Month: July 2022

The habit of life and a new chemo protocol.

~ Roger JG Albert ~ 3 Comments

July 18th, 2022

So, we went to the Hospital this morning to the nuclear imaging department to get a baseline assessment of how well my heart is pumping blood. That’s in preparation for my initiation into a new chemotherapy regime starting tomorrow since the one I was just on including lenalidomide, dexamethasone, and Daratumumab wasn’t working anymore and it was producing some very interesting symptoms like temporary paralysis or what my GP considered seizures. These ‘seizures’ didn’t last for more than an hour or two, but had lasting effects like extreme fatigue and headaches. I thought I might be having a stroke or something of that nature, but that’s not likely. In any case, my GP ordered a CT scan of my head. It found nothing! ⁉️He also ordered an MRI of my lower back. That will happen at the end of August. That might be revealing. I’ve had issues with my lower back since I was twenty years old.

Also this morning I injected one milligram of vitamin B12 into my left thigh. I do this every Monday because I have an inability to absorb B12 from food. Sometimes I inject it into my right thigh, just for variety. If you’ve never been tested for B12 you might want to consider it if you have a lot of fatigue. That may not be easy if you don’t have a family doctor, but worth it, if for nothing else, to discount it.

Tomorrow afternoon I go back to the Hospital for my first infusion of carfilzomib (trade name is Kyprolis). It has some interesting side effects and reportedly is hard on the cardio-vascular system, but is touted as a solid replacement for Bortezomib (Velcade). It’s relatively new on the market.

All the things I note above are to give me a longer life. That’s the goal. I’m into that, but eventually I’ll have to kick the life habit. We are creatures of habit. (see my note below) Are we ever. And the biggest habit we have is life itself. No wonder we are so reluctant to give it up.

July 19th, 2022

Well, tomorrow is today. Went to the hospital’s Cancer Care Centre for a 1 PM appointment for an infusion of carfilzomib. I got a low dose infusion, forty-four milligrams. I experienced no adverse effects that I noticed. My next infusion, next Tuesday, will be one hundred and fifty-four milligrams. That will be the ongoing dose I get every week for three weeks, then I get a week off before going back for another round of three weeks. So, my life is pretty much tied to the hospital at the moment. I may be able to alter my regimen a bit, but I don’t want to mess with it. I think that consistency is a major part of chemotherapy and I want this protocol to work for me for the foreseeable future. My foreseeable future is shrinking every day. That’s fine. That’s life. It’s interesting as I watch myself go through what little is left of my life, the recognition that my energy levels are dropping fast and that I can’t do things I recently took for granted. I have no regrets. I understand evolution and the need for death. I’ve played my part and will continue to play my part until there is just nothing left of me.

July 20th, 2022

Yesterday was a day filled with anxiety and doubt for me. A new chemo regime is always stressful. Will it work? Will I experience nasty side effects? Is this my last kick at the can? So many questions.

Thankfully, the crew of nurses and support staff at the Cancer Care Centre are amazingly calm and systematic. They patiently answer all of my questions, and this time around I had lots of them.

My infusions of carfilzomib are just a half hour long compared to one and a half hours for Daratumumab in my last protocol. However, for the first three weeks this time around they have me stay for an hour after my infusion for observation. That’s a good move because anything new like this is cause for caution. We were out of there by three thirty. Still, It’s an afternoon a week, and I need to be close to the hospital. No travel abroad, that’s for sure. I’m fine with that. Not much interested in travel right now in any case.

One thing I’ve noticed since I’ve been off of Dara and lenalidomide is that some of the symptoms I’ve been experiencing around my face seem to be attenuating. I can now feel my lips coming back online and my eyes don’t feel as puffy and buggy-outy as they have been for some time now. Maybe, just maybe, I’ll feel a little more ‘normal’ now. I hope this trend continues. The sensation around my eyes is particularly disconcerting. Anything to relieve that is good news. I’m feeling optimistic about carfilzomib but there’s a ways to go yet before we have any sense of whether or not it’s working to keep me alive.

I sleep well these days. That’s great. Of course, dexamethasone will mess with my sleep. I expect that and adjust as needed. It means that I may just read a little longer after I go to bed or wake up later and need to read a bit again before I can get back to sleep. I’m reading Agatha Christie at the moment. She’s such a good writer. There’s lots of murder and mayhem in her books, but some great problem solving too. Poirot and Hastings are principle characters in many of her books. Their interactions create a wonderful backdrop for their crime solving endeavours. Hastings is a great foil for Poirot. He’s not too bright but he is willing, and enthusiastic. The books do a much better job that the television adaptations of Christie’s work in terms of the dynamics of the Poirot/Hastings relationship. Read on. I paid one dollar on Amazon for all of Christie’s work on Kindle. What a deal.

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Just a note to end this post thing:

The fact that we are creatures of habit will be our downfall as a species.* We can’t seem to kick habits we know are bad for us. We know that fossil fuels are in the process of polluting the planet to such a degree that we may very well not be able to reverse the process. The pollution is what is killing us, not the fossil fuels themselves. We keep driving our cars and trucks. That’s a habit hard to kick because we also have a habit of spending money, and we have to get that somehow. Working for others (employment) seems to be the main way we do that, but contract work is also quite common. Employment is a relatively recent way of organizing labour. I wonder how much longer it will last. What I can guarantee you is that it will go the way of the dodo bird just as everything else does.

One huge issue we face is the generational lag that dominates our lives. We tend to think that we can live the way our parents and grandparents lived. We buy big fishing boats and huge RVs to wander around the oceans and roads like the 20th Century had never passed. We all want to live in detached single family houses (around here at least). Well, our parents did it, why can’t we? Maybe it’s because fish are disappearing at an alarming rate and gas is so expensive and polluting. But we’ll carry on because that’s what we know. We do feel anxious about it. That anxiety sometimes gets squished out of our minds in strange ways such as in ‘freedom’ convoys and ridiculous conspiracy theories. Oh well, steady as she goes. We all get to the wall sooner or later.

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*All animals are essentially creatures of habit. We all develop habits of life, some learned, and some tropismatic. We cling to them as long as we can. So it goes. It works as much for bees, chickens, and elephants as much as it does for humans.

Evolutionary Theory vs. Structural-Functionalism.

~ Roger JG Albert ~ 4 Comments

[Don’t be too put off by the title of this post. It looks highfalutin. It may be, but the text isn’t.]

It’s a truism to say that our lives are finite and that we go through stages of development and change. But, it seems, sometimes we need to be reminded of obvious but possibly unwelcome realities. I’m sure we all understand that we follow a path of change starting at birth and ending at death. In between we move from infancy to childhood, to adolescence, to adulthood, and then to old age. Of course, not all of us get to go through every stage. For some of us, the stages get cut off and we die young or accidentally. We may contract a disease at any age that proves fatal. Governments document all of these things with vital statistics and publish all kinds of data on birth rates, types of mortality, morbidity*, et cetera. British Columbia offers a lot of this information online. Statistics Canada also gets into the act and publishes a lot of health related statistics. It’s not an exaggeration to note that we are obsessed with our health and wellness. How much of the internet is dedicated to health related websites? The woo flows freely and the sales of every magic potion, miracle diet, and supplement imaginable are on offer. And there is overwhelming evidence that at every turn we find ways to deny death. As I’ve often noted, one of Ernest Becker’s most salient observations is that the twin pillars of evil in our world are death and disease.

Our entire medical system is set up to discover and ‘fix’ any human organism that doesn’t conform to what we consider normal for any stage of development. It is often unsuccessful in that endeavour, but it doesn’t like to discuss its failures.

Pathology as I use it here describes a condition of abnormality (non-normality), a structural and functional situation wherein things have gone wrong in an organism. The underlying assumption of pathology is that organisms all have a normal condition, and if things cease to work as they are supposed to according to medical science, then they are considered pathological, or at least the cause of their malfunction is searched out and an attempt is made to restore the organism to normality. Medicine, and in fact, our whole culture, decided a long time ago what normal humans should look like and how they should behave. Yes, we all live and die, but pathology isn’t really interested in those realities. A pathological perspective is only interested in bringing a diseased organism back to normality.

Science and medicine have analyzed and dissected the human body in great detail especially over the past five hundred years. Leonardo da Vinci, born in 1452 was adept at dissection, and he led the way for countless others who carried on the tradition. Later, biologists analyzed the human body from many perspectives, broadly using anatomy and physiology as major categories, but focusing on systems (cardio-vascular, endocrine, etc.), organs, cells, and their functioning. I’m no biologist so I won’t pretend to understand the intricacies of the investigation of human biological life. However, it’s clear that our organs (heart, liver, kidneys, et cetera) are of great interest to medicine, particularly if and when they cease to function the way they are supposed to.

As a quick aside, a major sociological school used (and still uses) what Emile Durkheim calls the organismic analogy. He suggests that society is much like the human body. He argues in his dissertation Rules of Sociological Method that there is no organic equivalence between human organs and social systems, but broadly, they share the same epistemological underpinnings. Human organs work in concert for the good and survival of the whole. That’s easy enough to understand. He then argues that human social systems, politics, family, economy, education, et cetera, must work in concert for the good of the whole society. Social pathology occurs when any one or other of the social systems that make up society fail to fulfill their function. The result is that the whole society is ‘sick’ or malfunctions. The problem with this perspective is that it’s not especially easy to find ‘a society’. From my point of view, societies are not be confused with countries or nation-states. They are not necessarily equivalent.

It’s easier to identify an individual human being than a society, or so it seems, until we ask the question: Is an individual human being a stand-alone organism? My answer is no. I could not and would not exist without air, food, water, et cetera. These elements are not necessarily a part of me, but they are essential for my life so excluding them from an analysis of what I am as a human is highly misleading. It suggests that we are somehow separate from the world that surrounds and sustains us. This is a foundational part of the individualism that characterizes our capitalistic world and it’s wrong.

So, broadly, we are captured by a world view that focusses on the structure and function of our organs in a biological sense and our social structures in a societal sense. This is why people often argue that what’s ‘wrong’ with our society is that the family isn’t doing its job, the economy is failing us, education is behind the times, and other simplistic criticisms. Figuring out how to fix it is another thing entirely.

In terms of the human body, if medicine finds that the heart is weak or not working properly, it tries to ‘fix’ it, that is to restore it to its presumed former state. It may conclude that a weak heart will have deleterious effects on the kidneys, and it may even find that a weak heart will threaten the organism as a whole. In contrast, an evolutionary perspective expects the heart to weaken as it ages. It expects that lungs will lose their ability to process oxygen. It expects that over time, muscles weaken, no matter what you do to counteract it. It expects death because death is built right into the model, unlike functionalism whereby death is left unconsidered or considered a clinical failure.

It’s true that an evolutionary perspective has made substantial inroads in science and even in medicine. It hasn’t in sociology, although it’s coming along**.

An evolutionary perspective follows the logic I present in my recent post: LIFE vs My Little Life. From this perspective, birth and death are normal human events. Death, especially, is not considered a defeat, it being an essential part of life. No death, no life. It’s as simple as that. That doesn’t mean we have to be happy about it. Just the amount of effort the human species has spent on denying death, on convincing itself that death is not the end of life, is testament to how unhappy we are with death and dying.

I don’t want to die, but I don’t have a say in the matter either.

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*morbidity refers to the incidence of ill-health in a population.

**see my (slightly outdated) dissertation on the topic published on this blog.

Freedom: Just Another Word for Nothing Left to Lose?

~ Roger JG Albert ~ 2 Comments

I’ve been relatively quiet about the ‘freedom’ movement in Canada. The ‘freedom’ convoy in Ottawa earlier this year set off a fairly entrenched opposition to vaccine mandates and other freedoms purportedly lost according to the leaders of this movement, at least one of which is still in jail for an inability to respect bail conditions. It’s impossible to know how many adherents the ‘movement’ has, but it is definitely a small minority of Canadians at this time. Who knows, however, what the future holds. 

Hyperbole is rampant in recent pronouncements from the leaders of this movement, one even suggesting, according to an article by Sarah Richie in The Canadian Press, reporting on statements by a ‘leader’ of the movement, Canada is facing a civil war. If it were true that Canada is facing a civil war, I’m not sure what the fighting sides would look like. Maybe anti-vaccine types on one side and everybody else on the other? I don’t know. I can’t seem to wrap my head around the notion of a civil war over vaccine mandates. 

Now, if the ‘freedom convoy inspired protestors’ represented a real political movement that, for instance, rejected the overriding influence of public corporations (global ones, primarily) in politics, I might sit up and take notice. However, I don’t see anywhere in the press or on alt-right websites that anything like a coherent platform for revolution or civil war is extant. Right now, it just seems that the only policy they have is flailing arms, shouts of ‘freedom’, flag waving, and rank ignorance of history, politics, and common sense. 

The whole notion of freedom and the purported loss of such is singularly misguided. Where does the idea of freedom originate? The idea of personal liberty and ‘freedom’ (although I hesitate to even use the term) can be traced back to the beginnings of a capitalist mode of production in Europe as far back as the thirteenth century, but really taking off in the sixteenth century. By the nineteenth century, the transformation of the peasant class into the urbanized working class was solidified. Along with the real transformation of people’s lives from rural to urban came the idea that people were now free to move around, change employers if they so desired, giving the impression that individuals were now in charge of their destiny. Veblen’s book The Instinct of Workmanship (1918), although makes for ponderous readings to some extent, is probably the best analysis of the creation of the urbanized working class that I have read. It’s not possible to summarize Veblen’s argument here. It’s a complex analysis of the rise of the business class and the idea that although we, as humans, long to do things, to work, we are not particularly suited to employment. The distinction between work and employment is basic to his argument. 

It’s always been true that individual human beings have agency. We are not like billiard balls subject to movement only at the invitation of the cue, although strangely there is some truth to this view. In fact, as Thorstein Veblen points out in the early twentieth century, that idea is the foundation of modern classical economics.

At this point I invite you to read a blog post I wrote in early 2019. It’s about the hedonistic calculus and what Veblen does with it in his dissection of neoclassical economic theory. It’s not a post wherein I write about my experience with myeloma because I hadn’t been diagnosed yet. I would also invite you to read my blog page on critical thinking which is based on an earlier article I wrote for teachers. It addresses the fact that we generally lack awareness of our place in the world because the school system systematically, via its prescribed curriculum and in spite of the efforts of individual teachers, fails to systematically address our social responsibilities. 

This brings me back to our ‘convoy’ protestors. The ignorance expressed by the ‘leaders’ of this ‘movement is astounding. They insist that they want freedom without ever telling us what they mean by that except to suggest that they don’t want vaccine mandates. They feel that vaccine mandates infringe on their ‘rights’. They should consider that they live in societies that require some individual compromise to ensure the safety and security of its citizens. 

Don’t get me wrong. I have no love for the Federal government’s unfailing support of often dangerous and completely self-interested business corporations, sometimes not even Canadian ones. But, like I said before, if the convoy goofies had an even basic understanding of Canadian political economy I might be inclined to hear their arguments. But they have no analysis, just empty opposition to perceived grievances. 

Their anti-mandate grievance and calls for ‘freedom’ have no place in a social world. We drive cars, but we need licences to do so. We can’t simply get out on the road  without a licence or insurance and expect to be left alone to do that. A world without rules and regulations would be an impossible world. There are countries where ‘rules of the road’ are mostly non-existent, but there are unstated agreements among motorists and others sharing the road as to how to conduct themselves on the road. Those unstated agreements are social contracts nonetheless. We rely on social contracts every day of our lives and in everything that we do. We depend on other people always to provide us with services for our comfort and security. Yes, we are individuals, but we always act socially and, in fact, we couldn’t exist as individuals. 

To think about how dependent we are on others, just think about how often you interact with others every time you buy groceries or fill your car with gas. What of the roads we drive on? We don’t build those as individuals. We build them collectively through our taxes (although not always without complaining about it). We, most of us, have water piped to our homes, electricity to power our heating systems, to refrigerate our food, and sewage lines to take away our effluent. Without millions of people all over the world ensuring that we have what we need to live comfortable lives, we would be living cold, brutish lives in caves. Imagine if you were only allowed to wear clothes you made yourself from material you yourself gathered. That’s not possible in this day and age. 

There are people who want to live off the grid. That’s fine, but even that means buying arrays of solar panels, having vehicles to transport goods, seeds, livestock, and the means to access health services if necessary. We may try to live as socially distanced as possible but we still need to acknowledge how dependent we are on others and why we should have some consideration for their health and security because in the end our health and security depends on theirs. 

It seems to me that the ‘freedom convoy’ folks don’t have a coherent platform, nor do they have even a basic plan. What they seem to have is a diffuse and incoherent opposition, maybe a sense that their lives are meaningless, but that they would be filled with meaning if only the government would be removed or there were fewer rules and regulations. The fact is that rules and regulations arise often out of a need to live in society with others and to resolve conflicts between them. To be moderately safe we all need to drive on the right side of the road. If even a small minority of people refused to accept this rule and started driving wherever they wanted to we would all be in serious trouble. If someone does drive on the left in Canada, and insisting they have a right to do that, they could have their license revoked, just as anti-vaxxers can lose their jobs if they refuse to be vaccinated. Nobody says you must be vaccinated unless there is, like in the military or in health care, a need for absolute safety (or as close as we can get to it). So, get over it. Play by the rules or play another game somewhere else.