyps and a T3 cancer.

By the middle of July, just after Bastille Day, I will know the state of my chimney and if there are more polyps {or worse} or not. This sets the clock ticking for the next “gold standard” investigation in due course.

I will be enjoying industrial strength laxative on Bastille Day. There will be metaphorical fire works chez nous. We already have the Sudocrem.

I personally would not diagnose a MOT pass, I would fail my contrôle technique and should probably be kept off the streets to protect other road users…