The Anonymous Widower

Is There An Interaction Between Bisacodyl And Warfarin Or INR Self-Testing?

I am on long term Warfarin and since 2012, I have self-tested my INR using a Roche Coaguchek device.

I have had no problems and for perhaps the last five years, I have been on a regular daily dose of four mg.

I should say, I’m a trained Control Engineer and if you can keep any inputs, like drug dose, constant, you should get a stable system.

Recently, I have been suffering from severe constipation and my GP has prescribed bisacodyl. I have taken it perhaps five time before bed and it works well

On Friday, I was feeling constipated, so I took one of the bisacodyl tablets before bed.

On Saturday, I tested my INR using a strip from a newly-arrived box direct from Roche  and found it was a rather extraordinary 5.2.

I had never seen a result higher than 3.2 before and put it down to one of the following reasons.

  1. The box of new strips was faulty. I have had dodgy ones before in the past, but not recently.
  2. There is an interaction between bisocodyl and warfarin. There are no reports on respected sites on the Internet.
  3. There is an interaction between bisocodyl and the Coaguchek testing process. There are no reports on respected sites on the Internet.
  4. I inadvertently took the wrong dose of warfarin.

I took a dose of two mg. yesterday and this morning I tested myself again twice.

  • With a strip from the new box, found a reading of 5.3.
  • With a strip from an old box, I found a reading of 5.

I shall test myself daily until I sort this out.

February 16, 2020 Posted by | Health | , , | Leave a comment

AI ‘Outperforms’ Doctors Diagnosing Breast Cancer

The title of this post is the same as that of this article on the BBC.

This is the first two paragraphs.

Artificial intelligence is more accurate than doctors in diagnosing breast cancer from mammograms, a study in the journal Nature suggests.

An international team, including researchers from Google Health and Imperial College London, designed and trained a computer model on X-ray images from nearly 29,000 women.

I have rarely worked with healthcare data, so I can’t comment on the accuracy of this trial.

However, over fifty years ago, I was able to make a lot of progress in the analysis of mass spectrometry data, by observing operators and asking how they identified various chemicals in the scan from the mass spectrometer.

I wouldn’t be surprised to find some detailed observation of the working methods of radiologists, formed the foundation data for this research.

The research seems to have done it well, judging by the published results.

Should we trust ourselves to methods like this in healthcare?

Undoubtedly! Yes!

Many systems like this are starting to be used in the maintenance of complex entities, as diverse as trains, planes, chemical works and advanced automated distribution depots.

But every fault, is always tested by a trained person.

This is a paragraph from the BBC article.

Prof Ara Darzi, report co-author and director of the Cancer Research UK (CRUK) Imperial Centre, told the BBC: “This went far beyond my expectations. It will have a significant impact on improving the quality of reporting, and also free up radiologists to do even more important things.”

I very much feel we will see very much more of this automated testing of the human body! And not just for cancer!

I already know of groups working on automatic diagnosis of arthritis!

 

January 2, 2020 Posted by | Computing, Health | , , , | 1 Comment

The Proposed Development Under Cavendish Square

These pictures show Cavendish Square.

Note

  1. Underneath the square is a very expensive car park
  2. Harley Street, with its medical connections, lies at one cornet.
  3. John Lewis sits on another corner.

It is a very pleasant place to sit and have lunch on a sunny day.

This article on IanVisits is entitled A Shopping Centre Under Cavendish Square?.

Ian details how, plans are emerging to turn the Cavendish Square car park into a shopping centre and medical complex, spread over four floors under a re landscaped Cavendish Square.

Ian also discloses how the square was used as an access point to build the Victoria Line in the 1960s.

This development could change the area in several ways.

  • Cavendish Square could become an even better landscaped garden.
  • The medical complex would be a much-needed modern extension to Harley Street.
  • Could the development be used to create the much-needed step-free access to Oxford Circus station?
  • Would upmarket shoppers be drawn to the development?
  • Could the square become electric vehicles only?

I very much think this development could be a valuable addition to the area.

 

December 30, 2019 Posted by | Health, Transport | , , , | 4 Comments

Oxbourne House Is A Mixed-Use Retail And Residential Project Located On Europe’s Busiest Shopping Street

The title of this post is the same as that of this article on the Fletcher Priest web site.

This is the introductory paragraph.

The project includes high quality apartments and a prominent retail provision, as well as step-free access to Bond Street Underground and Crossrail Station below, where a new street-level station entrance has been constructed off Marylebone Lane.

Note that Fletcher Priest are the architects.

These pictures show the state of the building on December 29th, 2019.

This Google Map shows the location along Oxford Street.

Note.

  1. Oxbourne House is the building along Oxford street with the ribbed structure on its Western end.
  2. The pedestrianised Marylebone Lane, at the Eastern end of Oxbourne House,  running down towards Oxford Street.
  3. The recently built entrance to Bond Street station is hidden by Oxbourne House.
  4. The Radisson Blu Edwardian Berkshire hotel on the other side of Marylebone Lane.

This second Google Map shows the wider picture.

Note.

  1. Marylebone Lane and the Radisson Blu hotel are to the left of this map.
  2. Cavendish Square is in the North-East corner of the map.
  3. Debenhams, House of Fraser, John Lewis are in a line to the East of the entrance.

It looks to be a well-placed entrance.

It Gives Rear Entry To The Department Stores 

Will travellers for Debenhams, House of Fraser, John Lewis and Cavendish Square use the pedestrianised Marylebone Lane and Henrietta Place route, in preference to the crowded route along Oxford Street?

Perhaps if Henrietta Place were to be pedestrianised as well and the signage was clear, many savvy duck-and-divers may be tempted!

I describe the current walking route in Walking From Cavendish Square To The Marylebone Lane Entrance Of Bond Street Station.

Access To Harley Street

The Marylebone Lane/Henrietta Place route gives good access to Harley Street and all its consultants, clinics and facilities.

If as I suspect the route were to be pedestrianised or at least had the kerbs removed,, as the Marylebone Lane entrance to Bond Street station has step-free access to all platforms, Harley Street would have better step-free access to public transport, than many hospitals.

Access To The New Cavendish Square Development

This proposed Cavendish Square Development seems to be mainly upmarket shops and medical facilities like consulting rooms and probably expensive diagnostic equipment.

The access from Bond Street station will be better than to Harley Street.

  • the route will be built step-free.
  • There might only be one road to cross at most.
  • It will be shorter.
  • As an aside, I suspect taxis will be able to drop and collect visitors from inside the development.

I wonder how many consultants will move from Harley Street to the Cavendish Square development.

Conclusion

The new Marylebone Lane entrance to Bond Street station, gives step-free access to an area to the North of Oxford Street

The new entrance also acts as the foundation for Oxbourne House, whose development probably contributed to the creation of the new step-free entrance.

 

December 29, 2019 Posted by | Health, Transport | , , , , , | Leave a comment

Good And Bad Doctors

I’m listening to a program on BBC Radio 5 called How Do You Cope?, which is discussing doctors. And what makes a good one!

I am reminded of the story of the birth of our first son.

He was born in a London teaching hospital and delivered by a student doctor, who obviously didn’t do a bad job and made no mistakes.

The next time I saw  C, she told me, that she’d had a visit from the Professor, who asked after her and her experience.

He told her, that the doctor was a problem for the Medical School, in that they felt he had shown the ability to make a very good surgeon, as he had the right attitude and physical skills.  But he was having difficulty in passing exams.

I sometimes wonder, if that would-be doctor became a brilliant surgeon or left the medical profession early.

December 22, 2019 Posted by | Health | , | Leave a comment

North And South

I went to see Spurs this afternoon to see them play Burnley.

Coming home, I got the train between White Hart Lane and Hackney Downs stations. As we walked to the bus for Dalston, there was a mixed group of fans.

Most of the Burnley fans were smoking, as opposed to few of the Spurs fans.

Is this the difference between North and South?

December 7, 2019 Posted by | Health | , , | 3 Comments

Twice-Yearly Jab Could Replace Statins For Millions

This is an article in today’s Times.

As I have four B12 injections year, that would fit well with my health care.

November 25, 2019 Posted by | Health | | 3 Comments

The NHS And Prices For US Drugs

On the BBC’s Wake Up To Money this morning, an NHS expert; Helen Buckingham, from the Nuffield Trust, talked about the NHS and the prices for drugs, developed and produced in the United States. These are points Helen made.

  • Various people in the US, would like the UK to pay the US price.
  • The UK price is determined because the NHS is a bit customer and tends to buy centrally.
  • In the US, it is illegal for hospitals and health organisations to deal as a group.
  • Countries like Australia get their drugs at a good price from the United States under the recent trade deal.

Obviously, this is how I read, what Helen said, so if you’re really interested listen to the podcast.

November 25, 2019 Posted by | Health | , | 2 Comments

A Solution To Hospital Car Parking Charges

If I need to go to my preferred hospital of University College Hospital, I walk round the corner from my house and get a number 30 bus, which stops outside the hospital.

If I want to go to the Royal London Hospital, I take the Overground four stops to Whitechapel.

I live in Dalston, which is reasonably close to Central London and I chose to live here, as I don’t drive.

Some other cities have good hospital access on public transport.

  • Addenbroke’s Hospital in Cambridge has a fast guided busy to the City Centre and the North of the City. It also has it’s own bus station and may even get a railway station.
  • The Queen’s Medical Centre in Nottingham has a tram stop with direct step-free access to the hospital. The tram system also has seven large Park-and-Ride sites.
  • James Cook Hospital in Middlesbrough has its own railway station.

But how many hospitals and that includes many new ones have terrible public transport links?

Consider two elderly sisters; Elsie and Doris, perhaps living on opposite sides of the country.

Suppose one sister has a bad fall and ends up in the local hospital.

  • The train system in the UK is improving and I’ve regularly met fellow train passengers well into their eighties travelling for four or five hours by train, to visit friends and relatives or have a holiday.
  • Crossing London can be a problem for some, but my London-savvy eighty-five year old friend does it regularly.

It’s just the last link to the hospital, that can be a problem.

Norwich And Norfolk Hospital

The Norfolk and Norwich Hospital is a large teaching hospital, that was built in 2001 on the Western outskirts of the City.

It replaced a City Centre hospital.

There is a bus from the station, but finding details of the schedule is difficult, as the bus company’s web site, is more about selling you deals, that telling you how often the buses run.

I suppose the only way to find out is to go to Norwich station and do some bus spotting.

This Google Map shows the location of the hospital close to the University of East Anglia and the world-famous John Innes Institute.

I’ve only ever been to the area by car and I do wonder what students without transport think about getting to the University of East Anglia.

It certainly, isn’t the sort of place, I’d have wanted to go to University. During our time at Liverpool, C and myself were always popping down Brownlow Hill to the City Centre.

In somewhere like Germany or Switzerland, there would be a tram from the train station.

A London Example Of Improvement

If I wanted to go to Barnet Hospital, I would take the Underground to High Barnet station and then get a bus. But the Underground and bus interchange at High Barnet is not easy, especially on a wet day.

But it does appear that there is a better route, which involves catching a 384 bus from Cockfosters station.

  • The bus provides a feeder service direct to the hospital.
  • Cockfosters station will be step-free in a few years.
  • The bus stops at both Barnet Hospital and the A & E unit.

It’s certainly a lot better than when I lived in the area as a child.

Why Can’t All Hospitals Have Decent Public Transport?

Hospitals are important to so many people and although not every hospital can have a transport network as good as Addenbrooke’s, the Queen’s Medial Centre or University College Hospital, getting to some hospitals is a major logistics nightmare.

  • Hospitals serving a large rural area, must be at the heart of the bus network.
  • There should be a frequent bus or tram service to the city or town centre and the main railway station.
  • There should be much better information.
  • Hospitals could follow Nottingham’s and Cambridge’s .examples, where the hospital is on the city’s Park-and-Ride network.

How many hospitals in the UK meet this standard?

Conclusion

I believe that if decent public transport is provided to a hospital, that many patients, staff and visitors will use it, as they seem to do in Cambridge, London and Nottingham.

  • In some places there is no easy way to get to the hospital and driving is the only way.
  • Car parking is expensive to provide.
  • Some hospitals have no space for car parking to be increased or added.
  • How many are late for their appointments because the parking is full or they can’t find a space?
  • Making car parking free will only make the problem worse, as everybody will drive.

Perhaps we should rate hospitals on the quality of the public transport, just as they are rated on care.

 

November 24, 2019 Posted by | Health, Transport | , | 2 Comments

Home-Made Cabbage Soups Could Help Combat Malaria

The title of this post is the same as that of this article in The Times.

The article comes from this page on the Imperial College web site, which is entitled Scientists And Schoolkids Find Family Soups Have Antimalarial Properties.

This is the introduction.

London schoolchildren have found that some of their families’ soup recipes have antimalarial properties, with the help of Imperial scientists.

Researchers from Imperial College London helped the schoolchildren test their family soup broths for activity against the malaria parasite.

There is also this quote from one of the researchers; Professor Jake Baum.

We may have to look beyond the chemistry shelf for new drugs, and natural remedies shouldn’t be off our watch list, as artemisinin shows.

I also wonder, if natural remedies of this type, which are generally administered by a trusted relative or friend, come with a degree of care and concern, that is often lacking in healthcare.

We should also remember, that aspirin is not a modern drug, but was known to the ancient Egyptians.

 

November 19, 2019 Posted by | Food, Health | , , | 1 Comment