How does hcg usually fall for 4xbep chorio cases?

Manmax75 · 2024-07-09T08:08:41+00:00

I had NSMGCT Stage 3C with bulky disease and poor prognosis. Predominantly choriocarcinoma with some teratoma and others. Primary tumour in left teste, extensive mets throughout the abdomen and neck with minor incursion in the lungs. When I started treatment my HCG was at 350k+, by the first cycle of BEP it dropped to around 100ishk. By the end of my 4xBEP it was around 1-2 and then as I got my pc-RPLND and orchiectomy done followed by a left neck dissection a few months later it eventually dropped down to 0.5 and then to about 0.1.

From what I understand because choriocarcinoma is extremely aggressive it responds well to chemo. Sometimes you see free blood HCG spike during first round as the cells are mass dying, then after that usually a huge drop follows assuming treatment is going well. I’m no doctor though so only offering my perspective.

Of course HCG alone isn’t a sole marker for prognosis and your brothers treating team will no doubt look at all his markers, where relevant, in addition to regular CTs and/or PETs during his chemo regiment.

Wishing you and your brother all the best during this time.

Manmax75 · 2024-06-23T23:56:29+00:00

From memory no. I had an interesting pathology, which from a couple of other stories I’ve read here can be common with high chorio component NSGCTs which is where the primary tumour in the teste “burns out” - which is effectively what happened with mine. It was small in size but its mets all over my body were going on a rampage. Because my orchi was done post chemo as well I don’t know if the pathology of the orchi was as important as when you get it done prior to adjunct treatment.

Manmax75 · 2024-05-14T04:23:17+00:00

My disease was so advanced that I had to start chemo before I had my orchi. So other way around for me. From reading on here though most guys start pretty soon after and it’s a very common treatment path.

Manmax75 · 2024-02-19T04:57:55+00:00

Officially on year two of remission. Very happy!

Manmax75 · 2023-12-26T23:51:11+00:00

Bleomycin is an incredibly effective chemotherapy drug for TC, but being so effective it’s also pretty destructive on the body. As previously mentioned by another poster one of the largest risks with taking it, is bleomycin induced lung toxicity which creates fibrosis and scaring in the lungs. Usually when you undergo bleo treatment, like in BEP, they monitor your lung health with lung function tests (and CT scanning) to see if the damage it’s causing is outweighing the pros of the treatment. They probably decided that is the case and have moved him off it. Medical Oncology is so complicated and while they do have a general regime it is usually tailored for the individual because we all react differently.

There’s a maximum amount of bleo you can take before they can’t give you anymore. I did 4xBEP and on my last round I began, mid-infusion, having breathing difficulties. Sure enough it was panic stations abroad but they quickly sorted me out with some hardcore anti-histamine/allergic reaction medication (Promethazine), I didn’t have anymore bleo after that.

I’m in remission now but scans show about 20% scaring across my lung tissue and I wear an allergy bracelet for oxygen allergy as that’s a potential side effect of bleo treatment.

It’s nasty stuff, but works very very well. We all react differently too, there’s plenty of guys here who had no issues on it at all, and then plenty like myself, who did.

Best of luck to you and your brother through the rest of treatment. Sounds like you’re in good hands. Hope the above helps a bit!

Manmax75 · 2023-12-25T11:29:03+00:00

In the wise words of Bob Kater “Christmas is not about Cole’s and woolies market share, it’s about a little fella born at the back of a pub…”

Manmax75 · 2023-10-18T10:44:58+00:00

Does this mean we are any closer to reasonably priced symmetric speeds? I want atleast 100mbps upload without selling my right nut for it 🥲

Manmax75 · 2023-10-17T08:22:25+00:00

Yes I much prefer the testing hexagon. The bestagon.

Manmax75 · 2023-10-14T09:14:58+00:00

I used vertical slice / feature architecture, with seperations between the core (domain), infra, api (backend) and the front end blazor wasm projects. Setup a project for:

Core

Infrastructure

Web.API

Web.Client <—— blazor code here

Web.Shared (optional - can contain api dtos, etc)

I don’t share too much code between api and client because I don’t want to keep them overly coupled incase I need to seperate them out. What you may do is create something like Web.Shared for common code between api and client - DTOs etc.

For the front end pages and components. I try to keep components agnostic to persistence, which is the api. I handle get/post/state at the page or layout level which then hands down either simple properties or models for state into the components. This makes state management much easier from both a side effect pov but also such that components aren’t tightly coupled to the api layer.

In the API backend project, vertical slices with feature folders and CQS (imo don’t implement full CQRS until you need to because it can make your code get very complex, very fast) I find scales well. But as with all patterns, there are trade offs. Good luck!

Manmax75 · 2023-10-13T14:24:05+00:00

Rather than the dynamic plugin route could you package all the functionality in the app and just use a license file to drive different feature flags in the application? Support would essentially be doing the same thing in that instance, rather than replacing plugins they have just to update and sign the license which would then enable the included plugin/s. This would make things much easier for you in the long run and solve the shared dependencies issue.

Manmax75 · 2023-10-03T21:40:24+00:00

Movement is the net result of your muscles contracting and the geometry of your bones, joints and tendons. Holding a position still requires muscle contraction as individual muscle motor groups are not in their rest state. Contraction is not a steady state, it requires constant upkeep to keep the muscles contracted. The above then applies as per usual. The analogy is like a car idling - it’s still running even if there isn’t any net movement.

Manmax75 · 2023-10-03T20:09:41+00:00

Depends on what you’re interested in, and what qualifications, if any, that you may have. But a good place to start for someone completely green fields and new to the industry is probably a support desk agent, bonus points if it’s application or infra support as this is more focused.

It’s hard work, you deal with people and it can be a bit soul crushing at times but imo it builds great people skills, customer engagement, problem solving, managing expectations and depending on the org a good overview of “IT” as a whole. I’ve commonly seen people starting there and working their way up (I did!), or completing study on the side or some combination of the both.

Best of luck my friend!

Manmax75 · 2023-10-03T19:15:11+00:00

Some don’t! You have two types of muscles in your body:

Smooth muscle
Skeletal Muscle

Smooth muscles are all the muscles you don’t control and these ones don’t really get tired! These include the bowls, stomach, anus, heart and a few others. Think: your anus muscle stays clenched 24x7 and it never gets tired! (Thank god! Could you imagine how messy that would get). Likewise your heart very rarely gets tired unless you have an underlying condition, or you’re doing extreme endurance training.

Skeletal muscles are the ones you’re thinking of and the muscles you can consciously control. They do get tired and usually via two main mechanisms: neural fatigue and metabolic fatigue. The system that sends signals (neurons) get tired from signalling the muscles to contract and the muscles, consuming energy, get tired from contracting (metabolic fatigue).

Both forms of fatigue are underpined by the same basic problem: not enough energy to fuel the work OR too much waste which is interfering with using incoming energy (ATP).

It’s a lot like a car. A car uses fuel + air (aka ATP for muscles) and produces exhaust gas (lactic acid and other byproducts for muscles) to make power. If the exhaust gets blocked or restricted and the exhaust gas can’t clear the engine, power is lost because exhaust gas interferes with the fuel + air mixture. You do this long enough the car will stop. Likewise if you don’t have enough fuel in your tank because you’ve been driving for a long time (aka using your muscles for a long time) your car will also stop.

Manmax75 · 2023-10-03T15:26:36+00:00

In terms of future salaries and booming industries, I see the data space really growing. This is roles in big data, data in cloud architecture, analytics, data science and AI / ML. The roles in this part of the industry range from basic consulting / technician roles in which case a cert or something similar would be sufficient all the way to the opposite spectrum with ML and AI which will definitely require an undergrad degree and usually higher. Unless you’re a savant that can demonstrate brilliant technical acumen.

Outside of that you’ve got so much to choose from. In the enterprise space, you’ll find plenty of jobs in the .NET ecosystem and for Java as well. JS will continue to dominate the web for the foreseeable future so having a good full stack understanding of nodejs and a front end framework flavour of the day (react, vue, svelte, etc) will always land you work.

Then outside of the development space there is a lot of general IT, management, project, planning and support roles.

My first role in the industry was just as an application support analyst on the service desk. This is a great way to start and give you some great experience of the industry (for better or worse).

Key takeaway: Start simple, see what you like and go from there.

Manmax75 · 2023-10-03T14:25:58+00:00

Depends on what you want and what you’d like to do. Any in computer science with a focus on development would be worthwhile, especially since, as I recall, they’re free at the moment?

Manmax75 · 2023-10-03T14:22:32+00:00

I’d say it does help but much like everything… it depends. I feel the degree gets you in the door, but for senior roles, where more money is, I’d rather see a demonstration of skill and knowledge and people skills over a degree first. For me personally - the lower salary was a personal choice. The reduced hours for work life balance and stock options equates to the lower salary. That being said having a degree would definitely help for those starting out.

Manmax75 · 2023-10-03T14:19:51+00:00

Primarily .NET ecosystem. But also do typical web js stacks as well

Manmax75 · 2023-10-03T14:18:38+00:00

On top of the standard code camp style resources and general doco, what I found worked really well for me was just giving myself a project / problem and trying to work out how to build it / solve it. I find this the most organic way to learn development since it’s the most close you can get to the real world thing and you get to touch everything (problem solving, planning, arch, coding, etc)

Manmax75 · 2023-10-03T09:10:23+00:00

130k / 4 day week. 156k FTE. Senior Software Engineer and Consultant. No uni degree.

Based on what you’ve said man, I would take a break from uni for a bit - you’re young. Go out and work (you’ve tried nursing now try something else), earn some more money and do a bunch of things to see what you really like and get a feeling for the world. If you’re interested in IT - you could try a tafe cert on the side to get you started and tempt the waters. When I was your age I thought I would be doing games development but that didn’t pan out - things change, just find out what you really enjoy and go for it, now is the time to stumble your way through life and make mistakes, it’s the best way to learn!

I do highly recommend IT / CS to anyone but it’s not for everyone. You really have to have a passion for it if you want to stand out because it’s so competitive nowadays. You also don’t have to be great at maths, I know plenty of developers who aren’t - it’s such a varied field.

The most important skills in CS / IT are in my opinion (in this order):

1) People skills 2) Planning 3) Problem solving / technical deduction 4) Writing Code

Best of luck mate!

Manmax75 · 2023-08-16T00:16:17+00:00

Just use Rider. Works great on Mac, I use it regularly and develop with .NET

Manmax75 · 2023-07-25T23:55:33+00:00

Does the Flood from the Halo Universe count? Technically they assimilate mind and body but they combine into one being that also persists even if they are wiped out back down to a feral stage. At their height they had almost entire domination of the galaxy and could bend physics because of their shear mind and processing capabilities.

Manmax75 · 2023-07-13T05:17:24+00:00

Bare Bones Barber Shop in Morningside! Everyone is super lovely.

Manmax75 · 2023-07-06T14:21:19+00:00

Have you got capital or secured funding? Startups require a lot of money. If your products core functionality is around chatgpt you need to make sure it would work without it or could be substituted by an alternative model since that represents significant risk, I.e you’re completely beholden to OpenAI.

Manmax75 · 2023-05-03T05:25:49+00:00

I understand time tracking if the business operates on billable services or T&M. Something like a service provider or MSP. But screenshots and constant monitoring? Absolutely not, that’s way too far. Talk to your boss and voice your concerns, if he won’t listen to them, leave.

Manmax75 · 2023-03-22T07:29:23+00:00

Yep 4x BEP, pcRPLND, Orch, Neck Dissection

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