Friday, October 30, 2015
Monday, October 26, 2015
Dept of Cardiology, King’s College Hospital, 14 October 2015
This 87-year-old gentleman was reviewed today in Professor McCarthy’s clinic with a remote history of bypass grafting in 1995 (LIMA to LAD, RIMA to OM, SVG to diagonal and RCA). There was an angiogram in 2014 prior to undergoing vascular intervention which showed that all of his grafts are patent. He underwent left leg angioplasty a few months ago for critical ischaemia of the limb and has previously had an EVAR in 2010. His main ongoing problem at the moment seems to be related to myeloproliferative disease with anaemia and increasing need for transfusion.
This gentleman attended today along with his wife and from a cardiology point of view he is actually asymptomatic with respect to any undue shortness of breath and he does not experience any angina whatsoever.
His exercise tolerance is very much limited by general fatigue secondary to the myeloproliferative disease and he does not describe any features of incipient heart failure,
Sunday, October 25, 2015
I tweeted this link on October 10 to a powerful article about the imminent execution of former Bangladesh Nationalist Party Leader Salauddin Quader Chowdhury after refusing to hear 26 defence witnesses http://linkis.com/blogspot.com/vHzkk.
Now several prominent Pakistanis have asked to testify before the International War Crimes Tribunal that Mr Chowdhury was living in Karachi when the offences of which they convicted him were committed: http://bit.ly/2061RSQ. The sentence surely ought to be suspended and these witnesses should be heard.
Saturday, October 24, 2015
The Times backs NHS England's call for a sugar tax http://www.thetimes.co.uk/tto/health/news/article4593962.ece
It would provide a badly needed saving of £500,000 on England's health bill. The Government has committed to increasing NHS funding in England by £10 billion in real terms by 2020-21, above 2014-15 levels, but all the same a £2 billion gap has opened up in their budget for 2015-16 alone.
The right way to deal with this is through fiscal attacks on self-harm, including not only the sugar tax, but higher duties on alcohol and tobacco. The Government estimated the cost of alcohol harm at £21 billion a year in 2012; restoration of Osborne's duty reductions, and some judicious additional duties on top of that could generate revenue of £1 billion and at the same time cut hospital admissions by 50,000 a year.
Friday, October 23, 2015
Liberal Democrats have tabled a motion in the Lords to scrap Cameron's tax credit plans which would leave three million low income people £1,000 worse off.
Zahida Manzoor, our Work and Pensions spokesperson, is calling for the House not to approve the regulations and, if that is passed, the Government will have to come up with a revised version of their proposals.
The Liberal Democrats will alsosupport Labour peer Patricia Hollis’ amendment calling for transitional protection, but we don't believe this goes far enough.
LibDems say that the Government’s changes to tax credits are unacceptable. David Cameron explicitly ruled them out during the General Election.
He is asking Parliament to cut support for people who go out to work to provide for their families.
These changes remind us of Mrs Thatcher's disastrous Poll Tax of 1982, which the Tories withdrew when it was opposed by the vast majority of the British people. But at least it was in the Tory general election manifesto, whereas this attack on the poor directly contradicts what Mr Cameron said in the 2015 campaign.
When he was asked during BBC Question Time on April 30 whether the Tories would cut tax credits, Mr Cameron replied:
"“No, I don't want to do that. This report that's out today is something I rejected at the time as Prime Minister and I reject it again today.”
Public Health England says a sugar tax and other measures to reduce our consumption of sugar would reduce the nation's health bill by a whopping £500 million. The NHS is facing a spending crisis, and this would be a great way to relieve the pressure. The extra revenue could be spent on bailing out the overspend already incurred by CCGs.
Wednesday, October 21, 2015
Blood test 08.00, haematology appointment 10.00, saw the consultant 10.50.
|Blood results last 9 readings|
As platelets were down slightly it was thought safe to reduce hydroxycarbamide from 3 times a week to twice a week. With luck this could prevent or slow down fall in Hb, and delay the need for transfusions. At my suggestion the registrar agreed to call for a serum ferritin test at the next consultation in four weeks' time. This will monitor the cumulative build-up of iron in the heart, liver etc as a result of transfusions. A reading of more than 1,000 mcg/L may indicate iron overload, though I don't think I'm anywhere near that threshold so far. He also agreed to write to the vascular consultant about the continuing problem of the ulcer on my right ankle, which Lindsay says I'm not to show again on his blog. White blood cells are low, meaning the immune system is not too good.
Tuesday, October 20, 2015
Friends of the Earth say hundred of solar firms will probably go bankrupt and tens of thousands of jobs may be lost http://ind.pn/1NSJ49N
UN chief environmental scientist Prof Jacquie McGlade says cuts in renewables subsidies, coupled with tax breaks for oil and gas, sent a worrying signal to the coming UN climate summit in Paris. She says
".....the UK appeared to have abandoned its leadership on climate change, while 150 other nations were making unprecedented pledges to shift towards clean energy".
Monday, October 19, 2015
In their latest move away from green policies, the Government have cut solar subsidies by 87% see http://bit.ly/1MOy5wt. Four solar panel firms have withdrawn from the market, and job losses may reach 27,000. This comes on top of restrictions on energy efficiency, onshore wind etc.
I declare an interest, having installed solar panels on the roof of our house at the end of August. We just got in ahead of the cuts, and up to now have generated 231 kwh, saving 91 kg CO2 emissions. It may not be much, but the industry was getting to the point where tens of thousands of houses could have been making that sort of contribution. The Tories are accusing Ed Davey, the Coalition LibDem Minister, for allowing the subsidies to soar. In fact he laid the ground for the UK to build a massive renewables industry and beat the 2030 target for reduction of CO2 emissions, potential achievements the Tories have now sabotaged.
Sunday, October 18, 2015
Sophie Sabbage The Cancer Whisperer gets half a page in The Observer for her rejection of the idea of 'battling cancer', as if it was a new idea. Her mother was horrified that she was writing a book about her own experience, culling entries from her blog.
In the Macmillan Online Community's Living with Incurable Cancer Forum (on which I post occasionally) there's a tendency for people to write of their cancer in adversarial terms, which is surely unhelpful since it must raise their stress levels without alleviating their symptoms. If they already lead a healthy life there may not be anything they can do that would affect the course of their disease; the NHS doesn't offer alternative or complementary treatment for cancer http://bit.ly/1PA393W.
But I do think its useful to post experience on line, and all the stuff about the myelofibrosis since I was diagnosed in July 2011 is on this blog. I'm not 'allergic to death' as many people are according to Sophie, though it probably isn't a good subject for dinner table conversation. There are practical questions that do need to be answered in many families such as who gets which bits of furniture, books, pictures etc, and what are the ingredients of the funeral or memorial event. The fun idea of having a sweepstake on the date of my death was vetoed by Lindsay as in bad taste, but for the record I've always said it would be in or about July 2016. Quality of life is more important than quantity, and by that time if I'm still around the quality may be somewhat reduced.
So far the disease hasn't taken over my whole existence and the posts about it have been factual. Continuing to work on politics prevents me from indulging in hadiwist
Saturday, October 17, 2015
Those present: Lord Avebury (Vice-Chairman), Lord Luce, Lord Ramsbotham (Vice-Chairman), Baroness Whitaker (Vice-Chairman), Alan Brown MP, Jeremy Corbyn MP (Honorary President), Dr Paul Monaghan MP, Andrew Rosindell MP (Chairman), Henry Smith MP (Vice-Chairman), David Snoxell (Coordinator), Richard Gifford (Legal Adviser), Oliver Taylor (Administrative support)
Wednesday, October 14, 2015
Well done Michael Gove for persuading Prime Minister David Cameron to ditch the £5.9 million contract to provide training for Saudi Arabia prisons http://bit.ly/1k4eTzE . It should be a general rule that we don't offer training or advice for prisons or judicial systems in countries where these systems are seriously compromised, eg the training in human rights of judges in Bahrain. There will be a test of how effective this training has been when the appeal by Zeinab al-Khawaja appears before the Bahrain court of appeal on October 21, appealing against sentences totalling five years imprisonment for 'offences' such as tearing up a picture of the king. A system that routinely yields punishments so flagrantly violating the right to freedom of expression is incapable of reform.
Monday, October 12, 2015
Robert Fisk is the first journalist, as far as I'm aware, to label Saudi Arabia for its scandalous destruction of Islamic world heritage sites, and to highlight the contrast between the West's criticism of the Daesh for destroying Palmyra, and their total silence as Saudi Arabia demolishes sites associated with the Prophet and his family http://ind.pn/1jkTyln. This is a matter of concern to the whole of humankind, and we should demand that UNESCO take it up with the so-called 'Caretaker of the Two Noble Sanctuaries.
Friday, October 09, 2015
Wednesday, October 07, 2015
Yesterday to Guy's ENT to deal with persistent nosebleeds The consultant Dr L prescribed topical application of one antibiotic four times a day for two weeks followed by a different antibiotic for another two weeks, and then a return visit to ENT outpatients.
Today was yet another visit to King's, first to have the six-monthly EVAR check-up to make sure there are no leaks from the plastic aorta, and then for a consultation with Dr R the vascular consultant. He was pleased with the EVAR scan which showed there had been a further contraction of the original aorta, though I can't see why that matters considering its never going to be used again. He looked at the ulcer on my left ankle and said it was progressing normally, only recommending the use of foam wound doughnuts to protect it from danage.
Tuesday, October 06, 2015
There's a lot of hysteria in NATO foreign ministries and media about Russian incursions into Turkish air space, but Turkey's policy on Syria is not aligned with NATO's. Erdogan's main objective is to get rid of potentially troublesome Kurds of the YPG, who have been the most effective opposition to the Daesh. It was with great reluctance that he allowed a small contingent from other YPG-held territory to cross through Turkish territory to help defend their beleaguered colleagues in Kobane when they were on the verge of being wiped out a year ago. If the Turks don't agree that the eradication of the Daesh is the paramount necessity for restoring peace in the region and allowing hundreds of thousands of refugees to return to their homes, we should be looking for other allies with the necessary muscle to do the job. We should be holding talks with Moscow on how to avoid incidents in the air that could have disastrous consequences for both Russia and NATO, and building a new coalition in which all participants are on the same wavelength. Patrick Cockburn as usual makes a lot of sense, http://ind.pn/1VCcKvV
Monday, October 05, 2015
We spent from 11.00 to 20.00 in the Haematology day care centre at King's, where there were too many patients for the staff to cope. Blood test finally 14.00, results back 16.00 and the transfusion started at 17.50, finishing 20.00. Hb was 95. not as low as I expected from the way I was feeling, but a drop from 106 only four weeks ago on September 11.
Blood tests, last 9 results