Tuesday, December 30, 2014

Murder of an Ahmadi Muslim

On  December 22 Mr Luqman Ahmad Shazad, an Ahmadi Muslim, was murdered in Gujranwala, Pakistan simply on grounds of faith; he is the eleventh Ahmadi to be killed in Pakistan this year.

Before the murder, there was a broadcast on GEO TV inciting hatred against the Ahmadis and an anti-Ahmadi conference was held in Gujranwala itself. Further details can be found on the Ahmadi site persecution website.

The broadcasting and circulation in the social media of hate speech against Ahmadis, Shia and other minorities is all too common in Pakistan, and is frequently the signal for religious violence. There are no laws prohibiting incitement to religious or racial hatred. The GEO programmes are relayed to the UK, including hate speech by the presenter Amir Liaquat Hussain or the extremist clerics Maulvi Humza Ali Qadri and Mufti Arif Shah Owaisi. GEO broadcasts that are reyed to the UK should be monitored by the police to pick up those that break the law, and action should be taken accordingly.

This latest murder is further evidence of the fact that Pakistan's Blasphemy laws and anti-Ahmadiyya laws continue to be used by extremists as a pre-text for brutal violence against Ahmadi Muslims and other religious communities in Pakistan. 

Wednesday, December 24, 2014


Dec 24, 2014  Nov 26, 2014 Oct 29, 2014 Normal

Hb 104 109 100 130 - 180
WBC 4.00 3.02 3.10 4.5 - 10.0
Neutrophils 1.80 1.16 1.43 2.0 - 7.5
Plt 551 391 427 150 - 450

With Hydroxycarbamide constant at 500 mg five days a week for the last two months Platelets have risen above normal limits (thrombocythaemia) carrying a risk of blood clots; Hb is stable at a point just above the level where transfusion might be indicated. Low haemoglobin causes fatigue. If it falls below 100, the prognosis given by DIPSS+ is affected, but UK clinicians never refer to it.

The dose is to be kept the same for the next four weeks.

Monday, December 22, 2014

DfID is the world's largest donor to the Global Alliance for Vaccines and Immunisation, saving the lives of hundreds of thousands of children. A great Christmas present!

Saturday, December 20, 2014

Grandson Alex gets his doctorate

Grandson Alex Lubbock gets his doctorate at Edinburgh University. Title of his thesis: Network biology and machine learning approaches yo metastasis and treatment response.

My introductory remarks as vice-chair of the Parliamentary Human Rights Group at a press conference on Bahrain, Committee Room G, 11.45 December 17, 2014

As we meet today to commemorate the martyrs who have lost their lives in the long struggle for human rights and democracy in Bahrain, and particularly those killed in custody and on the streets since the uprising began in February 2011, we now see the disgraceful reason why the UK has soft-pedalled criticism of the al-Khalifa despotism.
Bahrain has agreed to construct a £15 million naval base for our aircraft carriers and destroyers, helping to silence us on extrajudicial killings; widespread detentions; denial of the rights to freedom of expression and assembly; the subservience of judges to political authority, and the deprivation of citizenship of those who dare to oppose the regime.
We ‘express concern’ over these matters but at the same time we show that we don’t really mean it. For instance, the Government rejected the Commons Foreign Affairs Committee that Bahrain should be designated a ‘country of concern’.
On the contrary, as the Economist pointed out last week, the Government wanted to ‘demonstrate Britain’s revived commitment to the Gulf monarchies, with whom it maintains substantial trading and investment relationships’.
On Human Rights Day last week the Foreign Secretary Philip Hammond  called on governments around the world “to do more to foster the role of civil society in promoting and defending Human Rights”. Yet the founder of the Bahrain Center for Human Rights Abdulhadi al-Khawaja is serving a life sentence for promoting and defending human rights.
Nabeel Rajab, the current President of the BCHR, was imprisoned for three months for attacking the Formula 1 race in Bahrain; then spent two years in prison for peaceful protests, and is now awaiting a further trial on January 15 for a criticism of the government on Twitter.
On December 1 Maryam al-Khawaja, daughter of Abdulhadi al-Khawaja and a prominent human rights activist herself, was arrested at Manama airport when she arrived to visit her father, who is seriously ill from a hunger strike. She spent 19 days in custody before being released on bail, and was given a year’s imprisonment in absentia when she jumped bail, pointing out that Bahrain’s judiciary is not independent.
Maryam’s elder sister Zainab, who had just given birth to her second child,  was sentenced first to three years imprisonment on December 4 for insulting the king by tearing up his photograph, and then to another 16 months on December 9 – a year for insulting a public employee and an extra four months for damaging public property.
If this was North Korea you might believe it, but this is a country where the Foreign Office says  
“there is evidence of real efforts being made in areas where human rights concerns remain”.
Our Chief Inspector of Prisons is engaged in a project to help establish and promote independent human rights based inspection of Bahraini custodial facilities, presumably because this is still an area of concern; but apparently he knows nothing about custodial deaths, such as that of Hassan Majeed al-Sheikh, who was beaten to death in Jaw prison on November 6.
Nor do we acknowledge that people are still being tortured, and that the visit by the UN Special Rapporteur on Torture, Juan Mendez originally set for May 13, has been  ‘effectively cancelled’, to use the Special Rapporteur’s own words. The regime has set up an Ombudsman, who has indeed asked for urgent action to address the problem of overcrowding in cells, with Jaw prison holding 1,608 prisoners at the time of inspection compared with its maximum intended capacity of 1201 only; but the cases of torture raised by victims, such as those in which Prince Nasser was allegedly involved, are said to be committed in locations other than prisons. Nor does the Ombudsman inquire into the many cases of citizens killed or seriously injured by security forces, such as Youssif Baddah who is in hospital after he was shot point blank by a tear gas canister at a demonstration against the murder of his son at an earlier demonstration.
The chairman of the legal opposition Party al-Wefaq, Khalil al Marzooq and others, met Ann Clwyd MP, chair of the Parliamentary Human Rights Group and other MPs on November 20, and he told them that UK Ministers had not met Al-Wefaq officials for more than two years.  We understand that the Ambassador had met them, but not recently. The FCO was trying to persuade them to engage in the so-called ‘political dialogue’ and to participate in the elections. There was a severance of contacts in the run-up to the election, so al-Wefaq had no   opportunity of explaining that as they saw it, participation would have been seen as legitimising the political and constitutional status quo.
After many months of stalemate in the negotiations, Human Rights Watch said that Bahrain wasn’t ready for dialogue when top US State Department official Tom Malinowski was expelled from the country. He sought to engage with members of the unofficial opposition, whose objective is to replace the absolutist monarchy by a government freely elected by the people, in accordance with Article 1 of the UN Covenant on Civil and Political Rights, to which Bahrain acceded in 2006. When this idea is not only taboo but to refer to it indirectly means a three year prison sentence, how can we pretend that dialogue is anything but a means of postponing the inevitable?

With Professor Amy Austin Holmes from the American University, Cairo, December 19

Thursday, December 18, 2014

Sunday, December 07, 2014

Pickles and Traveller planning appeals

Secretary of State at the Department of Communities and Local Government, the Rt Hon Eric Pickles MP has been recovering planning appeals in the Green Belt by Travellers wholesale and sitting on them. In the two years to July 2013 89 Gypsy appeals were lodged for caravans in the Green Belt and 76 were recovered by Mr Pickles. Over the same period 6 ordinary house appeals were recovered out of 1,162.

Meanwhile, South Oxfordshire District Council leader said this week that 'there will have to be a review of the Green Belt in certain areas'. 15,000 new homes are planned at Ebbsfleet; another 15,000 at Northstowe in Cambridgeshire, and a further 13,000 at Bicester. Inevitably the Green Belt is being 'reviewed' because otherwise there's no hope of meeting the southeast's desperate housing shortage.  

This discrimination was challenged in the High Court on Friday in R (Moore & Coates) v Secretary of State for Communities and Local Government on Friday. The judgement will be interesting

Sunday, November 30, 2014

Bangladesh conference November 28

Bangladesh conference last Thursday.

Friday, November 28, 2014

One killer arrested

Photo from Nov 7, 2014 shows the parents of Saher Batool mourning while holding their late daughter's dress in Quetta.—AFP
Photo from Nov 7, 2014 shows the parents of Saher Batool mourning while holding their late daughter's dress in Quetta.—AFP
QUETTA: Police in Quetta claim to have arrested the killer of six-year-old Hazara girl Saher Batool, whose body was dumped after apparently being subjected to rape attempts.
“After one month, we have successfully apprehended the killer of Saher Batool,” Senior Superintendent of Police (Investigation), Asad Raza told a crowded press conference on Friday.
Police had found the child’s body on October 29 this year from Zarghoon Road area of Quetta, the capital of the restive southwestern province of Balochistan.
The victim, who was the daughter of a gardener working at an army facility, was found near a garbage dump close to her home.
The accused had strangulated the girl after a failed attempt at subjecting her to sexual assault, SSP Raza told reporters today.
There were marks of torture on Saher’s face and neck, he added.
During the press conference, police also produced the killer before the media while covering his face.
The girl’s murder had prompted the minority ethnic Hazara community, human rights organisations and political parties to hold protest demonstrations in order to mount pressure on the top officials to catch the killer.
There was no immediate reaction from Saher's family following the arrest.
“We will bring more facts before the public once the investigation is completed,” SSP Asad Raza said.

Tuesday's conference on the murders of Hazaras and other Shias in Pakistan

"Justice for Sahar" - attempted rape and murder of 6-year old Hazara girl Sahar Batool in Quetta, Balochistan, and hundreds of other Shia victims of extremist terrorists across Pakistan

Wednesday, November 26, 2014

Nov 26,2014 Previous Normal
Hb 109 100 130 - 180
WBC 3.02 3.1 4.5 - 10.0
Neutrophils 1.16 1.43 2.0 - 7.5
Plt 391 427 150 - 450

Friday, November 21, 2014

Traveller Movement Conference November 20.2014

Lord Avebury, Patron of the Traveller Movement, speaking at the Travellers Movement Annual Conference at 10.30 on November 20, 2014 at Resource for London, 356 Holloway Road, London N7 6PA

Andrew George, Chair of the All-Party Group on Gypsies and Travellers, said when the Government’s proposals on planning and Travellers were published in September that the Government couldn’t ‘redefine Travellers out of existence’. That’s exactly what they’re doing.
They want Travellers to prove that they are nomadic even though legal stopping places don’t exist.
Gypsies are to be redefined, losing their identity unless they currently travel. This means that people on tolerated or authorised sites will disappear from view.
Travellers have tried to establish permanent bases for themselves by purchasing land and applying for planning permission. Very few succeed, because they are vehemently opposed by local councillors and residents.
But now, appeals against refusal of permission in the Green Belt are being ‘recovered’, which means they are taken out of the hands  of inspectors and decided personally by the hostile Eric Pickles, who has been sitting on them for up to two years
Local authorities haven’t properly assessed the need for sites, let alone designated the land for them.  And now, land will only have to be found for people who can prove they’re currently travelling.
The Government also propose that where Travellers buy land and then apply for planning permission, that will count against them, knowing that in recent years doing it that way round and appealing is the only way of settling down.
What they’re  aiming to do by making nomadism impossible and then saying that Travellers have to be currently nomadic is to force them into bricks and mortar housing, as the communist regimes of Russia and eastern Europe did after the war.
The long-term objective is to eliminate caravan sites for Travellers altogether, a racist policy that doesn’t apply to mobile home parks for Gorgios.
The policy is also racist because Mr Pickles doesn’t treat appeals against refusal of planning permissions for Gorgio housing in the Green Belt in the same way as appeals against refusal of permission for Gypsy caravans.
In the two years to July 2013 89 Gypsy appeals were lodged for caravans in the Green Belt and 76 were recovered by Mr Pickles. Over the same period 6 ordinary house appeals were recovered out of 1,162.
Chris Johnson of the Community Law Partnership says   that planning permissions are often allowed for housing in the Green Belt or the Green Belt boundary is re-drawn to allow development to occur; and he quotes as one example the recent approval of 100 new houses at Bucknalls Lane, Watford.
Contrary to the assertion by Tories that the planning system is slanted in favour of Travellers, the exact opposite is the case, and even larger breaches are in the offing. The Government has approved plans for a 15,000 home new town at Ebbsfleet as the first of a new generation of ‘garden cities’ to solve the housing crisis, particularly in London and the Southeast.
Ebbsfleet is brownfield land but inevitably these new towns, or the alternative proposed by the award-winning urban designer David Rudlin which is to expand some 40 existing towns, would mean encroaching on open land and the Green Belt on a grand scale. Will Ebbsfleet Development Corporation find space for Traveller sites when it is established early next year, considering that Travellers have inhabited the area since time immemorial.
More generally if there is to be a new town strategy for the hundreds of thousands of dwellings required to solve the housing emergency, its unthinkable that it shouldn’t incorporate provisions for the tiny fraction of that number, of pitches needed to eliminate the shortfall in accommodation for Traveller sites.
Putting the obligation on the development corporations could have the advantage of being immune from the interference by Mr Pickles and the organised opposition that affects every planning application under the present regime.
The money could be provided via the Homes and Communities Agency, whose current programme for the three years 2012-15 will cover £62 million for around 600 new pitches. But that deals with only half the growth of the Traveller population.  
We need to know what the Government’s intentions are for the years 2015-18. If the HCA funding isn’t renewed, or if it is cut, that will be confirmation of the Government’s backdoor intention to deny Gypsies and Travellers their historic cultural identity.
The recovery of all appeals for Traveller developments in the Green Belt is to be tested in the courts in two weeks’ time, when they hear two judicial review applications against the Secretary of State. Unusually, the Equality and Human Rights Commission have requested and been given permission by the court to intervene in these cases. 
Whatever the court decides, the proposals represent a degree of central control which is incompatible with the Government’s professed belief in localism, the transfer of power wherever possible from Whitehall to local authorities.
Most if not all Travellers want a settled base so that they can access public services, particularly health and education. They are the most disadvantaged of any of our ethnic minorities.
Refusing to acknowledge that for the Travellers with a strong cultural tradition of living in small extended family groups on caravan sites, one of the reasons for their disadvantage is their precarious existence being hounded from pillar to post, the Government are perpetuating the problem.
When the coalition came into office they set up a ministerial working group on tackling inequalities experienced by Gypsies and Travellers. The Ministers produced what they called a ‘progress report’ in April 2012, implying that it wasn’t the end of the story; but in the two and a half years since that date there have been no further meetings, and none are planned.
There has been no attempt to review the trivial commitments they made on accommodation, neither of which could have had the slightest effect on relieving the shortage. The exercise was entirely cosmetic, designed purely to fend off criticism by the European Union of the UK’s refusal to adopt a  National Roma Integration Strategy as approved unanimously by member states for reducing the disadvantage experienced by Roma, Gypsies and Travellers. This seems to be another EU policy which Mr Cameron thinks he can ignore
The Ministers acknowledged in 2012 that
“there are still around 3,000 caravans on unauthorised sites, either on sites developed without planning permission, or on encampments on land not owned by Travellers. Gypsies and Travellers living on unauthorised sites can face additional difficulties accessing health and education services and the precarious nature of their homes can further exacerbate inequalities and stifle life chances”
But now, the people on these unauthorised sites are not to be included in the definition of Travellers, so local authorities will be able to ignore them in their assessments of need for sites. There are no commitments to increase the supply of sites, and the connection between the dire shortage of culturally appropriate accommodation and the inequalities identified by ministers was not reflected anywhere in the document or in later statements.
The Ministerial Group should be reconvened and asked to assess the likely effects of the new definition on the 3,000 families, and whether they consider that local authorities should offer them bricks and mortar houses on a take it or leave it basis.
The Group should also be asked to consider the bizarre situation identified by the Equalities Statement that accompanies the Consultation, that a Traveller who settles down permanently for whatever reason including old age, ill health, disability or children’s educational needs ceases to be a Traveller. She and her family are still members of a recognised minority ethnic group for the purposes of the Equality Act.   
This will be a factor in the court cases the week after next.  Failure to exercise the DCLG’s power “in a way that is designed to reduce the inequalities of outcome which result from socio-economic disadvantage”, seems on the face of it to be a clear breach of the public sector duty prescribed by the Equality Act, as I believe the EHRC will argue.
The responses to the consultation on Mr Pickles’ scheme for Gypsies and Travellers which ends in three days time will need to be considered carefully, and when the final decisions emerge they will need to be debated in Parliament. It will be too late for the Government to introduce the primary legislation that would be required if as proposed, they decide to alter the definition of Gypsies. This means that at least there will be a reprieve, and we will have an opportunity of seeing whether the parties, and individual candidates, will go along with Mr Pickles’ illiberal ideas.

Friday November 20 Report to Orthopaedic Surgery from Cardiovascular Services:

He developed angina towards the end of 2013 precipitating an angiogram which was performed in April 2014, This showed patent grafts [including a patent LIMA graft to the LAD, patent RIMA to the marginal system, patent vein grafts to the diagonal and right coronary arteries].

Overall, this was a reassuring angiogram and means that no myocardial revascularisation was indicated.

From the point of view of elective orthopaedic surgery, [there is] significant co-morbidity and his operatve risk will be influenced by that. From the coronary point of view however he is very stable and already takes low dose beta-blockers. His condition is therefore optimal and nothing further can be done to reduce what will be a moderate peri-operative risk.

The question is whether to press for a right knee replacement, or should I put up with it for the 20 months I probably have left. The vascular surgeons will probably recommend against it.

Tuesday, November 11, 2014

Product Development Partnerships

Developing Countries: Health Services


Asked by Lord Avebury
To ask Her Majesty’s Government what steps they plan to take to promote integrated healthcare structures and policy in the United Nations post-2015 development agenda.[HL2444]
The Parliamentary Under-Secretary of State, Department for International Development (Baroness Northover) (LD):The UK government supports the inclusion of integrated approaches to healthcare in a post 2015 agenda, as shown through the emphasis on Universal Health Coverage in the Report of the High-Level Panel, chaired by the Prime Minister, and its inclusion as a target in the proposal of the Open Working Group for Sustainable Development Goals.
Asked by Lord Avebury
To ask Her Majesty’s Government whether they plan to promote innovative medical technologies and product development partnerships as part of the post-2015 development agenda.[HL2445]
To ask Her Majesty’s Government what is their policy on the potential role of product development partnerships in the post-2015 development agenda. [HL2447]
Baroness Northover: The UK Government recognises the important role of new health technologies and product development partnerships (PDPs) in achieving the Millennium Development Goals and in the post-2015
10 Nov 2014 : Column WA3
agenda. The UK is the second largest government supporter of this research and will continue to promote it along with international partners.
Asked by Lord Avebury
To ask Her Majesty’s Government what discussions they have held with international counterparts on including product development partnerships in the post-2015 development agenda.[HL2446]
Baroness Northover: Officials from my Department regularly discuss the importance of product development partnerships (PDPs) and the continued important role for technology development in the post-2015 development agenda. The UK currently chairs the international Product Development Funders’ Group, including both bilateral and multilateral agencies as well as private foundations. Officials also participate in the annual Product Development Forum arranged by the Bill and Melinda Gates Foundation.
Asked by Lord Avebury
To ask Her Majesty’s Government what assessment they have made of the outcomes arising from the Department for International Developments-sponsored product development partnerships.[HL2448]
Baroness Northover: Public private product development partnerships (PDPs) have been shown to expedite the development of new drugs, vaccines and diagnostic tests, achieving results faster than either the public or private sectors alone.

Prior to the creation of PDPs, only 20 drugs were developed for neglected diseases between 1975 and 2000. Since 2000, UK Government funded PDPs have developed 19 new products including drugs for malaria, TB, neglected tropical diseases (such as sleeping sickness and visceral leishmaniasis), one vaccine for diarrhoea (rotavirus) and six new diagnostic tests (5 for TB and the first ever rapid diagnostic test for sleeping sickness).

Saturday, November 08, 2014


Consultation October 29. Blood results (last reading 4 weeks before in brackets) Hb 100 g/L(105); WBC 3.1x109/L (3.1)); neutrophils 1.43x 109/L (1.30); platelets 424x109/L (347), MCV 110 fL. Hydroxycarbamide to remain at 5 times/week but might be reduced further at next consultation November 26 if Hb continues to fall. Problem then would be that platelets would rise above desirable level.

Thursday, November 06, 2014

In Dylan Thomas's sitting room

Lindsay sitting at Dylan Thomas's desk at 5 Cwmdonkin Drive, Swansea with a photograph of her mother with Dylan in Caswell Bay behind her, November 5

Sunday, October 26, 2014

Labrador overnight guests

House guests last night - Fiki (white) and Khulu (black_

Thursday, October 16, 2014

Ophthalmology October 2

Diagnosis: Bilateral cataracts, bilateral macular degeneration
Visual acuity: 6/9 right eye, 6/9 left eye

OCT scan showed atrophy and mild subretinal fluid at the left macula, and retinal pigment epithelium disturbance with no fluid at the right macula. Both eyes are white and quiet and lens opacities were noted bilaterally. Geographic atrophy was noted at the left macula with some subretinal fluid. Retinal pigment epithelium disturbance was noted at the right macula with patchy hyperpigmentation. No treatment is indicated at present.

We have explained to him the risks and benefits of cataract surgery and the guarded prognosis due to macular degeneration. We have given him some information to read regarding cataract surgery and we will see him again in 2 to 3 months time with his decision......
The 'Guide to cataract surgery' says nothing about the 'guarded prognosis due to macular degeneration', but since 95 out of 100 notice an improvement in their vision and only 1 in 1,000 experience a total loss of vision after surgery it is a good bet. The Guide says there isn't a point when the condition is 'ripe' or 'ready' for surgery, but it should be when it affects daily life. Though I can still drive, 6/9 is getting close to the margin, so I think I'll ask to go ahead at the next appointment.

With Jason Brooke, founder of the Brooke Heritage Trust today

Wednesday, October 15, 2014

With Maryam al-Khawaja

At Maryam al-Khawaja's press conference this morning, at Index on Censorship office. She is head of foreign relations for the Bahrain Center for Human Rights, but lives in Copenhagen. Her father, Abdulhadi al-Khawaja is serving a life sentence for freedom of expression offences, and her sister Zainab is awaiting sentencing for tearing up a picture of the King in front of a judge.

Maryam told the press conference that IS sympathisers are being recruited into the police and security services in Bahrain.

Thursday, October 02, 2014

Eyes wrong

Visit to St Thomas's eye clinic this morning where after various tests Dr N H  confirmed cataracts and macular degeneration in both eyes. 'Right eye doesn't look too bad' its 'predominantly on the left. Vision is now 6/9, just within the limit for driving. Surgery isn't recommended for the cataracts because so far the deterioration isn't serious enough to outweigh the minor risks, one in 20 patients experiencing some complications, some of which can be corrected by further suger.

Nothing can be done about macular degeneration. When pressed, the doctor said that the median time between diagnosis and blindness was five years, and that should see me out as I expect to step off in July 2016.

Wednesday, October 01, 2014


Blood test this morning:

Hb                  105
PLT                347
Neutrophils         1.30
WBC                   3.11

The consultant was 'a little bit worried' by the trend of the neutrophil count, which has declined over the last three tests and is below the normal range of 2.2 - 6.3 10^9?L. Neutropenia, the condition of reduced neutrophils, means a greater susceptibility to infection, Dr M thought a bone marrow biopsy might be necessary, the previous one having been taken in July 2011, but first recommended cutting the hydroxycarbamide to five days a week to see if that would improve the neutrophil count, and arranged the next appointment for October 29.

Wednesday, September 10, 2014

Macmillan friends

Meeting this afternoon in the Kosta cafe at King's College Hospital with Tracey, Alwyn and Pam, friends from the Macmillan site who like me have incurable cancers. We had an amazingly upbeat conversation about our treatment, prognoses and our families, and we agreed that it was useful to exchange experiences in person as well as  on macmillan.org.uk.  We agreed to meet again in a couple of months, next time in the Macmillan room at the hospital. 

EVAR, September 10

Today's scan of EVAR (Endovascular aneurysm repair) showing that the plastic aorta inserted in 2010 isn't leaking, It also shows the stent inserted in one of the renal arteries in June.

Sunday, September 07, 2014

Virus crisis

Maurice and Diana's last day. Yesterday we went to Ham House in the morning, had lunch at the London Apprentice in Isleworth, then Strawberry Hill in the afernoon. Returned home to find my computer infected with a virus that was immune to AVG and apparently to all other anti-virus software. Maurice and I struggled to find a solution on the web, and the only site that claimed to have a solution we found was MiTechMate.com. As it was after 23.00 by that time we left the computer in safe mode overnight and returned to the problem this morning. The infected machine wouldn't connect to the web, so we opened a chat line with MiTechMate on the other computer in my office and apart from a difficulty in getting the site to accept my card payment, all was plain sailing. The contact at MiTechMate took control of the infected machine and removed all the infected files, at a cost of $65. I'm wondering whether to get a year's subscription at $130, or to take a chance that lightning won't strike twice.

Its disconcerting to find that there is some malware that gets past leading anti-virus packages such as AVG and AVAST.

Friday, September 05, 2014

King's College Hospital

Maurice and I visited King's this morning as part of the Day of Action on Alcohol Harm organised by the Royal Colleges, Alcohol Concern and the Institute of Alcohol Studies, Ms Jacqueline Green, Head of Stakeholder Relations, met us and took us to see Dr Michael Heneghan, Liver Consultant, Professor Heaton, Head of the Liver Unit, and Dr Will Bernal, Consultant, Liver Intensive Therapy Unit, We then moved to Todd Ward where we met Anne McKenna, Deputy Head of Nursing, Liver and Renal Surgery, and Natalie Huxtable, Matron, Liver. Then we attended the Liver Transplant meeting, where all the experts discuss the eligibility of candidates for liver transplants. King's is the largest and most successful centre for treatment of liver failure in the UK, and their available beds are full all the time, but the demand exceeds supply. After that we met Ian Webzell, Alcohol and Substance Misuse Clinical Nurse Specialist for a discussion on the post-operative treatment of patients with alcohol problems, a high proportion of whom relapse Nobody has a definitive answer to this problem, but there is universal agreement among NHS professionals that Government should be doing far more on prevention.

Everybody knows that the two main levers affecting consumption of alcohol are price and availability. Minimum unit pricing is a no-brainer, and the restoration of the alcohol duty escalator is another.  Local authorities should have stronger powers to control the proliferation of alcohol sales outlets, and all-night drinking should be reversed. What we need, as one of the professionals we met today underlined, was a commitment by the Government to reducing alcohol consumption on a par with the successful campaign against smoking of the last decade.

Maurice took the photograph: Ian Webzell is on my right, Dr Heneghqan on my left, and Jacqueline Green,  far left

Wednesday, August 20, 2014

Even more haematology

Haematology outpatients this morning below, with last time's and normal range. Platelets are within the normal range for the first time for ages, other values much the same as four weeks ago, outside the normal range but tolerable. Dr G was pleased there was no drop in WBC or Hb. He acknowledged that deciding the hydroxycaranide dose was pure guesswork so it was left at six times a week.

Blood tests
Aug-14 Jul-23 Normal
WBC 3.75 3.8 4.5 -10
Hb 108 108 130-180
PLT 388 470 150 - 450
Neutrophils 1.7 1.74 2.0 - 7.5

Monday, August 11, 2014

Optician, amd knee

Cataract and macular degeneration in both eyes diagnosed by optician today. Cataract in right eye can be dealt with surgically, she thinks, and is writing to the GP to refer me to King's accordingly. Macular degeneration is incurable and gets worse with time, but maybe I will be able to see until July 2016

GP telephoned this evening to inform me about the scan of my right knee. The cartilage between the bones is nearly worn out, and physiotherapy is needed to strengthen local muscles. Waiting list for physiotherapy at King's is 18 weeks

Oh well, can't be helped, as JW says.

Friday, August 01, 2014

More haematology

Notes from start of hospital stay May 14 to June 4 with pneumomia includimg 16 days in ITU:

Pneumonia etc

May 14, 2014 we both woke early and were up by 06.30, to have a cup of tea before going to King’s at 07.45 for the blood test required before every haematology appointment. Then back home for two more cups of tea and the newspapers before the haematology outpatients appointment at 10.00 which as usual turned into 10.45. The consultant Dr Aldawi said the platelets were OK, but haemoglobin was only just above the level where a transfusion would be needed. He wasn’t concerned about the slightly raised temperature I had the previous evening and at 02.00 that morning, or that I had coughed up bloody phlegm. He listened to my chest and said he couldn’t hear anything. But finally he ordered an x-ray which showed that I had pneumonia in my right lung., and Dr A said he would arrange for me to be given intravenous antibiotics. He left the consulting room for half an hour, and on his return said I would be admitted to the day ward All the cubicles were occupied and there was a further wait but when I was finally admitted it was clear they were not going to let me go. Lindsasy went home, returning at 15.00 with  washbag,  slippers and dressing gown, plus a sandwich, fizzy water and a tangerine.
At 16.00 the saline drip was replaced by 1200 mg Augmentin drip. Dr A said my kidneys weren’t working properly, as indicated by a rise in the creatinin reading from 108 to 180 since the previous blood test, but at the time this didn’t trigger an investigation of the renal arteries.
At 18.00 a nurse told me I would be g oing to Elf & Libra, a new ward for haematology patients, when they had a bed space available. !9.45 SATs were 85 so I was given oxygen. But they remained obstinately at around 90 and the next morning a consultant from Intensive Care fitted me up with a more intensive flowof oxygen which increased the SATs to 96. I had an infusionof anti-nausea medication and also of Meropinem.
Friday May 23 I was prescribed Furosamide to reduce water on the lungs, but still there was no suspicion of the renal arteries.

After that in intensive care my writing deteriorated and I can't read it.

Funny that it didn't occur to anybody that fluid retention was a problem linked to the kidneys. After five days out of hospital I was in a bad way and Lindsay called an ambulance on the Monday morning. After ECGs and scans of liver, heart and kidneys it was found that my renal arteries were both blocked, and the following day I had angioplasties and stenting which dealt with the problem effectively. I lost 10 kg over the next three days as the kindneys started doing their job of getting rid of the fluid.

Blood test July 23 (normal range in brackets):

WBC 3.8 (4.5 – 10.0)
Hb     108 (130-180)
PLT n 470 (150-450)
Neutrophils 1.74 (2.0-7.5)

All values are outside the normal range, but the one the haematologists watch closely is platelets (PLT). I take hydroxycarbamide which reduces the platelets, but also the haemoglobin. The dose is varied after each consultation to balance the two values. While I was in hospital I had a blood transfusion (2 units) which did increase the Hb from its previous reading of 8.5.

Thursday, June 12, 2014

Visit from Saeed Shehabi and Jalal Fairooz this morning

June 12, Haematology

Yesterday, am outpatient consultation with Professor M, a week after being discharged from a 3-week stay in King's College Hospital with pneumonia, starting May 14 including 16 days in intensive care. As a result of the blood transfusions I had in intensive care, Hb was satisfactory at 10.5, but platelets were raised at 550. Hydroxycarbamide is reintroduced 5 times a week. Amlodipine is reduced from 2 to 1 x 5 mg because Professor M says it could have an effect on fluid retention, still a problem although GP doubled Furosamide last Monday. Its a bit of a juggling act, and I have another haematology appointment next Wednesday week.

Yesterday evening I watched the second of three Channel 4 programmes My Last Summer about a group of five terminally ill patients and their carers discussing how they felt about their impending deaths. So far they haven't touched on the subject of assisted dying though I'm hoping they will do so in the last of the series. Surely its the patient who should have the right to choose whether to have an assisted death when his or her suffering becomes unbearable, as Lord Falconer's Bill provides. It will have its Second Reading in July, and I intend to speak for it, as a potential beneficiary.The later stages on myelofibrosis are unpleasant, and I should have the right to avoid them at the small cost of a few weeks of low-quality life.

Friday, April 18, 2014

Front garden April 15

Angiogram commemtary

The grafts by Mr Desai from December 1995 were all in 'pristine condition, but one of them was connected to the remains of the heart artery by a length of the original artery that was all furred up and therefore not supplying blood to the heart. This was the probable cause of the angina, and it isn't susceptible to surgery. Stronger anti angina medication, Ranosaline, is added to the arsenal I'm already taking.

The procedure took two hours, partly because the faulty connection wasn't accessible via the groin, and the surgeon had to start again via the wrist.

Afterwards I was exhausted and slept the whole afternoon and evening apart from a break for dinner and a short bit of reading at bedtime when I finished Max Hastings' Catastrophe about the events leading up to the Great War and the fighting up to the end of 1914. He puts the blame for the war squarely on the Kaiser and Germany's top generals, and he sees no point at which other players could have acted to avoid it.

I put the light out at 22.00 and slept solidly through to 08.00 this morning, and very unusually for me.slept this afternoon from 15.00 to 16.00, when I wass woken up by the front doorbell.

We still have no internet connection via the router after nine days off the air, and as its Bank Holiday weekend nothing can happen until Tuesday. The current thinking of the Parliamentary IT hep desk is that the cable modem is only seeing one IP address, which explains why there is a connection to one computer with the router disconnected. If this is correct, a replacement cable modem should cure the problem, and one has been despatched by Virgin to arrive on Tuesday. In the meanwhile any urgent printing has to be done by saving to a USB memory stick and taking it to another machine which is connected to its own printer. Similarly any files needing to be scanned have to be saved to a USB memory stick and taken to the only ,achine that haqs internet connection when it needs to be emailed. The only consolation is that there isn't a huge amount of traffic over the Bank Holiday weekend,