Laughter is the best medicine. It can relax muscles. It also gives exercise to body and helps relax joints.

I entered this conversation thinking that I already knew the story, in a way. Dr Wodarg had succeeded in preventing the WHO from creating a fake pandemic in 2009. He thought the world wasn't silly enough to be fooled twice, but he'd been wrong. 1/9

He'd previously had ready access to mainstream media and found this suddenly cut off when he opened his mouth to voice his concern about the hysterical mania of Covid. The comically corrupt whom he'd vanquished all those years ago had been waiting for him. 2/9

All sorts of web entries about his courageous and humane career in public health and politics had morphed into caricatures that painted him as a freak; a "denier", as the post-modern parlance goes, with no means of redress. 3/9

This much I knew before I even started asking questions. What I hadn't expected was to find political correspondence with him, & we found that all of a sudden towards the end of the interview. He calls himself a socialist, I call myself scale dependent, & stop there. But ... 4/9

... it turned out we'd kindled the same central concept—subsidiarity. Subsidiarity is a principle in social organisation holding that functions which are performed effectively by local organisations belong more properly to them than to a dominant central one. 5/9

HELLO: If you pee and every time you finish, your urine looks like this picture, you may have a serious medical illness.

Foamy urine especially if it is persistent and noticeable over time may mean you have a serious kidney problem.

Let’s talk about this today...
RT for others.

What are the features of a normal urine?

A normal urine should have a light yellow colour, painless, odourless (or faint smell), steady stream and should ideally not foam when you pee.

When there’s something wrong, then you see changes in all the above normal features of urine.

For instance if urine becomes very deep yellow, it may mean you are dehydrated;

If urine becomes painful or smells really really bad, it may mean you have an infection;

If urine has a poor stream, especially in a man, it may mean a prostate problem like cancer.

Do you get me?

So today let’s talk about Foamy Urine.

What are the things that can cause urine to suddenly be foamy. As I said in the first tweet, it MAY mean a serious medical illness like a serious kidney problem.

First things first- it does NOT always mean a problem but it may as well.

Now what are the causes of Foamy Urine:

1. SPEED-
If you pee really fast or with a lot of force, it may make your urine more foamy than usual. The speed and force makes the urine generate a lot of bubbles which tend to almost quickly disappear as it is formed in the toilet bowl.

Thrd: Menstruation/Dysphoria

1/ Difficult periods are sometimes the first catalyst for young women becoming alienated from their bodies.

Some have given congratulatory speeches about the vague accomplishment of "becoming a woman."

2/ Others learned about periods through a mundane sex-ed lesson at school. Yet others knew very little about their periods except they are sometimes painful, can be embarrassing, and make activities they’d taken for granted,

3/ like swimming and outdoor play, all-of-a-sudden much more difficult.

When young women hate their periods, they might be told, in a matter-of-fact grumbling way, “well, nobody likes having a period, honey. It’s just a part of life.”

4/ On a personal note, till my early/mid 30s, I knew very little about the menstrual cycle. For me it had always been completely out of sight, out of mind. Once a month, I’d be reminded it exists and I’d have a kind of “oh crap!” moment.

5/ I’d complete the necessary hygiene and try to move on with my life. I was often plowing through various stages of this monthly cycle with little acknowledgement or understanding of how my entire mind, body, and mood was ebbing and flowing. Every month, for years on end.

It's Monday AM post-@ASCO #GU21 & clinic starts in a couple of hours! Lots to process - I'll try to tackle optimal 1L tx for #kidneycancer. I'll make a case for cabo/nivo, leaning on the beautiful (& timely) tables below from @lalaniMD, @SoaresAndrey & @brian_rini (1/15)

What about IO/IO? We have long f/u w #CM214 data w nivo/ipi, no doubt (@AlbigesL et al in @myESMO Open). And treatment-free interval discussed by McDermott @BIDMChealth is no doubt impt. But we've known data not as impressive for favorable risk (2/15)

And furthermore, as @ERPlimackMD points out in another tweet, impt to look at primary PD rates (seen in @lalaniMD's table) - nivo/ipi at 19%!!! CR rate used to be something we highlighted w nivo/ipi, but now comparable across studies (3/15)

Okay now to the really tough stuff - comparing TKI/IO regimens. Something interesting I will add to @brian_rini @uromigos table above is the HR for PFS by INVESTIGATOR review. If the diff in HR for PFS by IND review caught your eye, this is even more striking (4/15)

I think INV-assessed PFS is impt, but if you're a skeptic, forget that argument. Turn instead to #QOL with axi/pembro. Kudos to @brian_rini @tompowles1 @ERPlimackMD et al for advocating for QOL in KN-426. @crisbergerot et al have taughts us the importance of these metrics. (5/15)