Wednesday, March 28, 2007

weighing down the system


mood: whatever.
state i'm in: trashed room.
tune: jamie cullum "mind trick (johnny douglas remix).


this week's case concerns a fictitious man with a BMI of over 40, that is, he is morbidly obese, who suffers a DVT which embolises to his lungs causing further problems there. obesity is one of the major causes of morbidity and mortality in this country, and is associated with nearly everything that causes more. obesity and overweight cost australia somewhere in the vicinity of $11 billion annually.

it got me thinking...


your at a dinner party. food's great, pretty rich but that's ok, cos you've been exercising all week. there's plenty of moet flowing freely, and everyone is having a great laugh.

the main course is cleared from the table.

the tobacco-stinking guest to your left says: "ok, while i've got a minute i might just duck out to the balcony for a cigarette." if you're a bit of an arsehole like me you might have a somewhat sarcastic dig at him, although with a serious undertone, something along the lines of "you're killing yourself with those cancer sticks, and costing the health system a fortune". i normally than follow melodramatically with the line "have you ever head the lungs of a smoker in your hand, filthy and black..?" (after a bit of scorn, this is one of my favourite things to say to people when they ask me if i have a cigarette.)

a minute later, dessert arrives, something involving layers of chocolate, a healthy dose of cream, and perhaps some sort of berry and sugar based thing stuck on top.

the obese guest to your right says: "alright, this is my favourite part, i've been waiting for this" and reaches out to grab the bowl of calories from the host with a gleeful eye, licking her lips. what would the table's response be if i said to her, "i can't believe you, you're killing yourself, and costing the health system a fortune". i might continue: "have you ever held an obese persons heart in your hands, oversized and covered in a layer of yellowish slimy fat..?"


food for thought.

Sunday, March 25, 2007

a good nights sleep

mood: flattening out.
state i'm in: real tired now.
tune: eric benet "love don't love me".


and now for why mainsteam media has pissed me off over the last week.

i watched a story on the adverse effect profile of the drug zolpidem on 'a current affair' the other night. it was a particularly pathetic story, even for them. rather than write another post, i will simply post part of the email i sent to 'a current affair', cc 'mediawatch'. i should mention that this is the first time i have emailed a tv program in complaint, i am not some boring sod who lives to whinge. normally i just get all riled up, swear a bit, and allow someone nearby to bear the burden of my bellyache.

unfortunately, the complaints feedback page of the website of PBL (publishing and broadcasting limited), owner of channel nine, has been down since i tried making a complaint to them. rather convenient, that one of the largest companies, and the largest media conglomerate, in australia, should have their complaints page unavailable.

my email follows:



"...

This brings me to my major point, concerning your presentation of the facts surrounding the medication. Neither of the two major patient recommendations were alluded to in your story. I present them below, in case your reporters were so inept to have not even unearthed what these are:

1. To be used on as required basis (i.e. not every night), and for a period not exceeding 2-4 weeks.
2. No to be used, under any circumstances, while consuming alcohol, in any quantity.

I am aware of the case of first patient presented in your story, and I am also aware of the fact that the woman was under the influence of alcohol at the time that the events mentioned in your story are alleged to have occurred. I don't recall this being mentioned, and if it was reported, it was certainly not emphasised. This I find irresponsible.

Yes, the adverse effects and potential drug interactions of zolpidem are potentially serious, and need to be thoroughly communicated to the patient. In particular, a patient needs to be made acutely aware of the need to avoid the consumption of any alcohol whilst taking zolpidem.

However, presuming you are making attempts to be acting in the public interest rather than just in the competition for ratings, it would be wise if ACA made mention of important facts, the likes of which would be genuinely in the public interest. Many people rely on zolpidem, indeed many people rely on many different medications, and it would be a shame if people's lives would be put at risk by them unduly going off their medication at the advice not of a health professional, but an appallingly constructed and sensationalised story from a pack of half-witted fools masquerading as a current affairs program. Importantly, and something you should have made explicit, the prescription guidelines for zolpidem, like any medication, need to be strictly adhered to.

If, in the future, ACA would like to make announcements to the general public concerning medications, perhaps having a physician outline the guidelines for safe and efficacious use of the medication, and appropriate action to take in the event of adverse effects, as your featured physician so poorly did, might be far more productive. This would be far more beneficial than merely pointing the finger mockingly at something that, in spite of apparent misgivings, the likes of which ought to be (and, in fact, will be) investigated thoroughly by the TGA, gives benefit to many others. Your style of reporting does not give me the impression that ACA holds any interest in the welfare of my society. In fact, quite the opposite, it appears to me that your program and network hold the public interest in contempt, and hence i hold you in contempt.

..."

beyond your front door

mood: now a little peeved.
state i'm in: ok, eyelids getting heavy.
tune: diana ross "upside down".



and now for why the government has pissed me off over the last week.

so many people take the attitude 'me and my kids will be ok' when having to deal with the thought of voting back into power the current government. that is a slack and arrogant attitude and pisses me off. why? because re-election of the current government will really affect some people, and it may effect these people in a quite harmful way. it may not be 'you and your kids', but i'm sure you would appreciate it if others stuck up for your interests and not just turned a blind eye.


here's some of the 'at risk' groups that need help:


1. it's rabbit season! having been almost wiped out of pastoral regions of southern and central australia, the pesky feral rabbit is making a resurgence. myxoma virus was introduced in the 1950s in an effort to control rabbit numbers with great success. following the development of resistance of the rabbits to the virus, calicivirus was introduced in the 1990s, funded publicly (under the previous government via the CSIRO) and by NGOs. once again, the effect was devastating, and rabbits became a rare site on farms and bushland in the southern and central inland parts of the continent in the late 1990s.

however, and in spite of great success, funding was cut and the program monitoring the results of the biological control of rabbits was axed, well before was deemed appropriate timing by those involved. less than 10 years later, resistance is emerging to calicivirus, and rabbit numbers are beginning to rise.

now pastoralists, with the assistance of scientists, lobbyists, and unionists, are having to return to the battelfield, funded only by their own organisations, to try and rectify the problem once again, a problem that could have been managed quite successfully had appropriate funding been forthcoming.

the environmental stakes are high, and the livelihoods of many pastoralists are at risk, as the rabbits recommence destroying the land with warrens, and the vegetation on it. unfortunately, they're on their own this time.


2. in 2003, the house of representatives standing committee on family and community affairs inquired into drug abuse and produced a report that was in keeping with the history of drug policy of the federal liberal party. it called for the abandonment of harm-reduction as the principal objective of the national drug strategy. the committee wanted prevention and abstinence-based treatment to be the focus of government policy.

subsequently, penalties have been increased for drug offences, funding has been increased for drug law enforcement, the federal government has run prevention campaigns based on dramatised scenes of the dangers associated with drug use, and money has been directed to abstinence-based treatment services. programs aimed at harm-reduction have remained critically underfunded.

a recent report by the committee has declared "prohibition, while theoretically a logical and properly intentioned strategy, is not effective". it goes on to add "the current national approach to illicit drugs - supply reduction, demand reduction and harm reduction - will achieve greater outcomes if a better balance between these approaches can be reached". it recommends restoring funding to harm-reduction programs

basically, it supports a firm belief of mine, that drugs are a health problem first, and a legal problem second.

once the centrepiece of drug control strategies in this country, harm-reduction programs, such as needle exchanges, the addition of thiamine to bread in order to counter the neurologic effects of excessive alcohol, and methadone clinics, have proven remarkably effective, especially in western europe where they have been embraced wholeheartedly. one might also bear to mind the pivotal role harm-reduction played in the mid-1980s in stimmying the spread of HIV in the community, most notably through work with intravenous drug users.

so far the federal government, most vocally bronwyn bishop and john howard, have rejected the advice of the new report, and declared that they 'do not believe in harm-reduction' and that current policy will stay. in my opinion, a very short-sighted approach, and obviously pandering to the easy-to-muster fears of the electorate of drug pushers and users. this is socially irresponsible. shame on the government, once again turning a blind eye to parts of the community that need assistance, but do not register on the radar of the mainstream community.


fingers crossed the voting public will turn a blind eye on how-to-vote cards tinted liberal blue, not on those in need, at the next election.

A4 chicken

mood: was happy, now sobred.
state i'm in: in remission from CV studies.
tune: brand new heavies "let's do it again".


cage hens in australia have something to look forward to beginning next year. 10 square centimetres more space within which to crap and lay. the new standards will give each bird 550 square centimetres - better than the previous minimum standard of 450 square centimetres. nevertheless, this means that the chicken has space amounting to less than a piece of A4 paper, for its entire adult life, approximately 70 weeks.

whilst people are buying fewer cage eggs than ever, almost three quarters of the eggs commercially farmed still come from battery hens.

unfortunately not all chickens will be alive to enjoy these new luxuries. here's one...



a hen found long dead in a battery farm. her claws had grown around
the wire and immobilised her. she starved to death
because she could not reach the food.




the other hen in the cage used the rotting body as a nest to lay her egg.
many eggs are seen on dead bodies. these can roll free
and end up in our supermarkets. tasty.


moral of the story? don't buy cage eggs!

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images: http://www.animal-lib.org.au

...of late

mood: really happy.
state i'm in: done with study!
tune: beats international "dub be good to me".


i rise out of the depths of a clinical medicine textbook to take a few much needed breaths, at the end of a long day of study, and i'm astonished to find that there is a world still living and breathing, just as i left it; and just as i've forgotten it. my towels swaying on the clothesline, dry for a couple of days, the tub for recyclables overflowing...

it's so easy to get lost for a week or two in study and only spend a few highly calculated moments doing anything but. life loses almost all spontaneity.

had a discussion with sandra the other day about how little chance we get to get to enjoy anything resembling a normal life. she only reads non-textbooks on holidays; her boyfriend, a surgical intern, has not picked up his saxophone in living memory; and i had to skip class to grab a coffee and read some nietzsche. oh, how i love med, but fuck she drives me insane sometimes, the demanding bitch she is.

ok, nuff whingeing.. for now.


--------------------


i shaved david's head last week for 'world's greatest shave for a cure'. here's some pics:


the before shot - giving him a geeky part for the photo-shoot


off it comes...


dubious shot


nearly there...


and done! it's supposed to be some wedges radiating out like a turbine.
c'mon, just squint and you'll see it


i think i'll be going over it tomorrow and removing the pattern. not sure if all the hospital folk are that impressed with it.


--------------------


otherwise, not much to speak of late on the personal front. just studying, the odd shindig, and some downtime with suff.

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images: mine

Tuesday, March 13, 2007

walk faster johnny...

mood: even more content.
state i'm in: ok, should be getting to bed.
tune: beatles 'hide your love away'.


ok, something to talk about.

as the liberal party slumps further in the polls, prime minister john howard still doesn't seem to get it; or if he does, he certainly won't admit it. in response to the latest poll, mr howards reply goes:

"i think one of the reasons is that the labor party has successfully created the impression that the economy runs on autopilot and it's got nothing to do with good governance. that, of course, could not be further from the truth."

i think that the impression that the people have, an impression essentially free from any influence by the labor party, is that the behaviour of interest rates seems to be on autopilot, very little to do with good governance, and even less to do with the empty promise of 'keeping interest rates low', made at the last election, heavily upon the back of which the liberal party returned to power. as the part of the economy that the average aussie-next-door pays closest attention to, with their highest-ever levels of consumer debt, this is a concern that does not bode well.

i really doubt that further nonsensical rhetoric such as this, much less mud-slinging, will garner mr howard and his government a great deal of support.

mr howard goes on to say that "i will certainly be focusing very heavily on the risk that labor represents to the australian economy, particularly in the area of workplace relations".

correct me if i am wrong (as an individual fired under the new legislation, less than three weeks after its introduction last year, i may be a little biased), but there is a large upswelling of contempt for mr howard's handywork in the area of industrial relations.

let's have a look at some other rather interesting points concerning the state of the australian economy, and some other influencing factors:



  • record highest levels of foreign debt (both public and private)
  • a balance of payments crisis - more than 5 years without a surplus - and this is in the middle of the largest minerals and resources boom in human history
  • record lowest levels of R & D investment
  • desperate skills shortages
  • record highest levels of under-employment
  • record highest levels of education costs
  • declining levels of quality of primary and secondary education in OECD comparisons
  • record highest levels of consumer debt
  • record highest levels of depression/suicide
  • highest interest rates in the western world
  • record highest REAL interest rates
  • very low level of home affordability
  • a decade of wasted opportunities to rectify environmental wrongs
  • fighting a very expensive war declared on false grounds
  • declining levels of 'trustworthiness' in international business polls, post-AWB kickbacks

looks like an economy on autopilot to me.

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image: public

Monday, March 12, 2007

i'm free!!!

mood: content.
state i'm in: sticky from this shitty weather.
tune: brand new heavies "forever" (soulpower remix).

the creative juices just haven't been flowing of late. several times i have gone to lay down a blog entry, and not gotten far - nothing worth prattling on about really.


school is going ok. it's a mixed bag this year. some weeks and days i have really enjoyed, others have been like nails down a chalkboard - hard to bear. had a life support skills session today, and when we were jumping up on the bed to compress some silicon man, and zap the said man with a defibrillator, i could get the slightest feeling of what it might be like in A&E - i think the others got the same feeling. there's a longing for some real medicine. we see it once weekly on the wards, and all the concepts we spend years grappling with just become clear all at once. then once a few thousand layers of geriatric complications and concomitants are factored in, the whole scenario becomes muddled and all the more exciting.

gonna buy a new textbook tomorrow, which is exciting. it's real fat!


i think the most exciting social events of late have just been the odd quiet time in or out with suffien, or my folks. really enjoyable, and simpler times than a dirty great big party. although, with keg #2 on friday night, that will all change. to be honest, i think i really need it, a good dose of fatty liver disease.


been trawling though my south east asia guide book a bit too. the part of my mind stuck in the future is on a plane to BKK. been checking out some hiking shoes for the jungles, and suff has been looking at some packs. still a long way off, but it's something really wonderful to look forward to, should it eventuate.


and life in the larger world has also been pretty boring. the USA spoke over a table to syria and iran last week, which was noteworthy, but it's unlikely anything positive will come out of this anytime soon (although it desperately needs to). australia really ought to be encouraging this, rather than waving a gun around in the distant background.

politics in australia has been boring too. just rubbish and more rubbish in the last two weeks. both parties released education policies, but these were unable to be seen under all the mud being slung in the direction of the opposition leader, who is now under fire for comments made regarding memories of events from when he was 11 years old. the public's ever-growing fondness for the opposition and/or disdain for the government appears unperturbed by these attacks however. i am pleased to see that, in the words of political editor michael brissenden, "the mud ain't sticking to the Rudd".


slightly off topic, i was rather saddened to hear that veteran of the small screen and stage, john inman, passed away from hepatitis A last week. despite the fact that, as a gay man, i scantly resemble mr inman one ounce in mannerisms, i can say that he still managed to make an enormous impression on me as a kid. in "are you being served?" he was so fucking funny, time and time again, and was one of a few figures in mainstream popular culture during my childhood that showed that a gay person could be a positive and extremely likeable character in a given situation. thank goodness for re-runs!

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image: public

Monday, March 05, 2007

fatty boom-sticks!

mood: a little deflated.
state i'm in: a healthy diet from now on... right after this passionfruit tart.
une: boogaloo "you've gotta have freedom".


well it's autumn (although you wouldn't think so). so that means checking out your winter clothes to see what looks good and still holds up from last year.

reluctantly, i tried on all my jeans tonight and well, my waist confirmed what the scales and some friends and relatives have been telling me for some weeks now. i've packed on a few little kilos. a lack of solid exercise has reduced muscle mass a bit too. given that muscle weighs more than fat, a little extra weight actually correlates to a big bit of fat. this means i have pretty much gained a size.

on a positive note, some of my jean that were hanging off me last year now fit pretty well again. but the ones i bought in december are a little tight.

maybe i can maintain this size, but just get rid of the fat. back to the pool every day or two, might start jogging too, and better keep the diet on the healthy side *points finger at suffien's cream of mushroom soup, buttered scallops, and toblerone cheesecake*.










can i get my leptin now, please.

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image: public