Men's things - XXIV - A presentation

Sharing my prostate cancer story

Within the last fortnight, I attended a gathering of black men in Manchester and Liverpool, where I was invited to tell my story about my experience with prostate cancer.

The story on its own could be compelling, as I do have friends and acquaintances, even strangers asking for advice and direction about how to navigate these issues, that I term, "Men’s things".

However, in such a semi-formal setting under the auspices of a registered charity, I felt it should not be a typical story-telling setting, but one where whoever listened learnt something and could act on it.

What the prostate gland does

To that end, I created slides with some images, because in all previous presentations I have attended on the topic of prostate cancer, the issue of the function of the prostate gland as a muscular switch between urination and ejaculation was not clear. For instance, I learnt this long after I had commenced radiotherapy treatment for prostate cancer.

Secondly, I had only found one image that gave a close-up view of how an enlarged prostate gland can present symptoms of difficulty or discomfort with the ease of urination. That visual image alone seemed to get men thinking about having checks on their prostate health.

Courtesy of NHS Overview of Benign Prostate Enlargement

Your active participation in your health, matters

On this perspective, I wove a story around my curiosity about some unusual blood test results outside normal ranges, through insistence to my GP for tests, the referral for further investigation, leading to a cancer diagnosis, then the treatment of prostate cancer, and the post-treatment side effects.

Beyond that is the need for black men to participate in surveys, especially when invited for bowel cancer screening, why men’s things should be more widely and openly discussed, and how early detection saves lives.

What I hoped men would take away from my presentation was that, “All prostate issues are not indicative of cancer, but every prostate enlargement should be investigated for cause and possible treatment.”

My presentation slides

Blog - Men's things - Prostate Cancer blogs

Blog - Photons on the Prostate - XIII

References

MedScape: International Prostate Symptom Score (IPSS) Calculator

Prostate Cancer UK: Risk Checker

Photons on the Prostate - XIV

Beyond radical radiotherapy

Three months ago today, I began radical radiotherapy for adenocarcinoma of the prostate. It is just six months after I received a confirmed diagnosis, and it needed immediate active treatment after consultation with a multidisciplinary team on options for surgery or radiotherapy.

I worked through the duration of radiotherapy and for a month after the completion of the treatment. However, increasingly, I suffered more impactful side effects that started with chronic fatigue, and issues with my urinary system that limited most outdoor activity as I needed to be close to available conveniences, and one unexpected effect was the way those elements appeared to affect my voice.

My voice became weak and strained, usually determined by my energy levels that was quite sub-optimal most of the time. While against what my body was telling me, I tried to continue as normal, I really had to take a break and have added domestic support that being at home did not offer.

Time off to recuperate

The decision to travel to South Africa while somewhat frail was not taken lightly, but I knew the essential support for my recuperation was best under the watchful care of my partner. I availed myself of all the customer assistance provided by the airline for my journey, no sense of determination could have propelled me through the experience.

I can attest there has been considerable progress, the occasions of fatigue are less frequent, the urinary issues while still needing medication have eased, the sound of my voice is much better with a few relapses, and the painful discomfort that needed opioid medication has completed gone and I have now totally weaned myself off codeine with minimal adverse effects.

The weather in Cape Town might have contributed to my recuperation. I can begin to consider a return to normalcy, which might take a process of reengagement. Much as I try not to have that preoccupy me and concentrate on recovery, there is a world to return to in the New Year.

Looking ahead

I am grateful for the support and care I have received through the period from anticipation when I first had exploratory tests in February, through further investigations, diagnosis, and treatment. My long-suffering partner, close friends, extraordinary neighbours, siblings, and colleagues compassionately accommodated my vulnerability with understanding.

Each time I present an update, I appreciate how it was fortuitous that we caught a high prostate-specific antigen (PSA) reading when we did because at the advent of my treatment, the PSA reading had fallen within the normal range, but for the fact that an MRI scan leading to a biopsy had detected Stage 2, yet malignant prostate cancer.

The need for men especially Black men over 45 to pay attention to their prostate health. Do the checks and have the tests, catch things early and have the best options for recovery.

Blog - Men's things - Prostate Cancer blogs

Blog - Photons on the Prostate - XIII

Other references

Prostate Cancer UK: Black men and prostate cancer

MedScape: International Prostate Symptom Score (IPSS) Calculator

Urology Care Foundation: Benign prostatic hyperplasia (BPH)

NHS: Prostate Specific Antigen (PSA) test

Prostate Cancer UK: The PSA blood test

Making new blood stories

Necking on the arm

“You are the vampire on duty today?” She laughed and called me cheeky, this being after I had seen my consultant for my biannual consultation which passed quite without event. Though I did fill in a survey for the registrar that saw me, who I did meet on my last visit, nothing memorable stands out from our conversation and it probably was the shortest engagement I have had in years.

Given the opportunity to ask questions, I had no inclination at all, beyond the cheerful greetings and recognition at the reception, the weighing-in, height measurement, and blood pressure readings were a rather perfunctory exercise.

Our man the hands like shovels was nowhere to be seen as I drank as much water as I could ingest through the night into the morning to ensure when the needle was coming for the vein, there was something to give. After giving up a urine sample, I sat and waited to be called into the treatment room where the nurse was taking blood for testing.

Cheeky and Swiss cheese arms

Presenting my left arm, she felt for a vein and then punctured my skin, I watched every action without being squeamish, but nothing came, it was dry and unyielding, and it was not Nicholas doing it. Then as she suggested trying my right arm, I could see a vein presenting quite boldly as I completed her statement about if she could not draw blood, “You’ll sink your fangs into me?”, I retorted.

The punishment for my precociousness was subtle, as she put a folded gauze staunch on the first needle puncture and applied enough tape that it almost rounded my arm catching the hairiest parts of my arm in the process. I knew the peeling off would be gritted teeth and some agony if I could be man enough to do it today or allow it to wear off over days.

The right arm initially did not come to play, but soon enough it gave in before desperate measures were needed. I am always surprised at the darkness of the colour of blood as it feeds and fills the vials. In no time, 7 vials were filled with blood.

Could we be better armed?

Yet, between the Netherlands and the UK, I am still surprised at the difference in the art of phlebotomy. Dutch hospitals insert a needle attached to a tube that feeds the vials, whereas here, there is no flexibility between the needle and the vial, which means the patient can easily be irritated and bruised by holding the needle in place and the action of attaching each vial. I should not have to write a novella about my many experiences of having blood extracted.

How I wish the Theranos experiment of Elizabeth Holmes had worked where their dream was to be able to conduct all blood assays from a single drop. Then I could not get a drop from my finger when I tried a home test kit some months ago. I believe Theranos was a good idea long before the means and technology were available. Maybe in a century, blood tests would be as easy as having a light spectrum impacting on the skin like we have with smartwatch pulse oximetry that records peripheral oxygen saturation (SpO₂)

I received my prescription all sealed up only to realise when I got home that a second essential one has not been dispensed. The pharmacy was quite helpful in facilitating it and I shall pick it up tomorrow. The other parts of the day included an induction to volunteer as a welcomer to the cathedral. I have a bit of bedtime reading on church history to do.

Now, I think about it, how that I am always inspired to write something interesting about having blood taken for tests.

World AIDS Day 2022

Beyond a fateful diagnosis

This is my 20^th World AIDS Day since my HIV positive diagnosis and I cannot tell for how long I might have contracted the virus before it was confirmed after a very developed and stringent testing regime, what matters is with a medical verification of my status, certain things needed to change.

I guess what changed the most in my life was my outlook between the idea that I might not have much time left to doing everything possible to enjoy whatever time I am fortunate to have to tell a better story beyond diagnosis.

Yet, living with HIV brought both adventure and the mundane, the mundane as in as the virus ravaged my body, I ignored what the consequences might be as year after year others noticed my apparently failing health.

The onset of AIDS

It was in the 7^th year of my diagnosis that things took a turn for the worse, early in year, much as I was in my professional peak, a dark brownish stain appeared under my left sole, something I dismissed as athlete’s foot and on inspection by a doctor in Spain, never came to much of a comment. Yet, I was conscious enough to want to hide expanding dark mark when I was reclining in a deck chair by the pool, because someone did come to ask about it.

By Spring, my energy levels were down, I spent Easter in Geneva with my best friend after which I was back on the job market. Then by mid-Summer I had a bout of shingles that came and went in 2 weeks with the blessing of no post-hepatic neuralgia, though my foot was now becoming a problem.

What was manifesting in August was a painful sore that I could not walk without my foot being heavily bandaged and no amount of painkillers could assuage the pain, I tested the limits of my ability to endure pain. I had developed full-blown AIDS presenting as Kaposi’s sarcoma, a virulent skin cancer and it was screaming on my left foot.

The legacy of the early sufferers

My gratitude and good fortune for the sadness and the celebration of World AIDS Day comes from the fact that many young men perished because of AIDS and the lack of help to treat the diseases that came as a result of contracting the Human Immunodeficiency Virus (HIV), many also had the painful lesions of Kaposi’s sarcoma leading to fully emaciated and painful deaths.

When I went into hospital delirious in pain after my doctor in the Netherlands instituted emergency measures to get me seen by specialists because on the first sight of my foot, she said, “This looks serious, I need to refer you.” The professor who came down to see me immediately said, “We have a bed for you upstairs.”

I was at the point where advancements in HIV medicine gave the consultant the confidence that medicine did not have a decade before, because he said, “We can treat this, but it depends on how you can take the treatment.” The prognosis was I would be fine if I could tolerate the treatment, or I will be gone in 5 weeks if I could not.

Indeed, my survival comes down to the many whose treatments that variously failed but redounded to the body of knowledge and expertise that grew over decades, I am one of the fortunate ones who came back from the looking death in the face to live and thrive. It always gives me pleasure to interact with medical students when they attend my biannual consultations, because I hope that in some small way, I inspire them about the power and miracle of progressive medicine that can treat diseases that were once untreatable.

On celebrating World AIDS Day

This is what World AIDS Day means to me, the need to know your status and embrace the result with promptly accessing medical options available. In 2002, you were not immediately put on antiretrovirals, even in 2005, they were thinking of treating a Vitamin B deficiency rather than the virus.

World AIDS Day is about everyone affected and infected, privately or publicly, silently or in advocacy, proudly or stigmatised, we need to come out and bring an end to the scourge of HIV whilst making the very efficacious treatments freely available to everyone touched by HIV. I am also grateful to the health services in The Netherlands and the UK, the consultants, doctors, nurses and personnel who have devoted time and resources to seeing the end of HIV.

And where would I be without the support of friends, family, neighbours, lovers, and the wider community that blessed me with their humanity and generosity, to them all, I owe a debt of unstinting gratitude. I am blessed.

Here’s to World AIDS Day 2022 because there is still much to be done and I hope that when the work is complete, it would be celebrated in memory of the many who sacrificed life and being to bring an end to HIV and AIDS.

Reflecting on 20 years after an HIV-positive diagnosis

 “In a perfect world, the positive would be open and the negative would be open-minded.” From a Grindr profile.

Preamble

Do not be afraid to take the test

Face up to the new reality

Avail yourself of all the help available

Do not be afraid to ask questions and seek clarification

If the medicine is not working for you, say so

It is always your body first before it is their guinea pig

It is your life, do not be ashamed of living it

Do not only survive but strive to thrive

Tell a story, your own amazing story

The day I knew

I write this today, not as a celebration, yet I am living witness to and a beneficiary of such amazing human ingenuity. Without certain advances in medicine and pharmacology, there would be nothing to celebrate.

Twenty years ago, on a cold Friday morning, I visited my local Genito-Urinary Medicine (GUM) clinic in Amsterdam, to receive confirmation that the blood test I had taken almost two weeks before had indeed tested positive for the Human Immunodeficiency Virus (HIV) and with that, alone to bear the news of my new circumstances, the 20^th of September 2002 became a date to remember.

The booklet I was given after my HIV diagnosis on 20/09/2002.

I cannot say for how long I had been infected with HIV, I had gone for a regular check-up since I was in an at-risk category and for the first time, I decided to take the HIV test, then resolved to receive and accept the result. For at other times including in the UK when I had gone for other sexual health screenings, I had either declined an HIV test or asked not to be informed of the result either way.

Medicine leads the situation

The said date comes with a medical result rather than an assumption or some premonition of my status, the science and the medicine with the essential expertise must always lead the determination and the management of any infection or disease.

Whatever the symptoms might be, until medical intervention has had its input, you do not have a diagnosis, it worries me that even as recent as 6 months ago, someone approached me to ask if his symptoms were indicative of being HIV positive just because I was also HIV positive. 

I am not a doctor, there is no way I could confirm or give any reassurances, he had to go for the test and be ready to attend to the reality of the result and the further consequences of having that possibly life-changing information.

Those that went before

How I became HIV positive is beside the point, I subscribe to the AIDS Memorial Instagram page and picture after picture speaks of the lives of people touched and lost to HIV/AIDS, amazing, talented, beautiful, extraordinary people cut down in their youth, mostly at a time when there was nothing medicine could do for them.

We celebrate them with purpose and fondness, for What Is Remembered Lives, they were people like me and literally in the same age group, I met many who passed on in the 1990s. Their experiences and lessons learnt contributed to the body of knowledge that has defined what HIV medicine has become.

Then I consider the reasons why I allowed HIV to ravage my body for 7 years before I did anything about it.

Fear

Initially, I was afraid of the truth, for if I had taken the test earlier and the result was positive, what benefits and advantages in society would I lose and how would that knowledge impact many aspects of my life? That fear is real, and it comes from an understanding of how society easily ostracises things they do not understand. Strangely, I was not afraid of dying.

Blog - In Telling: Beware of pill rumours (2022)

Stigma

When I learnt that I was HIV positive, I had to be careful with who I shared the news. The first person I told was my pastor when I returned home. When I told a friend which whom I had sexual relations going back a few years, what I got was constant abuse and vituperation, it was vicious and unrelenting, I could not tell if it was he could no longer meet me as he used to because he never once did reveal to me if he had contracted HIV along with the likelihood that I might have contracted it from him. We move.

Knowledge of what HIV was then and even now is still poor, and this is also in the LGBTQ+ community, there are many advances in medicine and drug formulary that manages this virus, but you still hear or see people use clean and by inference, you are dirty if you are HIV positive.

Worse still were people ready to use that knowledge to blackmail or threaten with exposure and harass with the law, and I have seen my share of that.

Blog - Dealing with sexuality and HIV stigma (2017)

Blog - Experience is not enough to teach you to understand things (2020)

Blog - Normalising HIV Challenge against stigma (2020)

Denial

I suppose this was my greatest undoing for when I learnt that I was HIV+, I did nothing about it, the booklet I was given along with phone numbers of doctors to contact went onto my bookshelf as I quietly contemplated what my future might be.

When people told their stories of what drugs they used and the attendant side effects, the thought that I would need to regiment my life to such strictures, privations, and suffering, did not appeal to me, I desired a more leisurely life and sought the community of similarly affected people who did not discuss it, but indulged themselves.

Blog - When I had the murderous cancer of denial (2020)

Reckoning

At the time of my diagnosis, you were not immediately put on any therapeutic treatment, certain indicators had to be met to qualify, however, by 2008, my health had begun to deteriorate so much that I seemed to ignore or just not notice what was happening. These changes were observed by those who saw me from time to time, usually from one holiday to another.

On my left sole, a patch appeared that looked like Athlete’s Foot and I treated it as such, but all fungal treatments did not alleviate the problem, it became sore and painful that I walked about with a tightly bandaged foot, still full of fear of what it might be and in denial of what it really was.

I tried everything but the medical route to address the matter to no avail, as the pain became unbearable, I made an emergency call to my doctor, as I could no longer wait for a regular appointment.

At the first sight of my foot, she immediately said, “This is serious, I need to refer you.” She dressed the fungating tumours as she made the appointment to see a specialist, the result of which was a hospital admission 6 days later with full-blown AIDS and my foot being consumed by Kaposi’s sarcoma.

Living

Once the seriousness of my situation was determined, I was admitted to the hospital on the 22^nd of September 2009 and began antiretroviral (ARV) treatment on the 30^th of September 2009. My consultant gave me a reality check. “We can treat this,” he said, “but it depends on how you tolerate the treatment, if you do, you’ll be fine, else, you probably have 5 weeks.”

I took my first course of chemotherapy on the 5^th of October 2009 and 6 subsequent courses to the 8^th of February 2010. During this course, the cancer lesions had completely healed by December and the HIV viral load was undetectable, my CD4 count which was at a nadir of 20 struggled to rise beyond 200 for years, now it is over double that.

I have taken a more studious and responsible approach to my medical situation since 2009, being quite aware of new treatments, and changes that might be beneficial and seeking the best outcomes for my wellbeing.

Beyond the medicals, I decided I would not live as if I was dying, for in whatever time I have left, I could live a fulfilling life. I have done a postgraduate course, travelled the world, fallen in love, and am planning a new chapter in life.

With reference to the booklet, I was given on the day of my diagnosis, on skimming through, the expected reactions after a diagnosis were denial, shame, anger, fear, sadness and depression, guilt, and confusion. I told the nurse who was crying at my plight, that this booklet is missing the most important message on such a life-changing event, the message of hope.

Before I put the booklet away, I wrote on it, HOPE, BELIEVE, LIVE and that is what I have done since then.

Gratitude

I am thankful for the grace of God that has sustained me, the love of my partner, Brian who in immeasurable ways has encouraged and buoyed me in difficult times much as we share the reward of happiness and companionship.

My best friend, Kola who never let me fall to the ground, the de Wolf family, my neighbours who were there to love and bear me up, John Coll, of blessed memory, and my ex-partners, Marc and Steven, still there with all consideration and friendship, old friends as Peter, Kayode, and Ola, new friends made who have brought new perspectives with the celebration of life, Bisi and Funmi.

My longsuffering parents, troopers and allies in ways beyond compare, my siblings all, prayerfully supplicating on my behalf, I suppose, there is a lot to celebrate about life itself. Yet, this story can never be fully told, at least not in a blog, it is just a sketch of what life has been.

References

Blog - A primer on cancer and chemotherapy (2009)

FOR AKIN - …on bravery, honesty and thriving. (2017)

Blog - How I battled HIV stigma (2021)

The Hospital blogs (September/October 2009)

In hospital to kill the pain

Golden red and painless

The looming abyss of a deep biopsy

Seeing hospital meals again

Getting off the pain train

Crutches on the drip

A relocation from the cacophony

Scuttling cancer with chemo

Nausea abates by suppository

A slumbering machine operator

Waiting for chemo

A life of cytostatic ostracism

I'm alive after my autopsy

One more night

Home - At last

We lose more than virtue without feedback

Encouragement and peace

When the woman with the issue of blood as was related in 3 gospels of the Bible determined to touch the hem of Jesus’ garment, she believed she would be made whole. Whole, as in healed and fully restored to good health, but Jesus also gave her more than she was looking for, he said, “Daughter, be of good cheer; your faith has made you well. Go in peace.” [Bible Gateway: Luke 8:43-48(NKJV)]

Those were very comforting words; first of great encouragement and then of full absolution that she did not have to worry that she had surreptitiously acquired her healing without asking or getting permission from the healer. There can be a lesson here about our interaction with God, but this is not what the blog is about.

The drawing of virtue

In another rendition of the same story, Jesus said, “Who touched me?”, He was in the press of a crowd, thronged and jostled, everyone and anyone could have been touching him, at least, that is why Peter was baffled, that he inquired, “Master, the multitudes throng and press You, and You say, ‘Who touched Me?’” To which Jesus answered, “Somebody touched Me, for I perceived power going out from Me.” Another translation used virtue rather than power.

Everyone was touching Jesus, but this woman had a different touch of determination that drew healing power from the touch of his garment to cure at an instant a woman who had suffered a debilitating condition for 12 years.

I have none of that virtue or power, but sometimes, someone would approach from something they might have observed about me for something they need, like help, advice, comfort, encouragement, for something to quell their uneasy sense of angst, concern, or fear.

Feedback helps all

Generally, I would volunteer what I have to share in the experiences I have learnt, the choice of words I have been given to speak or write, or any other means by which I could be helpful. I guess everyone including Jesus needs some feedback and a backstory that gives context to the demand so that a full narrative of the human experience is not like a chance of fate or some hit-and-run encounter.

It is draining and exhausting when you readily and openly give that good cheer and peace into the turmoil of existence and you get nothing back in regards to whether they have been helped or not at all. Then, one does not want to become parsimonious with the blessings we have enjoyed that could be employed for the good of others, however, feedback helps encourage all participants. We are encouraged to be more helpful as much as we hope that our encouragement is of great help.

My experience giving hope

In one situation, I was approached by a young man who in his 30s was experiencing his first encounters with sex and an idea of his sexuality, he was bothered he might have contracted HIV and he was ready to do himself in if the test he was going for came back positive. Providence brought him to me to encourage him on many fronts, the necessity for the test even as he was asking if the symptoms, he was experiencing meant he had contracted HIV.

I categorically told him, that only a test could confirm his status and to go by his symptoms which could be indicative of something else would just create unnecessary anxiety. That medical result was a critical indicator of what should happen next. Then, regardless of what the test result is, it was not the end of life, rather it would mark a transition of knowledge into what to do beyond that realisation. There were examples of people who went on to do remarkable things after an HIV diagnosis.

There was extensive medical help and expertise to manage HIV so he could expect the best outcomes for both his health and his life prospects. Apart from the fact that he should not go down the avenue of blaming himself and falling into depression, but he should be prepared to face up to the interesting life ahead, that sex is there for enjoyment and not as a taboo that gives life a guilt-ridden existence.

What happened after?

I had the feeling that I had both encouraged him and given him a sense of peace, he was ready to take the HIV test and whatever the result he would make the best of it. On the day of his test, I sent him some words of encouragement, wishing him all the very best. Then I heard nothing, no communication or indication, a week passed, and it was going into the middle of the second week when I decided to send him a message.

Well, our young man was off to Malta for a holiday, and I was left none the wiser as to whether this was to celebrate or commiserate on his HIV test result or life was just going on as normal. Much as I was curious, I did not want to dampen the moment with apathy borne of my sense of losing virtue in giving encouragement but not being intimated of the consequence. I kept ruminating about it and the many other times when you give out of your deepest experiences to lift people out of despair and then just move on.

Go in peace

Now, I doubt if the woman with the issue of blood would have lost her healing if she had slunk back into the crowds and not revealed herself to Jesus and the thronging crowd. She might have had a pang of conscience, but she would have been fine. It was her prerogative to reveal or conceal herself. However, if she had concealed herself, her story would never have been told, even as Jesus knew that virtue had left him.

None of the gospel writers even bothered to ask about the woman, her name, where she was from if she had family or any other history. Her story is narrated in a few verses, she had a condition she had suffered for 12 years, she determined Jesus could help, she touched him, and she was healed. Indeed, if there is any healing we can offer humanity around us, we should continue to give liberally and generously, a lot more is contributed to that activity if we know the help offered has been helpful in any way.

As for our young friend, I do hope whatever the result, he has decided to live and live well, beyond which he can be a great blessing to others.

The dizzying policy pirouettes of Freedom Day

COVID has no respect

When the Health Secretary, Sajid Javid revealed Saturday that he had contracted COVID-19, it would have been easy to be uncharitable and consider it careless and reckless that within a month of taking on the role, he had become a victim of a situation he was supposed to help prevent the public from suffering. Yet, one must wish him a quick and speedy recovery.

If anything, it indicates glaringly that despite the vaccinations, no one is immune from being touched by the virus, even if you are the Health Secretary and as the pandemic is the most critical issue in our politics, it would hit the centre of government with the risk of crippling it.

Rules are for fools

As he had met the Prime Minister and the Chancellor very recently, the exorbitant Test and Trace app had pinged Boris Johnson and Rishi Sunak respectively to self-isolate, they first indicated on Sunday that rather than self-isolate, they will participate in the pilot ‘workplace testing’ release programme that involved daily Coronavirus testing allowing them to remain at work, totally contrary to what they have required of the populace who were under severe risk of expensive and custodian sanctions if they breached quarantine rules.

In response to recriminations and protests, they soon reversed their decision, attempting to play it as being considerate of following the rules everyone else has been compelled to follow. Essentially, the government cannot admit they have been wrong even if it appears everything they do is as if done on a dare to see if they can get away with it.

Rudderless manoeuvring

The prompt U-turn would put a pirouetting ballerina into a dizzy spell, but nothing is beyond the incredulity of the Boris gang, they would create and foster embarrassment where it seems impossible, seize defeat from the jaws of victory like they lost the momentous advantage of the vaccination programme to return to infection levels last seen in January.

The questions the vaccines minister Nadhim Zahawi could not answer this morning included where the Prime Minister was when he was pinged by the app before he decided to self-isolate at Checkers and how many other people in the corridors of power had taken advantage of the pilot scheme which had been in the system since around January. I do not think any of the vaccines had that stretch of testing and pilots.

Beware of these gangsters

If it were a pilot, you also had to ask when it would be rolled out to the wider public because it had become obvious that pilot was a euphemism of inducing one rule for them apart from the rules, we were supposed to obey.

In any case, on our supposed Freedom Day, the muddled message of masks, self-isolation, social distancing, travel restrictions and much else leaves us celebrating the height of confusion with the prospect of more pandemic carnage before things get better, if they ever do at the cack-handed ineptitude of this Boris gang.

Self-Isolation - VII

Testing for science

I was invited on Thursday for an International Entrant Test for the purposes of ascertaining if on my return from South Africa I had contacted the CoVID-19 virus and if I had, it needed genetic analysis to gain some knowledge of the strain. By law, I was supposed to self-isolated for 10 full days without the option of a privately resourced Early Release Test after 5 days of self-isolation.

Much as I can, I have endured many days of being indoors without stepping out to check my mailbox. On Thursday at 6:00 PM, I was at the nearest testing centre where I was instructed on how to swab my tonsils and far up my nostril before the sample was packaged and sent off post paste to London for analysis.

A result, a reprieve

This morning at 6:50 AM, the result was posted to me by SMS text message and by email informing me that at the time of the test, I did not have the virus. This in addition to the test I have taken in South Africa the Thursday before was proof that I had not contracted the virus at any time. My concerns heightened by travelling for almost 11 hours on a busy flight, the lounge in Paris brimming at capacity and the transit bus to the flight to Manchester packing us in like sardines.

The message also indicated I only had to self-isolate if I had symptoms, I was soon going into hospital, someone I lived with tested positive, or I had been traced as having been in contact with someone who had tested positive. Knowing that none of the aforesaid applied, I was free to exit the regulatory self-isolation requirement.

Out walking again

Spending most of the morning in bed, I eventually got on my walking gear, dressed for the cold which was barely above zero and set out on the usual walking route that takes in a few stretches of the River Irwell in the City of Salford, getting in just over 11 kilometres in just over 100 minutes, with some time for a bit of shopping.

The return to form salutes a form of normalcy with a sense of regret that I am not far away in Cape Town with Brian. I do miss him very much, but we know we would soon be together again barring any of the unfortunate circumstances of 2020. On the scales, there is some work to do, I gained some and need to lose much. When it is just walking, it indeed is working.

Self-Isolation - V

Between Cape Town to Manchester

I have now had some time to reflect on my outing yesterday to participate in the International Entrant Test requested of me. The contrast between being in Cape Town and Manchester was glaringly obvious.

Stepping out of my home, I did not see anyone wearing a mask apart from those about to enter a supermarket or at the testing centre. In South Africa, it was an offence to appear in public without a mask covering both the mouth and nose. I had one on for the entire time of my being outdoors except when I had to swab my throat and nostril.

Arriving at the testing centre, I literally bathed my hands with sanitiser, there were no temperature checks like we had in Cape Town and if it were not necessary to register for the test, I would have been anonymous and nondescript, completely unacknowledged and invisible at a time when testing, tracking and tracing are critical to gaining control of a pandemic.

For the few that don’t

It remains my concern that had I not correctly entered my detail in the Passenger Locator Form that I filled in online a week ago, no one would have known I had flown into the UK from South Africa through Paris. Yet, I cannot ignore the fact that I was contacted on Monday and then on Thursday by the Track-n-Trace team, but I doubt I am being monitored for my movements. I am in self-isolation obeying the rules, I wonder who else is not as adherent.

Having a friend to call to help with shopping and errands is more than useful and I do appreciate the love and kindness of my friends.

Self-Isolation - IV

The river overflows

Stuck indoors yesterday in quarantine, I did not realise it had rained so much in the wake of Storm Christoph that brought with it floods, snow and evacuations, our usually tame River Irwell flooded its banks in the city centre.

As I have always been fascinated by the ebb and swell of River Irwell, I have missed my early morning walks which would have brought me close to seeing the malevolent side of nature. The river breached the minor flooding height of 3.00 metres at 9:15 PM on Tuesday the 19^th of January and reached the high-water mark of 4.30 metres at 7:00 PM on Wednesday the 20^th of January before it began to recede, though it is rising again to 2.68 metres as I am writing this blog. [Flood Information Service: River Irwell]

River Irwell level, this morning

Testing my mettle

At closing time, the Track-n-Trace or the UK Government Test for Coronavirus Service called using the information I had entered in my Passenger Locator Form last Friday to ask if I will participate in an International Entrant Test (IET) programme to determine if I had contracted the Coronavirus from South Africa and ascertain what kind of strain it is.

If I were to take into consideration the inconvenience of my enforced quarantine, I would have declined the offer and stayed at home. I am under no obligation to submit myself to testing apart from for the benefit of science and maybe society at large.

The registration process was laborious, cumbersome and intrusive even as they wanted me to take the test today. Having no mode of transport, I would not have been persuaded to test if the testing centre were not within comfortable walking distance. It was just under 2 kilometres away.

Testing my patience

We scheduled the appointment for 6:00 PM and I made my way out to the walk-through testing centre where the conversation and guidance was easy in a completely hands-off manner. I took a swab of my tonsils as I still have then, then stuck it up a nostril for 10 seconds before spilling the contents of the swab kit and obtaining another in which to place the swab.

Then I had to call a freephone number to register my test, following prompts like a manic depressive making time to goose-stepping with 1s and 2s in different orders, I probably did 1221211 before I got to speak to someone who put me back on hold because they probably did not know what an IET was. Passed on to another, a few questions and back on hold to listen to the Top-40 chart of music I could neither make head nor tail of.

A few seconds from 14 minutes into the call, they had obtained as much information as possible, linked my details to the sample and I was ready to have my pizza box kit shipped to London for expedited analysis. Bathing my hands in sanitiser, I stepped into the rain slightly becalmed and got back home with just as much a Poirot shuffle in my gait to spend another six days in self-isolation.

Experience is not enough to teach you to understand things

Ignorance is a comfortable shelter

Experience is no guarantee of a quest for knowledge, or enlightened understanding of a situation. Nowhere is this more obvious than what I have seen of the broader gay community’s understanding of the core science and social issues pertaining to HIV/AIDS. [POZ]

Despite the public information and community activities promoted by many LGBTQ+ organisations to people, in places, and at events, the appalling ignorance of people to these issues is frightening.

Now, I do not intend to use this blog as an education aid, there is enough for people to search for and update themselves if so interested. However, I was reminded of a conversation I had years ago when someone aware of my situation treated me with disdain, disgust, and revulsion.

Quite inscrutable to understanding

It did not bother me; I have been a recipient of too many negative attitudes to be concerned about the chance encounters. What surprised me was when this same person years after the first brush informed me his parents have been HIV+ for over 20 years.

I held myself back from saying, how can you have this disease embedded in your family and then treat others badly? I could not understand how he until recently had not acquired knowledge or insight to interact with others with a sense of humanity. The absence of curiosity that belied the original conversation was baffling in the light of the shared experience.

It might well be that seeing his parents who he says are thriving today, on their antiretroviral (ARV) medications and in rude health, there were times in the past when they were poorly and ill, that witnessing those times had mentally scarred him. I did not probe any further, I was just weakened by the thought that experience is no impetus for understanding the ‘how is’ or ‘why is’ of anything.

Mind your language

There needs to be something else, an ingredient of curiosity and determination to learn and appreciate things. There are some many things to understand, the vagaries of prevention (PrEP), exposure (PEP), testing, viral load, CD4 counts, and social campaigns on U=U.

Fundamentally, there is also the matter of language and stigma, people with HIV are not dirty and conversely, not knowing your status if you are sexually active does not make you clean. Whatever your preferences, the greatest thing you can do for human dignity is to treat everyone with consideration, courtesy, and respect. Education is a good thing, with your learning, seek to understand the seemingly difficult and taboo things. [Counselling Today]

Blog - Dealing with sexuality and HIV stigma

Courtesy of the Stigma Project.

Big Fat Arse Sugar Management

Crazy science for amazing discoveries

Scientific research is almost an obscure activity with reclusive scientists in their clandestine laboratories or backyard garages working on some mad idea that would not survive public scrutiny if discussed at the onset.

Meanwhile, someone somewhere has to sponsor these seemingly hare-brain activities which might first yield a “Eureka” moment and then possibly something beneficial to humankind whilst having some other venture capitalist laughing all the way to the bank having taken an almost incalculable risk that has now come good.

How to keep us breathing in health

An area of research that would never stop is that which pertains to battling diseases that affect us and which sometimes includes experimentation with animals – this for some is unfortunate but for all that we can humanely do to manage the suffering of animals the breakthroughs would eventually benefit both that species of animals and the human race.

I do not see anything wrong with animal testing in the main because the testing of those processes on human beings would elicit greater ethical and legal issues that could become insurmountable.

This is however my opinion, many might disagree with it; that is their prerogative but I would not entertain commentary that becomes disagreeable on this matter.

Animal skin in leather and fur

To put this is context Karl Lagerfeld [1] brings balance to another dimension of animal usage where there is the entire clamour about the use of fur but none about leather shoes, handbags and all other leather goods which are still animal skin but with the hair shaved off.

He goes on to deal with the matter of the few size 0 models in relation to a society that is full of obese and overweight people – obviously, those with vested interests would wail about animal cruelty and role models which again is their prerogative but they do need a wider perspective to the issues rather than their narrow agendas that they purvey.

One should not deny them the fundamentalism and fanaticism of their passionate causes; the will to live might desert them if they cannot bellow from the hilltops, wave their placards with fervour and make appearances on television as “rent-a-soundbite” experts.

However, I detest the way their ability to make noise about their causes visits the menace of the minority on the more tolerant majority whose concerns are rather more mundane and probably more serious as we devote our time to our responsible activities in everyday life.

Big bottom diabetes prevention

Now the rolling gait of African women has its attraction to a particular kind of African man – in Nigeria, certain ladies have to reside in fattening houses to be ready for marriage.

I have sometimes wondered how these women have been able to handle these humongous backsides without the need for radical hip replacement surgery after a while – I have considered this look rather unhealthy.

So imagine my amusement with scientists who have given rats dodo-butts and found out that shifting the fat from around the stomach to having a big backside helps prevent diabetes [2].

I have my doubts about the benefits of having a big backside and being free of diabetes and otherwise going from my comments about the rolling dawdling gait which might just be what tips the scales to a point where the springs break.

What is even more incredible is how the thinking of the scientists involved was able to link big arse cultivation to sugar management in the body – that is the madness of science and the genius of new ideas.

Now imagine conducting such tests on a human-being and realise that there might just be a point in some animal testing.

Sources

[1] Karl Lagerfeld defends fur industry saying 'beasts' would kill us if we didn't kill them – The Daily Telegraph

[2] Having a large bottom could help protect against diabetes claims study – The Daily Telegraph