Friday, 29 August 2014

Take your meds. Or else.

It's not often I venture into the Heart Foundation website. It is a surreal experience, and not in a good way. I'm getting consecutive posts on the same visit out of the way so I don't have to think about it for much longer. I'm not a fan of the heebie jeebies. 

There are many weird and alarming things to read, but the HF's "Improving adherence in cardiovascular health" has a smell to it that I don't particularly like.
stop taking your meds = you're fucked
The smell gets a bit worse when you discover that a "Heart Foundation Pharmaceutical Roundtable" exists and their mission is to "to reduce suffering and death from heart, stroke and blood vessel disease in Australia." That's all very noble, but do you think there might be just a teensy weensy conflict of interest among the members of this roundtable?
i wonder what's for morning tea? 
I wouldn't have much problem with this relationship if the advice of the HF was any good. But I don't think it is.

Included in the "improving adherence" project is a series of case studies targeted at doctors and pharmacists and they had my sphincter muscles tightening and my eye brows moving in opposite directions. But maybe that's just me and my paranoia. I should probably be on meds for that.

A summary of the power point case studies can be found here. But don't stare too long or you may end up shitting bricks.

Basically, the presentations depict a scenario where a patient is prescribed some cholesterol lowering medication and eventually gets apprehensive about taking them - because he can't be bothered or can't see the point (I think). 
Mr AB is in serious shit
The pharmacist and GP quiz the patient as to why he's not taking them and convince him to recommence. Victory for the pharmaceutical company!
Mr AB is clearly an idiot and needs to be saved from himself

V is for victory. And also for Vytorin
I'm sure there are very good reasons for doctors and pharmacists to be concerned when a patient isn't taking their meds - people with psychiatric conditions are an obvious example. Not to intentionally stereotype, but I'm guessing the last thing a doctor wants to see on the news is one of their patients rollerblading nude down the freeway and causing accidents. I could therefore understand the GP and pharmacist getting a bit antsy when it becomes evident the patient has stopped taking their Saphris. 

However, when it comes to cholesterol lowering drugs - which I'm not convinced provide any significant benefit to the average human - that someone has decided not to take them is hardly on the same scale. Life threatening to the patient? Unlikely. Life threatening to the general public? No.

Where I'm going with this is - at what lengths will law makers go to ensure the patient takes their prescribed medications? And how much power will the professionals be given to encroach on patients' privacy? It may require the patient's consent now, but it's hardly a stretch of the imagination to see that little rule being over-ridden in the future because "it's for our own good".

It worries me. There's only so much you can do to help people. If they don't want to help themselves or they have listened to your advice and think it is bullshit - that is their problem. I don't think there are any scenarios beyond serious psychological conditions that warrant forcing a person to 'adhere'. 

To clarify:

Am I qualified medical professional? No.

Who am I exactly? An internet nobody. Ranting into the abyss of the internet relieves stress. 

Do I think I'm smarter and know more than these professionals? No. Well, maybe on some things like football, but not generally, no.

Do I get a kick out of endangering people's lives by suggesting they don't take life saving medicine? You have missed my point.

What is my point? If someone wants to take cholesterol lowering drugs and knows the risks and supposed benefits, that is fine with me. What I'm worried about is that the dickheads making laws in this country will give health professionals the power to monitor medication 'adherence' and the slippery slope of privacy invasion leads to an involuntary stay in hospital until adherence is restored. 

Anything else? Yes, glad you asked. The relationship between the Heart Foundation and the drug companies and their noble pursuit of saving lives - I don't like it. 

Do I wear a tin foil hat and have a concrete bunker ready for the zombie apocalypse? None of your business. And no, there is no room in it for you.

Why do I like asking questions of myself and then answering them? 'Cause it's fun and allows me to feel pompous and self-important. 

A roundtable I approve of - a delicious magpie goose roundtable

Saturday, 23 August 2014

Things that you learn from venturing into Crazy Town

From the Australian National Heart Foundation (aka Crazy Town)

"There is no scientific consensus that sugar as a nutrient causes heart disease. While overall kilojoule intake is important, other factors such as reducing levels of salt,and saturated fat are more important in preventing heart disease."

Yes, yes, we (the ignorant unwashed) all know the big white tick is basically a bullshit concept, based on nonsense and mind-blowing pompous arrogance, but it may interest you to look at just a sample of the AHF genius that is their list of tick approved foods.
Buying food with this on it is guaranteed to increase your smugness

Just a few examples of foods that are considered "heart healthy" and have the tick:

Milo Crunchy Bites – 24.2% sugar  
Sultana Bran Buds – 23.8% sugar  
Kellogs K-time Twists – 36.2% sugar 
Oats Express liquid brekkie – 23.5 – 25.3g sugar per 250mL serve.
Healthy Choice Apricot Chicken – 24.5g sugar per serve.  
Kantong Sweet & Sour sauce – 23.3g sugar per serve, 18.2% sugar  
That is all I could be buggered looking up - there are surely many more with similar sugar content. All low in saturated fat and salt, of course.

But never mind that - they have a perfectly good reason for sugar being heart healthy:
  • "Sugar is not a Tick criterion because, based on the current level of evidence, the major public health problems facing Australians such as obesity and overweight, diabetes, heart disease are related to excess energy (kilojoule) intake, not solely sugar as an ingredient.
  • For cereals with sugars present as dried fruit, eg. Just right or Sultana Bran, the sugar content will always appear higher due to the natural sugar content of dried fruit.  It is important to note that a sugar criterion in this instance would present Sultana Bran as a poorer choice than Coco-Pops."
So, it's fairly clear - don't worry about sugar content and your heart and body will do just fine. Call me a conspiracy-theorist, or a knowitall keyboard warrior (I'm not denying either), but that is just totally idiotic. Do they actually believe that to be true, or do they just have no other way of making their stupid scheme work given the fucked up national guidelines on healthy eating? Sort of a no brainer really. Honestly, if you can't eat fat or salt - they can't really come out and say 'no' to sugar because there's nothing left to eat except dry toast and water with some steamed broccoli on the side.

Exactly how you would get the tick on your product is spelled out here. But when I say 'exactly', it gets a bit vague when you try to figure out how much it'll cost you:

Fascinating, I'm sure. They also seem to be a little touchy when it comes to criticism on who uses the tick.

I learned some other fascinating tid-bits on my visit to the town populated by Simple Jacks, but they'll have to be the subject of other posts. There's only so much stupidity a person can deal with in one sitting.

Have a good one.

Thursday, 14 August 2014

Accidental waterboarding

More Modern World by Tom Tomorrow here

I know it's just satire, but the cartoon Barack's attitude seems to be one taken by Governments and politicians everywhere. It's my opinion that Mr Obama gets away with it a lot more because many people (at least here) seem to think he's charismatic and "nice". But then Australian politicians are neither of those things and our citizens take the bullshit as truth. The number of votes says so. 

Fear is a powerful incentive to believe anything and trust anyone.  

What can you do?

Tuesday, 12 August 2014

Man walks into hospital with no ApoE. Stupidity ensues.

A 40 year old American man sought treatment for sky-high cholesterol (760mg/dL or 19.7) and triglycerides (534 mg/dL). The xanthomas covering his body were so extreme, it was painful to walk. I could have put in some photos, but they're not very nice, so you can see for yourself in the complete paper here.

The docs eventually found out the man was a bit of a genetic freak and had a complete absence of apoliprotein E due to several genetic mutations. "
ablative APOE frameshift mutation" is the cool name they gave it. I understand this is not exactly unheard of, but the lab geeks got a bit excited because they usually have to mess around with mice to 'make' an animal with fucked up or non-existent ApoE. Having a human to prod and test is probably a novelty. 
Malloy et al 2014
They tested his eyes, heart, cerebrospinal fluid and cognitive ability and according to them he was fairly normal. He didn't do so well in a memory test and appeared to have a learning impairment (didn't speak until age 3) but that was brushed off as possible dyslexia

There are many things you could probably take away from this fascinating man, but the one thing that they appear to be shouting with a megaphone is:

Your brain doesn't need ApoE, and in fact probably hates the stuff, so lets find a way to get rid of it so you don't get Alzheimer's.

I'm paraphrasing, but that's the gist of the comments in the paper and also in the quotes attributed to the authors in the press.

A few examples:
  • "having no apoE is better than having the apoE4 protein"
  • “it is unlikely that APOE is key for normal brain development or function, as there are other proteins that can compensate in its absence.”
  • “Minimizing APOE4 levels in the brain may provide us with a new venue for intervention with Alzheimer’s disease and other cognitive disorders,”
  • "This opens the door to explore such possibilities more rigorously because we have the proof of concept that reducing APOE isn’t harmful to patients,”
  • “This particular case tells us you can actually live without any APOE in the brain,” said Dr. Joachim Herz, a neuroscientist and molecular geneticist, who was not involved in the research. “So if they were to develop anti-APOE therapies for Alzheimer’s, we would not have to worry about serious neurological side effects.”
  • Several experts are working on ways to reduce APOE4 or increase APOE2 in the brain, and the results have been promising.
  • Dr. Herz said, “based on what we know now, I would say this patient will most likely never accumulate amyloid.” 
That's all rather exciting but I have a few issues with their conclusions, such as:
  • This is one man and he's 40 years old. 
  • Did someone dispose of the lipid hypothesis and not tell me? 
  • ApoE is something scientists only have a partial clue as to what it actually does and they just want to start pulling it out of people's heads. 
  • The ApoE variant that is claimed to have the least risk for Alzheimer's is E2 and E2 people have shitloads of ApoE.  
  • ApoE E4 is purported to be the 'ancestral allele', but the geeks continue with this mindset that our ancestors must have all had dementia. 
  • This is one man and he's 40 years old.
This quote made me laugh - "Dr. Malloy is working to treat the man’s cholesterol problem, which has barely improved despite medication and a healthy diet."

They tested his heart thoroughly and didn't find much wrong with it so it seems they're just giving him statins for the hell of it. You can, of course, imagine what a 'healthy diet' involves.

"The main potential side effect of reducing apoE would be the effect on cholesterol and triglyceride levels. This patient had extremely high levels of both -- something we would have to avoid when treating patients. It would obviously not be beneficial to reduce the risk for Alzheimer's disease if in the process we increase the risk for cardiovascular disease."

The paper is an interesting read, mainly because of the subject, but the conclusion is quite odd - "This suggests that functions of apoE in the brain and eye are not essential or that redundant mechanisms exist whereby its role can be fulfilled. Targeted knockdown of apoE in the central nervous system might be a therapeutic modality in neurodegenerative disorders."

I'll be stuffed if I let anyone target my ApoE for knockdown. 

irrelevant pictures, I have them

Friday, 8 August 2014

And here I was thinking they were mythical creatures

Homozygous ApoE E4 centenarians. They exist. Without dementia.

Holy shit.

And he/she didn't have the "protective" mutation A673T, whatever that is. 

I know it doesn't make a lot of sense to get excited about this, hell we've all heard anecdotes of someone's uncle's step-mum living to 100 and smoking a pack a day for 85 years - but for those who know they have one or more Apolipoprotein E4 alleles, it may offer a glimmer of hope. 

The authors of the study (Yun Freudenberg-Hua et al) happened upon a 97 year old homozygous E4 carrier (E4/E4) with a MMSE (mini-mental state examination) score of 25.

Which in English means he/she had no clear signs of dementia at 97. 
"Disease variants in genomes of 44 centenarians" - Freudenberg-Hua et al
I'm guessing it was a woman, but they don't say. It sounds like the old duck had some other things going on that obviously affected her longevity and brain function in a positive way, but it's nice that the authors didn't just put it down to some freak case and continue to lay blame on the E4:

My gut feeling is that humans with E4 lived just as long as everyone else before it became customary to pour bucket loads of sugary shit down our throats. I have no proof of that, of course, but it makes logical sense to me.
Black Jewfish aren't mythical either. Which is good, because they taste delicious.

Thursday, 7 August 2014

Get your grubby hands off my metadata

As we continue the steady slide into full blown totalitarianism, it's not entirely surprising that our Government here in Australia is making the most of the so-called war of terror. The Attorney General, George Brandis, has proposed that they will make telecommunications companies retain records of all websites visited by their customers for two years.

Mandatory data retention laws might sound innocent enough to the unsuspecting and trusting punter, but when the dickheads who come up with these ideas don't even have a clue how it'll work, you know you'd have to be a fully-blown idiot to believe any good will come of it.
Brandis - "you there, peasant - behold my cunning plan to take your secrets and eat your children" 
As far as I can tell, because I'm having trouble following the argument, we should be happy to trade our civil liberties and privacy for the promise of a terrorism-free society and the warm glow that goes with that.

Call me a pessimist and glass half empty kinda bloke, but I think that is an extraordinarily shitty deal. I'd compare it trading all my personal belongings for a lifetime supply of vegan microwave dinners. I'm expected to hand over something immensely important to me in return for something that I have no need or want for, and that quite frankly, stinks of bullshit. 

Fortunately I'm optimistic enough to believe that it'll never happen. As stupid as politicians and bureaucrats are, it'll cost too much, be too difficult to administer and we humans aren't quite as compliant and brainless as they think.

I hope.

And anyway, why don't they just ask Google for all that information? Dumb bastards.
My grandpa would be scheduled for rendition for this
Unlike spy agencies and politicians, my late grandparents had a great sense of humour. On a long road trip many years ago they set up the above scene as a sort of "grandma talks too much so I had to get some peace and quiet" joke. 

Depressingly, it is easy to imagine a world in the not-too-distant future where a similar photo emailed to grand kids might be intercepted by some stooge in the basement of ASIO. Phone calls are made up the chain of big-swinging-dicks until the old man's door is blown off its hinges and he's whisked away to be "accidentally" tortured in a secure location and never seen again.

It seems as we get further in to the 21st century there is much less room for this type of humour. Some voter somewhere might get offended or feel unsafe and we just can't have that.

Wednesday, 6 August 2014

Lawn sale - come buy my awesome shit

and help save my great-grandma.

((This is another one of my stupid attempts at selling rubbish to my work mates. Studies show that there is a strong correlation between spewing nonsense and a fat wallet.))

When - this Saturday from 8am until 1pm. Early birds will be subject to my wife’s death-stare. And you may be forced to listen to one of my 4 yr old son’s stories about how he found a toy car under the lounge that he hasn't seen for ages (we love him dearly but dental surgery is less painful and time consuming).   

Where – my house.

Why – raising money for my great-grandmother’s hip operation. Or to fund my saucepan addiction. Whichever strikes me as more important on the day.

What – lots of great shit that you really can't do without, including:

Big rotary hammer drill – good condition - I’ve only ever carried it around with no shirt on to scare the god-botherers when they visit. 
Trampoline with a few springs missing. Way too dangerous for my kids but I’m sure yours will love it.
Bench press with leg and pull-down attachments - I’m getting too muscular and need to stop. 
Sony camcorder. Sorry, no home movies included.
Juicer, hardly used (I’m sure you’ll love it and use it every day)
A brand new 20 litre saucepot. Hey, it was on sale and looked so pretty. Stop judging me.
Four of those annoying scrub turkeys – going free if you can catch them. I’ll even help you pluck them and promise not to tell the authorities.
Zoo pillow – for breasfeeding on. No, I didn’t make that up.
And…I should really write things down...there’s lots more, I’m sure of it. Why does no-one warn you about memory loss when you’re 17 and a bucket-bong is your best friend?

It seems Google is unable to read my mind when searching for images of "man drill abs". Pathetic, Google.  
Questions – I have tonnes of them. Like, what do vampires have against garlic? Is there really no cure for being an arrogant prick? And what exactly is Kim Kardashian famous for? If you want to answer these, or even ask me a question, come along on Saturday and chew the fat.

Why haven’t you listed any prices? Because being vague and obtuse is my thing. And the whole point of having a lawn sale is so people come to your house and haggle rather than you do all the work for them. Honestly, does Harvey Norman/Costco/Walmart provide useful information or customer service? No, and I think that’s something we can all learn from. And besides, I haven’t decided on prices for everything yet because my wife is a world champion haggler. Once in Thailand she managed to make an 85 year old crippled man cry by convincing him to sell her a hand-crafted ivory elephant statue that had taken him 6 months to complete for 300 baht. And she hates elephant statues.

If I come to your house will there be a jumping castle/sausage sizzle/free booze? There’s a chance there may be all of those things and more. Personally, I wouldn't leave it to chance – bring your own and enough for me too.

Disclaimers – All references to a “grandma” in this posting are of a fictitious and facetious nature. I do not have a grandma with a broken hip, and even if I did, I would not use her for financial gain or sell her to complete strangers. Unless, of course, there was a particularly shiny saucepan on sale that I just had to have.

I also don’t condone violence toward protected animals, even if they do dig up our garden every day and could possibly be quite tasty in a curry. Curried scrub fowl…mmmmmmm.

The 85 year old Thai man is also a figment of my imagination. I was just building up my wife’s talents to intimidate any potential bargain-hunters/cheapskates. Seriously, the only thing we’re giving away is our Saturday morning. And the scrub fowl.

Update - I see by the number of views that we’ll either get over a thousand people stomping through our garden tomorrow or you people are toying with me and building up my hopes of some crazed bidding war over whatever we haven’t nailed down. That’s great if it happens, but under no circumstances are our children for sale.

Email requests for me to walk around carrying the drill with no shirt on are flattering, but seriously, incandescent flesh isn’t helpful when you’re trying to get people to hand over cash and not flee in horror. Unless your customers are like that moody bird from Twilight – and no real person is that messed up.