Friday

Monday amendment to the Education Bill on collective worship in schools http://bit.ly/ufXPqv.

I pressed it to a division but omitted to leave a colleague in the chamber to shout when it was called for the second time. Up to that point 50 had gone through the Content lobby to 115 in the Not Contents, so we would have lost handsomely if the division had been completed.

Wednesday morning, Subcommittee F heard evidence from Home Office officials on European Union DrugStrategy see http://bit.ly/tO2wbT

In the afternoon, Education Bill again, this time on the rule that when considering the closure of a school. a local authority should avoid reducing the number of denominational places http://bit.ly/vjQkOJ

Thursday, appointment with Mr R in the morning, followed by debate on the National Planning Policy Framework in which I spoke on planning for Traveller sites http://bit.ly/vAp6Hq

Today I have been catching up on emails and preparing for tomorrow's annual Peru Support Group conference, which I shall be chairing from 10.30 to 17.30.

So far I'm managing to lead a more or less normal existence apart from getting quite tired, but I'm starting to tell friends and colleagues that I'll have to scale down my activities, probably within the next year. I'll say something to the Peru Support Group tomorrow, as we don't meet very often. The news of my MPD/MDS is already on my new website my-silbury.co.uk and Twitter @EricAvebury as well as here on this blog but there are still a good many circles of contacts who don't see any of those.

I

Blood test October 17

Eric AVEBURY, DOB: 29-09-1928, Hospital No: D442931, NHS No: 4644474150

26 Flodden Road, LONDON, SE5 9LH

17/10/11 Renal/liver/bone/urea

Sodium 144 mmol/L [136-145 mmol/L]
Potassium 4.5 mmol/L [3.5-5.0 mmol/L]
Urea 6.5 mmol/L [3.3-6.7 mmol/L]
Creatinine 117umol/L [45-120 mmol/L]
Estimated GFR 52 mL/min
Calcium 2.19 mmol/L
Corrected calcium 2.13 mmol/L [2.16-2.6 mmol/L]
Phosphate 1.17 mmol/L [0.80-1.40 mmol/L]
Total protein 73 g/L [60-80 g/L]
Albumin 43 g/L [35-50 g/L]
Globulin 30 g/L [25-35 g/L]
Bilirubin (total)5 umol/L [3-20 umol/L]
Alkaline phosphatase 87 IU/L [30-130 IU/L]
Aspartate transiminase 24 IU/L [10-50 IU/L]
Gamma-glutamyl transferase 19 IU/L [1-55 IU/L]

17/10/11 FBC

WBC 4.50 10^9/L [4.0-11.00 10^9/L]
RBC 3.18 10^9/L [4.5-5.8 10^9/L]
Hb 9.9 g/dl [13.0-16.5 g/dL]
PCV 0.312 L/L [0.400-0.540 L/L]
MCV 98.1 fL [77.0-95.0 fL]
MCH 31.3 pg [20.0-36.0 pg]
MCHC 31.8 g/dl [32.0=37.0 g/dL]
RDW 18.8% [11.0-15.0 (def) %]
PLT 558 10^9/L [150-450 10^9/l]
MPV 10.8 Fl [7.4-10.4 (def) fL]
Neutrophils 2.44 10^9/L [2.2-6.3 10^9/L]
Lymphocytes 1.19 10^9/L [1.3-4.0 10^9/L]
Monocytes 0.38 10^9/L [0.2-100 10^9/L]
Eosinophils 0.05 10^9/L [0.0-0.4 10^9/L]
Basophils 0.00 10^9/L [0-0-1.1 10^9/L]
NRBC <0.2%
%Hypo 3.2

Some poikilocytes, abnormally shaped red blood cells, and RBC below normal range. Poikilocytosis is a rather general condition, but a predominance of one particular type of abnormally shaped red cells, some of which may indicate possible presence of a specific disease or disorder.

Medical - vascular

This image of my left femoral artery was scanned last Thursday, and Dr R discussed it with me this morning. It shows that the artery is totally blocked at one point, but the blood finds alternative pathways so that diminished flow still reaches the bottom of the leg. Dr R said that angioplasty to remove the blockage could be undertaken but (a) it doesn't last and (b) if it goes wrong it carries a small risk that the leg would have to be amputated. So he advised that as I'm capable of walking, it was better to leave it alone. His letter to the GP:

"The duplex scan of the left leg showed that he has got a short occlusion of the superficial femoral artery at the adductor hiatus. We had a discussion about treatment options, including angioplasty. However, since his walking distance could be unlimited uf he walks at a slower pace, I do not think at this stage the risk of having an angioplasty of the SFA is justified. The plan is to see hum again in my clinic in six months' time, with a follow up of his EVAR and I will reassess him again from the leg point of view".

Blood Cancer

This morning Lindsay and I attended an Open Day organised by Leukemia and Lymphoma Research (LLR), one of the main organisations that funds this research, at UCL Cancer Institute. There were seven presentations on the research being conducted, followed by demonstrations in the laboratories. It was a steep learning curve for us, having no previous knowledge of the science beyond articles in the media. We heard, for example, about how T cells, which play an important role in getting rid of viruses, can be modified to hook onto cancer cells and destroy them. The equipment needed for this research is enormously expensive but steadily becoming more powerful. UCL is probably the premier centre of excellence in the UK, and clearly attracts bright young researchers from all over the world, some of them funded by the EU.

With Congressman Javier Diez Canseco at London University's Institute for the Study of the Americas seminar last week.

Medical again

Consultation with Professor M at King’s College Hospital this morning, to discuss the prognosis of my MPD/MDS. On average the life expectancy from diagnosis of this condition is 3.5 to 5 years, but probably one year before it starts to interfere with normal life, with blood transfusions becoming necessary, and treatment of the side effects such as the build-up of iron that transfusions produce. This estimate is no doubt an average, and I didn't ask for the standard deviation.

The prognosis varies greatly between patients: some deteriorate gradually, while others remain on an even keel and then go downhill sharply. But the timing of the end result is much the same in both cases. Professor M said that none of the list of dysplastic syndromes in the WHO classification as described in Wikipedia fit my symptoms, but the practice nurse will send me precise details of the one that best fits my symptoms. Blood test:

WBC 4.50 [4.00 - 11.00 10^9/L]

Hb 9.9 [13.0 - 16.5 g/DL]

PLT 558 [150 -450 10^9/L]

Neutrophils 2.44 [2.2 - 6.3 10^9/L]

Creatinine 117 [45-120 umol/L]

Kidney slightly abnormal; Immunoglobulin normal; no blasts

The original indicator of MPD/MPS was the C-MPL mutation, which encodes the protein CD110 and thus plays a major role in platelet formation.

This afternoon, at my desk

Party for Lindsay, to mark her 11 years of work leading the Myatt's Fields Park Project, under which £3.5 million has been spent on the park, resulting in a great new children's playground; a children's building for the One O'Clock club for mothers and toddlers; a new football pitch; a new wild garden; renovation of the Victorian buildings; landscaping of the whole park, and a popular new cafe.

With our kind host this afternoon Khider al-Surchi (on my left), his brother Jowhar al-Surchi (on my right) and two of their sons. It was good to know that the injustice done to the family in the nineties had been remedied at last.

Parliamentary Group welcomes UNICEF's programme

THE APPG FOR GLOBAL ACTION AGAINST CHILDHOOD PNEUMONIA WELCOMES

UNICEF EFFORTS TO VACCINATE CHILDREN IN THE DADAAB REFUGEE CAMP

The APPG for Global Action against Childhood Pneumonia today welcomed the efforts of UNICEF to provide routine pneumococcal vaccinations for children entering the Dadaab refugee complex but warned that more must be done.

 Childhood pneumonia is the leading infectious cause of child mortality worldwide, causing over 1.5 million child deaths every year. Many of these deaths could be averted with the use of simple vaccines and effective treatments. Without a concerted effort on behalf of the global community, pneumonia will continue to claim the lives of millions of children each year.  

Kenya was among the first countries in Africa to introduce the vaccine against pneumococcal disease, one of the leading causes of pneumonia, and, thanks to UNICEF, this vaccine has now been supplied to all three refugee reception points in the Dadaab complex.

Located in the North Eastern Province of Kenya, on the Kenya-Somalia border, the Dadaab camp is the world’s largest refugee complex. Established in 1991 as a temporary measure to help refugees fleeing conflict in Somalia, it is now home to around 430,000 inhabitants and is estimated to grow at a rate of 1,200 new arrivals every day. The Dadaab complex now ranks as the third largest population centre in Kenya after the capital Nairobi and the city of Mombasa.

It is estimated that around forty percent of children entering the Dadaab camp have received no vaccinations at all and, despite the efforts of a range of NGOs, malnutrition, diarrhoea and respiratory tract infections remain widespread in the complex. With such a high concentration of people, hygiene standards are extremely low and the complex suffers from a critical shortage of clean water.

Co-chair of the APPG, Lord Eric Avebury said “Its brilliant that UNICEF are providing for the vaccination against pneumococcal disease – and also against rotavirus, the second biggest killer of small children - in the vast Dadaab camps. We must develop a coordinated response to protect other refugee children in Africa, such as those in new camps for the 35,000 in Ethiopia fleeing the attacks on civilians in Sudan’s disputed Blue Nile state”.

The APPG for Global Action against Childhood Pneumonia was established to raise awareness of the global disease burden of childhood pneumonia and to increase access to effective prevention and treatment interventions such as vaccines, effective use of antibiotics and education around the disease.   

Further information: Eric Avebury 020 7274 4617

  

At Springhill last Sunday

From Brittany

83rd birthday

More medical

The clinical nurse specialist at King’s tells me that I have myelodysplastic syndrome (MDS, www.mdspatientsupport.org.uk/what-is-mds/) as well as the myeloproliferative  (MPD) already mentioned. MDS has a number of subdivisions (see en.wikipedia.org/wiki/Myelodysplastic_syndrome), of which RARS-t in the WHO classification seems to match the symptoms best. This has the best prognosis of the lot, with an average life expectancy of 3-5 years. The article doesn’t say how long patients can expect to continue functioning more or less normally.

Its a mystery why the consultant didn't mention this when I saw her the Friday before last.