Hello Cruel World
Wednesday, May 31, 2006
Febrile Neutropenia (wonder what the tune is?)
Well, I have had an exciting hands-on experiential guide to just why the different chemotherapy guides & advisory leaflets have BIG BOLD BLACK WARNINGS about coming in to the hospital if I run a temperature:
Bloods 27/5/06 Na 135, K 3.2, Cr 95, U 4.1, Hb 86, Plt 268, WCC 4.2, Neut 2.3
MSU + throat swab - 0 growth, blood culture pending
xx yo F who had a recent L mastectomy & commenced chemotherapy 12/7 ago (12/5/06) presented with 2/7 Hx, non-productive cough, lethargy, sinus congestion + 1/7 Hx fever. Her bloods revealed febrile neutropenia & she was commenced on IV fluids + IV Gentomycin + Cafeprime(sp?). Her blood profile responded and after 3 days of IV AB was changed to oral Augmentin Duo Forte + Ciprofloxacin. She has remained afebrile for 3 days.
(1) F/U Bloods - Thursday 1st June, 2006
(2) HOAC - Friday 2nd June, 2006
(3) Oral Augmentin Duo Forte + Ciprofloxacin for 4/7
After coming down with a standard change-of-season cold from running around moving house, furnishing flat, etc, I tried to take care of it in the usual way, but more carefully than usual, with rest, warmth, fluids, garlic, vitamins, etc. Didn't work, temperature ended up between 39.2C and 39.8C — well over the 38C where I head for the hospital — and being taken into the Emergency Department after midnight Wednesday (Thursday, ~1am), I thought I would only be there for 24 hours to bring down & stabilize my temperature.
Well, I now know they need you to be between about 36.5C and 37C (afebrile) for 24 hours, so that was already a poor hope, but after about 18 hours in ED (aka A & E, for Accident & Emergency; luckily not very close to Bringing in the Dead, which I'd only seen recently), they could only really get stuck into treatment once I was in my little isolation box, back up again on the 8th floor.
In fact, there was not much treatment available because it's a virus infection and, from the cultures (throat swab, urine & blood samples), hadn't any bacterial superinfections. That is one main thing they're worried about because of the supressed immune system; once you get something that brings you down a bit, it's very easy for whatever opportunistic bacteria are around to leap on board and start making gravy. So they kept me on a drip, pumped full of a variety of antibiotics to stop anything getting ideas above its station, but also, warm, well fed, with a constant drip-fed supply of fluid, glucose & electrolytes, which was pretty much all they could do to support me through the viral cycle, and that took about 3/4 days. Bit of a shock to everyone, scotching various plans. It was also a shock to me to hear that I'd actually passed out for a minute or so in the waiting room; not fainted, which I remember doing in hospital after a previous operation — like grey flowers blooming across my field of vision, then darkening — but going stiff instead of limp. I have a complete blank there, just remember feeling sick & giddy & one small "blurt" of vomit, which according to witnesses happened just after the seizure. Probably fairly important in getting a quick admission, but not something I'd like to try again.
Meanwhile, one courageous friend had gone into the flat with bags, tongs & a facemask to deal with the perishables. Having moved in on Saturday night and started feeling the cold coming on Monday evening, shopping for a bar-fridge, tho of highest priority, was not completed. I'd been getting little cartons of milk, to be used over a couple of days (it is chilling down to winter), small quantities of fruit & vegetables, smallgoods, etc. It was very comforting to not have to face the lettuce & spring onions trying to break out of the cupboard, or the remains of the milk & sliced ham waging biological warfare. Alas, the other soup vegies & smoked hock, ready for the second saucepan of soup also departed along with the remains of the cheese & the utterly untouched formerly-fresh loaf of bread, now Fungus Jungle. Knowing this, I was strong enough to pick up milk & bread on the way back from hospital, but didn't have enough funds (took minimum to hospital) to add more. At least I had the tinned baked bean supply & usable margarine. Am seeing if I can make an edible pumpkin soup with onions, dried mixed herbs & barley, but no meat, greens or other aromatic vegetables.
Friday, May 19, 2006
Rant Repeated (Budget)
Budget: Future Fund ignores real future planning
My main argument with the discussion I've heard so far is the almost total concentration on the aspects of tax rates & welfare — the stuff the politicians want you to concentrate on, and NOT on what is the most basic & of long-term importance. It raises the whole question "What is government for?" Luckily there are wed & exhausted populace, fearful of losing the pittance they work so hard for, because they know there's no support for their real policies. Why, for instance, is the only hard work that counts the work that gets you to a high-paying job? Many people work just as hard without that.
Back to the 1850s, not the 1950s (including attitudes to women as well as workers). I really have to struggle NOT to hate those people, but simply despise all their works.
What do you think of the 2005 Federal Budget?
www.smh.com.au/yoursay/2005/05/11/index.html (& previous pages)
Good to see those billions are not being wasted on developing sustainable industries, fixing the water crisis or addressing global warming.
It's reassuring to know that the country's being run by intelligent, innovative, forward-looking people!!!
A "Reward greed, punish need" budget.
Most of us don't need a tax cut. What we do need is better infrastructure.
Keep the money and spend it on health, education and public transport.
So much for great economic managers. The government has acknowledged the massive skills shortage, but instead of investing in TAFE and universities, they are giving the money over to private enterprises to line their pockets. Australia has the education infrastructure just sitting there waiting for more students, but they don't have the funds to teach them. All because the Federal Govt resents State control of education. How pathetic!
As a low income earner let me put it to you this way. It's all carrot and stick.
The wealthy need to be rewarded with more money to work more. There's the carrot.
The poor (and those on welfare) need to be punished in order to incentivise them to work more. There's the stick.
Seems that most comments here are `what do I get?` This government has taxed us all to buggery, boasted that they haven't spent it and then give it back in tax cuts to make themselves look great. How about they spend the money today so we don't have to borrow it tomorrow.
Federal infrastructure projects or federal funding of state projects on such things as rail, water, telecommunications are paramount.
Additionally, proper funding of tertiary education must be restored (somewhere between 60 to 90 percent), tiered by year so that those who succeed to second, third and fourth years are given discounts, so they are encouraged to continue without paying for their degrees forever.
Unfortunately, this government and all their budgets are what most of the mug punters are after: a few bucks today and who gives a stuff about
tomorrow. I can't say the ALP would do better, just that we must demand better.
This budget lacks an incredible amount of foresight. Australia is in desperate need of major infrastructure projects and health care reforms and what do we get, irrelevant tax reforms.
Short sighted and greedy. Like any other I will take a tax cut with both hands.
We will pay for it in the future though as our University and health systems cave in. As our Universities decay, Australia's research capacity will decline, in turn relegating us to an intellectual and economic backwater.
A budget our children will curse us for.
Tax cuts are a waste of Government spending. Honestly, the extra $6 a week I'll get means nothing to me, but when you think of the pool of "surplus" money from which these tax cuts will be pulled - and the impact that this money could have when spent on essential services like health and education....
Why is the Government focussing on short-term rewards instead of the long-term care and support of its people? Why are we so gleeful about having a few extra dollars in our pocket? Are we all so short-sighted and blinkered by greed?
Has this country gone mad we have health system in need of desperate funds.
We have a road system collapsing and our country is dying from soil erosion.
Fix these problems first before giving money away to the rich.
The budget sucks
I'm in line for very large tax cuts. However, if we are planning for the long term of this nation less tax cuts and greater spending on
infrastructure, education and direct job creation would be of greater benefit. Without this the only jobs that will be created will be unskilled with low rates of pay. If you want to get people off benefits you actually need to give them meaningful and rewarding things to do that give them the financial ability to improve their situation. Just cutting their pension is at best pathetic and displays the government hasn't got a solution.
If you want single mums to go to work legislate to make work place provided childcare compulsory. They legislated for the GST so why can't they do this? This does not cause a burden for the public purse and our companies are enjoying very large growth and profit so they can probably afford it. That would be an incentive. Furthermore, any tax cut I'm about to be given will be swallowed in interest rates rises in the next few years. What extra money isn't taken by interest rate rises will be spent on imported consumer durables (as we now import all of these) thereby making our current account deficit worse than it is (can it possibly get worse!!). This budget simply offers short term band aid solutions.
I'd rather the Govt put more into infrastructure development than give a measly $6 a week tax cut, at least more would benefit and it wouldn't get eaten up by higher prices and fuel costs.
This is fantastic, I get an extra $40 per week so I can make payments on my freshly minted, imported plasma screen television. It's too bad about the crumbling education system and the shocking wait times for basic healthcare. None of that matters as long as I can watch Big Brother in high definition.
Any tax cut will be swallowed up (and then some) by petrol price rises...
Not a single mention of energy or environment issues in this budget.
Peak Oil is coming
It is appalling to realise how little care the Howard-Costello government extends towards those in our community who can least afford it, while they glibly make the rich get richer. The rich will barely even notice another hundred dollars in their pockets, whereas the poor will be hurting in ways that Howard and Costello could never imagine. The taxation measures outlined in the May budget mean that many lower income families will struggle to feed their children or keep a roof over their heads.
How will the Coalition meet the bill for the devastation of our society that this policy will cause? How will they pay for the upsurge of mental illness and crime that WILL increase as a result of this policy? Stealing from the poor to feed the rich is short-sighted in the extreme.
A total wasted opportunity this government has no vision for the future. Nothing for roads, health, education or the environment. a pathetic budget
Bugger the tax cuts, fix the health and education systems. Centralise some portions of the systems if necessary.
Tax Cuts - Squandering our Future 
Australia is living off two great sources of capital laid down earlier, but we are not renewing or building them up - a bad sign for the future. The bulk of any 'surplus' should be re-invested in these, to help tide us over future difficulties.
One is our natural resources: fertile topsoil, clean fresh water, fisheries & so forth. Only recently I think there was an estimate of $10 Billion to restore them to function on a long-term, sustainable basis after the damage done over a couple of centuries.
The other is the massive public (& private) investment in our infrastructure: water & sewerage systems, transport (not just roads) for goods & people, energy generation & distribution, as well as health systems, education & other vital parts of our society's structure. Many were developed from mid-to-late Victorian times into the first half of the 20th Century, & have barely been maintained since.
Now we have a chance to repair & *improve* these, learning from earlier mistakes. This is what will give a good foundation for our descendants to improve their lives, instead of scraping by, regretting lost opportunity.
Like the mutual building sculpture above Martin Place showing how a man can't break the bundle of sticks bound together, though each could be broken with ease one-by-one, the point of government is to bundle together our money and effort to do the things that singly are very difficult (how many of us can buy or build a new train or hospital?). And private companies are run for profit, not to provide a service.
For instance, a well-built sustainable water collection, distribution & purification system will take some maintenance over time, but will last without huge extra investment. The same for improving energy or transport systems (eg fixing/rebuilding bridges or taking freight off roads, which reduces road damage bills). A big push into reforming (in the genuine use of the word) agricultural practices & land-use, or ways of building cities can lay a good foundation for centuries of advance instead of continuing decline.
An educated person might be lost to their particular profession, but it's not likely they'll lose all their skills, they may return to it, otherwise they'll probably go to a different, but still skilled & worthwhile job. I've lost my skills as a biologist & medical researcher over the last 20 years, but work in a useful skilled job in a different field (though I'd prefer to feel I was contributing more to society &/or the world).
If 12% of Australians are in the current top tax bracket, 88% are lower. The majority of us know that if we strike trouble - like my recent medical & family crises - we will need social support. Not just trustworthy & affordable health care, but someone to help the aged mother I care for, meals on wheels, community nurses who aided my convalescence, etc.
Even if you have help from family or friends, that other support stops the total ruination that you too often see in both the third world & the US when a crisis hits someone. That's why there's community support for spending on services - even if people doubt that spending will go towards what they most value.
There could be a lot more said on this, which I won't go into. EXCEPT to refute those who say: "You'll spend it all and we won't have anything left when there isn't any surplus." Note that I wrote about putting the investment into things, both physical & social that will stay.
AND: for the furphy about "Oh, these are State, not Federal issues".
Just where do the States get the majority of their funding? Most of the money is collected by States and by the Commonwealth, put into the "kitty", then split up & distributed, some via State, some via Federal, trickling down to Local government. Remember that fuss last year about NSW's share being cut? There are also several bodies which co-ordinate Commonwealth & States to look after particular issues either nationwide or like the Murray-Darling system or Great Barrier Reef.
Wednesday, May 10, 2006
Major medical personal upheavals still going on. Might be able to fill in when I have the time & energy.
Chemotherapy starts on Friday, 12th May, 2006 and will continue for quite a few months, followed by radiotherapy and hormone treatment too. Fun, fun, fun...
[EDITED LATER TO ADD:]
Though drugs are more intense than last time, and more side-effects, OTOH the dose regimen is shorter, one day rather than a whole week. I'm considering finding a small flat to operate from for the next few months, it could help me organise cleaning out Mother's and be safer than staying at Pyrmont while I'm sick. Finances might be able to take it, especially if I can manage to stay on working.
Chemotherapy - Adjuvant FEC
- Starts Friday 12th May
One dripfeed every three weeks, for six cycles. Picked Friday so can recover over weekend.
This, if we've calculated right, would end on August 25th.
Many people are able to keep working part-time.
Hair will go; drugs to help with nausea & diarrhoea, other side-effects possible but rarer - can mean a pause while you recover.
Would start at end of chemotherapy - not sure if after 3-week gap.
Daily (weekdays) a 20-minute dose for five weeks.
This would take to mid-October or early November, depending on gap, also any pauses.
Not sure how practical working would be through this. Apart from how serious any effect of the therapy would be, trying to fit in the travel to the hospital & time of the treatment as well as work & commuting to it seems very awkward. Doing all that while not feeling too good might work against healing well too.
Foggier on this - happens after chemotherapy, but not sure if it overlaps with radiotherapy.
Tablets, don't know more details.
Until I'm able to put up information here, search for "Adjuvant FEC" or "fluorouracil, epirubicin and cyclophosphamide" if you want to find out some details.
Tuesday, May 02, 2006
A Host of eggcorns, malapropisms, et al
Making Light: Dreadful phrases:
"Renee ::: May 01, 2006, 05:01 PM:During my university years, one prof specifically advised against trusting spellcheckers--he'd found a study where one group of students was given a page of text with twenty spelling, grammar, and punctuation mistakes and told to correct it, while another group was given the same page and allowed to use spellcheck to correct it.
The spellchecked version had half again as many mistakes in the final count, including some that were not in the original piece.
Monday, May 01, 2006
Hullabaloo - Digby's Blog
Hullabaloo: Uptight, Crazy and Reactionary: "However, I might also suggest that the fact that we are all in our mid forties to early 60's means we are taking care of both the elderly (who are living to amazing old age) and the young (who stay young a lot longer than they used to) while looking at a scary old age that some factions of the government are actively trying to fuck with, and who may very well succeed. "
This is my blogchalk:
Australia, New South Wales, Sydney, English, photography, reading, natural history, land use, town planning, sustainability.