Coronavirus streets in Manchester - LXIV

It is still out there

What we cannot ignore in these somewhat perilous times is that the pandemic is quite present with us. Whilst indeed there are mitigations for dealing with the Coronavirus, in that many have been vaccinated and boosted, the vaccine is not prophylactic per se, it simply helps against debilitating symptoms and severe illness.

That knowledge alone should have us all know that we still need to maintain some precautions with regard to the possibility of infection. The wearing of face coverings and masks is still important as is avoiding enclosed or poorly ventilated places, especially in crowds, then the washing and sanitising of hands.

Be careful of the carefree

The fact that there is no legal requirement to self-isolate again as it is a mere advisory means that we might quite likely encounter people who have the Coronavirus, who are aware that they are infectious, but for whatever reasons, they have not self-isolated. They are out amongst us, careless or carefree, and troublingly so.

There is also no telling where one might go and perchance pick up the infection, we just have to be wary. In my case, I had a neighbourly chat a few days ago and then the day before yesterday, I was informed that they were COVID-19 positive. I was quite concerned for them, wishing them a speedy recovery.

Waiting for half an hour

However, I was informed that our proximity might have made me vulnerable to infection meaning I needed to perform a self-test to be sure that I was not infected and a vector of infection. I got out my Rapid Antigen Test kit and performed the swab into the reagent and 3 drops on the lateral flow device. The Control line showed up and the sample was being processed by the device and 30 minutes later, only the Control line was showing and nothing for the Test line, indicating I was negative.

I registered the test result with the NHS website and performed another test today that read negative too. It is a relief as I am in the vulnerable cohort, and one cannot risk getting infected regardless of the number of times one has been vaccinated and boosted. I should be on for my 4th shot in May.

The truth is, we cannot be indifferent, we do have to live with this virus milling around us whilst exercising all the necessary caution and safety procedures, this should all become second nature and hopefully, there is still something happening in the pharmaceutical world that does more to avoid infection totally through eradication rather than just reducing the effects of the virus.

Coronavirus streets in Manchester - XVIII

New arrivals as potential vectors

It was only two weekends ago on a Saturday just into the second kilometre of my 7-kilometre walk to the banks of the River Mersey ensconced by the Chorlton Water Park and Sale Water Park that I saw arrivals to the student halls of the Manchester Metropolitan University. Young men and women brought over by their parents to begin a new phase in their lives.

Then, I wondered about how my city was changing as if we had now found a cosy arrangement with the pandemic where life could somewhat return to normal. Life did return to a kind of normalcy for the freshers’ week, for each time I went out for a walk there were crowds and groups, hardly social distancing, revelling into the night, it was concerning.

Neither here nor there

Then at the beginning of the week, the government began backpedalling on the lifting of restrictions, their urging that we return to our offices was less so, we were now to work from home as much as possible, the whole saga was becoming more comedic and tragic than how the Grand Old Duke of York marshalled his men up and down the hill till they were stuck in the middle, being neither up nor down. At least they were receiving clear directions even if the purpose was unclear.

[]

On a personal level, health is wealth, to a country in the times of a pandemic, public health is national wealth. The latter cannot precede the former. The bungling administration of Boris Johnson who when he resigned as Foreign Secretary in Theresa May’s cabinet suggested there was a failure of statecraft, in his case, there is a total lack of imagination.

Believing in human ingenuity

Without assuring public health, the national wealth will suffer and all efforts to protect the economy would be exorbitant and consequently fruitless.

We have to believe in human ingenuity that when all things are equal with public health, regardless of how the economy has been battered, it can be revived. History has shown how war has damaged economies and the end of the war ushered in growth and productivity through some pain, but the trajectory is always upwards.

The failure to address the public health emergency with competence and strategy has left us in the throes of a second wave that would be more damaging than the first and possibly leave the economy in a more sickened state than if things were properly dealt with in the first instance.

A student life halted

The students that returned to campus life have somehow met up with the Coronavirus with 127 of them testing positive with COVID-19 leading to the self-isolation of about 1,700 students in Cambridge Hall and Birley Campus, just within 2 kilometres of my residence.

Their self-isolation is to prevent them from spreading it in the community and further down the line, if this is not contained, there is a likelihood that students will not be allowed to return home for Christmas, just to prevent community contact spreading. [BBC News: Covid outbreak: Manchester Metropolitan University students in lockdown]

Can’t blame the students

From another perspective, the students have been short-changed and scammed, universities opened to justify their tuition fees, the hostels opened to keep the landlords afloat through their justifiably collecting rent. Now, they are stuck in their rooms, they can neither attend classes nor return home. It was a catastrophe in the making for which the government would shift the blame to the victims of this pandemic, the students in this case and the public in the general surge in infections nationally.

Whereas, it is without a doubt that the UK government is totally responsible for the mishandling of this pandemic and that is why we have the highest number of deaths due to COVID-19 in Europe. We cannot spin that any other way than say it with conviction as the incontrovertible truth.

Everyone for themselves and for all

On our streets, one thing is evident, the virus is invisible, it is pervasive, it is spreading and the need to maintain social distancing, wear masks, avoid gatherings, wash hands and so on remains a matter of personal safety and self-preservation. There is no telling where in this city of three large universities there are other pockets of infection. Within the week of opening primary and secondary schools, 15 schools were shut with the pupils asked to self-quarantine.

My other concern is how from outside the UK, other countries might be watching things go awry and so place us on a restricted list of travel as both a destination and place of origin. It is obvious that Boris Johnson and his big tent of circus clowns will never get to grips with this pandemic, we as individuals must save ourselves.

 

But for the joy of being an antelope

Hours of waiting and waiting

In 5 weeks of events that was somewhat out of my control dictated by my apparent susceptibility to a water-borne infection, it started with my boyfriend noticing in a conversation that I was not particularly myself.

Against my protestations, he contacted my best friend and then a close friend in Manchester, between them, they decided I needed emergency hospital attention that led to an ambulance being called. We were assured the ambulance would arrive in 2 hours whilst the numbing discomfort like a tyre around my waist left me almost slipping into a kind of delirium without passing out.

Over 5 hours after the call for ambulance services, the medics arrived and after checking my vitals decided I was best attended to in a hospital. A GP had called me to assess my condition and her view was I probably needed to be in a hospital. At the hospital, I was immediately seen to and a cannula inserted to my arm. There was another almost 6-hour wait from a doctor could attend to me. I was up all night, arriving at 11:25PM until just before 6:00AM.

Not ill enough to be promptly seen

Sat in the waiting area, we watched the walking wounded arrive and because I seemed to be comfortable sitting down, my situation was not considered an emergency. A patient walked in spilling blood all over the floor and it took over 2 hours before the contract cleaner nonchalantly considered it important to clean up. He ignored the issue concentrating on other mundane things as if he was only going to clean the floor at a scheduled time, regardless of whether the blood on the floor constituted a health hazard.

On seeing the doctor, I was admitted and placed in an assessment room where I was given broad spectrum antibiotics and electrolytes, the prognosis at the time was for a few days of treatment as an in-patient.

Discharged with pills

During my 8-hour admission, I found myself recounting my condition to a doctor, a medical student, and a consultant. Eventually, it was decided I could be discharged with additional antibiotics to be taken 4 times a day, to return on Saturday for a check-up where again, I was put on electrolytes because I had basically lost my strength.

For what seemed a benign condition, the recovery was much longer than I could have anticipated, it took weeks to begin to regain my strength during which I lost about 6 kilograms. My GP ordered new blood tests and an ultrasound scan of my kidneys.

Persistent irritation reviewed again

Meanwhile, what was diagnosed as both an inflammation of my kidneys and a urinary tract infection did not seem to deal with the urinary tract issue. This prompted my visit to a sexual health clinic and another regime of antibiotics for non-specific urethritis, this cleared up the problem whilst no further diagnosis was made.

My recuperation has made considerable progress that for my scheduled ultrasound scan today, I decided to walk up to the hospital, something that would not have been eventful. I walked past a man too engrossed in viewing his mobile phone to concerned about others as he slightly obstructed access to the traffic lights on the pavement. I crossed the road not giving to much thought to it.

A few minutes later, he was in a chase of a thief who had snatched his mobile phone and made away on a bicycle. There was nothing he could do but rue the moment and carry on with the rest of the day, I guess he was a university student.

Steak and kidney not on the menu

I arrived at the hospital early and unusually I was immediately called into the examination room and prepared for the sonographer. The cold gel applied to my stomach gave a slight shock to my system and then I adjusted to the coolness. The sonographer was not giving up anything as I asked whether my kidneys were good enough for a steak and kidney pie. The results of the scan are to come from a consultant rather than the sonographer.

We were done in about 15 minutes before I made for the reception to have the spelling of my surname corrected. In Yoruba, what would normally have translated to ‘being a hero is joy enough’ what the switching of the vowels in the 3^rd and 4^th syllable, became ‘this hero is just an antelope’. That won’t do.

After my hospital appointment, I walked back home on the main road, stopping off at a Starbucks café for about 45 minutes. I guess the results would be back in a couple of weeks, but as the three blood tests, after my admission indicated nothing unusual, I should expect things would be fine in the end. Much of this was made easier to withstand by my friends and I am grateful to them.

Berlin: Lest We Forget Those We Lost To Sexually Transmitted Infections

Stones of remembrance

Just further down the road at the big junction on the right after Wittenbergplatz but before Nollendorfplatz at An der Urania in Berlin stands a black marble stone with a red AIDS ribbon and one other on the ground, a square with inscriptions.

The quarter of space marked by a number of streets to the right also harbours many meeting places of people who have most been affected by HIV/AIDS as it scythed through the young with the vengeance of an unforgiving and unrelenting Grim Reaper.

However, this memorial did not just think of HIV/AIDS but it included Hepatitis and broadly Sexually Transmitted Diseases (STD).

Before you get holier than thou

Very easily, one can be sanctimonious and sententious as if completely unaffected and that might be the case for the abstainer, the celibate or the eunuch.

We however cannot deny that we are sexual beings and the desire to fulfil that need exists in the majority.

Some have experienced it through consent, some through violation, some as their innocence was snatched away by the unconscionably reprehensible, in violence or by subterfuge, none of which apart from the first are in the slightest, fun.

Death still looms

The greater point is to be aware of one's sexual health regardless of risks taken and to avail oneself of immediate treatment before other complications arise.

The rather innocuous infections can easily be vectors and vehicles enabling greater susceptibility to incurable diseases of which HIV is one and besides there is a rise in co-infections with the difficult to cure Hepatitis C.

Even in the West, people still die of these diseases as in some cases some diseases are becoming resistant to the heretofore effective drug therapies, like Gonorrhoea.

A memorial to all

What really touched me most was not that this was a memorial to the dearly and unfortunately departed, but that many living souls might have walked past a memorial to themselves.

Our secrets, fears, infidelities, embarrassment, shame, habits, ignorance, daring, promiscuity, innocence, naivety, stupidity, carelessness, carefreeness or just our plain humanity can put us in a place of pain.

We can mitigate those issues with accepting whom we are, being honest to ourselves and using the help to ensure we are no sooner victims than we should be.

To those we lost, you are never forgotten. Shalom!

Europe: HIV Testing Week - Get Tested

Some important links

The First European HIV Testing Week – 22^nd of November – 29^th of November, 2013.

HIV Testing Information – Avert.org

Why test – European HIV Testing Week

Management of HIV/AIDS – Wikipedia

Summary of new recommendations for the management of HIV/AIDS – WHO [PDF]

We love sex

There are some facts we need to get out of the way from the onset.

We are sexual beings; we are programmed to desire and find some satisfaction with sex.

Whether sex leads to procreation or is used for pleasure, practiced in search of a thrill or done to fulfil fantasies, sex or the lack of it defines a quadrant of our lives.

We have as human beings adopted higher moral and social values concerning sex to first establish consent, per adventure, maybe even a relationship regardless of the pairing of genders to express ourselves sexually.

Our weaknesses

Much as we strive to maintain norms, we have foibles or weaknesses driven by sexual appetite, some that we curtail, and others to which we yield.

We love or we lust, we are faithful or we cheat, we abstain, or we indulge; it is very easy to find aversion to sex or the fondness for sex defining what we believe and do.

That is why sexual health is of the paramount importance regardless of how we find or ignore sexual expression.

It is for that reason that we have the first European HIV Testing Week from the 22nd of November until the 29th of November.

The world is wild our there

For whether we trust ourselves or lay that responsibility on others, we know where we have been imperfect and inadvertently taken risks in search of many things including thrills.

Unsafe sex giving more feeling and heightened excitement, that chance encounter in a nondescript place with a stranger, being on the down-low because low down it is just so good.

The other day, your prudish reserve got a swerve, your saintly halo gave way to regret, guilt and remorse, you swore and vowed, yet found yourself still where you thought you had forsaken.

Inhibitions that lost their moorings in a moment of crazy and wanton abandon, decidedly or involuntarily.

Maybe none of this resonates but if you do have sex and you can only vouch for what you do, your trust in others is no defence for exposure you open yourself to when you find a willing partner.

Test to know

Testing brings many benefits, knowledge of what your status is with the peace of mind that comes with being told you are fine or the early detection allowing for prompt intervention and favourable outcomes for your health and wellbeing. (Avert.org)

Having HIV is no more the death sentence it once was if it is put under management with medical expertise and antiretrovirals (ARVs). The medicines are efficacious and potent, this matter is not one to procrastinate such that the virus ravages the body to the point that complications result in AIDS as the body yields to opportunistic infections bringing the threat of death.

Get your test done, now

All this avoidable with knowledge garnered from testing and using the free services for diagnosis, treatment, medication, therapy and support networks.

The at-risk groups identified in need of urgent action are men who have sex with men (MSM), migrant populations and ethnic minorities.

Living in Europe we cannot afford to be ignorant of what the options are for controlling and managing the HIV epidemic starting with ourselves, and that is why you should schedule a test today.

Thank you.

World AIDS Day: Banish the Ignorance

On HIV/AIDS

Today is World AIDS Day and it is important that we review where the discourse is going with regards to how it affects us either directly or indirectly.

Much as we reflect on and remember the many who have lost their lives to the disease prominent amongst whom is Fela Anikulapo-Kuti of Nigeria who we celebrate as a seer and keen observer of social issues that remain relevant today, there are people who live with HIV/AIDS and even many more who do not know that they have the virus.

How come this?

It is against this background that an article that was sent to me this morning written by a correspondent of the Nigerian Vanguard newspaper incensed me.

I have no reason to question the credentials of Dr. Nwokocha who apparently is the medical director of Hosanna Medical Centre in Lagos but I have great persuasion to question his reasoning.

On World AIDS Day, one will expect that news organs in Nigeria will find ways to educate the populace on the issues surrounding sexual health and the cause of the statistical disaster that suggested that there were up to 3.3 million diagnosed cases of HIV of which there were 220,000 deaths in 2009 and counting.

Predominantly heterosexual in Africa

Much as it is lazy and weak to moralise and get obsessed with the issue of HIV/AIDS and sexuality, the demographic in Africa is radically different from that which we find in the West, because it’s prevalence is driven by a heterosexual population in the former.

Obviously, the absence of the homosexual population from this data can be accounted for because of the cultural stigmas and homophobia driven by political opportunists and religious dogma – none of which helps any of the affected people regardless of their sexuality.

A medical emergency ignored

It goes without saying that there is a medical emergency to tackle amongst those who know they are infected but do not reveal their status, those who are infected and do not know they are and the innocent ones who by reason of being in diverse relationships with the other groups risk falling into either knowledge of their status or dying of brief but unexplained illnesses.

Amongst women, beyond maternal mortality there is also the risk of the transference of the infection from mother to child one would expect Dr. Nwokocha to be a very busy man.

Errors unforgivable

Looking at the article, I have to wonder if the horridness of the copy is journalistic incompetence compounded by medical quackery of the order that should call into review the medical nous Dr. Nwokocha has.

The introduction talks of “heterogenous sex” when heterosexual sex is intended and HIV/AIDS where HIV is Human immunodeficiency virus but referred to as “Human Imuno Deficiency Syndrome Virus” infections/AIDS, whilst hepatitis is spelt as “haptetis”.

The syndrome is related to AIDS and it quite different from HIV, which is different from other sexually transmitted infections of which there are viruses, bacteria, fungi, parasites and protozoa. The learned doctor goes on about bacteria as if his knowledge is stunted.

Bad Medical School

Then he veers into the causes of homosexuality with unfounded and fantastic claims that reads like mumbo-jumbo of quack snake-oil merchants that stand at street corners fleecing the gullible with confidence tricks.

It begs the question what aspect of medical school he missed that his blinding ignorance reinforced by our obsequiousness to lettered idiots allows him to profess knowledge where he evidently has none.

As human knowledge has progressed in technology, medicine and other elements of human endeavour, we have changed and adapted to use the knowledge to advance humanity.

It is not a mental disorder

In 1973, the American Psychiatric Association declassified homosexuality as a mental disorder and this new knowledge has progressively been accepted by other mental health organisations until it was fully declassified by the World Health Organisation in 1990.

It would then seem, if a doctor were to overturn this body of expert medical knowledge and study, he might well be vying for the Nobel Prize in Physiology and Medicine after having had his thinking and hypotheses peer reviewed by the best in the field or else he is just plain ignorant.

We can have all sorts of moral debates on the issue of sexuality but I would contend that if the Wright Brothers who invented flying were to see the aircraft we put in the air today, they would not be remiss in considering the art and science of flying today as witchcraft.

An irresponsible doctor

The biggest danger posed by Dr. Nwokocha’s assertions is in offering uneasy comfort to heterosexuals in Nigeria who are most affected by HIV/AIDS and consequently everyone else by suggesting homosexuals and so-called homosexual behaviour are the vectors for sexually transmitted infections.

That is at first utterly irresponsible and reckless but you are left to wonder why those with the means flee Nigeria for medical treatment when charlatans like Dr. Nwokocha are allowed to touch living things where rats will find better succour in the gutter than visit his medical centre for cheese.

It goes without saying that people might find certain sexual conduct abhorrent but for supposedly educated people to use that platform to foist reprehensible views that have no academic quality portraying some moral justification to promote stigmatisation and persecution is beneath contempt.

Reconsidering World AIDS Day

I am saddened that the Nigerian Vanguard did not rise to any standard of responsible and educative journalism and to have given the likes of Dr. Nwokocha a World AIDS Day forum to postulate atrocious fallacy in the face of more pressing HIV/AIDS issues in Nigeria just shows how we embrace ignorance over useful knowledge and what we need to see better for ourselves and those around us.

This World AIDS Day should have us reflect and give no space to stigma, prejudice and negative propaganda, there are people out there, suffering and dying, when you begin to single out people and groups, how long will be before you get to the woman, the child, the neighbour, the relation, the family and finally ourselves?

Let us do the needful and the rightful, get tested and support every initiative to understand and appreciate how humanity great and small is affected by HIV/AIDS – Dr. Nwokocha’s kind of thinking has no place in this better world.

Editorial: Twelfth of May 2011

Concerning another monkey vaccine

Two news stories appear to coincide with managing the scourge of HIV/AIDS, on the one hand is the study of eradicating the primate variant of HIV known as the Simian Immunodeficiency Virus (SIV) in rhesus macaques making use of a genetically modified version of the rhesus cytomegalovirus (CMV).

The good news here is that this vaccine appears to strengthen the immune system to the point of controlling SIV and eventually reducing its progressive infective rate until the disease is abated.

However, there are many concerns with this study from the controversial view that patient zero contracted HIV from a chimpanzee to the concerns of introducing a strain of human CMV as part of a treatment regime.

Africans may not benefit

CMV belongs to the herpes family of viruses that is usually benign or dormant but can break out as chicken-pox, shingles, fever blisters (herpes I) or genital herpes (herpes II) amongst others, it is more prevalent in sub-Saharan Africa than anywhere else making that line of research rather risky and ethically questionable in terms of safety and assurances for effectiveness.

This study might well be of greater value to those outside sub-Saharan Africa but after the failures of a number of vaccine trials, many of which were aborted too, it is important to remain vigilant that all checks, procedures and monitoring are in place so as not to raise false hopes at first and then cajole subjects into trials that might be of greater detriment to their already weak health status.

Helping sero-discodant couples thrive

Accepting the fact of the prevalence of HIV/AIDS has been hard enough for some societies and beyond that the measures needed to prevent infection are fraught with cultural, religious, political, social and economic issues.

UNAIDS have released a study that heralds the reduction of infection between partners where one is HIV infected or in the jargon, sero-discordant couples. The study began with about 1,750 couples from 8 countries in Asia, Africa and South America.

Entry into the study required the infected party have a CD4 count of between 350 & 550 which represents a level at which the WHO does not require the patient to have commenced Anti-RetroViral (ARV) treatment.

Between news and scientific fact

One arm of the study was immediately entered into ARV treatment on commencement of the study and the other arm only commence treatment after two consecutive tests measured a CD4 count regression to between 200 & 250 or had developed an AIDS-defining illness.

The results show a reduction in transmission of HIV infection in 96% of the cases as reported by UNAIDS but the news story does not appear to comment on the significance of viral loads which is the amount of virus in the blood that could determine how infectious a person can be.

It is however known that ARV does reduce the viral load significantly to somewhat undetectable levels it does not however mean the complete absence of contagion.

Subtle observations with this study

The study that took in couples from the United States was aborted and though it was supposed to run for 78 months seems to have ended 3-4 years early because of the positive results though one should be concerned about the fact that low viral loads and higher CD4 counts for the time of that study does not confer immunity by any stretch of the imagination.

The lack of Western subjects is also instructive because medication in the study did not include multi-class combination drugs like Atripla though combinations of other discrete drugs would have been effective all the same.

At the same time, it is possible that Eastern Europe might have benefitted from this study though on balance the cases of heterosexual HIV infection would have been more prevalent in the areas that had the study.

HIV is more than a medical condition

It is important that the kind of complacency that appears to attend to HIV infection in the West because of more effective treatments does not cascade to these other study areas that included India, Brazil, Thailand, Malawi, Zimbabwe and South Africa, the absence of Nigeria from that study group should be investigated too.

On the whole, the progress in trying to control, manage or cure HIV is welcome but the news stories appear to herald situations which on closer scrutiny of the facts belies less of the optimism being communicated.

Most importantly, there are significant anthropological consequences of these studies between countries, cultures, traditions and laws coming north of the equator in Africa would have given this study much more empirical import just as allowing it to include the West, China, Russia and Eastern Europe. HIV in different societies is a lot more than a medical condition even in the broadest terms.

Acknowledgements

The following sources form the basis of this editorial; the news about the CMV vaccine against SIV was published by the BBC then related to drug regimes reducing HIV transmission as published by UNAIDS but 6 months earlier, the BBC had run a similar story.

The HIV Prevention Trials Network (HPTN) Study is fully documented at the HPTN 052 website. Meanwhile the list of available drugs for the treatment of HIV as at February 2011 is hosted at the AIDSMeds website. Regarding CMV the New York Department of Health offers some information about the Cytomegalovirus.

My body and my blood

It began as it did

What a mixed day I had today and I was left with my mind speaking to my mind seeking comfort from my heart my head settled on my shoulder as I contemplated about what to do next.

Tomorrow seemed such a blur as hour passed hour, the weight of events left me seeking the soporific inactivity of sleep and dreams that would close my mind to the realities I faced.

I got up so early this morning to a major change activity at work; the implementation went so smoothly as each colleague pulled all stops to deal with each eventuality that arose that we were finished just in time to be prepared for my fourth quarterly check with my consultant.

It was supposed to be at most a 2-hour meeting with me being able to return home to the day having taken the equivalent of a long lunch break at least that was what I expected.

Bloody news from the bloods

During the change my treatment consultant called, the bloods were telling stories that needed immediate attention; even she had forgotten I was calling in to see her later today. I needed to make a call, book an appointment and arrange a battery of other blood tests to chase down an infection that had recurred – that was par for the course.

Our lives are documented to certain embarrassing indicators that bloods tell laboratories arriving as corroborated news when readers of those runes tell you why that queer feeling was most exceedingly queer indeed.

I braced myself and completed the change as if nothing had happened, my mind in overdrive but not in panic, my rational mind putting things in perspective, what complex beings we are, I am amazed at the resource a person can have to cope in times that can be so troubling.

Just the way it is

The medical facts I have to face are without sentiment, the medical staff review the charts, discuss their findings, recommend a course of action, however, very little of this medical reality can be the subject of objective discourse with friends, family, acquaintances or colleagues, you obfuscate with generalisations about results, decisions, procedures and complications.

I dressed up, packed a bag of Christmas gifts to my medical consultant, my treatment advisor and the hospital chaplain and rode my bicycle to the hospital with just over 10 minutes to spare.

The initial measurements were taken, weight steady over the last 6 months, blood pressure was fine though if you read up on those numbers they were borderline pre-hypertensive – there is a fight in my system, something keeps it going and it is just as amazing as an everyday miracle that you get up each day to a brand new dawn.

Since we last met

My medical consultant called me in and we exchanged pleasantries with an introduction to another intern, I generally have no qualms to people in medicine gaining knowledge from my medical condition to serve as part of the body of knowledge they would acquire to help others, I guess I could be quite an entertaining patient, never a tense moment, it almost ends up like a social visit as we weave through the medical intricacies spiced with the varied amusements of life in general.

My observations over the last three months were my left foot had become a bit stiffer than the right one, like I was becoming flat-footed; an orthopaedic shoe inlay might be recommended because it affects my gait and sometimes my posture and it can be quite uncomfortable for long walks.

After the serious pains I had just about 6 weeks ago and the opioid pain medication that dealt with the issue, there was quite a large shedding of skin in the area of the original cancer lesions, this was to be expected and that was documented in the medical notes.

The left shoulder had acquired just about a square centimetre of stubbornly dry skin, which was observed and considered indicative of an infection that I would receive treatment for.

We can endure this

The medication was working well for me, I did not need a new set of pills though having never been a recreational drug user the world of that stoned feeling that comes every now and then does not leave one too comfortable but it is all manageable. I am told a new range of pharmaceuticals are coming on stream in the next year all geared to addressing the uncomfortable contra-indications but we will cross that bridge when we get to it.

The tale of the bloods was encouraging, the immunity indicators had improved considerably despite fighting an infection, and the prognosis is that after treatment one would crest that threshold that allows for the prophylactic elements of my medication regime to be withdrawn.

Meanwhile, there was that visit to the laboratory to address the treatment of this niggling infection and I was there on time. Once blood was drawn and swabs taken the historical context of the medical situation made for a whole set of circumstances that left me rather deflated.

Researching the stalemate

There would be no treatment now and I might be facing an invasive procedure that I am not particularly keen on, I need to discuss those options to arrive at some course of action and treatment.

As I got home, I trawled the Internet for research material on these sets of circumstances and all indicators show in my view that the numbers are conclusive enough that the need for an invasive procedure can be refused. I have never had an invasive procedure ever in my life apart from two biopsies, one taken when I was 8 and the other last year which was dermatological with regards to the skin cancer lesions.

I would rather endure the aggressive form of treatment and have the consequent serological tests confirm treatment success or failure but no crazy science and that is my resolution.

With myself by myself

However, I am yet to discuss this all with all the parties but we shall start from a particular perspective, it so happens to be my body; in many ways I have been careless and in others rather careful but having seen and felt what this body has been through and what my mind had had to weigh in terms of options and consequences this is one place where the challenge is on the side of medical science to persuade me of the course and reluctance does not begin to describe my aversion to the popularly accepted but controversial procedure.

That was my day in which I bore gifts, we talked about culture, we exchanged ideas and laughed about doctors who don’t follow the advice that they give their patients or in the words of my consultant, doctors enjoy the fine things of life too, whilst the pastor was having the last rehearsals for the carol service and I found myself being many people to myself just to keep myself together for the challenge that awaits me.

Life is somewhere between easy and complicated, being my own friend, my own confidant and my own advisor means I have created quite a lonely life for myself and here is where I get to talk about it – what an outlet, what a relief, a catharsis indeed.

A primer on cancer and chemotherapy

Knowing more about it all

I have decided to provide a basic primer on cancer and some detail as to what lead to the diagnosis and treatment recommended for me.

This might help you answer some questions and in other cases leave you with even more questions. Please bear with me; I may not be able to address some more personal aspects of the information until a future date.

The important thing is; we know what it is, it can be treated, it is being treated, I am responding to the treatment, I believe I would be completely healed and any support leading to the goal of full recovery from affliction through survival to thriving is well appreciated.

Thank you friends, well-wishers and readers for your understanding. I also appreciate that connections and allusions can be made with the information offered – the cardinal thought and driving credo I have had for a very long time is – I will never live as if I am dying, I do NOT intend to start doing that now. I live to live well.

A primer on cancer and chemotherapy

The beginning

A basic primer on cancer, the cancer I was diagnosed with was Kaposi’s Sarcoma (KS) [1] and there are many variations of it, but due to a pre-existing condition, this manifested first as if it was athlete’s foot [2] and was localised to my toes and my soles.

The regular athlete’s foot treatments that cleared up the infection every summer before did not seem to catch on that I started using foot baths of Dead Sea salts; this aggravated the situation because it softened my skin to the point that lots of it rubbed off and came off allowing for other bacterial infections.

I should have had this checked around this time but a culture of self-medication along with an apparent shyness of doctors did not help – you learn, you change, you live.

Initial ideas and treatments

The infection became deep-seated and painful requiring medical attention and consequently the diagnosis that involves the treatment I am having now. The lesions that appeared under my feet first made them suspect a diabetes-related issue but my blood pressure in my extremities read as normal, that was eliminated along with results from the blood tests and the gathering consensus was KS, which was confirmed after the deep biopsies.

Because of the strong smell coming from the lesions, the infection had a bacterial component which was treated with a number of antibiotics as Metronidazole [3] used to treat fungating tumours but was not entirely effect and Flucloxacillin [4] which is a narrow-spectrum antibiotic.

Whilst these both seemed to reduce the smell and the pain, the lesions which had dried up in a manner under the sole but had become a bit less so under the toes meant a more aggressive course of treatment was needed.

Chemotherapy as a course of treatment

The agreed best course was chemotherapy [5]. Chemotherapy is in the broadest sense the treatment of disease by chemicals. These chemicals may have properties that inhibit the rapid multiplication of cells which is an attribute of cancer as well as work on aspects of the characteristics of cancers, their location in the body and the way it spreads.

The course recommended for me is Liposomal Doxorubicin [6] – liposomal meaning encapsulated in some fatty molecule and Doxorubicin is a very strong antibiotic. What happens is the liposomes allow for a slow release of the disease fighting chemical into the body after intravenous introduction which just takes an hour and this is not fully excreted from the body for up to six days.

This chemotherapy is widely used for many cancers and is very tolerable without most of the side effects associated with other chemotherapy treatments, I am glad about that, but one has been provided with medication against nausea, I prayed about it all.

Sources

[1] Kaposi's sarcoma - Wikipedia, the free encyclopedia

[2] Athlete's foot - Wikipedia, the free encyclopedia

[3] Metronidazole - Wikipedia, the free encyclopedia

[4] Flucloxacillin - Wikipedia, the free encyclopedia

[5] Chemotherapy - Wikipedia, the free encyclopedia

[6] Doxorubicin - Wikipedia, the free encyclopedia