It’s been a while since I bored my readers with my statistical analysis of weight charts but I actually have some new story since my last post where I’d regained some of my weight loss after my adventure with thinking I had a fatal disease (thus an excuse to ignore weight) and my Texas trip (lots of fun eating out). In this post I reported this gain so here’s my updates. Here’s the chart I last posted (of weekly weigh-ins):
The yellow threshold showed eight weeklies weights of my period of gain. Well, I’ve mostly reversed this as shown with the updated chart below:
So I’m almost back to my target weight that I maintained (with some bouncing around) in weeks 40-48 before my regain starting in week 50. The two blips in the reloss (week 63 and week 68) was my pigouts on the New Years football games and the Superbowl where I couldn’t resist lots of snack foods and beer. So my reloss averaged about 1.4lbs/week (about the same rate as my regain) but well below my rate (2.3lbs/week) of my steady loss in the first 24 weeks. But at least I arrested the gains and now am in a position to, once again, try to do maintenance in the 180lb range (just under overweight BMI).
A little more interesting is the following chart:
These are my weekly weigh-ins, starting in week 23-24 (end of my long steady loss), then my spring trip (big gain), followed my my continuing loss to steady-state (40-49), my regain and my reloss. I fit a polynominal to show the trends but extrapolating it will be wrong since I expect to hit steady-state again in the coming months (so I’ll add another degree to the polynomial to get a good fit). Despite the clear variations over almost a year the regression line shows a small decrease which I expect to have go a bit lower in the next few months. Despite some “advice” (on weight control) in popular press ignoring the scale is obviously silly; instead more data is better than less, but then one needs to do these kinds of analysis to see the trends and adjust lifestyle behavior accordingly (how stupid is it to ignore the scale!)
BUT, am I really out of the woods on the whole MDS thing. My oncologist thinks the B12 injections worked, but the most recent blood tests show I’m back on a downward trend (cytopenias) and, in fact, at new lows in two of the counts. What is really going on?
These two don’t look so bad but show: a) two year downward trend, and, b) downward trend from 30Dec2013 to 29Jan2014 (note: horizontal scale is julian days of the test data I have accumulated, starting at end of 2011, missing 2012, and recent tests at oncologist):
So my red cell count and hemaglobin are in the very low end of the “normal” range and have recovered some since the low (and starting B12 injections). So I don’t show any signs of anemia, which is good and what the oncologist/hematologist was happy with. But my other two counts are more discouraging:
I don’t have my neutrophil count (last test didn’t even measure this) but the drop and new low for white blood cells probably represents significant neutropenia, which was the original indicator that triggered by family doc to send me to the hematologist. And for the first time my platelets are almost out of the normal range and dropped and are a new low. IOW, my multiple cytopenias is continuing and actually worse than on my first visit to hematologist.
So, what does this mean? On my last visit to oncologist the latest rest results were not available and she declared in our consult that I was responding and could switch to oral B12 under assumption that is working. But once the latest results were mailed to me, unless there is significant statistical error in the blood tests, my cytopenias are getting worse and thus don’t justify her optimism.
So I’m not sure what I’ll do (not scheduled for another appointment until another three months). It doesn’t look right to me.
And one complaint I have about the medical system, specially in the informatics is that the printouts (also in computer files the oncologist views) are never compared over time, especially graphically. While undoubtedly a doctor has much more experience looking at the data than I do, nonetheless it is the comparison over time, as in these graphics, that is more revealing of patterns and the patterns don’t look good to me.
But what do I know, I’m just the patient. And that’s my other mild complaint about doctors, especially older ones. They still have this notion that patients are too ignorant/stupid to understand their health and thus they do all the interpretation, as despite their skill/training/experience it could be easy to miss seeing patterns in the data without even the simple graphical/statistical tools I’m using.
So do I complain? Second-guess my docs?
There were lab results to indicate I really did have MDS, but my oncologist dismissed these as saying vitamin B12 deficiency (and age) could produce the same abnormalities seen in the marrow biopsy. But what if this is just an optimistic guess? Or worse, false optimism being provided to me?
MDS has no cure and it’s fatal so really there is nothing than can be done medically. Is my oncologist just focused on treatment (or the lack thereof) and therefore isn’t telling me the truth (or worse not seeing it herself?)
If I do have MDS, which is certainly fatal, so what if the oncologist misses it (until I have symptoms from the cytopenias), from the medical POV. But my POV is different. If I’m really dying then I want to manage my remaining time. We’d considered a luxury (can’t normally afford) trip to Spain, now cancelled, but if I only have a few years left (perhaps even less where I’d be fit enough to travel) then doing expensive things (thus burning my “retirement” assets) is what I’d want to do. So I care! And I want to know.
So in this context is my refocus on weight control even relevant?
Nate Silver makes the point, in his book, that people, in many disciplines, are not good at using statistical information. I suspect this applies to many doctors. But, OTOH, am I also misusing statistics and thus alarming myself, unnecessarily? Who knows? Any ideas, Nate?