One Of The Most Depressing Days Of The Year
I hate June the twentieth, as it was my late son’s birthday. He would have been forty-four today, if he hadn’t died of pancreatic cancer four years ago. I never hate my late wife’s birthday in the same way, but that could be eased as another son virtually shares it.
So why did England’s kamikaze defending have to ensure their exit from the World Cup last night?
The media will be full of this depression today.
To make matters worse, BBC Breakfast is talking to a lady, who lost her husband and daughter in a speed-boat accident.
I’ll have to find something stimulating to do.
If my son were still here, we’d at least be arguing the whys and wherefores!
My only comfort is life could be worse. I did try to organise a luxury trip to the World Cup some months ago, but failed.
I would feel a lot worse, if I was waking up in Brazil.
Skin Cancer Trial Results Exciting
That is the headline on this story on the BBC web site. Here’s the first few paragraphs.
The results of two international trials against advanced skin cancer have been hailed as “exciting and striking”.
Both treatments, for advanced melanoma, are designed to enable the immune system to recognise and target tumours.
The last statement is key. After all one of ourposes of your immune system is to fight infections and any other dangerous things it finds in your body.
Research has shown that coeliacs on a gluten free diet, have a reduced cancer rate compared to the general population.
So should everybody avoid obesity, too much drink, smoking and gluten, if they want to reduce their cancer risk?
I don’t have the data, so I won’t make a prediction. But the man, who helped to identify the link between smoking and lung cancer, Richard Doll, was a coeliac and was obviously on a gluten-free diet.
He lived until he was 92.
He obviously looked at the data and probably massaged his immune system.
The Other Side Of Healthcare
According to reports like this, the new boss of the NHS is going to create more smaller community hospitals. Here’s the first few paragraphs
Smaller community hospitals should play a bigger role especially in the care of older patients, the new head of the NHS in England has said.
In an interview in the Daily Telegraph, Simon Stevens signalled a marked change in policy by calling for a shift away from big centralised hospitals.
The health service chief executive said there needed to be new models of care built around smaller local hospitals.
I think there is something, which is just as important, that he doesn’t seem to mention.
That is that all hospitals should be easy to access from most of their catchment area.
When I lived in Suffolk, the only way to get to the excellent local hospital at Addenbrooke’s in Cambridge, was either by a private car or taxi. It certainly couldn’t be done by public transport.
Where I live now, I only have to walk round the corner about fifty metres and every ten or fifteen minutes, there is a 30 bus direct to University College Hospital. The other local hospitals; Royal London, Barts and Homerton are also easy by public transport. I could even get the 30 bus to Harley Street for a private consultation.
But not everybody is so lucky and many hospitals are downright difficult or even impossible to access by public transport. Two hospitals in Suffolk; Ipswich and Bury \St. Edmunds come to mind.
Fixing this problem, will not only help patients, but make it easier for visitors without their own private transport to get to the hospitals.
Hopefully good public transport to hospitals, may also ease parking problems for staff and visitors and hopefully cut down the number of patients who miss their appointments.
A Summary Of My Health
Doctors have always been puzzled about my health. In my early years, Dr. Egerton White struggled to find, what was wrong with the sickly child I was.
I used to miss one school term in three and it was probably the Spring Term, but as I’m relying on memory I could be wrong. I was always suffering from rhinitis, sore throats and often coughed for England. At one time, I was diagnosed with scarlet fever, but as I was the only case in London and no-one caught it from me I do wonder if it was a misdiagnosis.
Dr. White, at one point thought I had an egg allergy, but in the end I got the usual treatment of children in those days, they took my tonsils out.
Sadly, none of my medical records of those days exist, as they got lost somewhere between London, Felixstowe, where my parents had retired and Liverpool University.
But as my current doctor and I have agreed, whatever has bugged me over the years didn’t kill me as a child, so hopefully it is unlikely to kill me now!
Spending time at Felixstowe on the windy East Coast seemed to improve my health, but I still had lots of small problems like athlete’s foot, terrible dandruff, joint and foot pains and an overactive gut. I should also say that I suffering pain from my left arm, where the humerus had been broken by the school bully.
My mother’s health incidentally was generally good, but my father suffered from terrible rhinitis and catarrh, which wasn’t helped by his smoking of a pipe. His father had been similarly effected and found that the best way of coping was smoking and drink. Consequently, he died in his forties.
Moving to Liverpool for four years for university and work, seemed to dull my troubles and I can’t remember any new problems until a few years later, when I was living in a flat in London, when I started to get pains in my knee joints. One doctor recommended an operation, but luckily I decided to pass.
Things seem to get better in the mid-1970s, when my wife and I moved into an eleventh floor flat in the Barbican.
Generally, for the next thirty years or so, my health was pretty good, although my arm, where it had been broken, could be painful in hot weather. We had moved to Suffolk and generally spent a lot of time outdoors.
Then in the early years of this century, I was diagnosed as a coeliac by Addenbrookes and went gluten-free. My health changed for the better, with most of the joint pains and gut problems disappearing. But I still seemed to suffer from the odd bad Spring, although it got better, when my wife and I could afford to take luxurious winter holidays.
Then my life fell in, in that my wife of forty years died of a squamous cell carcinoma of the heart in 2007, followed by our youngest son, who died of pancreatic cancer in 2010.
My health got worse on the death of my wife, with hay-fever like symptoms at times.
I then had a serious stroke in Hong Kong, whilst on holiday. Luckily, they gave me the superduper clot-busting drug, and my brain is no worse than it ever was!
As I lay there for about three months with the sun streaming through the window, some of my old symptoms returned. Rhinitis was pouring down my throat, like it hadn’t since the 1960s and my left humerus was giving me some of the worst pain ever.
Since then, I’ve sold up in Suffolk and moved to Hackney, so that I have access to public transport.
The rhinitis is often present, usually in the Spring, and my body feels very much as it did, when I was at school. I’ve also started to get conjunctivitis in my eyes
In one instance, I collapsed and was taken to hospital. They were puzzled, but did report that I had something like water on the lung. A couple of days of oxygen and I was able to come home.
This Spring, my small problems have been getting worse, with constant wind, itchy skin and especially eye-brows. Then I was found to have a fungal infection in my toes for which Terbinafine was prescribed.
This reacts with my Warfarin, but as I test my INR daily on a meter, I’m able to keep it under control. I should be able to, as I have a Degree in Control Engineering.
One thing that seems to help cope with the muck pouring into my mouth and throat is fresh lemonade, as it scrapes the muck into my stomach. The odd glass of weak Scotch has a similar effect. At times though it all goes away and white wine tastes like white wine, rather than vinegar.
The Only Pain Killer I Ever Use
My teeth and mouth are a bit painful tonight, so I’ve resorted to the only pain killer, I’ve ever found effective.
The Only Pain Killer I Ever Use
I’ve always found it so and I suspect, it is able to deal very well with the muck that seems to run into my mouth.
But after all, so many million Scots can’t be wrong! Can they? Although they probably think my habit of diluting it with London tapwater, is a bit Philistine!
On the other hand there’s a serious article from Time magazine here. This is the first paragraph.
Whiskey is one of the cheapest and best painkillers known to man.” So reported Dr. Harold George Wolff of Cornell last week to the Association of American Physicians meeting at Atlantic City. Earlier doctors, he said, prescribed whiskey freely but were finally forced to discard it for “moral and ethical considerations.
The report is dated May 19th, 1941. The only problem is that they weren’t talking about Scotch whisky, but bourbon.
Smoking In Restaurants In Poland
The weather in Poland was so good that I ate outside in a couple of places.
But unlike the UK, where people tend not to smoke where food is served, you sometimes get smokers in the areas outside restaurants.
My Short Term Memory
Over the last four years since my stroke and the move to London, I’ve often thought that my short term memory is going.
Sometimes, I’ll go out and leave the windows open for example.
But this morning, I realised this has been happening since C became very ill on her final journey.
In other words, do we for short term purposes rely partly on our partner’s memory.
At least it doesn’t seem to be getting any worse!
Interaction Between Warfarin And Terbinafine
A few weeks ago I was prescribed a course of oral Terbinafine to clear up a fungal infection. It seemed to work well, except that there is still some of the tinea in my toe-nails.
But over the time, I was taking the drug, I have felt that my INR was constantly wanting to slip downwards towards and below two.
Luckily I test my INR daily, and use a simple control algorithm to calculate my Warfarin dose. Normally, it is 4 mg, but if it goes below 2.3, I increase it to 5 mg, and if it goes above 2.8, I reduce it to 3 mg. So the algorithm got me taking a lot of 5 mg doses as opposed to the usual4 mg.
Only since I finished the course of Terbinafine has the INR stabilised around 2.5, which is my target value.
I didn’t at first see any link until everything settled after the course finished. But I decided today to type “Warfarin Terbinafine interaction” into Google. I found this paper from the BMJ entitled Drug points: Serious interaction between warfarin and oral terbinafine.
I think this minor incident shows the value of regular INR testing! Because I was testing daily, as the INR started to drop, my algorithm told me to increase the dose to 5 mg. In fact my average dose has gone up from 4 to 4.5 mg. in the period that I was taking the Terbinafine.
So there was no harm done at all!
My Letter In The Times Yesterday
I had a letter in The Times yesterday about BBC Radio, under the headline of Let’s Hear It
Amid the debates about the BBC’s licence fee some are questioning the value of the BBC’s radio stations …
Sir, Four years ago I was in hospital in Hong Kong after a serious stroke. Luckily, I had a laptop with me and I was able to listen to BBC radio
online.
BBC radio aided my recovery and certainly allowed me to keep my sanity. Those who would like to see the abolition of BBC radio should try six weeks in a hospital where the television and most of the staff are all in a foreign tongue.
I might add, that I now think that most patients in hospital should be allowed a computer or smart phone to fix their mind. Subject of course to it not conflicting with their treatment.
How To Remove A Fish Bone
I was reading Melanie Reid’s column in The Times yesterday, which was all about waiting for an operation, when I remembered an incident with a fish bone.
C had breast cancer a few years before she died and a couple of days before she was due to have her operation, we went to have a fish supper in a restaurant in Cambridge.
Unfortunately, I got a bone stuck across my throat and we ended up in Addenbrooke’s Hospital. They repeatedly tried to remove the bone, but after a couple of hours, it was decided that it would be best if I came back in the morning and they gave me a general anaesthetic to get it out.
So I duly arrived in the morning and I was admitted to a ward to wait. They said it wouldn’t be long.
But I waited and waited and the staff nurse was getting fed up with having one of her beds blocked by a fish bone. Apparently, there had been a whole series of serious emergencies and they’d run out of operating theatres.
Eventually about four in the afternoon, the staff nurse got so fed up, she forcibly recruited a very junior doctor, to remove the bone, in the way that Dr. Finlay would have used. That is by means of pure medical dexterity.
The first two attempts were complete failures, mainly because I wasn’t calm enough. So partly in jest, I suggested they got a pretty nurse to hold my hand. So they volunteered this Spanish nurse to hold my hand.
It worked and a couple of minutes later the bone had been removed from my throat and the staff nurse got her bed back.
If there is a moral to this story, it is that so much of the old skills we use for all sorts of actions in all professions are being lost and not handed down through the generations.
The Anonymous Widower 