Wednesday, July 23, 2014

Are you sitting down? A State and Federal Government SNAFU...

There are so many extant prefaces that will do, but I choose this one:

"Truth is stranger than fiction."

Yesterday, while playing with the up-and-down controls on my hospital bed, and listening to the "Summer Night" setting on my Homedics Sound Spa with 6 Sounds, Fred brought in the day's bundle of mail.  I almost missed the real challenge to my mental well-being , as we are receiving an inordinate amount of what amounts to Hate Correspondence thanks to my inExecutive Decision to cancel this year's ManorFest due to Personal Insanity.

You know, we paid through our considerable noses to have an unplottable address, so how are all these Haters getting the address to Marlinspike Hall, anyway?  Harrumph.

Unplottability refers to the deliberate concealment of several areas around the world. Unplottable locations are either magically hidden from plain sight or simply removed on maps. Common reasons for unplottability are for individual safety and the protection of certain secrets, particularly within the schools of wizardry.
Anyway -- too tired for more original segues -- about one-third of my way through the interminable gripes, most of the "we-all-have-problems-and-yours-are-nothing-special" sort -- my swollen and painful hand landed on a thick envelope of poor quality, making me cry out:  "Oh shit!  Something from the government!"

And so it was.  Apparently that brief trip to the United States of America, within which is located the land of Atlanta, itself subsumed by the backwardness of the state of Georgia -- a trip via miniature [pink] submarine and Captain Haddock's own wormhole, which originates in Marlinspike Hall's moat -- apparently, that brief trip to see the Board Certified Neurologist Doctor Raymon J Wilensky [RJW] left Fred, myself, the submarine, and all the physical holdings of the Haddock family PLOTTABLE!  How else to explain a thick envelope of poor quality from a division of the State of Georgia, made out to my Americanized moniker?

Eight pages long it was.  

It's title?  An initially agonizing, sharp-intake-of-breath inducing: NOTICE OF DECISION.

I make thousands of important decisions a day.  Still, I rarely issue an eight-page notice detailing them. That'd just be embarrassing. Besides, I have a blog for that!

Okay, to sum it up, it was from something called the "RSM Project Office."  
I went "Oooohhh!"
Then I went "Oooohhh, what the hell is the 'RSM Project Office' and do I have to freaking climb up to the Computer Turret to find out?"  

Yes, Dearest Readers, I did.  Because the (800) number listed for said Project Office is One Of Those Maniacal Menu-Operated Weapons Of Governmental War Attrition Tactics. Also, as Our Beloved Milanese Nightingale, the Bianca Castafiore, recently discovered, we only have functional cell phones whilst leaning at a 70 degree angle out one of the turret's bow-and-arrow openings, necessitating that Sven Feingold stop his important topiary shaping to come up and hang on to our telephoning ankles for the love of God, and also for His Sake.

See? Either way, these "RSM Project Office"  arseholes from Atlanta, Georgia, necessitated the arduous journey to the Computer Turret.  Yesterday being Monday, that meant that my huffing and puffing and slip-sliding through the intervening barn, now renovated as the Carny Rehab Facility, meaning that, yes, red-faced, sweaty moi would be interrupting a post-weekend Group Therapy Session of pissed-off carnies. And why are they pissed off?  It would have been a great weekend for them, full of gainful employment and illicit drug transactions, had ManorFest 2014 gone off as scheduled.  And who cancelled ManorFest 2014 due to "personal insanity"?  That's right, moi again!

Anyway -- I made it to the Computer Turret, though more than disheveled, Sven batting off the intrepid acrobats with a police-grade head crusher and the occasional zap of a Taser.  He held my ankles as I plunged out the window and dialed the useless Georgia government phone number... then returned, using the stairs, this time, to his appointed duties.  We need to petition the Captain for a raise, or supplemental gratuities, or something, on behalf of Sven.  Just the fact that he's keeping The Castafiore occupied ought to be worth considerable "executive bonus" points to Archibald Haddock, y' know?

Okay, so I was stuck with email to shoot through the moat algae and out the other end of the wormhole to Atlanta, Georgia Land.

I wrote the email produced below, though for purposes of transparency and The Fair Reporting Act As It Applies To Blogs About Fictive [shut UP!] Lives, the last paragraph was added after 5 emails were returned as "undeliverable," except 1 reply from "customer service."

Please read this email in its entirety, paying attention to the details,
wherein lie many of the pertinent details. 
My name is, for your purposes, L. Ryan and today I received the "RSM Project Office"'s
denial of my "request for benefits." 
It's a fascinating document, for primarily two reasons. 
*One: I did not request Medicaid benefits. That must have been a glitch inthe ACA Marketplace application I completed in October 2013, as I would
never deign to bother the Great State of Georgia and its forward-looking
policies toward health care. I don't have that kind of time to waste. 
*Two: At the end of the document, I was intrigued to discover that Ireceive SSI benefits in the amount of $331.57. Why "intrigued"? Because I
don't receive SSI benefits.
If you'd please squelch the errant SSI payments I supposedly receive, I'dbe forever grateful. 
If, however, I somehow deserve that money... oh
please, send me a check that covers the last 14 years of our lives,
non-taxable, and that doesn't deprive me of the rest of my [private disability] "benefits." 
If someone has, by chance, been collecting SSI in my name? Well, it'sprobably your job to deflect that bit of larceny back to the federal
government. I've done my part as an [expatriate] citizen and submitted a fraud report,
just moments ago.  Having no "company" name to supply, I used the
"RSM Project Office" name and address as the fraudulent party.

I sat up here knitting apple and banana cozies, answering the occasional frantic email from family members, most perturbed, though, by the missing emails, and the cold-as-ice family sentiment poseurs -- figuring that SIX emails to the Department of Human Services should jolt some bureaucrat into a reply.  Yes, I mentioned in one of the [...] deleted segments that I am the Queen of Gullibility.  I am, I swear.  The thing is, once you screw with me, I don't forget you, ever, and, unfortunately, the organization for which you work is also tainted with your evilness, even if you have cozies on your rusty toaster and your 1970's avocado Salad Shooter.

Apple and Banana Cozy by BeadlesandPins at

[Oh, damn.  Fred just dropped a bottle of chardonnay. What a technological breakthrough, live blogging! Now, had I knit a chardonnay cozy, might that bottle remain intact?  We'll never know.]

Oatmeal Cable Knit Wine Cozy, $12,

[Kind of disturbing, huh, this "cozy" craze?]

Well, anyway... This is the text of my email to the federal government Social Security Fraud Tip Thingy:

I was notified by letter yesterday from the "RSM Project Office" of the State of Georgia DFCS department of their decision regarding two things, an application for Medicaid coverage and my monthly SSI income. 
The small problems I have with this notification are mostly covered by these facts:
1.  I never applied for Medicaid -- unless the ACA Marketplace submitted the request in my name, something I explicitly asked not be done.
Either someone out there is receiving that amount in my name or the "RSM Project Office" just sits around making up stuff to foil anything to do with President Obama's landmark legislation.   
I consider either possibility equally probable. 
This is not a joke, despite my attitude.  I have no idea how long "I" have been receiving this imaginary money, but should I, indeed, prove eligible for its receipt, please forward it to my sad bank account, with interest.  In lieu of that, please find and arrest the person/entity who is enjoying that government benefit in my name. 
Do I really believe that a division of Georgia's government has stolen SSI funds from the good and decent Federal government?  No.  But I do believe they are ignorant enough and blinded by political animus to overlook an obvious bit of fraud.  I've asked them to report it... I doubt that they will. 
Ah, those of you out there who just love State and Federal SNAFUs are waiting, breath-bated, for the one response that DID come!  Well, here you go, and look, Fred just found another bottle of chardonnay, duct-taped under the kitchen table by Bianca "Wile E. Coyote" Castafiore.  Just in time.

On Wed, Jul 23, 2014 at 2:35 PM, <> wrote:

Good afternoon,
Your request has been forwarded to the DFCS Fair Hearing Unit for review and response.
Have a great day.

© 2013 L. Ryan

Tuesday, July 22, 2014

some ordinals... but not others...

let's see.

first, great thoughts of flaming balls of courage (in the southern style) to miss kate mcrae and her lovely family out in california, land of all possibilities, ocean, sky, sand, and forest.

she's had a neurological scare, and i suppose that any neurological symptoms suddenly showing up in a brain cancer survivor makes one want to redefine "scary" and scream "bleeeeccckkkkkkk!"  just guessing.

so she has an mri and all that stuff coming up so that we can dismiss scary and stop yelling  "bleeeeccckkkkkkk!" -- thereby rendering us all much more acceptable to be around.

second, great thoughts of flaming balls of freaking courage, pain relief, and waves upon wave of energetic laughter, even of the cosmic sort, to our brother-unit el profeso obstinado, the former grader boob.

no, grader boob is not dead, deceased, but he is kinda gone. on a temporary basis.  he recently penned the humorous observation:  "I was asked to come in for an interview to one of the full-time spots I applied for months ago. The universe has a sense of humor."

it's simply that, due to a cancer invasion, el profeso obstinado has knocked off the hours he usually dedicates to red-penning and instructive, encouraging marginalia.  there is also the small detail that such activity would be even less compensated than usual.

let's see, i've pulled off a "first," and a "second," and without much difficulty, i could add a third, fourth, and fifth.  but i'm not feeling ordinal.

© 2013 L. Ryan

Saturday, July 12, 2014

The Primacy of Silence

I am rationalizing as fast as I can.  Without a goal, though, it's much like treading water, no rescue of self or others the end point, just lactic acid weighing down the legs and my uselessness made manifest by drowning.

At camp one summer, I qualified for the final exam in a Red Cross Certified Advanced Life Saving course. The elite bunch of us candidates were given instructions on what to wear.  Jeans, a leather belt, a button-up long sleeve shirt, a short-sleeved tee underneath, lace-up shoes, ankle-length socks, and a hat.  I remember how unspecified the hat seemed.  How color did not matter, how function trumped style.  We all had on, as a final layer and defense against pubescence, one-piece bathing suits.

It was early morning and there was fog on the camp lake.  We took our final exam off the end of a rickety pier.  The examiners seemed matronly, an odd remembrance, since I am sure they were not matronly. Maybe everyone looked a little heavy, given the extra layers we had piled on.

So all candidates jumped into the cool, slightly stinky pond water, and tread water for a specified time.  Then we were to take off the jeans, shirt, tee, belt, shoes, and socks.  I suppose we did something with the hats, but I cannot remember what.  Some of these items were to be transformed into flotation devices.  Some of them I saw fit to let drift to the slimy pond's bottom.  I lost points for giving up on my lace-up boots. Perhaps, if I had saved them and made it to an illusory desert island, they'd have supplied sustenance enough for the whole class, for a month, at least.

Then we showed off our proficiency by floating a bit, hanging on to those inflated blue jean legs, for example, or resting our heads on pouffed out tee shirts.

That's when I began to have cramps in my calves, as I was more treading water, still, than honestly floating with confident reliance on my deflated jeans.  Still wish I could visualize the hat.  I keep thinking that it was some sort of oddity, like an old lady's gardening helmet, and not what you'd expect, like a San Francisco Giants baseball cap.

I long ago decided that I was not going to trapped inside my family's predilection for silence, and its awful predatory and coercive ways of underscoring the primacy of silence.  This blog, every email I write, most of my conversations -- they all honor that long ago decision.  It comes off as narcissism, as a form of anti-socialism.  It reads as an inability to edit, not just my verbal production, but my private thoughts, as well.

I am reminded of how Rothko, Picasso, and many "unknown" artists would occasionally allow rancor under their skin, and be coerced into producing the finest of representational art, in some unexpected and banal medium.  To prove that they were classically trained.  To prove that they could draw intricacy like nobody's business.  They usually managed to achieve something reminiscent of the best boy or best girl in the final year of prestigious art school, a something or other to promote their impressive portfolio.  Especially fun are the naive artists, the primitives, when they break into some Parisian metro near-photographic pen-and-ink brilliance. Everyone feels secretly foolish after these displays.  "See, I can do what you think I cannot.  I simply choose not to, I choose another way.  Which I have now, of course, dirtied and demeaned for wont of proving this silly ability to you." We like to blame the other for our pricked pride, our mainlined production, our betrayal of ourselves.

My hat was of woven grass and had a plastic flower, something approximating a yellow mum without the fragrance.  I guess it was supposed to float up side down, and perhaps serve as repository for my boots, spare keys to our dorm, a cabin-without-a-lock, and my pyrography award plaques.  Next time, a fez, or a Stetson.

One of the instructor's had to save me, and she went all out -- "for the sake of demonstration," she whispered in my ear.  My chin ensconced in her palm, to both keep my head above the pond's water and to maintain control of my body, should I decide to panic and, as the drowning sometimes do, attempt to take my rescuer with me to my watery grave.  I am glad she did not decide on that scenario, as a firm grip on my hair would be the next step.

With a smart scissor kick and a modified side-stroke, she brought me successfully to shore, or, in reality, to the slimy ladder on the side of the pier.  I scrambled to my feet, and rejoined my classmates.

It wasn't an ego-destroying failure, but it stung.  Had I passed, I'd have been part of the group swim from the cordoned safe-swim area for all campers across the lake to wild waters and a very famous rope swing. As it was, I ate ice cream and watched two of my compatriots forget to let go of the rope whilst safely over open water. Ouch.

© 2013 L. Ryan

Wednesday, July 9, 2014

high, low and in-between

yes, i know that i've posted this video/song before.  i will probably post it again.  get over it.

I come from a long line
High and low and in between
Same as you
Hills of golden
Hails of poison
Time’s thrown me through
And I believe I’ve come to learn
That turnin’ round
Is to become confusion
And the gold’s no good for spending
And the poison’s hungry waiting

What can you leave behind
When you’re flyin’ lightning fast
And all alone? 
Only a trace, my friend,
Spirit of motion born
And direction grown.
A trace that will not fade
In frozen skies
Your journey will be
And if her shadow doesn’t seem much company
Who said it would be? 

There is the highway
And the homemade lovin’ kind
The highway’s mine
And us ramblers are getting the travelling down
You fathers build with stones
That stand and shine
Heaven’s where you find it
And you can’t
Take too much with you
But daddy, don’t you listen
It’s just this highway talkin’

All things that are alive
Are brothers in the soil
And in the sky
And I believe it
With my blood
If not my eyes
I don’t know why we can’t
Be brothers here
I know we should be
Answers don’t seem easy
And I’m wonderin’
If they could be

-- townes van zandt

Prayer of Pan Cogito – Traveller

Prayer of Pan Cogito – Traveller

Thank you for creating the world beautiful and of such variety
And also for allowing me in your inexhaustible goodness
To visit places which were not the scene of my daily torments

- for lying at night near a well in a square in Tarquinia while the swaying
bronze declared from the tower your wrath and forgiveness

and a little donkey on the island of Corcyra sang to mi from
its incredible bellowing lungs the landscape’s melancholy

and in the very ugly city of Manchester I came across
very good and sensible people

nature reiterated her wise tautologies the forest was
forest the sea was sea and rock was rock

stars orbited and things were as they should be – Jovis omnia plena

- forgive me thinking only of myself when the life of
others cruel and irreversible turned round me like the huge
astrological clock in the church at Beauvais

for being too cowardly and stupid because I did not understand
so many things

and also forgive me for not fighting for the happiness of
poor and vanquished nations and for seeing only moonrise and museums
- thank you for the works created to glorify you which
have shared with me part of there mystery so that in gross conceit

I concluded that Duccio Van Eyck Bellini painted for me too

and likewise the Acropolis which I had never fully understood
patiently revealed to me its mutilated flesh

- I pray that you do not forget to reward the white-haired old
man who brought me fruit from his garden in the bay of the island of Ithaca

and also the teacher Miss Hellen on the isle of Mull whose
hospitality was Greek or Christian and who ordered light
to be placed in the window facing Holy Iona so that human
lights might greet one another

and furthermore all those who had shown me the way and said
kato kyrie kato

and that you should have in your care the Mother from Spoleto
Spiridion from Paxos and the good student from Berlin who
got me out of a tight spot and later, when I unexpectedly
ran into him in Arizona, drove me to Grand Canyon which
is like a hundred thousand cathedrals standing on their heads

- grant O Lord that I may forget my foolish and very weary
persecutors when the sun sets into the vast uncharted
Ionian sea

that I may comprehend other men other tongues other suffering
and that I be not stubborn because my limitations are
without limits

and above all that I be humble, that is, one who sees
one who drinks at the spring

thank you O Lord for creating a world very beautiful and varied

and if this is Your temptation I am tempted for ever
and without forgiveness

--Zbigniew Herbert

© 2013 L. Ryan

Tuesday, July 8, 2014

Wonderful Competency

This is a pleased-as-punch pass-along of a report published yesterday in Consultant for Pediatricians, as part of their "photoclinic" --

    [Citation: CFP. 2014;13(7):330-331]

There's not one thing remarkable about it.

Except it shows evidence of prompt response to a new case of CRPS, an awareness of IASP "Budapest criteria," and a complete absence of NeuroStupidity.

Way to go, Mfon Ekong, MD; Anissa Meher-Homji, BS; and Lynnette Mazur, MD, MPH of the University of Texas Medical School at Houston!

Complex Regional Pain Syndrome

A 10-year-old girl presented with a 3-month history of right knee pain and difficulty walking after her pet German shepherd bumped her leg. She also complained of a 2-week history of hair growth below her right knee.

On physical examination, she had edema, a 12 × 10-cm patch of hair, and decreased range of motion of the right knee. Results of complete blood count, erythrocyte sedimentation rate, complete metabolic profile, creatine kinase tests, and myoglobin tests were normal. Findings on magnetic resonance imaging were unremarkable.

The girl received a diagnosis of complex regional pain syndrome (CRPS) and was hospitalized for inpatient physical therapy. An indwelling catheter was placed for a femoral nerve block. Ropivacaine was continued for 8 days, after which the girl was transferred to a local rehabilitation facility to continue physical therapy, along with continuous passive motion (CPM) of the knee. She was started on gabapentin, fluoxetine, vitamin D, and as-needed diazepam, and was discharged after 1 month to continue her treatment at home.

CRPS, formerly called reflex sympathetic dystrophy, is a painful syndrome accompanied by physical changes in the affected extremity. Dysfunction of local sympathetic and autonomic nerves may be responsible.1-3

Our patient reported 3 of 4 symptoms (allodynia to clothing, edema, and decreased range of motion) and 2 of 3 signs (hyperalgesia to pinprick and allodynia to light touch) meeting the clinical diagnostic criteria for CRPS set forth by the International Association for the Study of Pain (IASP) (Table).4

[read the rest of this wonderful competency HERE]

Sunday, July 6, 2014

Doctors Cole, Wilensky, and Huddleston Do the Mermaid Hair Flip

It was difficult for my new health insurance reps to understand.  Following abhorrent treatment for my long ago diagnosed CRPS / RSD, beginning with what I can only call a "neurological rape" on May 12, 2014 by Dr. Raymon J. Wilensky, and followed by a healthy serving of Neurological Stupid via email from Dr. Daniel Huddleston, my official complaint received much promised acknowledgement and an even greater assault by studied attrition.

You know what I mean.  Dr. Cole, a Very Important Person, will be addressing your complaint by deigning to call you, first on this day, then on that day, then by the "I'll play clueless" nurse who called, twice, in her stead.  All in all, three days were set up as "Talk with Dr. Cole Days, You Lucky Peon, You!"  Sure that they'd won the War of Attrition, my phone, which has been ringing off the hook for all sorts of truly emergent situations, never rang with the bated-breath of orgasmic teasing that fairly frothed at the mere mention of... Dr. Cecily F. Cole.

I played my role well, I think, right up until the actual conversation.  I verbally touched forehead to ground (What?  It could happen.  I do Qigong daily, and Tai Chi.  Okay, so I sometimes do it from my hospital bed, and with a side of bourbon and branch, and a hotline to God.  And yes, sometimes I switch midst rising hands, roaring dragons to the latest Wimbledon match -- a relief no longer available since Djokovic's beautiful performance today... Though, I "taped" it, and could watch it again and again... for at least a week. Rising hands, invisible balls, roaring dragons, and a wicked crosscourt that gorgeous clean cut jokester from Serbia. Although, please, someone, save the man's hair.  That hair atop outfits that recall the 1950s in style, if not fit, is so... misleading. Novak is fun.  Novak is sexy.  Novak is a riot.  Novak is a tennis wizard, but to whose lanky locks are we treated? The never-quite-cool papa to two sets of twins, Roger Federer, with what looks like three yards of a Nike headwrap holding in his impressive brains, but not able to control his basic pouty ways.  I am ALMOST tempted to call in the Lincolnton Stylist to the Stylishly Deprived, that Laconic Lexicon, La Loca Lale, my halfling sister.

I think the basic problem, Djokovic-wise, hair-wise, is an excess of hair.  He needs hair-thinning, an adroit airing out, without resort to the Lincolntonian Final Solution to Hair Mass -- the deviant, devious mullet. There's got to be some solution to the bang problem that won't revive either the mullet or (my weakness) something in a pink punk.  Though an undercut with high hair, a bit of spike, huh?  Can't you see it? But would Novak allow it... pesky Free Will surges again to halt my easy solutions for the world.

Tall hair with an undercut, and a *touch* of blond highlights?  Whadayya think, La Loca Lale?

He needs to dare to go longer...

So Dr. Cecily F. Cole did call, and knowing she is a busy woman, I cut to the chase with even more rapidity than mine own self intended.  Or maybe it was all this business with my brother being ill, both Mother-Units being ill, and one of them blithely unaware that most of her caretakers were knock-knock-knocking-on-Heaven's-door.  That'd be the Bio-Mom-Unit.  Is it possible for karma to screw up, get confused by a scarily strong anti-karma confusion field, and have the karma deserved and dedicated for her alone to be dispersed and scattered, taking out the people who insist on getting in its way?  Two of her three Powers of Attorney, stricken with cancer's butt ugly impression, their beauty marred by her karma's confusion?  It's beyond me to figure out, and who really wants to understand.  We've been taught passivity in Karma's unerring ways... because Karma never errs.  In Karma we trust.

My ugliness shows itself again, questioning Karma's accuracy, doubting Karma's result, assuming that I can even see the ultimate act in an eternal sequence of dominoes.  Presumptuous bitch that I am.

Deference.  I lack deference.  Deference must be what's due a new conversant.  Deference for the résumé, the authoritative weary tone.  Deference for the battles that Cecily F. Cole is fighting and not making mention of in her quiet authoritative weary tone.

This was the set-up:  She was to be the kind sounding board and yet, also, [too!] the unyielding cement wall of reason.  I fed her my fill of straight lines, until one stuck in my throat, giving me a mouth full of tired vomit. In what could only have sounded like a whiny loop of uncleaned, bulky porcine tripe, I bemoaned Huddleston's reference to the "elephant in the CRPS sickroom -- it's clear psychogenic origins." Ah, she cut me off, she cut me off at the knees (a little low, in my estimation, as all our DIY leg amputations tend toward the mid-thigh) and strayed into Condescension Land, but with the sound of Gospel Glory in her suddenly tremulous Christian kindness, overly modutated voice.

[The VOICE, by the way, was what I had arduously, assiduously, sought to avoid in this whole complaint-filing process.  I want it IN WRITING. I could have, should have, usually would have... made a recording, but it's not the same.  The Powers That Were were so insistent on having Dr. Cecily F. Cole make contact by telephonic means that their intent to bugger, bugger, bugger me was buggerlicious in the extreme. And here was her moment, my service return sitting up, flat, waist high, begging for deft Christian Condescension and the Easy Put Away.]

And there it was:

"I want you to know that I know your pain is real."

Oh sweet Mother of God with a helping of Holy Hell as the cherry dollop on top!  The only good thing I had going on at this conversational nadir?  No sputtering.  Enunciation that the Stepmother-Unit woulda been proud of:

"I know my pain is real.  I don't need your assurance of that, nor your condescension."

At which point, I cut to the proverbial chase.

"When your nurse called me, she asked an intelligent question.  'What can we do to make this right?' A fine question, given that I'd just assured her, and wish to reassure you, that I am not in the least litigious.  Were I litigious, Dr. Wilensky's ass would resemble grass.  Instead, I've given thought to her query, and come up with an answer.  Admittedly, a two-part answer, but still rather restrained, I think."

This caught Dr. Cole off guard.  To be so suddenly victorious, thrust without much effort into the rarefied air of condescension before rampant self-pity -- a trick so much harder to employ in the froideur of the written word!  She and whoever else had their ears glommed onto the speaker phone's reception must have been caught in mid-Happy Dance, which, for some reason, I see as Lorde's signature mermaid hair flip, frozen in time's precious loop.

"I want you to know that I know your pain is real."

My bipartite solution to her neurological rapist (Wilensky) and her Ochoan doppelgänger (Huddleston)? Return me to my former neurologist -- I don't know how, what strings Cole would have to pull, what hair she'd have to flip -- who knows better than to set off a cascade of neuropathic oddities by means of neurological insult, and who knows that I'm intimate with the mind-body connection, but dare not so demean my body by so vaunting the absurdities of this mind!

"Give me until Friday to set that up."

You know that you, too, would push too far, just to get some cartographic mysteries settled.

I added my second recommendation:  "And I think it would be useful to see that your neurologists had some continuing education..."

Perhaps there was a better way to say it.  Perhaps not.  My audacity elicited an outburst of Pricked Pride:
"All of our neurologists are Board Certified..."

That's about as silly as it gets, Dear Readers.

The Brother-Unit so ill with cancer remains so, and has frozen me out.  I'm sure he has a List of Irrefutable Causes.  He is causing me great pain, when I allow him that power. Most of the time, I wing his way my bits of green leaves, my ill-gotten bits of peace, my thirst-slaking tisanes.  I gently touch, I who have so mocked Healing Touch, and shake out, shake off, his pains and other ways of dolorosa. I touch the outline of him, gently palpate his skull, his beloved nose, kiss the mass destroying the keen line of shoulder, and call out the wonders of peppermint lotions, gently, gently on his feet.

Anathema again, or for the first time?  I cannot remember because it does not matter.

© 2013 L. Ryan

Wednesday, July 2, 2014

CRPS in the Context of (Neuro?) Autoimmunity (With Thanks to Mice)

Researchers at the University of Liverpool have taken a major step forward in understanding the causes of a disorder which causes chronic pain in sufferers. 
Complex Regional Pain Syndrome (CRPS) is a serious condition affecting a limb after an – often small – accident or operation.  It can cause severe pain lasting many years, as well as limb swelling, hair and nail growth changes, and muscle atrophy, but until now there has been no clear evidence of the cause. 
Now the research team from the University’s Institute of Translational Medicine alongside colleagues at the University of Pécs, Hungary have successfully transferred antibodies from the serum of patients with CRPS to mice, causing many of the same symptoms to be replicated. 
Dr Andreas Goebel *, who works in the University of Liverpool and is a Consultant in Pain Medicine at The Walton Centre NHS Foundation Trust, led the study.  He said: “CRPS is a serious condition which isn’t fully understood.  The findings of this study hint at a cause for it – harmful serum-autoantibodies – and raise the possibility of finding a treatment.”
[Read more of the story HERE from HealthCanal - Health News]
* Dr. Goebel's considerable research in chronic pain and CRPS HERE]

What to say?  It sounds momentous, yes?  But really, quite a bit of research, years old already, has been done that points to "clear evidence of the cause." Unfortunately, "THE cause" sort of thinking goes hand-in-hand with the "Silver Bullet Cure" crowd, and denies the complexity of the "syndrome." Be that as it may, it's a reflection more on the dumbing-down of pseudo-medical journalism, and not a reflection on the quality or bounds of the research on which the article is "reporting."

Why, for instance, do proponents of immunological causation feel the need to ignore the brain?  Just thought I'd toss that out there, as something not particularly helpful, but indicative of either/or thinking that just does not fly when dealing with the intricate relations and processes of the human body.  The peripheral and central nervous systems and their functional counterparts as parasympathetic and sympathetic impulses/small fibre neuropathy/glands run amok (hypothalamic-pituitary-adrenal -- HPA -- axis dysfunction)/immune system dysfunction/inflammation/psychosocial and environmental influences/and the darned partridge in a pear tree.

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A CRPS-IgG-transfer-trauma model reproducing inflammatory 
and positive sensory signs associated with complex regional pain syndrome

The aetiology of complex regional pain syndrome (CRPS), a highly painful, usually post-traumatic condition affecting the limbs, is unknown, but recent results have suggested an autoimmune contribution. To confirm a role for pathogenic autoantibodies, we established a passive-transfer trauma model. Prior to undergoing incision of hind limb plantar skin and muscle, mice were injected either with serum IgG obtained from chronic CRPS patients or matched healthy volunteers, or with saline. Unilateral hind limb plantar skin and muscle incision was performed to induce typical, mild tissue injury. Mechanical hyperalgesia, paw swelling, heat and cold sensitivity, weight-bearing ability, locomotor activity, motor coordination, paw temperature, and body weight were investigated for 8 days. After sacrifice, proinflammatory sensory neuropeptides and cytokines were measured in paw tissues. CRPS patient IgG treatment significantly increased hind limb mechanical hyperalgesia and oedema in the incised paw compared with IgG from healthy subjects or saline. Plantar incision induced a remarkable elevation of substance P immunoreactivity on day 8, which was significantly increased by CRPS-IgG. In this IgG-transfer-trauma model for CRPS, serum IgG from chronic CRPS patients induced clinical and laboratory features resembling the human disease. These results support the hypothesis that autoantibodies may contribute to the pathophysiology of CRPS, and that autoantibody-removing therapies may be effective treatments for long-standing CRPS.

An interesting site:  Centre for Immune Studies in Chronic Pain

© 2013 L. Ryan

Tuesday, July 1, 2014

Quicksand, Kübler-Ross, and Lilith in Lincolnton

First, I'd like to thank my relative-in-law in the backwoods of Lincolnton, North Carolina, for her contributions to my daily Chuckle Fest.  I used to chase off perceived stalkers, yes, even from a public Blogger blog, open to [apparently] even the scuzziest of scuzzes. No longer.  But I should watch myself, as family tree add-on maintains quite the finely honed quill, perhaps a turkey's tail feather, perhaps the wing feather pulled from recent road kill, or perhaps some poor local pet, a porcupine, say, put to death by my halfling brother -- we all need hobbies.  I mean, just check out her blog.  Makes me quake in mine boots, it does.  It's title, alone, will give you pause, in the manner of shock 'n awe:   "me, myself, and i...."

The Devil, my Mammon, has informed me that Freud declined reincarnation based solely on information beamed to his tripartite cocaine-soaked brain from the Lincolnton, North Carolina locale.  I guess that would have been too facile a resurgence.  Some bloggers fall prey to Godwin's law... some of us to the ease of Beelzebub.

Now, it may not be her leaving me little tidbits of search term maliciousness.  It might be the aforementioned mommy-buy-me-a-bidness-mommy-pay-my-mortgage pet killer.  It might be his sister, La Loca Lale, and by "loca," I mean demented.  It might be La Loca Lale's fiancé (excuse me, diet ginger ale goes up mine sinuses at the thought of such a cohort... which can only mean "demented squared."). She's riding the crest of the born-again wave at the moment, and I hope that's not the means by which he's been snared.  I suspect it has more to do with nuts and bolts, dollars and cents.

Anyway, from this partial genomic partner, La Loca Lale, I can borrow her own astute self-assessment:
I have since a young age aspired to be a hair stylist. It has always been a dream of mine. I am now in my 26th year and love my career. What an amazing ride it is! I LOVE seeing happy smiling faces, and especially making a difference in some ones life with my talents. I believe that God blessed me with my skills as a hair stylist. My specialty is Color/Perms, and cuts. I have a handsome son who gives me support in all I do. I am proud to say  I am  mommy, and Finance to a wonderful man. Truly I am Blesses beyond measure.
Yes, I glanced over at Fred, head back in snoring mode, wearing his Holy Pants, and yes, I wondered: "Is this wonderful man Finance to me?"  It's a lot to think about.  But I do breathe a bit easier knowing that no son of mine has the job of giving me "support." I thought I had today's reigning social fabric all figured out -- so long as he's not incarcerated, isn't "support" and being my "Finance" the job of my Baby-Daddy?  Clue me in, Dear Readers, clue me in!

Whoa.  I just got hit with a wave of nasty-mouth backwash.  No, I am not putting down anyone who works hard and supports herself and her offspring, and particularly not those who choose to do so through imparting style.  You should know by now my love of the famous American Work Ethic.  And my dislike of embezzlement, writing bad checks, shoplifting, and other means of divesting others of their money.  So dream on, my sister, of your goodly Godly stylist calling, and may it fill your coffers with all that your financial needs require, and provide your son with nutritious food, shelter, and suitable undergarments, sturdy jeans, and the coolest of tees.  And a college fund, so that he can get the heck out of Dodge when he comes of age.

The really neat thing about La Loca Lale?  I wouldn't put it past her to be so creative as to print her own money, if the need were great!


That crap out of the way, I had planned a post -- several, in fact.  One on the various anti-inflammatory diets out there, as I've come to believe in those parts that I can afford.  One on the vitamins and supplements that I believe have greatly improved my CRPS-devastated nails, but that, again, are almost prohibitively expensive.

And also always on the tips of my fingers -- one final post begging everyone to continue the chant:  "Shrink, tumors, shrink!"  The Brother-Unit with cancer is putting Kübler-Ross through an afterlife workout very early in his illness journey, knocking those five stages out of the ball park like a home-run king.

I'm right there with him, except that I'm not right there with him, which is the only place I long to be.

In honor of the Grande Dame of Death, my favorite shorthand of Kübler-Ross' infamous five stages:

Uploaded on Dec 7, 2009
Go through the stages of loss with this giraffe.
About Robot Chicken:
Robot Chicken is Adult Swim's long-running stop-motion animated homunculus of a sketch show. Witness sex, violence and 80's toy references collide through fan-favorite characters like the Humping Robot and the beloved Robot Chicken Nerd as creators Seth Green and Matthew Seinreich are joined by an unparalleled roster of celebrity voices to skewer pop culture in this balls-to-the-wall comedy. Check out the latest clips and episodes from Robot Chicken on
Watch More Robot Chicken:
Oh, and Lincolntonites -- you're very welcome here.  Just don't leave traces of yourself.  It makes extra work for the Marlinspike Hall Genetically-Indentured Domestic Staff.  And the admonishment goes only to those Lincolntonites who could make tenuous claim to half-blooded familial relations (attenuated, even, by marriage).  Aunts, uncles, mothers, stepfathers, cousins, and (especially) sweet nephews, are exempt from any ire issuing from the Bronze Doors of Our Manor, arcing over the sweet waters of our algae-ridden moat, and lofting the many multi-verses required to reach your town.

Have a blessed day.

© 2013 L. Ryan