Physio

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I went to my first session with a physiotherapist today. There may not be a second. Not unlike many hospital visits, I left in worse shape than when I walked in, unaided.

My physio seemed sweet, engaging and interested when I first arrived. Disregard that nonsense about 'first impressions,' She lulled me into a safe place then toyed with me.

'Lift your leg up; and out to the side. Good Mr Crumble, but we don't have too much lateral movement in the hip do we.'

'Well no, that's why I'm here.'

'Does it hurt when we extend?"

"Yes, it does."

Nadia - We have different design specs

Nadia - We have different design specs

That was like a secret signal. She set about me like a psycho toddler going postal with a rubber bendy toy. I tried to muffle my whimpering. That spurred her on. I watched my legs flash before me in a blur as she worked her way through Volumes 1-4 of the Nadia Comăneci workbook on things you shouldn't be able to do with your lower limbs. She stopped as abrubtly as she started.

"I think I need to refer you to one of our specialist physio's." 

I shivered; she smiled.

At that point I more or less resigned myself to a wheelchair and bib for life on a fluids-only diet. If a referral to someone who specialises in involuntary contortion is my next treatment plan a wheelchair sounds like a positive alternative. None of us like to be drama queens and while it is only a dodgy hip, I wish we could just get to the hip resurfacing chat without all this preliminary box ticking of, "if it hurts, refer."

I'll book an appointment with the Ninja Physio then and try and be brave. I just can't wait.

A Bad Thing

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A bad thing happened last night. It happened in a bad place, just before bedtime. It came out of nowhere and completely knocked me for six. I wasn’t ready for it, I very much doubt anyone can be but it shook me to the core. While I am not one to inspect my working parts on an overly frequent basis I do happen upon the occasional spot check. Such was the instance last evening. And while I have, and I think regular readers will concur, greeted all the disappointments and indignities of middle age with sanguine equanimity I simply wasn’t prepared for what greeted me as I peered down below; a grey pubic hair. I stared at it with the same beguiling fascination that I did so many years ago when the first hair appeared. That one I welcomed with a smile, not so this aged imposter. Before it could exact any further damage on my ego I lunged for the snips and off it came.

Unfortunately, and I would caution that you will all experience this at some point in your lives, grey hairs are like ants; where there is one there are more of the little bastards. Closer inspection yielded more to be harvested. It was at this point when my workmanlike enthusiasm rather got the better of good judgement. I am now shall we say, somewhat more aerodynamic than was the case when I woke up in the morning. Vanity is never an endearing trait, much less so in the middle aged but I yield to no man in my defence of an Englishman’s God-given birthright to defend his pride and dignity with a pair of nail scissors. The tough truth though, as we all know, is that it is what it is. The experience has been similar to the six stages of grief; shock, denial, anger, bargaining, depression and acceptance all wrapped up in a 24 hour bundle. When your turn comes, perhaps you will handle it with more maturity than have I. Good luck chaps, stay strong.

A Good Start

Why bother? Let's revist the Snake Oil Willie Band for a reality check.

January is out of the way, done and dusted. For the many who chose to elevate their sense of sense righteousness in going dry for the month, February has dawned with perhaps, a sense of relief. Tomorrow, pious sobriety will be thrown asunder by most as we launch into the Six Nations with a veritable jamboree of rugby. For me, there is just one incy-wincy-wee-small flaw in the plan. I've done dry January for just about 30 years now and recently, have started a programme of giving up all the bad stuff for 3 months every two years. This is one of those years. I've dropped 16lbs so far and we'll be going for the usual 3st in 3 months on the Bloody Minded 1100 cal/day Crumble Mind-over-Matter Hard Core Diet. This year then, January represents a bloody good start to water and Green Tea for just another two months. 

The Good Guy Club

Way back in the early eighties I went to a Leukaemia Research ‘Ball,’ in the Hook area which was organised by a family who had tragically lost a young family member to blood cancer. In those days, Leukaemia in it’s various forms killed an unacceptable number of youngsters but great strides have been made in research and survivability has more than doubled since. The party in Hook was good fun. Held in a village hall the catering was done by the matrons and mothers of that commuting enclave and it was all cheerfully village fete, raffle and coronation chicken like. Ten years later the event had grown into something altogether more substantial and was held in a large hotel with auctions, entertainment and attendant celebrities to match. The growth of the fundraising effort over the years was mirrored with success in the laboratory. Those raffle tickets really do help.

My mind is again focused on the wretched thing with a close friend having recently been diagnosed with the illness. Fortunately, the doctor’s roadmap for him back to the bright sunlit uplands of health and happiness is likely to include stem cell donation. Unfortunately, while his friends would happily drive to wherever they needed to be this afternoon to donate our stem cells,  Anthony Nolan doesn’t actually want ours; mostly because our bodies are old and knackered. You see, the best stem cells come from those who are aged between 16 and 30, weigh over 7st 12lbs and are in good health. I should immediately point out, the old urban myth of stem cell donation being painful, ‘they stick a knitting needle in your thigh bone,’ is utter nonsense  90% of donors do so by blood in a process called peripheral blood stem cell donation. You can find out more here.

Being a donor gives ordinary people the opportunity to do something quite extraordinary in their lives. The implications for the recipients are as profound as they are joyful. Please, kindly spread the word.

Barrett's is a Bastard

The biggest boost to a soldiers morale is hearing your name at 'mail call!' I should say, given the imperious advance of technology, 'in my day, the biggest boost..........' That is, right up until you heard the oldest and most worn line in the book, 'Crumble! Give this to McTavish.' Try it with the kids at Christmas; it is the joke that keeps on giving. I remember one day my heart soared when my name was called out and I walked back to my billet with a letter in hand from my girlfriend of the moment who I hadn't seen for some months. While it wasn't the most upbeat letter it wasn't the one every man jack hates to receive. In it, she detailed with great care, a list of ailments that would befall me should I continue to smoke. It was a long list although she ended by pointing out that it wasn't exhaustive. You're damn right it wasn't. She didn't mention bloody Barrett's...

So, I've got Barrett's Oesophagus, (I wish he'd take it back). While smoking isn't exactly the cause it almost certainly contributes to the condition and at best, we can say that smoking is kind of unhelpful here. So what is it? Simply put, BO is a condition where the sphincter like valve between the oesophagus and stomach loses it's elasticity allowing acid from the stomach to splash up and burn the lower end of the oesophagus. Doesn't sound good does it? It isn't. The area that becomes damaged provides a fertile breeding ground for a Defon 1 really nasty cancer. That's why I have the joy of having a routine two yearly check which is better than not having a two yearly check. Right up until the point when they call and say, 'hmmmmm, could you pop back; we would like to have another look.' 

Just want to point out that this would never have happened if John Hurt had gone to the QA in Portsmouth with his really extreme Barrett's Oesophagus.

Just want to point out that this would never have happened if John Hurt had gone to the QA in Portsmouth with his really extreme Barrett's Oesophagus.

So I did. I had a lesion. Now the word 'lesion' doesn't sound too bad. The second doctor I saw though didn't call what they found a lesion. He called it a granular cell tumour. The second doctor got my attention. The surprising little detail they omitted though, until my third visit for an ultrasound, 'we have to find out how deep it is,' was that this unwanted new resident in my oesophagus was out of the Barrett's zone. That is, by a freak coincidence, in having had the routine endoscopy they picked up this other squatter. Bear in mind, this thing was tiny, only 4mm but by the time it was removed last week it had grown to 20mm. Yep, I've seen Alien too...

Subsequently,  I found myself in the operating theatre for the apparently small procedure, ‘we’ll just go in and snip it off,’ last week. It turned into a rather longer 2 hour procedure. I am now not on the pre-Christmas liquid diet I had envisaged. The day after the op I felt like a troop of Royal Marine Commando’s had climbed up my oesophagus using ice axes and crampons. It did in fact, hurt like buggery. Still, that’s me having ticked the box marked, ‘my first operation,’ and hopefully it will be another handful of decades before the next...

Bit premature there son........

Bit premature there son........

The family reaction left me somewhat bemused. Mrs Flashbang abandoned me as I was being wheeled away to go shopping then home, ‘call me when you’re ready to be picked up.’ My daughter didn’t call but spoke to her mother on the grounds that I didn’t display much empathy when she had her wisdom teeth out. One son, who has watched every single episode of House and knows more about medical complications than the average consultant did call but was slightly more interested in the procedure than I found comfortable while the other son messaged from his expedition saying, ‘so, is this the moment we put your Bucket List together Dad?’ charming……....

For what it is worth, and this is the point of the post, if you suffer from persistent acid reflux and heartburn, go and see your GP. Many souls knock back a few Rennie's or Gavascol and soldier on. That is not the correct drill. Some GP's will upgrade the usual remedies by prescribing Omeprazole which is a quick and easy fix but may cover up a more ominous problem smouldering away. An early diagnosis of Barrett's is obviously better than a late diagnosis. There is more to write on the subject, from a slightly more serious perspective, with regard to diet and I will do that in due course.

In the meantime, I'm very much looking forward to my return to the QA in Portsmouth for my follow up scope in Dec with the Olympic Endoscopy champions led by Professor Bhandari. If you want to see an example of world class medicine in the NHS, it's right there in Portsmouth.

Time!

It's time.............. oh bugger.

Some Hours Later.....

Well, that went oh, how can I put it? Better than anticipated. The self administered enema wasn't nearly as grim as my worst imaginative fears led me to believe and the trip to the Queen Alexandra Hospital in Portsmouth was as quick and easy as was the actual procedure.

flippin' hurrah!

It's a big hospital although the endoscopy department is closer in vibe to a village hospital. The staff are open and welcoming and take great care to explain and demonstrate before they do anything. In fact, I was beginning to feel right at home, right up until the point they invited me to lie down and bend my knees to my chest. Actually, I'm not going to take the mickey on this occasion in case anyone reading with a future appointment might be put off.It's pretty straight forward with a feeling of mild discomfort and the odd twinge in the stomach. The build up and thought of the procedure is very much worse than it is in practise. The team were all chatty, engaging and interested and made the whole thing feel as routine as loading the dishwasher after a good lunch. Kirsty, the rear entry Endoscope Queen, explained every twist and turn and its all there on a big screen for you to watch should one choose to. I chose to close my eyes and think of England but the team scored another double bonus point when one said, 'Do you do a lot of fitness Mr Crumble, you have the resting heartbeat of a real athlete.' More talk like that and I'll be back for a second go. As luck and good grace would have it all is well, 'pink and healthy Mr Crumble,' which I'll admit is a surprise following many years of very determined consumption of grain & grape not to mention bacon sarnies, (Best on the Planet when made with Mrs Flashbang's world famous salsa), Kettle Crisps, carcinogenic barbecued sausages and sundry other rubbish.

So, if you find the envelope on the door mat one morning don't go into a cold sweat and worry about it or ignore it - JFDI, (Just Fxcking Do It). Men morph into little boys when they go near hospitals, (I'm an Olympic level competitor at this having missed the births of all three children), but this screening is only as big a deal as you allow your imagination to make it, so don't. A good friend has just gone through two years of pretty radical treatment for bowel cancer and he was as fit as anyone his age. Don't be that guy.

A final thought. On leaving the hospital, (actually I was doing somersaults and pirouettes of joy), I passed this shop which is more in keeping with an Esso petrol station than a hospital. What in the flying fxck are the people who run these hospitals thinking when every third person walking in there is morbidly obese?

Rosie; Will The Fun Never End?

It's been a bit of a driecht and dreary winter with Spring struggling to make itself felt with temperatures cooling off again today. So lets cheer ourselves up as we head into the weekend with some Happy Friday news and it comes from friend Rosie with her latest update in her fight against the unforgiving bastard that is Breast Cancer. If perhaps you feel you've had a bit of an ordinary week or month then look to Rosie for inspiration for she has endured an absolute sod of a time these past eight months. The quiet courage with which she has taken on the enemy with her fantastic wit and self deprecating humour has certainly lifted my spirit. In fact, I've found it quite humbling. While there are no absolutes in these matters, it does appear that a more favourable wind is blowing and the outlook is now one of shall we say, cautious optimism. Breast Cancer awareness groups do emphasis the importance of touching and feeling breasts to aid early detection. I'm going to step forward here and state quite clearly that I am enthusiastically committed to this strategy and would encourage other husbands to adopt the self same approach. It is very important to empathise without shame or fear of embarrassment. In this regard, I shall lead from the front. You may incidentally, read Rosie's other posts here, here here here here and here.

Over to Rosie,

Previously on ALF..... 

Diagnosed with Grade 3, Stage 2 Triple Negative breast cancer... Adhering to the recommended 'poison-slash-burn' policy, our heroine has completed 8 cycles of chemotherapy... and - as of 3 weeks ago - breast surgery.  She returns to this blog after an unprecedented 2 month absence.....

Last missive I was anxiously awaiting a date with the MRI and hoping for no signs of life from ALF....sadly not quite to be.... and following what the medical profession euphemistically referred to as my "modest" response to chemo, it was decided to upgrade my surgery to therapeutic lateral mammoplasty and axillary node clearance instead of a lumpectomy and sentinel node biopsy.  Both are as terrifying as each other but essentially, as with most things in life, you get more bang for your buck with an upgrade.... 

I was also rather disappointed to discover that my bionic accessory, the Portacath, had to be removed before surgery. Here was I thinking "marvellous - no cannula for me, they can deliver general anaesthetic like a lightening bolt straight to the chest", but apparently not.  So it was back to see the lovely Dr. Lopez again - all snake-hips, skinny black jeans and pointy shoes for some more Rohypnol and another afternoon away with the fairies. 

Thus prepped and primed, I arrived at the hospital for surgery, but just when you think things can't get any worse... I was presented with the non-fastenable hospital gown, some quite extraordinary paper knickers and a fetching pair of white embolism socks.... not forgetting, of course, that those of us who have been through chemo will already be sporting some kind of natty headgear - in my case, a pale blue beanie.  As fashions go, it's definitely an acquired taste.....  Mark failed miserably to contain his mirth and so in revenge, I dispatched him to M&S to buy some front-fastening sports bras for my post-operative needs. 

Meanwhile my surgeon (aka Supreme Being) arrives armed with felt tips, a measuring tape and a camera and proceeds to draw carefully measured lines all over my right boob with black and red markers, elegantly depicting ALF as a large, black blob.  He then stands me against the wall and takes endless pictures whilst I feebly attempt to protect my dignity with the hospital gown tied precariously around my waist.  It's at this point that Mark returns from his impromptu shopping trip brandishing foundation garments and wanting to know if they fit.  Struggling hopelessly to do the wretched thing up myself (and avoid covering pristine underwear in felt tip pen), both husband and surgeon take over and before I can say 'B cup', my gown has slipped and dressed only in knee-high socks, paper knickers and a beanie, I am stuck helplessly whilst the pair of them wrestle to do up said sports bra with "innovative front zipper".  Discretion being the better part of valour, my surgeon gives up first, claiming he wasn't taught this sort of thing at medical school so Mark wins by default, 3 falls to a submission.  Dignity quietly leaves the room.....

The operation has been hugely successful... or in the words of Supreme Being : "everything went as anticipated".  Obviously I have dropped quite a few cup sizes, but essentially a work of art and even the furniture put back in the right place...   My armpit a slightly different matter and it feels as though I am hosting a particularly large and prickly holly bush under there. This sadly is part and parcel of lymph node clearance as inevitably a lot of nerve endings get badly damaged..... I also acquired a brand new fashion accessory: the medical drain.  A complete nightmare and I wanted to rip it out at every available opportunity (indeed, I nearly did....by accident on odd door handles and the like), but managed to stay the course... 

 

it's everyone's fight

Waiting for the pathology results was horrific...before the statutory week wait was up, I had descended into "angry, bald dwarf" mode (again) and writing my own eulogy at 4 o'clock in the morning (again).... however, I am delighted to announce that for the first time in a long time, I have some seriously good news.  The final pathology showed ALF to be a riddle wrapped in a mystery inside an enigma... as in a residual 13mm invasive b*****d, surrounded by potentially invasive crap over a total dimension of 21mm..... inside a mix of fibrosis and calcified degenerative tumour cells......wait for it....CONSISTENT WITH RESPONSE TO CHEMOTHERAPY.  1 out of 17 lymph nodes contained metastatic breast cancer and that 1 node was the marker node we already knew about.  Margins were clear.....  The histology is excellent.  Cue tears, relief, general drama....

Two weeks on, I appreciate I am not totally out of the woods, but it has become a heck of a lot sunnier in here.  The odd cloud.... I have developed something called 'cording' under my arm which is an irritating form of scar tissue which impedes arm movement.... I fear I might not be able to play my wild card at the Wimbledon Lawn Tennis Championships this year... and I still have a holly bush under my arm. Relentless exercises and physio the way forward so I can get my arm above my head in time for radiotherapy which starts after Easter...  will the fun never end...?  I am stonkingly tired all the time, but I guess that is to be expected.

Next update from the radiology department... until then, I leave you with a shameless plug for my niece, Melissa, who is running the Paris Marathon on 3rd April in aid of Breast Cancer Now. Any contribution graciously accepted...

 

 

 

I Don't Look Good Naked Anymore

It's Day 75 of the extended January detox and apart from a seemingly deleterious effect on the frequency of blogging it's all going, well ok. I've dropped 30lbs from a post New Year over-indulged lardy self to a more respectable, but not quite lithe, weight. An instructor on my Combat Survival Instructors course once said to me, in his almost indecipherable Black Country dialect, 'it's good to fast now and again. It's good to feel hungry; not many people know what feeling hungry is.' Well I've got a newsflash for my old instructor. I've been hungry for 75 days, every single one of them. I'm in the groove though and am on course to hit the 3 stone in 3 month target and may plod on for a wee bit longer. People ask me why. The obvious answer is 'why not?' but the clip above probably sums it up better than anything I can say here. Food for thought you might say.. 

Zika; Cracked It!

Zika = no nookey.

The Zika virus continues to make a nuisance of itself although we know not much more about it now than we did three months ago, or for that matter 30 years ago. The Centre for Disease Control and Prevention in Atlanta are monitoring its spread very closely, as are the World Health Organisation.   Academics and researchers are working as fast as they can to create solutions for containment and eradication. I'm here to help.

Skin So Soft; Used by Royal Marines in the jungles of the world and by attendees at Highland Games across the North of Scotland.

 

While leafing through the Times from a hundred years ago today, which is infinitely more interesting and informative than is the 2016 version, I came across an article which I share with you below which suggests a certain type of dragon-fly and ducks have a positively catastrophic effect on mossies. It only leaves me to advise anyone travelling to affected tropical parts to go armed with packets of Silk Cut and bottles of Avon's Skin so Soft. If that stuff can see off those tenacious bastard midges in the Highlands it'll see off anything.

 


 

HEALTH IN THE TROPICS; NATURAL ENEMIES OF THE MOSQUITO.

The progress of tropical medicine is, like its beginning, full of interest, and its importance cannot be exaggerated, for the future of the white man in the tropics depends upon it. There are many lesser chapters in the great romance which have had too little attention bestowed upon them; one of these is the chapter in which it is told how by following nature closely it may be possible to "set a thief to catch a thief." An experiment was tried along these lines some time ago. It was observed that the little fish known as 'millions" are very destructive of the larvae of insects maturing in water. The idea was that if the fish could be got to live in pools where mosquitoes deposit their eggs a distinct reduction in mosquito-borne disease might be secured. The "millions" were brought in tanks and placed in the pools. Unhappily they seemed die off. More recently, however, these pools, supposed to have been emptied, have been found to contain the fish, and it is suggested that a few hardy specimens have managed to become acclimatised and will form the beginning of large shoals. The result of this work should prove, interesting.

Bad Guy

In the second report on Glossina Investigations in Nyasaland, published in the Bulletin of Entomological Research, an observer relates the remarkable way in which a "dragon-fly preys upon the tsetse fly." He says, “I saw one, of these dragon-flies, which had been following and hovering round the party of six boys with me, suddenly swoop down and take a tsetse from the back of one of the boys, who was stooping at a pool to drink, its movements being extremely rapid. It settled on the grass near and commenced to devour its prey. Each dragon-fly accompanied our party for some little distance, obviously expecting to find its prey in our vicinity.’

Good Guy

The dragon-flies seem to take the tsetse, whether it is in a full or an empty condition. 'The writer reported on 21 cases he saw of dragon-flies taking tsetse flies. The insect is described as "indefatigable in its work." The females feed and oviposit readily in captivity, so that the question of once more "setting the thief" to work presents itself in practical form. Apparently the attacks on the tsetse are made by one special form of dragon-fly, Orthetrum crysostignia, because another form which was on one occasion observed to attack the fly behaved in so clumsy a fashion as to convince the observer that it was a novice. 

Cometh the hour......

An experiment described by the Colonial Journal is of interest as illustrating the same principle. Two pools of equal area were made in a stream in a mosquito region. Ducks were placed in one and fish in the other. The first pool was quickly cleared of mosquitoes; the second, in which were the fish, remained uncleared, all the mosquitoes duly became mature. Wild ducks were then introduced, and it was found that they seemed to prefer the insects to all other form of food. After two days all the larvae had been destroyed. 'These experiments," comments the Journal of Tropical Medicine and Hygiene, "confirm the observations of William Lockwood, who found that the duck was particularly adapted to devouring the larvae on the surface of water, and of the duck who found mosquitoes in the gizzard of a wild duck.' 

 

There we go. Now if we can just redirect a few million ducks from the menu's of restaurants in Bejing to the America's, (and avoid them ending up on the menus of restaurants in Brazil),  and breed bezillions of dragon-flies we will, in partnership with the Times of one hundred years ago today, have the problem boxed off.

 

Zika

A quick word on the Zika virus. The name "Zika" refers to a forest just outside Uganda's capital, Kampala, where the virus was discovered in the late 1940’s. It has since been identified in other parts of Africa, Southeast Asia and the Pacific islands. The spread of Zika is similar to that of the chikungunya virus: Once it is exposed to a dense population, aided by the right factors and conditions, it spreads rapidly. Concerns about severe birth defects associated with the Zika virus are not only understandable, but also are aggravated by the difficulty in detecting infection. Several studies are underway to conclusively prove the link between Zika and microcephaly, a congenital disorder associated with small infant head size and neurological impairment. Studies in Brazil have already shown a strong correlation. There is also evidence linking Zika to autoimmune disorders such as Guillain-Barre syndrome, but more findings will likely emerge over the coming months.

However, hard facts are difficult to come by and the media are not being proportionate in their reporting. It may well be proved to be very serious but the BBC colouring the whole of Brazil in crimson red on their graphics is hardly helpful. One recent report suggests that up to last week there were only 270 confirmed cases of microcephaly in Brazil and only 6 of those had Zika. 

There are also some suggestions amongst the Twitterati that there may be a story drawing in the mandatory Tdap vaccination for pregnant women in Brazil, (became mandatory in 2015). Tdap is manufactured by Glaxo and Sanofi. There also seems to be growing evidence that the disease can be sexually transmitted. I’m not taking a view on any of this. I’m simply keeping an open mind and question how a 65 year old virus suddenly becomes a threat to human health on a trans-continental scale. Mossies rarely travel far.

The WHO officially considers the Zika viral outbreak, which is currently plaguing the Americas, to be a global emergency. Yesterday’s announcement followed an extraordinary meeting to assess the extent of the infection. Labelling the virus an international health emergency improves the chances of getting it under control, thanks to an anticipated influx of personnel, resources and expertise spurred by the WHO designation. The emergency decision could even accelerate efforts to develop a vaccine, though this will not happen immediately. The virus is spreading rapidly through South and Central America and could lead to 4 million new cases this year. At least 20 territories, including Panama, Guatemala, Barbados and Puerto Rico, have registered local transmission of the virus. The disease, which is spread by the Aedes mosquito, produces no symptoms in the majority of cases and only mild symptoms in others. 

 There will be an economic impact. Containing and managing an outbreak is expensive, as is dealing with large numbers of dead and infected. This can lead to severe disruptions in trade, accompanied by enhanced screening measures to prevent the transmission of the virus across borders. Developing treatment, cures and vaccines requires huge investment, as seen in the recent Ebola outbreak in Africa. And then there is the loss of productivity resulting not only from sickness but those refusing to work and those taking time off to care for the infected. If the disease is neither deadly nor debilitating, however, the loss of economic productivity from death or incapacitation is low.

Mossies are a fact of life in the Tropics and whatever personal protective measures individuals take its usually a case of minimising bites rather than eradicating them. Zika is not the only mosquito-borne disease that is endemic to the Americas; dengue, chikungunya, West Nile and malaria have all taken hold, (before I was posted to Belize I came out of the Med Centre feeling like a pin cushion although at the time, the last thing we were worried about in the jungle and in the rivers were mossies. The Green Tree Viper, the Fer de lance, the Jumping Viper, the Bullet Ant, African Bees, bitey spiders too numerous to mention and scorpions; nice). Without mass eradication efforts, similar to those carried out in the mid-20th century, it is likely that several mosquito-borne diseases will remain endemic to Latin America. The difficulty in controlling these other diseases is a strong indicator that controlling Zika will be equally difficult. There are significant costs associated with constantly combating and treating mosquito-borne diseases, costs that are hard for cash-strapped countries to shoulder. In fact, the prevalence of such diseases in the tropics has historically hindered the economical emergence of countries in that climate range.

The biggest geopolitical effect of this outbreak may not be seen until 18 years or more after the current outbreak. Fear of Zika and microcephaly has to potential to lead to a decrease in pregnancies in the region, possibly assisted by political initiatives. The governments of El Salvador, Columbia, Jamaica and Honduras are already telling women to delay pregnancy until the virus is under control. Unlike other countries and regions that are expected to face demographic crunches in the next two decades, much of Latin America still has a healthy demographic curve, with a large, young population base. A rapid halt in population growth, caused by something akin to Zika, would threaten the continued productivity associated with sizable Latin American labour pools. This has the potential to hasten regional decline in decades to come although, I do emphasise, no one seems to yet have real handle on this thing regardless of what the newspapers are saying..

January Detox & Fat Birds II

January Detox hits hard with the M&S wholefood salad with some smoked mackerel for lunch. What is there not to love..... hmmmmm, yumety, scrumety......

After a genuinely enjoyable, amusing and indulgent Christmas, which was quickly followed by a ripping New Year it's time again to pay the piper. I've done the January good boy thing for so long now I enter into it more with dogged resignation rather than spikey irritation. I don't count calories or any similar such nonsense. We all know what the bad stuff is and we all know how much is enough. I drink water or green tea and will lose over a stone by February. It's not difficult, just dull. I then cheat by having the annual health check and blood test just when the pipes are at their cleanest. Unfortunately, the plan unravels spectacularly every single year when the Six Nations hoves into view. One of these years........ I really must see it through.  

 

 

So, the blog is six years old next month and I took a wander through some old posts and came across this beauty from Jan 6th 2011, January Detox and Fat Birds. One of the best I think you'll find...... even though it was written when I was in a somewhat less than sympathetic mood to fellow humanity.