Monthly Archives: March 2013

Mad about birds!

IMG_1383IMG_1712Here are a few of the photos that I’ve taken at the bird reserve (Parco della Piana, Sesto Fiorentino…just outside of Florence) in the past couple of weekends. 

Yesterday we saw our first black-winged stilt couple of the 2013 season, but they slept most of the time (and they slept today, too) because it’s still quite chilly…in other words, too coldIMG_1150IMG_1243IMG_1798IMG_1735IMG_1705
to think of starting a family. Here’s one of them on the right (top)…looking a bit grumpy…just woke up, before coffee, y’know… 😉

We’ve also seen robins, woodpeckers, reed buntings, siskins, chiffchaffs, chaffinches, great tits, plus various duck species and so on…hawks, e.g. Oh, and yesterday we spotted a greenshank, which was nice. 

Oh my, how did it get to be so late???

We went on daylight saving time last night, so I’m a bit discombobulated…

Anyway, enjoy! :)IMG_1366

Alive but without permission…

IMG_1674Many thanks to John for posting a comment on a very funny post that I wrote on June 2, 2007 (= oldie but goodie!). Oh, I have been giggling/laughing out loud for the past ten minutes…These are so incredibly FUNNY. So much so that they are worth re-posting…

Okay, everyone…get ready to laugh…until your tummy hurts…and don’t say I didn’t warn ya! 😉

These, by the way, are REAL patient reports that I took (mostly) from one of my favorite funny books, Richard Lederer’s “Anguished English.” Here goes:

The patient refused an autopsy.

Patient has left white blood cells at another hospital.

She has no rigors or shaking chills, but her husband states she was very hot in bed last night.

Patient has chest pain if she lies on her left side for over a year.

On the second day the knee was better, and on the third day it disappeared.

The patient is tearful and crying constantly. She also appears to be depressed.

When she fainted, her eyes rolled around the room.

The patient has been depressed since she began seeing me in 1993.

Discharge status: Alive but without permission.

Healthy appearing decrepit 69-year old male, mentally alert but forgetful.

Patient had waffles for breakfast and anorexia for lunch.

She is numb from her toes down.

She is quite hard of hearing. In fact, she can’t hear at all in the left eye.

Sinuses run in the family.

He was eating his tray so I didn’t examine him.

He has an allergy to asthma.

The patient is a three-year-old who has been vomiting off and on for twelve years.

He states he hit his head on his forehead.

My personal favourite: the patient was bitten by a bat as he walked down the street on his thumb. :)

“Curcumin for monoclonal gammopathies. What can we hope for, what should we fear.” My comments on the Vermorken study, 2012. Part II.

I thought the business of dividing this post into different “chapters” might end up being confusing. So before I launch into today’s bunch of chapters, I just wanted to point out that I did this in order to make reading them a bit easier on the eyes, that’s all. 

CHAPTER THREE. Now we’ve reached paragraph 2.3, titled “Curcumin does not influence the paraprotein level in all patients.” The authors suggest that curcumin might not act directly on the abnormal plasma cells. It could act indirectly on secondary mechanisms that play an increasingly important role in later stages of MGUS. One of these secondary mechanisms is IL-6, a close friend of myeloma, as we know. 

Another interesting statement: Increased C-reactive protein- (CRP) and erythrocyte sedimentation rate- (ESR) values (indicators of systemic inflammation) that can be increased in myeloma as well as MGUS are independent prognostic factors for survival in myeloma [24,25]. 

Vermorken and his team then suggest that curcumin might be beneficial to MGUS and SMM folks who have increased CRP and/or ESR, adding that long-term use of curcumin reduces CRP.

This suggestion is repeated in the following paragraph (no. 3), by the way: Not all patients with monoclonal gammopathies have increased levels of CRP or ESR but these levels are indicators for prognosis. If indeed like in SLE the activity of the BAFF pathway would be correlated to CRP or ESR [30] in some or all patients with monoclonal gammopathies, curcumin could be helpful and CRP and ESR would be very useful indicators for success of intervention.

I have something to say on this particular issue. I have seen a decrease in both of these markers over the years. My CRP has always been in the normal range, but compared to the pre-curcumin period, it has decreased more than 10% (and, in some tests, even more than that).

The results for my ESR have been even stronger. It used to be in the upper 80s (mm/hour). Yikes. How did my blood even circulate??? It must have looked like sludge, bleahyuuuuckgross. Anyway, in my most recent test results it had gone down to 34 mm/hour, close to the high end of the normal range = 25 mm/hour. That’s more than a 50% decrease…Uhm, did I just hear someone utter the word “significant”? 😉

CHAPTER FOUR. Then we get to this (I highlighted two of the sentences): Since curcumin is helpful in chronic inflammatory states like autoimmune disease [42] the above suggests that curcumin could have a preventive effect on the development of MGUS in chronic inflammatory conditions. However, this is not easy to prove and would need long term monitoring of large groups of patients. Trials about prevention of the emergence of MGUS with curcumin in a context of chronic immune stimulation and low grade inflammation could be useful and should undoubtedly include measuring ESR as well as CRP with high sensitivity. It is important to note that curcumin concentrations in the inflamed target organs are perhaps not of determining importance. Crucial for a favorable outcome is probably the influence of curcumin on circulating immune cells. These could be confronted to higher curcumin concentrations in the gut and migrate to target organs. Relatively low doses of curcumin would therefore probably be effective.

Circulating immune cells, eh? Low doses would probably be effective? Hmmm. Very interesting…

In paragraph no. 4, the authors suggest that patients with high levels of circulating IL-6 would probably benefit (more than others) from curcumin intake. Then they add: We have so far seen that there are reasons for being hopeful about the potential of curcumin to be beneficial for prevention of monoclonal gammopathies in patients with inflammatory conditions. The influence on inflammatory symptoms could form early indicators of success. Yes indeed.  I am hopeful, too!

Immediately afterwards, they add: For high risk MGUS and SMM high doses are needed to provoke an effect on the paraprotein load and this, even more, obliges to anticipate the possibility of side effects. It is therefore mandatory to discuss reasons for potential concern. Ah, I have to comment on that. As you know, I’ve been on a high dose of curcumin for MORE THAN EIGHT YEARS now, and my side effects have been ONLY beneficial. Now, I won’t waste time writing out all the amazing and unexpected benefits I’ve had from curcumin, since I’ve written about many of them ad nauseam. 

However, one side effect that I haven’t mentioned very much is an aesthetic one: my rosacea, which used to be so bad that make-up hardly made a difference, and I just wanted to hide and never go out in public. Yeah, it was that bad. Well, to my amazement, my rosacea (inherited from my Dad, who has it, too) has completely cleared up. I do get the typical rosacea flushing now and again, but (YAY!!!) there are no more bumps, and my skin is soft and looks normal. Lookin’ good! :-)

Well, I haven’t finished with the study, but I think I’ll stop here for today. It’s getting late…So…Ciao for now! :)

“Curcumin for monoclonal gammopathies. What can we hope for, what should we fear.” My comments on the Vermorken study, 2012. Part I.

INTRODUCTION. You may remember my March 28, 30 and April 1 2010 posts about a study by Vermorken et al on the possible dangers of taking curcumin. If you don’t, then please have a look at the three rants…I mean, at the three POSTS, before proceeding any further:

March 28, 2010: http://margaret.healthblogs.org/2010/03/28/a-word-of-caution-against%E2%80%A6another-word-of-caution-part-1/

March 30, 2010: http://margaret.healthblogs.org/2010/03/30/brussels-sprouts-instead-of-broccoli-part-2/

And then, the clincher. April 1, 2010: http://margaret.healthblogs.org/2010/04/01/

Well, here we go again…

About two years after the first study, here is another one, available for free online: http://goo.gl/oqzE9 (click on “PDF” to download the full text). This 2012 study has an ominous question contained in its title: “What can we hope for, what should we fear?” Uhm, what should we “FEAR”???!!! Holy cats! Now I’m scared! 😉

Naaaah, let’s not panic. It’s just one of those eye-catching titles…Let’s see if it really means anything…

This time, even though you can read the full study on your own, I decided to go through it with you almost step by step, only skipping the stuff that I didn’t find as interesting or that we already know (what MGUS is, blablabla) and adding my own comments, right or wrong as they may be. In case it’s not obvious, I’m annoyed…but also as cool and calm as a purring cat (see photo)… 😉 IMG_1645

CHAPTER ONE. I actually agree with a few things these authors write. First and foremost: it’s not a good idea for EVERYONE to take curcumin, the active ingredient of the spice turmeric. For example, I wouldn’t take it if I were trying to get pregnant (either gender)…or if I had gallstones…Or if I had any of the medical conditions listed on my Warnings and Side Effects page… 

And I also agree with them that curcumin probably isn’t going to help all cancer patients. I mean, it’s just like anything else. We’re all different, so it makes total sense that some of us will do well or even really well on curcumin, whereas others won’t.

That said, let’s get down to business.

The first thing we read in the abstract is that curcumin is considered to be safe for healthy people but possibly not for those with MGUS: Curcumin might be helpful for some but certainly not for all patients with monoclonal gammopathies. Intriguing statement. I agree, sort of. As I said earlier, if you have gallstones, e.g., you shouldn’t take it, since curcumin increases bile production (but if you don’t have gallstones, curcumin will prevent their formation…).

Then we get to the study’s “Introduction,” which gives us an idea of what the main argument is going to be: The anti-inflammatory activity of curcumin comes, however, at a price: immunosuppression.

Aaaaaah, immunosuppression. Well, since I’ve discussed my own (lack of!) immunosuppression in a recent post (March 22nd), I won’t use myself as an example here. Just go have a look at that post, if you haven’t read it…

Skip skip skip.

The introduction ends with this statement: Because myeloma is a devastating incurable condition while MGUS and SMM are often asymptomatic, patients with a high-risk MGUS and with SMM are candidates for preventive strategies. It is absolutely essential for a preventive approach that it does not itself increase the risk of progression.

Again, I agree. The problem is that conventional treatments don’t fall into that “won’t increase the risk of progression” category. Conventional treatments are harsh, very harsh, and let’s not forget that the International Myeloma Working Group is NOT in favor of an “early intervention” approach, since there are no benefits. Indeed, there are many potential hazards (loss in quality of life, etc.).

And that’s what my own position is: don’t poke the sleeping dragon (=myeloma). Conventional treatments (in my opinion, and obviously I am referring to MGUS and SMM situations) have a high “poke-the-dragon” risk. Too high…again, in my opinion…

But I do agree with what the authors say about the current impossibility of identifying patients who would benefit from taking curcumin. There haven’t been enough clinical trials, they say. I’d like to add that there will probably NEVER be enough clinical trials, which in most cases are sponsored by the big pharmaceutical companies… Curcumin simply isn’t profitable enough, so it gets essentially ignored by big pharma… And that is why I am extremely thankful for the persistence and dedication of researchers such as Terry Golombick (Australian curcumin-MGUS trial). (FOR THE RECORD: I wrote this post over the weekend, that is, before Dr. Golombick left a comment on my March 22nd post… :) )

CHAPTER TWO. Then we get to this statement: It should be kept in mind that in multiple myeloma, so far, no significant activity of curcumin has been noted in clinical trials in which the validated endpoints used for other myeloma drugs [17] were applied to adjudicate efficacy of therapy.

You know, the more I think about it, the more I believe that this sort of comparison makes no sense whatsoever. How can you possibly compare an incredibly toxic, poisonous substance that kills everything in sight (good and bad cells alike) to a natural, nontoxic extract that inhibits or kills only bad cells but that clearly isn’t as strong or as fast or as effective or as well absorbed?

Just a quick aside: I was actually shocked to read some official recommendations for the handling of chemo drugs. It gave me an idea of how toxic these substances are. Here are a few of the randomly picked websites I looked at: http://goo.gl/fOizv (a guide on how to administer, handle and dispose of chemotherapy) and http://goo.gl/P6qu4 (the story of a healthcare worker exposed to chemotherapy).

Curcumin, on the other hand, has no handling problems. You can rub it all over your body or EAT it. In other words, it won’t harm you in any way, oh, except it might stain your hands a bit (so wash ’em in very warm water after taking your daily dose!). Huge difference, I’d say. 

The problem is that we are impatient. We like and want quick fixes. Conventional drugs, when they work (sometimes they don’t, and that should be noted), have the potential to bring down our paraprotein levels quickly, etc. etc. etc. With curcumin, there are no quick fixes. By the way, before you get your knickers tied in a knot (love that expression!): I’m not implying that anyone should go off chemotherapy and take curcumin instead. That’s not my point, here.

My point is: we just can’t compare honeybees to Godzilla ( = that was the first image that popped into my silly mind…).

The real issue for me is how to increase the strength and efficacy of curcumin without turning it into something toxic (which might risk waking up the dragon!). If that could be achieved, then we could use the above-mentioned endpoints.

As things stand now, though, we just have to be content with the small improvements in our markers or with being stable. Of course, stable is always good!!! :)

I have to get back to work now (an incredibly boring translationzzzzzz), so that’s it for today. But I have written a few more rant-and-rave chapters on this study…soooo, stay tuned!!!

Fighting with a hair dryer…

Oskar is a blind kitty with a good sense of fun. In this video he, er, battles with a…hair dryer: http://goo.gl/J0mUL.

It’s so amazingly cute, isn’t it? My cats do lots of adorable things (which of course I never catch on camera, sigh!), but as soon as they hear the sound of the hair dryer or the vacuum cleaner, they run for their lives…

Have a great weekend! :)

My comments on the long term use of curcumin in two smoldering multiple myeloma patients. Part II.

Phew. Finally. Part II.

Sorry for the delay, but some unpredictable stuff has happened recently. Just to give you ONE example, a few days ago my mother-in-law, who has Alzheimer’s, got lost (long story), and Stefano and I had to leave work immediately to search for her. Luckily, after more than two hours driving all around the neighborhood and checking stores and churches, we found her wandering down a street near her house…relief…boy, what a scare, though…

Okay, now back to the smoldering myeloma case report for a few considerations…

In Table 1, did you notice that the percentage of plasma cells in the bone marrow of both these patients decreased more than 50% over the course of two years? Wow. Now, even though bone marrow biopsies are hardly the most reliable tests around, those numbers seem significant to me, and they (sort of) reflect my own experience with curcumin. In late 2005 I had 50% cancer cells in my bone marrow. But then, in January 2007, after a year on curcumin, that number had gone down to less than 40%. My hematologist considered that a significant decrease. So I guess I do, too. Anyway, that was just one observation based on my own experience.

And now let’s discuss the issue of immunosuppression, which is VITAL to us myeloma folks. Here is what the authors say at the end of the study:

Neither of these patients had any clinical events attributable to immunosuppression (infections, progression to myeloma or development of a second malignancy). Furthermore, neither patient displayed any side-effects from long term, high dose curcumin therapy and neither has developed skeletal events that require bisphosphanate therapy. Our results are encouraging, but the exact role and place of curcumin for patients with monoclonal gammopathies and SMM will need to be determined by large scale, multi-centre studies.

Earlier in the study, they also say “A detailed analysis of immune function in 18 patients who had previously been studied and treated with curcumin for 9 months (see Table 2) did not show significant changes in the number of T-cell (CD3, CD4 and CD8) subsets.”

Again, that mirrors my own experience. Except that, unfortunately, I don’t have measurements for my T-cells, since I am my own, totally unofficial case report… 😉

But I would still like to mention a few specific and positive experiences that I’ve had in all these years on curcumin. Now, I’ve written about (and undoubtedly also repeated!) all this in various place on the blog, so I’d like to apologize for being repetitive, but hey, sometimes it’s necessary and indeed helpful to go over stuff again…

Experience no. 1: throughout 2005 I had chronic and painful yeast infections (which might have begun earlier than that…I forget now and don’t have time to check my medical records…but I’m certain that the symptoms worsened in the course of 2005). I couldn’t get rid of the dastardly things. My gynecologist kept giving me antibiotics, then, when those didn’t work, different, stronger antibiotics, in all shapes and forms. Nothing worked. Nothing. Pain, discomfort, blablabla.

However, shortly after I began taking curcumin, the infections simply vanished. Poof. Gone forever. This has been ONE of the amazingly positive side effects of curcumin…one that changed my life…

Experience no. 2: I stopped having the flu vaccine three years ago, which makes this year, 2013, my THIRD no-vaccine year. The first no-vaccine year, I got the flu (no worse than when I had the vaccine, though)…but, after all, I’d gotten the flu during my vaccine years, too, so that was hardly surprising.

But here’s the thing: since that first no-vaccine year, I haven’t been really sick at all. I didn’t get the flu last year, and so far (knock on wood!) I haven’t had the awful high-fever/vomit flu that has been going around here in Florence. This means that I’ve been just fine, healthy, for about A YEAR AND A HALF, NOW (except for a couple of minor 24-hour viral episodes that I’ve written about here on the blog and that resolved after a lot of sleep, basically)…Yet I used to be THE Queen of Antibiotics. No kidding. I mean, I still have a just-in-case store of antibiotics in my medicine cabinet. But I haven’t taken any in a year and a half. Extraordinary. I can’t believe it, myself.

A quick aside: Stefano, who had never had a flu shot in his life (and had never really been sick), began having it at the same time I did. And he began having terrible cases of the flu. Since he and I stopped having the flu shot, though, he’s been fine. As healthy as a horse, as the saying goes. I’m not saying, of course, that everyone should stop having the flu shot, because I’m not a doctor, blablabla. But it does make one wonder, doesn’t it?

Related note: I don’t live in a bubble, isolated from the entire world. I’ve been exposed over and over again to the flu and all sorts of ailments. My students come to work sick, with fevers and coughs and so on. I also go shopping in crowded supermarkets, get on coughy germy flights, etc. etc. etc. But here I am, with my teeny tiny, almost inexistent immune system…and not even a sniffle. If I didn’t have myeloma cells inside of me, I’d be the purrrrrfect picture of health… 😉

Oh, I almost forgot. And then there’s this: my hematologist is always astonished that I’m so healthy. She maintains that, with such a low immune system, I should be sick all the time and also have chronic infections. Well, I plan to keep astonishing her. 😉

So much for the immunosuppression of curcumin! In my case, the exact opposite is true. So: PHOOEY! 😉

Now that I’ve written so much on the wonders of curcumin, I’m curious to know if any of you would like to share your own personal stories, good or bad. I’d be glad to publish them as part of a post, or you can just write them in a comment form…

Well, this concludes my remarks on the SMM case report. I’m working on a related post…something that really annoyed me…So please stay tuned! 

Pap test result and…and…”better than a condom”??? What next???

First things first. When I got home from work today, I found the letter with my pap test result sitting in our mailbox. Result: normal. No sign of tumor cells or anything else. Peachy!!! :) I was sure it’d be fine, but it’s always good to know for sure…

Now, about that “condom” business (see title above)…I just finished reading an extraordinary article about curcumin, published in Maclean’s, a Canadian weekly news magazine. I mean, in addition to all its other almost unbelievable properties, curcumin is now being tested as a potential contraceptive. No kidding.

I’m stunned, I have to admit, even though I thought nothing about curcumin would be able to stun me, ever again. But this bit of news…wow…Now, if only curcumin could feed my cats and make me a cappuccino first thing in the morning…mmmh, now there’s a thought! 😉

Okay, seriously now. This is an easy, interesting read even if you’re not interested in contraception, as I am definitely not, now that I’m officially a member of the Menopause Club. 😉 Oh, here’s the link to the article: http://goo.gl/k6kHU 

And…that’s it for today. I hope to finish editing a couple of posts in the next few days (between translations and whatnot)…the second part of the SMM case report, for one (!)…But right now I have to go start making dinner.

How time flies, mamma mia

Funny Friday! Dave, take your headphones out!

Long day at work today. Brain is fried. All I have the mental strength to post right now is some fun stuff. Enjoy! :)

Baby sea lions on a surfboard: http://goo.gl/B4UEV

Remember Henri le Chat? Here’s another funny one: http://goo.gl/oauxQ

Soccer cat!!! http://goo.gl/TRdm5

I love the BBC! Funny talking animals: http://goo.gl/PiqDS

And more talking animals: http://goo.gl/PNU5q 

:)

Snow in Florence…

I’ve wanted to see snow in Florence since I got back from the States in late January (I missed most of the snow storms that hit the East Coast of the U.S., including the one that left my parents without power and heat for days…). I know, I know, I know: if I lived in a place that got tons of snow every single winter, I’m sure I’d get tired of it, really tired. But I don’t. I live in a place that rarely gets snow. And so…I LOVE it!!!

Well, right before lunch I, er, got me some snow, so to speak… 😉

What happened: I reached up to put something away in one of the upper kitchen cabinets (ours are high up, above my head, you see, and I’m a rather tall gal), opened it and phwisssshhhhh BOOOOOM! A container of confectioner’s sugar (also called icing sugar or powdered sugar) came shooting out like a cork from a champagne bottle and exploded right over my head and also over the clean cups and plates drying on the counter. And then it hit the floor. SPLATTTTT!!!

Snow. Everywhere. 

I can’t write down the first word that came into my head, but, er, I can tell you that it began with an “F…”!!! But then, immediately afterwards, at the sight of half the kitchen (and me) covered in powdered sugar, I just began laughing. And then, sigh, I cleaned up the mess, which wasn’t as much fun…

Well, I suppose it was one of those “you had to be there” scenarios (= not so funny to you, I mean; and duuuuh I didn’t think of taking a photo at the time…I was in such a hurry to clean up the sugary mess, since I really didn’t want the cats to walk into it and track it all over the house…), but today I have to work like a maniac and have no time for writing or editing any posts, so this quick silly thing is all you’re going to get… :)

And if you didn’t at least smile at the image of Margaret (hmmm, admittedly, you don’t know what I look like, unless you’re a friend of mine on Facebook or in real life! 😉 ) covered with sugar from head to toe, perhaps you will (smile, I mean) when you watch this video, which shows some of the most adorable creatures I’ve seen in a while…mostly, animal babies. [youtuber youtube=’http://www.youtube.com/watch?v=ZxqyPHm4_6g’] (Thanks, Lori!)  Ahhh, very relaxing! :)

For those who would instead prefer to have something of a more serious nature, here’s an interesting report about bitter melon and pancreatic cancer: http://goo.gl/XLDY3

Okay, gotta get back to work. Ciao for now! :)

“Burn the unfavorable data.” An Omniscan story…

A blog reader (thanks!) gave me the link to this not-so-shocking-anymore (!) article about Omniscan, a gadolinium-based contrast agent that often gets injected into the veins of patients undergoing MRIs, including myeloma patients: http://goo.gl/scjaG. (I decided to post the link today because it’s veeeeeeery closely related to the post I published two days ago on “evidence-based medicine.”) 

Do you remember my posts on gadolinium? If not, just click here: http://goo.gl/VeqeB 

In a nutshell, gadolinium is a toxic metal that makes myeloma cells proliferate like crazy. And now it appears that “unfavorable data” regarding Omniscan was supposed to have been burned in 1994 (!). Luckily, it wasn’t, thanks to the researcher who “reached troubling findings”…Don’t miss the part about the 25% of missing gadolinium…eeeek. 

Well, as I mentioned in my previous, related post, in my opinion…

WE NEED TO KNOW ABOUT THIS STUFF. 

(Sheesh…)

UPDATE: thanks to a query by a member of the Italian MGUS support group on Facebook (of which I am co-administrator), I found this abstract, titled “Nephrogenic systemic fibrosis: the first Italian gadolinium-proven case” http://goo.gl/qTwvH Eeeek.