Sliding down the slope

 Am I sliding down the slopes?

As slippery slopes

Life would grind to an end

Sarcasm fully intended

Fragile and vulnerable

With intents and purposes indomitable.

My life is a mixture of dark humor and melancholy

Bright life is lively, sweet, and jolly 

But mine is a gloomy, vile plot exactly the opposite of jolly

The great fall was my birthday 

Not filling mind

With fire to be kindled

Shenanigans of a holiday

To add some fun

Tromp and run 

With my  hurrying feet

Breathless fell on my feet

Carte Blanche brain with swimming tumors

I was swept off my feet a freak

For her glory and dazzle

Here I explain

Mum frequently pulled up to my feet during the interminable pain 

But I hit an iron table and a terracotta figurine fell on my brain and knee surgery site 

A warrior is born to battle and fight

Right knee swelled 

Thou knowest all my heart an' mind, Thou knowest, Lord, I fell.

Hurting toes 

Black and blue right big toe

Hurting elbow

Mo  is slow

My sprint was life going too slow

Engulfed in pain limping had

A hot water bath mum stood as I bathed in bleb of shampoo

There was a second severe fall too

On new year's eve I fell

But this I know full well

Gave a horrible dying yell

Mum came to rescue

She's clever and sensitive I tell you

Again hit the knee but the forehead 

As she from behind my arms and neck held.

The path to peace is vast and wide

  Reflecting the grand design

  The warrior is the throne of the divine and always serves a greater purpose

World is a circus

Marks out a warrior that knowledge - 

Courage and will power are not the same

The world is not for hara kiri

Let's be cheery

Desire distribute love

Don't mourn out the window to the stars high above,

Headaches of NET MET

 

Hope is something really tough and tireless 

You have to give up. 

It's an addiction to break.

Even when I feel like hell, as pain wells up

Painkillers are no  use, what diff'rence would it make?

The problem is, in Hell there's no hope

All my life I had to grope

Now it feels like sliding down the slope

Now in darkness I am not fit to cope

What do you think I am?

Somebody who doesn't give a damn

A warrior not a lamb

 In a thousand words.... 

I don't have a clue, 

Mum and me trudged through

Nothing rings true

But I'll start by abandoning hope. 

Please help me Satan. 

Spare me from your evil plan.

That'll make me so happy. 

Help me give up my addiction to hope. 

Thank you

Fevered I feel like crying

Crying and sighing is not an option

Although it's a concoction

Getting nauseous

Experiencing severe , splitting headaches

Seeing the terrifying

As life continues to unfold 

as interesting, exciting place.

,

I need PRRT full dose

 

Neuroendocrine neoplasms are tumors that arise from diffuse neuroendocrine system cells. They are most commonly found in the gastrointestinal tract, pancreas and lungs. Neuroendocrine neoplasms are fairly rare diseases, but their incidence and prevalence have increased substantially in recent decades. The majority of neuroendocrine tumors overexpress somatostatin receptors (SSTRs), which are targeted for imaging and treatment.

Somatostatin receptor (SSTR) alogues, which are used for imaging of neuroendocrine tumors (NETs), can also be used for therapy by replacing the imaging isotope with a therapeutic isotope. This general field is referred to as peptide receptor radionuclide therapy (PRRT). PRRT is not specific to NETs, but NET therapy is currently the most advanced and only U.S. Food and Drug Administration (FDA)-approved example of it. Furthermore, this combination of imaging and therapeutic isotopes with the same target is a good example of theranostics, which is a portmanteau word consisting of “therapy” and“diagnostics.” The term “theranostics” is fairly new, but the best example of it is one of the oldest isotopes, essentially originating 

the field of nuclear medicine, 131, which is used for simultaneous imaging and therapy.

Development of Peptide Receptor Radionuclide Therapy

NETs are well known for being heterogeneous. They can arise from a variety of different organs; can be benign or malignant; are well, moderately, or poorly differentiated, as in grade; have variable metastatic potential; and are either functional or nonfunctional (i.e., produce hormones and symptoms or do not) . Symptoms can markedly reduce quality of life and are an important consideration for therapy. NETs have a low incidence but a high prevalence given the lower mortality associated with these tumors.

One commonality among NETs is expression of the G protein–coupled SSTRs,of which there are five subtypes in humans. The human somatostatin molecule, composed of 14 amino acids, is a hormone used by neuroendocrine cells for neurotransmission and cell proliferation. An abbreviated version of the human somatostatin molecule, 

composed of eight amino acids, is octreotide (Sandostatin, Novartis). Octreotide was FDA-approved in 1988 for symptom control in patients with functional NETs (package 

insert, Novartis). However, it is also known to have antiproliferative effects and is practically used in that way for patients with lowor intermediate-grade metastatic inoperable NETs.

"Over the past two decades, SSTR-targeted imaging using radiolabeled somatostatin agonists followed by PRRT has been remarkably successful in managing neuroendocrine tumors," said Jingjing Zhang, MD, Ph.D., assistant professor in the Department of Diagnostic Radiology at the Yong Loo Lin School of Medicine at the National University of Singapore in Singapore. "However, potent SSTR antagonists—which only poorly internalize into tumor cells if at all—have surprisingly been shown to be even superior to agonists for such purposes."

To further investigate the role antagonists can play in treating neuroendocrine tumours researchers developed a study to determine the safety, biodistribution and efficiency of a new type of SSTR antagonist, 177Lu-DOTA-LM3. Fifty-one patients with progressive, heavily pretreated neuroendocrine neoplasms underwent PRRT with 177Lu-DOTA-LM3. Treatment-related adverse events were graded for all participants, and dosimetry was performed for 11 patients.

177Lu-DOTA-LM3 was administered without severe adverse effects and was well tolerated by most patients. Disease control was reached in 40 out of 47 patients (85 percent) who were monitored after 177Lu-DOTA-LM3 therapy. Two patients achieved complete remission by the European Organization for Research and Treatment of Cancer criteria.

Of note, the uptake and dosimetry of the antagonist 177Lu-DOTA-LM3 were compared with those of the commonly used SSTR agonist 177Lu-DOTATOC in patients undergoing treatment on the same dosimetry protocol. 177Lu-DOTA-LM3 demonstrated higher uptake and a longer effective half-life in tumor lesions, resulting in higher tumor radiation doses than for agonist 177Lu-DOTATOC.

"These encouraging findings demonstrate the feasibility and superiority of SSTR antagonist 177Lu-DOTA-LM3 as compared to SSTR agonists. Furthermore, antagonist PRRT can be performed under concurrent treatment with somatostatin analogs without the need for interrupting these medications. This is especially important for patients suffering from carcinoid syndrome or even carcinoid crisis,". "The results are very encouraging for theranostic applications of SSTR antagonists to further improve outcomes in patients with neuroendocrine neoplasms in the future."

Mutation is the engine of evolution. Phenomenon of mutation in an oncogene exploits evolution, Darwinism there's treatment for longevity not eradication

 "If growth occurred without evolution, cancer cells would not be imbued with their potent capacity to invade, survive, and metastasize. Every generation of cancer cells creates a small number of cells that is genetically different from its parents...This mirthless, relentless cycle of mutation, selection, and overgrowth generates cells that are more and more adapted to survival and growth. In some cases, the mutations speed up the acquisition of other mutations. This genetic instability, like a perfect madness, only provides more impetus to generate mutant clones. Cancer thus exploits the fundamental logic of evolution, unlike any other illness. If we, as a species, are the ultimate product of Darwinian selection, then so, too, is this incredible disease that lurks inside us.” from Emperor of Maladies by Dr. Siddharth Mukherjee

Hence the growth of new blood vessels or angiogenesis is not so much a disease as a phenomenon, the result of a basic evolutionary compromise. As a body lives and grows, its cells are constantly dividing, copying their DNA — this vast genetic library — and bequeathing it to the daughter cells. They in turn pass it to their own progeny: copies of copies of copies. Along the way, errors inevitably occur. Most are random misprints.

Over the aeons, cells have developed complex mechanisms that identify and correct many of the glitches. But the process is not perfect, nor can it ever be. Mutations are the engine of evolution. Without them, we never would have evolved. The trade-off is that every so often a certain combination will give an individual cell too much power. It begins to evolve independently of the rest of the body. Like a new species thriving in an ecosystem. For that, there can be no easy fix.

Thus recovery or cure is a forlorn hope as this growth phenomenon exploits evolution, Darwinism. All we can do is increase longevity, thereby attempting to understand the phenomenology behind VHL and increase the efficacy of modern medical techniques. Increasing the outcome of the average lifetime has to be the motto not a baseless idea of eradicating.

A surgeon once told me he shall pray that nobody gets this fatal rare disease. Children get support chosen by the committee and the ministry are pediatric diseases and prevalent in children.

I was once a child since 16 days old my life is a struggle because I am not Benjamin Button. I grew up suffering all the time from a variety of symptoms and fatal diseases.

Currently, I have even approached the Delhi High Court asking for aid for my treatment and the case is under consideration. 

Fundraising efforts are not working as there's less awareness.

Von Hippel-Lindau disease is a neurocutaneous syndrome. A neurocutaneous syndrome causes problems that affect the brain, spine, and nerves (neuro), and the skin (cutaneous).

In Von Hippel-Lindau disease, tumors most commonly develop in the brain and retina of the eyes. These tumors, called angiomas, consist of blood vessels. Other types of tumors develop in other organs and include tumors in the adrenal glands (pheochromocytomas) and cysts in the kidneys, liver, or pancreas. As people with the disorder age, the risk of developing kidney and pancreatic cancer increases. vHL patients battle a series of tumours. vHL gene is involved in many forms of cancer. 

Daughter of Sun

 

A gift from heaven, a precious pearl,

a heart filled with dreams - a sweet little girl!

Little girls make the world sweeter!.

Lives of parents completer!

Two little hands,two little feet

A tiny girl fast asleep

A wonderful blessin'

Heavenly blessin'

A joy never ceasing

A treasure from above

From the stars and high above

Is a gift of love

New life , new hope, new dreams

Moonlit streams.

Turneth into a new born girl on Christmas Eve

Santa's gift to light up the tree

May your life be full of love and laughter

Holiness is hope after

Shelves full of books

Gladness of your looks

Comes after

The shouts,and the laughter.

O world of innocence, O world of laughter

 Bedtime stories so sweet and wise

Alone, important and wise,

Possessing mother's eyes

May your life be filled with beautiful stories

Memories and stories

Detective stories

Those wise allegories

Immortal words lie between pages of a book

There ought not be anything disagreeing  you look,

Serving  as a faithful friend

I intend 

There's no such special friend

life's greatest treasures.

You'll be the fulfilment of parents' dreams

You'll be bursting with wonder in their heart

Giving them a new start.

Destruction

 Since you ask, most days I cannot remember.

I walk in my shoes, tattered by the voyage.

Then the almost unnameable passion returns.

I never wanted to die.

 Even when those I loved died, went away from me, beyond me. 

My life was never always a question, if for no other reason

I wanted to wake up and see what happened next. 

Even then I have nothing against life.

I know well the grass blades you mention,

the furniture you have placed under the sun.

But self destruction has a special language.

Like wrecked, disabled carpenters, they want to know which tools.

They never ask why?

 I have so simply declared myself,

I have been beaten by  the enemy, eaten the enemy,

Have put up with the craft,  magic.

Who asked me to drop dead.

The other sold the house illegally

To a cacophony  padmasree 

In this way, heavy and thoughtful,

warmer than oil or water,

I have faced, drooling at the war..

And I continued to want to open like that, like the flowers

who lift their heavy heads as the hills outside the window

Flare gold for a moment before they turn

on their sides and bare their creased backs.

Even the cut flowers in a jar of water lift

Their soon to be dead heads and open

Their eyes, even they want a few more sips,

To dwell here, I hoped to be paradise, a few days longer.

I did not think of my body at needle point pain

Even the leftover will is now gone.

Troubles  insurmountable have already betrayed the body.

Still-born, they don't always die,

But dazzled,  I can't forget a drug so sweet

A face would look on and smile.

I am thirsty for compassion.

I can't bear this pain no more, the agony is to kill

To thrust all that life under your burning third eye representing fire. 

His left and right eyes indicate his activity in the physical world. ... In his anger he opened his third eye, and fire from the eye devoured pleasure,

  Kali mata save me by stopping the cycle of life and death

I pleaded with him to open his eye!

Burn me to bhasma

I seek salvation, moksha

That, all by itself, has become a passion.

Death's a sad tone; bruised, you'd say,

Waiting for you, love, desire and health 

year after year,

To  so delicately undo all wounds 

I need wealth

To empty my breath from its bad prison called the Earth

But being a warrior should I want to cross the periphery, the edge

Balanced there, self destruction sometimes meet,

Raging at the bull , a pumped-up moon,

Leaving the bread they mistook for a kiss,

World is an  made for falling into an abyss

Of  deprivation and anxiety

Troubles are insurmountable

Climbing the mountain all my sufferings are accountable 

Leaving the page of the book of life  carelessly open,

Something unsaid, gnawing inside, the phone off the hook

And the love, and aspirations

Whatever it was, an infection.

Stifling to Death

Stopping all pain and breath.

I hate the Earth 

My forte

Unvanquishable infusion of life

With a deep sense of humanity

Who thinks of humility?

I'd rather live in Hell-fire 

Pandemic's quick fire shall burn

Violence on each other out fear

 In frustration and pain I can no longer bear

With no peace in my brain 

I shun paradise

I shun rain

Kalki the tenth Vishnu Avatar will expunge humans like dinosaurs

Because all have become a carnivore

Desiring my meat

The disease of conceit.

World when it was pointless and chaotic

However, viruses can infect all other forms of life

Virus genes are everywhere, merged into the genomes of all organisms

With with correct mechanisms

Viruses cannot generate their own fuel

These artificially engineered modification 

Were thought to increase the range of host cells 

So it can infect and put the world in frustration

Now the virus in the stormy world dwells

Mutating Covid is Kalki

Aatar who rejuvenates existence by ending the darkest and destructive period to remove

The world will improve 

betrayal, discord, disharmony, unnaturalness, wrongness, evil, immorality,

From what I've seen, I hate humanity

I hate humanity

 With hypocrite mentality

No  morality

Yesterday Now Tomorrow

 

So let's begin.

A merry heart does good like a medicine.

It might display His immense patience

 Those who would believe in Him would receive eternal life.

 Now to the eternal, immortal, invisible, the only God, be honor and glory forever and ever.

China proved to be clever

Life is not eternal neither is it immortal

In all things, I have shown you that by working hard 

 we must help the weak and remember the words of the Lord, how he himself said

Parents ought to have children bred,

 It is more blessed 

To give 

Than to receive

We must help the weak 

Remember the words of the Lord, 

 ‘It is more blessed to give than to receive"

A generous person will prosper; whoever enlivens 

Others will get all things

 Shown you that by working hard 

We must help the weak and remember the words 

Of the Lord, how he himself said,

 ‘It is more blessed to give than to receive rejuvenated, restored, renewed, renovated.

There is a Santa Claus in all

In certain situations I found man reveals himself placed by chance

 And  there's nothing left for him to do but hate his fellow man

A generous person will prosper; whoever refreshes others will be

For the gifts and the calling of God are permanent.

You can be certain 

So when you give to the needy, 

Do not announce it with trumpets, as the hypocrites do with posters on the plane, 

selling cheap t-shirts and jeans, but remain unreachable

To honour indeed  by others I tell you,

It's true they have indeedreceived their reward in full.

He who sleeps on a full stomach whilst his neighbour goes hungry, 

Such devils had ta'en a longer, stronger pull,

The night is so long and the table is oh, so full

God commands justice, the doing of good, 

and liberality to kith and kin,

 and He forbids all shameful deeds, 

War against injustice is a feat

On three sides celebrities have covered me from all sides neat.

The deluding trap has to cheat

 Almighty will deprive usury of all blessing, but will give increase for deeds of charity

Hard work pays off in the future, laziness pays off now.

Clear as a bell 

Laziness lacks originality

change of greatness

Without the action, there's only laziness

I encountered apathetic portraits of your lavishness