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Low Parathyroid Hormone – Hypoparathyroidism?
The results for the three different mutations of HFE gene are in. I don’t have any of these. Which excludes the vast majority of the diagnoses for hereditary haemochromatosis. The footnote from the lab suggests contacting the centre for rare iron related disease in the big university hospital 150 km away. They may just talk with me as an ex-boffin.
I do feel a tad rusty these days, like the tin man my joints could use some oiling.
That means the polycythaemia primary or secondary question is in focus. Is there a malignancy or did my blood just adapt to smoking tabs?
My parathyroid hormone (PTH) is low, it is 26 pg / mL.
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“The iPTH reference interval of a healthy blood donor population was measured as 25.2–109.1 pg/mL (2.7–11.6 pmol/L) at 2.5 and 97.5 distribution percentile. The iPTH reference interval from data stored in the laboratory database was 19.3–112.5 pg/mL (2.0–11.9 pmol/L). Furthermore, 60% of the whole population had prevalently insufficient vitamin D concentration (<30 ng/dL; <75 nmol/L).
Mineri et al., Clinica Chimica Acta Volume 521, October 2021, Pages 1-8.”
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So it is at the rare end of a distribution yet just within the 2.5-97.5 percentile range. It is probably within experimental error out of the range. The error bars on 26 picograms must be big in a small sample!!
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“PTH is secreted primarily by the chief cells of the parathyroid glands. The gene for PTH is located on chromosome 11. It is a polypeptide containing 84 amino acids, which is a prohormone. It has a molecular mass around 9500 Da”
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My results for Calcium and Phosphorus were very normal, this latter statement is a bit weird. Low PTH levels are very rare and usually come with low Calcium levels. That pathway is messed up. Low parathyroid hormone screws with the Calcium concentration and bone turnover.
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Symptoms of hypoparathyroidism
Hypoparathyroidism often starts if glands in your neck are damaged during surgery.
Symptoms include:
- a tingling or burning sensation in your fingers, toes and face
- muscle pain, stiffness and spasms
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I have these two but these are caused when Calcium is too low!! So I do not have hypoparathyroidism.
We have another “contradiction” of sorts so the GP has asked advice from an endocrinologist. My guess would be re-test and if the value is still low maybe do something.
I am going to have an Alpha 1 Antitrypsin assay tomorrow which may add a piece to the jigsaw puzzle, concerning my lungs.
I’ll wait to hear from the GP as to what the endocrinologist suggests. It could be more tests, or not.
On the GP front we are probably good until September now…fingers crossed…
The working notion is that whatever it is that may be going on, it is just not manifesting in a sufficiently serious way, yet…
It could just go away or it could develop.
I am a bit of an anomaly, so it is no surprise that my blood results are a tad skewed from the normal.
Girlfriend in a Coma, Punctured Bicycle and Caligula
Reviewing my most recent blood tests in preparation I can’t help questioning. Is it serious? Probably not. But like Spike Milligan quipped “I told you I was sick!” Is the whole shebang massively overly dramatic?
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“I know you’re antiseptic, your deodorant smells nice
I’d like to get to know you, you’re deep frozen like the ice”
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I don’t think I am obsessing simply going along with it all but it being my nature, I do look things up. It gives me something to do and stops me playing outside in the traffic.
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“I’m knobbled on the cobbles
Cos I hobble when I wobble
Swim!
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Hello to you out there in Normal Land,
you may not comprehend my tale or understand”
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I did not come by this notion of surgery all by myself. I have not been the one pushing this agenda. It has taken up a lot of time and money so far, both for me and the French health system.
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But I’m a creep, I’m a weirdo
What the hell am I doing here?
I don’t belong here
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Perhaps I am missing the point entirely.
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We are stardust
Billion year old carbon
We are golden
Caught in the devil’s bargain
And we’ve got to get ourselves
Back to the garden
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It all seems so very far away, so unimportant.
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Where be it Blackbird to?
I know where he be
He be up your wurzel tree
And I be after he
Now I sees he, and he sees I
Bugger’d if I don’t get him
With a girt big stick, I’ll knock him down
Blackbird, I’ll have thee
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I remember aged just shy of thirteen walking along a beach in Pwllheli North Wales, that sentiment is more timely now.
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People try to put us d-down (talkin’ ’bout my generation)
Just because we get around (talkin’ ’bout my generation)
Things they do look awful c-cold (talkin’ ’bout my generation)
I hope I die before I get old (talkin’ ’bout my generation)
This is my generation
This is my generation, baby
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The Problems of Should
Many problems arise not because things are but because people think they should be different. This enforcement of conditional opinion about how things should be is directly causal of conflict and of angst. There is another level to this where problems arise out of people thinking that things should meet expectations. Expectations are a mental-emotional construct of largely human origin.
To give a trite example.
Data collection suggests that for the western European male population an average life expectancy is a tad over 80 years. Nevertheless many die in their sixties. People kind of think they should live to 80. There is even planning to that target. I am largely convinced, in my opinion, that it is very unlikely that I will live to that age. I should not have that opinion and it can make people uncomfortable that I do. Many people like the idea of a long life and the expression that X left us too early is not uncommon. You should not die that young. It is a tragedy.
If you say such a death is natural and therefore not a tragedy you are speaking heinous. You should not be so cruel heartless and frank. Because of opinion like that you are a problem. You do not comply with the social should. Should makes you a problem and a right bastard to boot.
Wanting things to be different, access to the green grass on the other side of the fence is a human notion of change according to how things should be. The notion of “rights” in a democratic society is currently being widely eroded. This is because people think that others should not have opinions which differ from theirs. There is suppression and on occasion violence because people should agree, have the same colour skin and follow the same notion of deity as the noble and omniscient US.
“If you convert to our religion, we will not slay your ass painfully! You should follow our God, the only true God!”
This should causes death and bloodshed.
I live as I do, it does not really impinge on the outer world over much. Theoretically there may be opinions that it should not be thus. I should not live like this. The holders of those opinions have created a problem by the notion of should. It does not gel with the reality.
There is a disconnect between should and is/are. Which can be viewed as problematic. If you drop the imposition of should-based opinion any notion of problem evaporates.
I am now prepared for no hip operation in the rest of this foreseeable calendar year {As a starter for ten}. There is no problem outside the compound with this. It will limit some of my gardening and I will be taking pain medication. As a thought experiment others might imagine that this should not be the case. Yet despite the should, it is. A problem in this kind of gedankenexperiment arises solely out of a contrast between notions of should, an aspiration to the contrary and some idea about what is right for me to bear.
“In this day and age…”
In the UK news people harp on about waiting lists for appointments and operations as if these were some God-given right. They are not. I am not owed, due nor do I particularly deserve an operation. Were it not for modern medicine neither the wife nor I would be alive.
Viewed from one angle a bit of end of life pain is no big deal. It is only a problem if people deem that it could be and therefore should be different.
Problems often arise out of attempts to alter reality and the unfoldment of life. People try to steer things towards how they think they should be, how they ought to be, of how they want them to be.
The infliction of people’s opinion of should is one of the A number one causes of strife.
Israel thinks Iran should not have nuclear weapons so they coerce Trump into using big bombs. It is OK for US to have nuclear bombs but THEY should not.
There is a part for me which thinks that if Israel had been a lot more friendly and cooperative helping local economies to develop a comfortable middle class over the last few decades, all the simmering anger and bile might have faded. However that is not the case. A different suppressive ideology has held sway. Oppression has no sell by date; it must be continued until revolution. The mind set of they should be taught a bloody vengeful and punitive lesson has endured.
It has not brought peace, it has not brought love, it has not brought harmony.
A little thought shows that should is a key component in many problems, local, relational and in terms of geo-politics.
Arguably should is more dangerous and destructive than nuclear weapons.
Sanitized Anodyne Clone-World Dream 25-06-2025
Here is this morning’s dream from around 5 AM.
The dream opens in a vast underground complex under a dome like roof. It is overly bright, lightened in a stark LED high temperature way. There are no plants. I can see two gatherings of people. These are of the “currents” and the “futures”. There is no luxury only a sense of sanitized, anodyne, air-brushed even. There is no fecundity.
The “currents” are older than the “futures”. They are more organised. They comprise solely white caucasians both male and female. They belong to three groups and are dressed accordingly. They are wearing V-necked medical scrubs type garments with white long sleeved t-shirts underneath. The white sleeves protrude from under the short sleeved gown arms. The dress is either mid-dark pastel blue, fuchsia pastel Rhodamine pink or a shade of deep pastel yellow. They all have fresh haircuts. The men are clean shaven and the women all sport pony tails. They are late twenties early thirties and relatively physically without flaws. People each belong to one “caste”. The sense of quasi-androgynous infertility pervades, though the genders are clear. There is some ceremony test or ritual about to take place, for the “futures” to progress.
I find myself in the group of “futures” who are all slightly younger and similarly adorned. Someone gets up on a stage to initiate proceedings. They will be subjected to a test in pairs. There is a simulation, a business game, which they have to participate in. This has been outside of their schooling to date and is a rite of passage into the “currents”. There is an air of anxiety about the test. They are all young relatively beautiful, flaw free and expectant.
I am paired with a young woman with dark hair dressed in Rhodamine pink. I am many thousands of years older than anyone else in the simulation. I cannot see my form but I know that I am very physically handicapped compared to others. The woman is a little disgruntled to be saddled with me. I explain to her that I know the game, the simulation, inside out, because I helped to write it and am aware ahead of time of all the pressure points. We can use intelligence. The game starts and we go to a “market” store to collect materials. It is run by some “currents”. The others are all running around to other stores. We collect the critical materials first and head off to our prep station.
As we leave the store there are some know-it-all “futures” hurrying about. I am in their way and cannot move quickly enough to get out of it. They gesture threateningly towards me to get out of their trajectory. I remain unmoved. A young man runs at me with intent. He hits into me and bounces off with enhanced momentum. I am unmoved and unhurt. He is sprawled on the floor and bruised. He is complaining of his aches. He is perplexed that a cripple like me is so fixed and heavy and immovable. Over the thousands of years I have met many like him. I know his type. I have the weight of time accrued and accumulated. That time is near primordial in essence.
His female partner helps him get up and dust himself off. She looks at him with disdain and at me with a curiosity and unfamiliarity. She has not met anything like me, before.
The dream ends.
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Note: We have begun watching the TV series “humans” in which a family has a new female synth or android in their house, a very human like “robot”. Some of the synths are exhibiting non machine intelligence or in other words life.
Shit Happens…
This afternoon whilst watching Al Jazeera News I had a feeling of warmth towards Donald Trump. He said “Fuck” live and direct to camera. It brought a smile to my face and has slightly changed my opinion of him. He should do this more often; it will be good for his ratings.
I never thought I would say that.
On June 21st I quoted Robbie Burns “The best laid plans of mice and men often go awry…”
Which is a more poetic way of saying shit happens.
The ethos for the year has been to investigate the possibility of getting replacement hips done here in France before we sell up and downsize. I had an orthopaedic appointment on Monday. That investigation seems to have hit a road block which I cannot see a way around. I am due a non-urgent nuclear medicine appointment for a 90mTc Bone scan. Later this week I get my gene tests back and may discuss the “osteoporosis” blood results with the GP. After that the next appointment will be early autumn, assuming nothing acute crops up. I may explore if there are other avenues for the hips. It being both a small world and the back of beyond there may be none.
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This means that I will have to factor in many more months with the severely osteo arthritic hips. I can probably hack it.
It does raise the question of if to put the house on the market or not, with a mind to a UK based plan B.
It is just one of those things which cannot be helped, shit happens. I will just have to adjust to what is / may be possible. It is perhaps a kind of accepting stoicism that things are out of my hands.
Did you know there is a shopping channel “JML direct”? It was on this morning when I got out of bed. It look likes I will be getting up early ongoing as a pain management strategy.
Word wanted to write that “piano management” perhaps suggesting an alternate career.
It look like a re-adjustment in orientation and thinking is now in progress…
What is the next tune, Pete?
Taking Stock – Massive Disconnect
It is one of those things. If two people are interacting and one thinks they are miscommunicating and the other does not, who is accurate? Many assume that they are communicating better than they actually are. People can be oblivious when miscommunication occurs.
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The observable evidence of the “we are above the law” thinking from the USA has just been drilled deep into concrete bunkers in Iran.
“We don’t like the bastards, we can kill their asses as and when. Deals, treaties, international law are only pieces of paper after all!! We have the God given right!! {And the B2 bombers}.”
So now it is overt {again}. It is unclear as to how things go from here. Maybe the global least harm is a petering out.
I am not filled with joy at the prospects of peace and goodwill for all.
I have been noting of late a complete disconnect between how I am and think and, others. Today the orthopaedic surgeon suggested I look at what I might want to do and to use this as a guide as to the when of facing the knife. In my mind I simply adjust to that which I am able to do. I do not get upset and frustrated if I cannot jog round the block or walk 10km. The suggestion washed over me. Why would I even bother to think like that?
This disconnect is even more obvious when watching 24 hours in A&E on the TV. I hear people talking to camera saying that they could not survive without so and so, expressing their catastrophising on hearing that their loved on has gone to A&E, thinking the worst.
Why not simply make your way there and find out what the best guess scenario is from the doctor? What benefit is there in catastrophising?
Clearly, I am weird by comparison.
One could argue that I am indulging in medicine, with all these scans, check-ups and blood tests. I don’t think that any of them are urgent or life critical. I have already accepted that I have pre-cancerous prostate cancer. It seems to me a matter of when not if. The PSA value is going up…
I am due an arse-cancer chimney sweep soon. After that there is a five year holiday for “good behaviour”. It is probably worth getting that done.
Way back in the nineties when they were investigating my polycythaemia, I was a regular visitor to the phlebotomy centre. It being St Thomas’ there were a few Jamaican nurses, some of whom were a good laugh. I would get bled. They would check my haemoglobin on a regular basis. If my addled memory is correct the results of phlebotomy were to enhance my haemoglobin count over a few months. We ended up dropping it, the bleeding, I was asymptomatic and perhaps the medical student had finished their research project.
In terms of all the tests none of them will change the reality, they may alter the apparent awareness of reality. That is about it. Maybe it is simplest just to drop them all, to let things be. If I don’t drive it, it will fizzle out.
We come back to the whole pain question. I have no idea how others experience pain, nor whether or not I have a high pain threshold. I suspect that I am not at the overly sensitive end.
I can tolerate things without moaning. I am not overly prone to whinging. We could park the idea of hip surgery and revisit it in a years’ time.
Maybe I just need to wait and see what transpires…
It is a very strange disconnect when people imagine some kind of ambition or want. They transfer it on to me. They think I am somehow like them. They expect this. It is impossible to explain how I feel to others, nor begin to convey the difference in wiring, orientation and motivation.
It comes back to this feeling. I make people uncomfortable by interacting therefore it is perhaps better that I do not. I observe this discomfort. I don’t have to inflict myself.
Hmnn…
Dream Follow Up – Myeloproliferative Neoplasms
“In oncology, polycythaemia vera (PV) is an uncommon myeloproliferative neoplasm in which the bone marrow makes too many red blood cells. Approximately 98% of PV patients have a JAK2 gene mutation in their blood-forming cells (compared with 0.1-0.2% of the general population)”
Before this afternoon I had no idea that a standard way of taking a bone marrow biopsy is as illustrated below. Careful what you dream…
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The main diagnostic criteria for polycythaemia are:
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My haemoglobin level is 17.4 g/dL and my haematocrit is 49%. This meets the criteria {just}. The next steps in diagnoses are bone marrow biopsy and a genetic search for JAK 2 mutation.
The treatment for actual disease, secondary polycythaemia and haemochromatosis is phlebotomy and aspirin. One of the markers for secondary polycythaemia is hypoxia. This measured from the arterial blood. These consistent with the bloodletting part of the dream. Mid-week I will find out if I have HFE gene mediated haemochromatosis. This may exclude PV.
PV is associated with a reduced life expectancy and can change into to some seriously nasty stuff. Thick gloopy blood has an increased tendency to clot. Hence PV has implications for hip surgery if that goes ahead.
I have mild hypothyroidism according to the blood work but I am asymptomatic. There is no smoking gun for osteoporosis. A problem with bone marrow Myeloid tissue could be a factor in the osteoporosis diagnosed recently. If the marrow is making too many red blood cells it could be neglecting its other duties {naively}. The bone may not be thick enough.
If there is no JAK2 problem things get scientifically very complex very quickly. Most likely they will diagnose secondary polycythaemia. It is a moot point if we will go down the JAK2 route. Fat, fags and beer being the holy trinity, plus COPD. This looks the most probable. Maybe we do need to rule it , JAK 2, out, though.
PV if diagnosed is rare with an estimated occurrence of 22 per 100,000, which means that most GPs may never see it. It is hereditary to an extent which could suggest some geographical clustering. I may have a follow up on the HFE genetic results due.
In a sense the dream is preparing me for more medical merry-go-round.
I need to get my head clear because we are meeting the orthopaedic surgeon about “bionic” hips tomorrow. What happens next is fairly pivotal for my/our thinking…
As an aside of late I have been dreading opening up a news web site like “The Guardian” of a morning. This morning the thought was “what unpleasantness has Trump unleashed on the world overnight?” He got to ejaculate his big bombs over Iran.
The United Nations has rarely looked so helpless. A dream of unity peace and togetherness after the brutality of World War has been shat upon time after a time. People forget…
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Myeloid Bone Biopsy – Charlie Chaplin Cars – Elephant – Blood Tests Dream 22-06-2025
Here are last night’s dreaming segments.
The dream starts in a hospital operating theatre. There are people dressed in blue medical scrubs and with face masks and gloves on. On the screen is an X-ray like image of my right hip joint. They are using the apparatus to guide the placement of a long needle like structure into the ball of my femur and what remains of the gap between. I am awake and partially sat up. I am watching the procedure. A nurse is assisting the man doing the procedure others are monitoring vital signs.
He is saying to me that he is taking a tissue and bone sample for a Myeloid biopsy. The word is specific. They are going inside the bone to take this biopsy. It is important that they do this. This Myeloid sample will be sent off to the labs so that they can get a better understanding of what is going on. The scene is in colour and I can sense the cool air-conditioning in the “operating theatre”.
The scene changes and I am now in a black and white film in an urban setting. I am being chased by people driving black old school Charlie Chapin style cars. It is all very slapstick and the film being projected has a few flaws. The chase is semi frantic on the part of the pursuers. It is keystone cops and farcical. There is much skidding around corners. Although they are pursuing me, I am not interested. I am waiting for the results of my Myeloid biopsy. They will not leave me alone even though I am unwell. They are foolish.
The scene changes and, back in colour, I am at the edge of a field. Along the edge of the field is a fence. The other side of the field is a wood / jungle. The field has just been harvested. In the distance the gap between the wood and the field increases. I can see a small baby elephant. It is standing next to some saplings which are waist height to me. As I move towards him he moves, unhurried, off into the jungle. I arrive and there are two short rows of these saplings with green leaves. They are in a line and each row has several plants. I understand that these saplings are medicinal.
I am now on a Caribbean island; there is a sense of windward. The care home / hospital buts up against a white sandy bay and has a promenade. It is tropical. On one side to the left is the ocean and on the other a well-kept dark green lawn. There are water sprinklers going on the lawn. There are coconut palms. I am a little late for my appointment. I enter the building and there are two women dressed in starchy crisp 1950s style nurses uniforms with little hats. They woman on reception welcomes me very warmly. I am a regular and they like me, care for me. One tall nurse who is white welcomes me in a strong Jamaican patois. I respond in a like dialect only mine is play. She says that even though it is her lunch hour she will see me her “favourite” patient. She is teasing me playfully. She takes blood from the vein in my left elbow joint and from the artery on my right hand. She injects the arterial blood into a gas chromatograph. She says that even though I am something of a pin cushion these days she can always find a blood vessel. There is a sense that these blood tests are a very regular occurrence.
The dream ends.
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Notes:
Myeloid tissue, in the bone marrow sense of the word myeloid (myelo- + -oid), is tissue of bone marrow, of bone marrow cell lineage, or resembling bone marrow, and myelogenous tissue (myelo- + -genous) is any tissue of, or arising from, bone marrow; in these senses the terms are usually used synonymously, as for example with chronic myeloid/myelogenous leukemia.
Can Aliens Get Green Cards?
As is often the case when there is an atmospheric high pressure area over Western Europe in summer the issue of cross channel immigration is in the news. We have ICE-ICE-BABY doing raids, imprisoning and perhaps deporting people in the USA. A hint of xenophobia is an important ingredient in any right-wing government as is a deep suspicion of the intellectuals and the scientists.
“Come the time of the cultural revolution they will be first up against the wall!!”
The gist is that illegals, aliens and other non-pure bloods are unwelcome. Interestingly second or third generation immigrants in the UK are often very antiimmigration.
“Keep those brown boys and girls out! Especially those who won’t eat bacon sandwiches!!”
Conspiracy theorists are very interested in interplanetary visitors. Last time I went to area 51 I met a bunch of likeminded individuals.
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We had a very good discussion.
One of the core tenets of Scientology is past lives. Each thetan may have had many, some of which are not of this world, extraplanetary. Technically this makes them aliens, they have not applied for entry visas into the USA or UK. Or for that matter Earth. They have snuck in without permission and documentation, which makes them illegal aliens.
Trump could go after Tom Cruise and get Elon Musk to try to repatriate him. This would be good TV and a sure fire ratings winner. The Church of Scientology would appeal. This saga would be brilliant clickbait on the internet. Musk could be an alien too; hence he is building a ship to take him home.
A while back someone {who knew} told me that I would probably pass the auditing for some of the {higher} operating thetan levels in Scientology. I very nearly started the process on Tottenham Court Road when I was first year undergraduate at UCL, back in the last century. So there is an outside chance that I too am an illegal alien. My body has a UK passport and a French Carte de Séjour.
How would you tell if someone from another planet had incarnated into a human body. What would you measure? The DNA would be the same…
Maybe there are many extraterrestrial “aliens” already among us, some of whom do indeed have Green Cards.
Dreamyoga 