23th September
After bit of heavy lifting I've had twinges for a few days and tested to find a few very small and light spots.
7th September
As there hasn't been much to show in the haem tests, I rarely do them. So there will be no daily updates to the graph. This doesn't mean it has all gone away but that it more worrying looking for a problem every day than ????. Once I have relaxed more from the earlier regime I shall consider what monitoring to do.
1st August
There has been a few twinges over the last two weeks but I'm not testing daily due to the lowering counts that seem to be fairly consistent.
19 July
Still having a few twinges lately but next to no haematuria. A bit worrying and I haven't been working that hard due to the rain, which means more time sitting, eating, computing etc.
2nd July
Have had a few twinges lately but no haematuria.
17th June
Well I was hoping this would be a clear month, but alas it's not to be so. I had a few quite strong twingie moments yesterday and the day before and today there was a marker. Don't think I even tested yesterday? It also happened at Ru's. I drank a fair bit of wine during the last couple of weeks and little or no cleavers - so I'll make adjustments there.

papillary carcinoma:
http://cancerweb.ncl.ac.uk/cgi-bin/omd?papillary+carcinoma

A malignant neoplasm characterised by the formation of numerous, irregular, finger-like projections of fibrous stroma that is covered with a surface layer of neoplastic epithelial cells.

neoplasm:
New and abnormal growth of tissue, which may be benign or cancerous.

webpathology.com/digital_atlas | bladder images

Here are two images of benign urothelial cells.

First a 'tidy' set of layers forming the urothelium.

Urothelium normally consists of 4 to 6 layers of cells. The uppermost layer consists of umbrella cells (not well seen in this image) which may have irregular hyperchromatic nuclei.

Second a more disparate set.

The urothelial cells are somewhat disorganized in this example, however, they are still clearly benign. The lamina propria (the pale area) is edematous (swollen with fluid); probably a symptom of the scattered inflammatory cells (pink).

The next image is one from the urinary cytology test I had in June 2008

The report on this is: A papillary group of cells, which I would regard as highly suspicious of well-differentiated papillary transitional cell carcinoma' Dr N J Robertson. Derriford Hospital, Plymouth.

This is an enlargement of the above highlighting some cells

20th June 09:30
Yesterday I spoke to Dr M as I gathered she had the results of the cytology tests. Two of the three ’showed indications of transitional cell carcinoma’.

Draft ideas to present to 'Statutory Health Professionals'

How significant is the indication is that either the haematuria has stopped or just about so?

The first issue is that I wasn't able to monitor events earlier as a) I wasn't aware that there could have been a problem for possibly six months prior to the obvious; b) once there was a visual indication I thought the first two instances could just be anomalies from strain; and c) when I did approach the GP she was against my self-monitoring.

I see no reason why people should be discouraged from self monitoring, and the cost of 10p per week can hardly be a legitimate reason not to object. Urine testing can expose a substantial range of metabolic imbalances or abnormalities. Once a person finds an anomaly they could then monitor daily. On approaching a GP for assistance then everything possible should be done to help the 'patient' (bad word) investigate and or monitor their condition.

As far as my personal condition goes, I'm waiting at least until the end of the month so I can show a months results of little or no haematuria. That there is some, is only notable as I have testing sticks indicating that, which would otherwise go unnoticed to the unaided eye.

Without the test sticks I would have no idea of what is going on.

My 'worry' now is not that I may have any obvious haematuria indicating a continued or increased physiological damage, but that even a few cells could indicate an unwanted turn of events. I haven't found data on urine samples in either a haematuric or a 'clean urine' situation.

At least the data I am gathering may be of some use even if the situation deteriorates.

I have created a graph, spanning 3 months with a backward projection indicating the level of haematuria for fortnightly periods. Both exponential and logarithmic trends are optimistic.

However I can see the reluctance of any GP to be unimpressed, and for their professional standing would like to have further information via cystoscopy. Their requirement to maintain a professional standing does not necessarily equate to the best procedure, just the commonly accepted one.

I am not a slave to the health professionals and their insistence on an invasive procedure is largely authoritarian. Until their desire to investigate equates to mine their use of "we need to get to the bottom of this'' or "this doesn't help us" is just bullying. There is no 'we' or 'us' in present situation. I am gathering information so I can acquaint myself with my body. Without a satisfactory and common knowledge there can be no agreement on what action would enhance this diagnosis.

Statistical evidence is the method by which common procedure are agreed, and yet I see no evidence that my analysis is spurious to the investigation. Only further monitoring and evidence would provide enough statistics to show that such an investigative method would be useful in diagnosis.

On the graph below, apart from the obvious and substantially progressive decline, the notable points are:

1. The red horizontal line indicates the theoretical maximum that the urine testing sticks can define, at approx 200 cells/µlt
2. At 300 cells/µlt the blood may be visible??
3. The blue mark and blue hatched area is an estimate of the average for the two week period before I acquired the testing sticks. The figure if anything is more likely to be on the low side.
4. Exponential projections would never reach zero, and the logarithmic projection indicates complete cessation at the beginning of June, which is much the case.

Haemoglobin

wikipedia.org

Myoglobin

1.
An iron-containing protein found in muscle fibers, consisting of heme connected to a single peptide chain that resembles one of the subunits of hemoglobin. Myoglobin combines with oxygen released by red blood cells and transfers it to the mitochondria of muscle cells, where it is used to produce energy.
thefreedictionary.com

2.
Myoglobin is a single-chain globular protein of 153 amino acids, containing a heme (iron-containing porphyrin) prosthetic group in the center around which the remaining apoprotein folds. It has a molecular weight of 16,700 daltons, and is the primary oxygen-carrying pigment of muscle tissues.
wikipedia.org

haemolysis(or hemolysis)

I am trying to understand the difference between haemolyitic and non-haemolytic reads on the urine tests.

It appears that test for blood checks for haemoglobin from both broken and intact cells and to further complicate the matter 'UriTest'cliam the sticks are equally sensitive to myoglobin.
 

1.
Origin: from the Greek Hemo-, meaning blood, -lysis, meaning to break open.

- the lysis or the breaking open of red blood cell (erythrocyte) causing the release of haemoglobin into the surrounding fluid.
biology-online.org

2.
The destruction or dissolution of red blood cells, with release of hemoglobin. Also called erythrocytolysis, erythrolysis.
medical-dictionary.thefreedictionary.com

Haematuria, or 'blood in the urine' can be either visible (Macroscopic or Frank Haematuria) or only noticed by urine testing (Microscopic Haematuria).

From: renux.dmed.ed.ac.uk

Microscopic haematuria need not be abnormal. Over 12,500 rbc/ml is abnormal, and the detection limit for dipstick testing is approx 15-20,000 rbc/ml. Note that macroscopic haematuria carries different connotations.

Queries that arise are: Is the 'colour' from red blood cells or haemoglobin, where does it originate and what options are there to resolve any problems.

The following is a copy of an article from london-urology.co.uk
 
Introduction

Haematuria is a common condition and one which must be taken seriously. While there are some spurious reasons for patients reporting blood in the urine (eating beetroot, dye ingestion), most patients reporting macroscopic haematuria will be correct. An exception may be in women after the menopause confusing vaginal bleeding with blood in the urine, but this is rare.

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