Cancer screening

I will be damned. Numbers is all we the evidence we use. 

https://click.mail.medscape.com/?qs=90f8ddf3c4b76fcbf8599b2d4b771dfdc6dcdc3fa19fe6f29f09f7ade119b457728adbf9f614a688660250114b41031d9aebe07bf227652f

If biochemistry and physiology of beauty and health are the elements of every mix, then results are assured

Creutzfeld Jakob disease

Prions or Creutzfeld Jakob disease as the primary disease is known is probably lowest form of infectious particle known to man, very slowly progressive to an extent of tolerance or self limiting in many active closed systems. Mad cow disease, British outbreaks of the 90's that interrupted our peace was the faster variant caused by introduction of brain and bone infected feeds to cows and therefore burgers for human consumption, the theory goes.. 

Kuru, the skull trophy variant is probably closer to mad cow in transmission. Papua new Guinea skull trophy tribes were instrumental in sustaining this variant incidence. These are only proteins, lower than even viruses that are either DNA or RNA in form, yet still very infective and invariably fatal. The classic CJD is probably spontaneous  mutation, neuro degenerative rather than infection. The end result classical though. 

The  présentation is with dementia, a lot more rapidly progressive in a much younger patient profile, with no genetic predisposition or acquired cause to in sight.

 

Myoclonus is a predominant part of this picture. EEG helps but not diagnostically helpful. One needs a brain biopsy to confirm. Doctors tend to chicken out at this level as they consider this too invasive to contemplate, more so if the diagnosis is not in the differential. 

Post mortem biopsy gets to be our only salvation from the political insult that soon follows. 

I have to know as my diagnostic capabilities was insulted by non less than the minister of tourism when we diagnosed it in a white 40 yrs old lady, without no travel history, no biopsy for confirmation. 

This wasn't the first time I was accused of using my gut for diagnosis. It should have bounced, student days lay strong foundation for such incidents. I can show a rhino a trick or two in the thick skin department but this uppercut was from a fellow black person, with no medical knowledge except for Wikipedia and internet.

My guard was down. 

We were hoping to save further insult to a patient when resources were few and far between. 

Working from within the HMO system, getting the histo pathological results would change nothing treatment wise. Another would have thought this self serving exercise though, and the minister was one. 

Biopsy had to be summarily arranged without further hesitation. The first mad cow on our shores couldn't be left to medical iliterates to diagnose and manage. The  tourism status of South Africa was deemed to be at risk because of a mad platteland doctor bent on being medically right. That was the Sunday paper headlines as it appeared then. One had to accept little knowledge is dangerous. I read the Sunday times first time that weekend, six free copies donated. Never knew I had that many friends.  

Three months later the biopsy confirmation arrived. No fanfare, no Sunday headlines. Needless to say the minister never came back to apologize either.

 

May have to do with the fact that I refused to see her for that first  appointment. 

The honorable minister had very little of honor about her. She wanted to be seen before sick patients. My supervisor then was white. He could be race card pushed. 

If biochemistry and physiology of beauty and health are the elements of every mix, then results are assured

Science and spirituality, United beyond ignorance

Death or any semblance of scientific addition to the concept, beyond what we know in medicine is straw grasping exercise. Nobody has come back to add to facts of any objectivity to this topic. I cannot claim to know any better. I am trapped by my Newtonian group association. Theoretical physics has led us close without having to risk the wrath of the black hole though. 

Just before one as individual identity enters into existence, we are a loan sperm, record breaking sperm not to underestimate its achievement, and an ovum within range. The time has to perfect, so has the position in the uterus for fertilization to even get to be a possibility. 

If the sperm can penetrate the zona pelucida, then an embryo is formed. From that from that moment this one cell if it survives Darwin and genetic culling screen, will accumulate as much éléments, periodic table elements to be specific. as it possibly can to mitotically multiply self. 

Nine months and absolute parasitism through the umbilical cord later, three or so kilograms of solar dust accumulate  is cut free from the cord only to be attached to a milk dripping nipple, hopefully mother's. More solar dust and mitotic division continues from this extract as we navigate this process of claiming more periodic table elements as our own. 

We form a character around this solar accumulate that we get to identify as self. We get older and the solar dust housing that we have used rent free for 60 or so years wants to be returned to mother solar system and we cry foul.

How inconsiderate? How sleazy can one get to be, claiming the loan material to be now part of  his identity? How close is this to a snake that's about to shedd a skin that kept it blinded to possibilities beyond its opaque lens, lie castrate and start crying about it? How real is association between the spirit that is surely is the real self to the solar accumulate that is obviously reached its use by date? Are we not hanging on for dear life to the the dead shedd skin and refusing to step up to the now clear and vision perfect freed self? 

I know I am giving no answers. There are no certainties in life. I could probably do better by edging closer to the black hole, but the other side should be a whole lot better, judging by no U turns once the view is sampled. No qurantees I would be the first. Even the richest ain't coming back. The attitude I think should surely be wait and see. One can't cross the bridge until one is there. We should be comfortable in our ignorance. The edge is in being aware of our ignorance. Data or being aware of this knowledge gap should be our trump card. 

If  biochemistry and physiology of beauty and health are the elements of every mix, then results are assured

Predicting breast cancer, 18 months before it presents

Predicting that one's turn getting cancer, at least adenocarcinoma of the breast, might not be as far fetched a looney corner as one might assume. 

As early as 1992 under the leadership of proff Saeffer and G Modi as part of the then Baragwanath hospital neurology team, I presented a paper that predicted breast cancer 18 months before one can radiologically visualise it as a mass, using only à bedside examination. A patella hammer, to be specific. It was not that welcome to say it out loud, more so to peers a lot higher in statue, that we have been missing cancer sign and snorting it out with bath water all that time. Doctors used to have intelligence to insult then. 

We found that Lambert Eaton mysthenic syndrome could be used as a predictor of breast cancer at probably the first few cell levels. We could radio immuno assay pinpoint the auto antibodies on the breast mass when the excision biopsy was eventually done on follow up, which then was 18 months, averaged. 

The theory is easy enough for even the barefoot doctors of yesteryear to understand. Adenocarcinoma cell, in this case of breast type induces an natural immune response that produces antibodies to hopefully eradicate the rogues. In the process though the same good intention antibodies target self at the neuromuscular cleft, resulting in what an examining doctor should hopefully pick up, 18 months before it's there. EMG confirmation made it as objective à study as any, even before any further step is taken, right onto every scientist desktop. The paraneoplastic character of LEMS is well documented, usually related to oat cell lung cancer. 

Our limited resources dictated then that we send radio immunoassay studies to London for histopathology confirmation which sort of let the cat out before slaying it.

 

I expected that someone would have done further studies on this after mass exodus from state hospitals around that time. This was no CR 17 campaign files of any sort. There was no lid slapped on it. I presented this at a neurology congress in Durban. It was published. I left Feb 1994. No rights or nothing, unlike drug companies, neither did my seniors or hospital patent or seal nothing. 

Don't you judge. I was taking home about R2000 after my bond was paid. No wonder I had a normal BMI. 

Impala hospital that poached me then was offering 8 times more, a house, plus a merc. One had to have more than a monk determination to stay, not to mention monk sexual character, or lack thereof. Add monk needs to that list.

Such doorway opening into the next interface of medicine can't be left ajar this long, not here, not internationally, not in space. It's crime to human suffering and patients dying of cancer today. They probably were flagging something loud and clear more than 5 or so years ago already. The doctor only had to be able to read the sign post. 

All we see these days are observational studies. 

These probably gives justification to my distaste for Newtonian studies. The need to go to the black hole to study one doesn't hold water. It can only lead to dearth of science. 

As technology makes strides into new frontiers, IQ seems to be in fast retreat. 

The human rights sect of medicine can't be blamed for that much paucity in almost everything. 

I should mention I was driving a Mazda then. It was going to be almost an impossible task to hand back that merc.

I should have tried a little more though. I owe myself that much honest reflection at the very least. Poverty is not an absolute excuse to jump ship, more so as a black doctor. We should have stayed not only for the  re inforcement of the state hospitals, but delay of the collective ANC IQ collapse. 

. 

If  biochemistry and physiology of beauty and health are the elements of every mix, then results are assured

Pain free swag to the next athroplasty

Osteoarthritis and intra articular steroids treatment is probably the only way to pain free survival until next athroplasty.

I am not a Texan. Definitely not an American by any means. 

Pathophysiology and disease management based on understanding is my mainstay at every level. 

I have yet to see a more satisfied patient doctor relationship than OA clinic when celestone rémicaine  is the communication of choice. Trigger happy shooting from the hip, all day long. 

No side effects compared to NSAIDS, no squabbles about pharmacy waiting periods. Heck, I have had to inject some difficult customers even before getting their file, just to ease the wrestling in the quieie while waiting, and none leaves without delivering their file for documentation. 

Only justification I use is the intervening periods between the shots. It should preferably be about 6 months for me to face finance department without twitching. I will come down to 3 without a snort though. 

Not enough research done there as the HMO tactics of justifying interventions based on cost tends to be frowned upon in medicine, for good reason, sometimes. 

The complications is when say fibromyalgic patients gate crash to have access to magic results when the word gets out. 

I will allow those provided a reasonably good biokinetist can pre mark the trigger points. And the expectations are accordingly lowered. 

This is as close to anesthesia environment as one can possibly get, no talking to patients, just smiles.

The variables are best kept minimal and under one roof though. 

It's advisable to screen gout and inflammatory athropathies first. Those should be managed differently with  support from departments other than orthopedics, when say the joint is only part of a syndrome.

 

Intra articular steroids will for sure hasten the time to athroplasty if time from a wrist watch is the only criteria used. If you use displacement  from point A to point B, pain free extended interval to athroplasty can be the only conclusion. And the displacement will be significant, whether Newtonian or Einstein in parameter. 

The fact that it's without renal complications in the sample most  at risk is a big bonus.

 

If biochemistry and physiology of beauty and health are the elements of every mix, then results are assured

Death is neurological

Death is I should repeat at the risk of sounding tautological, neurological. Anything less or possibly more has potential complications way beyond medicine. Stories of waking up from the dead and worse still, suspended life as in cultural folklore are rampant.

You don't want to have to pray that your loved one die in peace after conspiracies of suspended animations by supernatural beings surface. Opposite, waking up in the morgue just as bad. We seem to be trapped between creation and the death. 

We have no reach beyond our six senses, which unfortunately is physical and earthly limited. We have no reach beyond death and birth curtain. You're bound to be taken for an expensive ride if you try venture beyond what you objectively can see. 

Diagnose death right from the very beginning and starve the charlatans off their sustanance. It's a wild west outside the objective world.

There should be no brainstem reflexes on a warm body, okay at least environmental temperature if you're not in sub zero zones, and if you happen to be, warm it up. A flat EEG is not a prerequisite. Mind you I didn't say flat ECG or absence of a heart beat. Beings can be salvaged for time after heart stopped, dependent on external factors. TV might look fancy but it's not medicine. With experience one adds non objective criteria that shouldn't be science, like the bloodless greyish skin hue bodies attain with no circulation.

Hypothermia is going to be our next big frontier in medicine. We use it opportunistically without understanding it much, otherwise nobody would be physically dying if we had even 5% extra edge. We could be suspending life everytime we can't manage a complication. It is as close an objective edge a living being can get to the edge and come back with all his marbles accounted for, okay most from an observer point of view. It could be the source of data that will change our perception of the way we view this side of creation. It could be our peep into intergalactic travel and creation. It could be a window into eternal scenario. 

Freeze button so to say until we know what we are doing with a little more certainty. 

Frozen at the edge of the black hole in science, with potentially creation or birth on the other side. At the beginning everything was energy. As close as we can get before the end everything is accumulated mass. Granted some more massive than others. Whether one is talking big bang, genesis or birth to death riddle. E =mc². When either mass or energy approaches a certain critical point, a leap into the parallel universe happens. The total energy divided by mass stays a constant. Just the records or data gets to be re written, and we are left asking questions. 

For reasons we don't yet know, scientific information at the edge of black holes is scanty or misread. Nobody has come back with analysis good enough for science to work on yet. Nobody with a computer to enter data anyway. We learned nothing from asking Zuma to read back the finance data. 

It helps little to attack this issue from the other side of the curtain either. Nobody speaks new born dada language. We have no recollection or interpretative skills once the amniotiitic fluid dries off either. Good riddens seems to be the general attitude.

If only more people came closer to edge. With  so much fear created about the black hole, we can't possibly hold our breath. 

If biochemistry and physiology of beauty and health are the elements of every mix, then results are assured

Microscope and MRI weighted doctors

Biopsy crazed lot or litigation cowered profession lacking in diagnostic capabilities of yesteryear. 

I am from the era where ignorance was frowned upon. Professors walked with a swag born out of years of knowledge transfer most of our present histology diagnosticians could hardly dream of, bundled together in a heap. 

Is it an appendix, wait, get the CT scan report first. Lipoma, fibroadenoma, tuberuos sclerosis or neurofibromatosis, wait for the biopsy results expected next week. Extra dural, middle cérébral artery bleed with sub arachnoid extension, don't know, we are waiting the MRI report. The imaging was done yesterday. 

Invading the laboratory with fibroadenoma from teens can hardly be justified, not in the first world, not here, don't know what world, not in Ethiopia either. We're sacrificing scarce resources only justifiable for pathology with junk. It could save the DNA lab time for rape cases with multiple downline positives for centuries to come if professionals manned up.

No fibroadenoma mutates into cancer. Granted probability and Bell curve can't reach 100% certainty. As long as a doctor or nurse can diagnose the condition as a fibroadenoma, make the client aware of the negligible to zero risk, and agree to observe, we move on to the basal cell carcinoma that does need a biopsy. 

There could be a positive ankle to this though. My last appearance before the principals office was because a nurse that came to me for consultation took an offense to my honest and truthful conclusion. After about 5 minutes swimming through fat around her epigastric area, we found the culprit, a lipoma hidden in the mass of friendlier less globular company. I dared to ask what that specific globule did to her to deserve excisional biopsy. 

Why the discrimination? She is a rolling fat bulb as a unit. Shouldn't we take biopsy of her total mass and brave and hyperkalemic complications head on? Needless to say I was given written notice for refusing to lie. 

Primary health care can only work as a screen if tertiary level gets the swag and stop being biopsy dependent. The resources are under strain because we biopsy fibroadenomas. We scan the appendix and subdural as equals on the investigative list. The diffential has been driven right up to Google list of every possible option. We might as well have computer send people for scan and save on manpower. Let the security at the gate enter your symptoms on the mainframe. Will save time waiting for the doctor at the very least. 

 

The pathologist and or radiologist cannot and should probably not be made to screen. He saw no patient. The vicious cycle doesn't end here either. Their differential from radiology and histopath doesn't help nobody either. It's getting longer probably as a side effect of vague and direction from the requests too. Could be just fatigue setting in. 

We need a Saul moment here. We need  divine intervention. 

If biochemistry and physiology of beauty and health are the elements of every mix, then results are assured

Erectile dysfunction

This subject is taboo so ingrained in culture men would rather walk the streets risking prostitution than work on his and his wife’s problem. Therein lies the immediate solution though.

I have a problem of telling the truth irrespective of how much hurt it can possibly cause. Delve right into the heart of mammoth, no foreplay, mind the pun. I live in the present. Nobody can predict the future. Nobody should be allowed to if Bell’s curve has to be accepted. And it should be. Nothing is and can get to 100% probability. The number zero has proven it. Jesus is proven it, even death can be beaten. Lesser beings have trailed a fiery path direct to the heavens. I don’t want to say nothing about tax. Indecisive Cyril, let alone blissful Zuma, Trump etc. will probably circumvent it.

The truth is if it rises when outside, it probably is not organic based in the first place. It can only be psychological as the pathway is the same. From the brain to the corpus carvenosum and corpus spongiosum combined hard rock, exactly the same tract.

Unfortunately once the psychological default pathway has been opened, it probably will get reinforced every time until it gets to be a flood. The pun just won’t lay down long enough for me to release the load. The subject just needs a trigger point, which is the previous memory, probably induced by that expectant third party. The more understanding she is, the more the default pathway gets to be ingrained in stone.

Psychotherapy should probably work but I believe one should limit induction therapy to as little as one can in taboo subjects. It a treacherous field, littered with un exploded mines. Nobody has time for it even, the expectations are high and patience is veiled thin by long delays in seeking consultation. 

I have a simple therapeutic self created screen. If on clinical examination nothing abnormal is found, I tell the subject in front of the induction media to indulge in foreplay for a month without crossing the line. Free reign. No penetration though. Pet all you like but no sex, then come back for review in a month. 

I have yet had anyone honor the next appointment. I hope it’s because they overcame the psychological hurdle, nothing to do with my truthful and sometimes downright rude way I handle issues presented to me. I hope that they don't come back because the only condition I put on a review date was not kept, on their part at least. 

Without no threat of failure, the subject performs like straight sixes of yesteryear. Well almost, nothing is that close to perfect.

Remember to examine the subjects for pathology though. My screening shouldn’t be blemished by spinal stenotic, diabetics with dysautonomia, coronary artery diseased Lerich syndrome and spastic gaited patients on your review quieie just to proof someone did come for review. 

If biochemistry and physiology of beauty and health are the elements of every mix, then results are assured

Disclaimer.. None of my sampled patients were gays

Optimism gaining upper hand? Faith sneaking through?

Walking on rock cliffs along the beach is a new found passion for me. Couldn't be enough just to follow the path like all young and old do whole day long. Tried and tested scientific paths with disclaimers outnumbering vegetation covering everybody but you. The adrenaline junkie in me needed more fire though. Need to carve a new path where non existed before burns deep in me. 

 

I discovered though that the trusted survival instinct of collapsing in a heap the minute I step wrong could be a dangerous liability from a cliff edge. This cataplexic reflex saved many a hospital visit for a fractured ankle I could have had throughout my lifetime. 

 A lion cup with its head in the mouth of a giant goes into cataplexic default mode. A crocodile litter enjoys a safe ride in the jaws of loving mother to the nearest stream. A human baby loses a Monroe  reflex by few weeks as it learns to trust the noisy changed neighborhood she or he is adopted into since birth. Females a lot faster to the target than boys as usual. Could this be the probable natural order of things. The way God meant it to be if a priest got asked for explanation.

To trust that the next level of support could be better irrespective of the immediate quick scan report is optimism at its best. Your eyes scan  environnement and relay the data to your cortex all the time, you slip and you go cataplexic. Unforgivable if you fall 6 meters down and break something more than just an ankle. This is faith proven in scientific experiment over and over again. No need to invoke the mystics, part no sea or burn a tree to get Moses this side of the line drawn on the sand, yet we're still at odds as far as science and spirituality is concerned. 

What is it overriding my visual cortical report beyond the six senses that we have categorised at scientific level? Might help a bit if a priest and a scientist could speak the same language sometimes. Might help a bit if the spiritual scientist doesn't have to think in two parallel planes. Objectivity shelved the minute you dorn that priestly robe or risk being subjected to everlasting hell fire.

 

Remember the climber praying to God as he free fell 3 km from a cliff face. He made a promise to obey every command without question if saved. Suddenly the rope tightened and stopped him, mid air, but it was pitch dark every where. The booming voice of the Lord asked him to take his knife out and cut the rope. Needless to say he refused. 'Saved me and then kill me, in sequence' think I am stupid, he thought. The frozen corpse was found the morning after. Only two meters above ground and 10 meters from the base camp fire.

At least my cortical brain is trying to cross the line. I am being tripped by my evolutionary self. Faith for better even when input data feed seems grave. I might have to follow the footpath herd to save myself from scientific fundamentalist. My brain is wired to believe. Sorry to fellow scientists. We don't squeel. Lying to myself is just as difficult though. Easier to lie to the public, if politicians have to be believed. 

Humans get persimistic with age, at least from the toddler stage. You learn that some environmental interactions are catastrophic, if used erroneously. Fire being a very good example. 

I can't for the sake of me learn to stay upright and sacrifice an ankle though. Cut your losses while the door is still open, so to say. Do I have to get hypnotized into it. Where is higher cortical control we're so renowned for. Plastic brain my foot.

You can only be embarrassed as the worst outcome if instability creeps in for whatever reason, my reflex control seems to be. That only applies off the dangerous cliffs face though. My brainstem got to be awakened to changing cortical scan. My spirituality is still in developmental stages. My fork is still pin straight, no matter how spirited I have tried my skill at bending it. 

There is power beyond our cortex. There is reason beyond science. Just have to able to tap on it and come back on the right side of the psych hospital fence. 

If   biochemistry and physiology of beauty and health are the elements of every mix, then results are assured

Rape and the law, from medical point of view

If Liz doesn't know what she is doing, the results determines her fate and she steps down. In six weeks. 

If our MP or even our president doesn't know what they are doing,  they found the right club. So right is the glove fit they have to wait to be charged by a similarly corrupted justice system in the form NPA to even wake up to the fact they may get pushed out by popular revolt. 

 

That's what you get for lowering the entry level into political main stream, voted in by similarly disabled population, deftly crafted by a lowered education system.

 

Democracy in motion. Flawed to the core, but democracy nonetheless. 

Bell curve is populated by same minded voters. One man one vote to be precise. Voting exclision on the basis of capability, let alone criminal record would be considered uncivilized. 

To make matters worse the outnumbered

intelligencia are too busy to waste time on mundane run of the mill issues like voting. We need a dictator with a brain to represent us. One eyed kings voted in by one eyed masses are running democracies to the ground. 

In fact it seems you qualify based on whether your IQ doesn't stray too much above your age in years. 

"Welcome back comrade" hugs in abundance, prison cell or parliament alike, feeding troughs seats in abundance reserved for the select few. 

Recycled even for those charged and convicted for the very crime. Thulas Nxesi's vote for Zuma can't numerically be equal to mine or else your maths is flawed. 

*Women can't rape, based on the legal definition of rape, probably worsened by the fact that we can't provide no sperm for DNA analysis to fulfill the penetration definition criteria. Anybody who is ever owned a penis should know God gave it a mind of its own, with only minimal primal brain to drive it. If your cortical self can't outsmart it, you will be taking cold showers in the middle of winter, rape after rape. Women know that. She will be patiently waiting. 

Even a pope gets érections, with grave consequences for some innocent altar boys in this case. Catholic church should have known better. It seems they haven't learned their lesson though, priests still have no release outlet, neither do the altar boys, unless they are keeping it a secret. 

 

No excuse for the man nor the priest though unless the woman or the altar boy is on top and in control your case is weakened. 

*Culture defeats us too. Statutory rapists have to be outside KZN to be deemed as such, otherwise culture overrides the constitution. With an HIV incidence that high, it should rightly be redefined as attempted murder had the legal system stemmed from an independent statutory body. That for me was a way to up the rape conviction rate to almost 100% because the 'she asked for it' argument falls away. We could have wrestled the rape conviction out the courts into medical space, beginning to the end. We would need no lawyer. Mother is 13yrs at conception, pass the baby cord blood for DNA, father's blood for confirmation and castration in that order. The fix is to mitigate against space in prison being the limiting factor in applying the sequence fairly. 

*Nationally a minor cannot rape, thus the same gruesome act on that 14yrs old daughter of yours has to wait for the perpetrator to be defined further than DNA, or medical charge so to say. If the perpetrator is an adult male, such male might be guilty as charged, provided geographical limitations of cultural override don't apply. If the perpetrator is a 15 yrs old boy, sex between minors gets to be the default verdict. Diplomatic immunity we should probably call it. 

How do we even begin to define an event as having occurred based on who the perpetrator is? How does the episode definition depend on who is judging? 

We need something better than democracy. We need something better than lawyers and judges.  

How pitched the scream outside the court room 'about asking for it' shouldn't determine or modify the verdict, irrespective of where it comes from. Malema, Vavi, Blade, Bathabile or an angel from God, kanga or naked.

Judge being defined as a student marking his own script gets new meaning in South Africa. 

If biochemistry and physiology of beauty and health are the elements of every mix, then results are assured