Saturday, July 26, 2008


I found this hysterical and very effective instructional video over at FlautoNP's blog. Thank you, FlautoNP!

The ways we learn! I have always been a fan of outrageous teaching and made every effort, in my time, to underscore even the most arid of facts with some sort of demented presentation. Of course, there is only so much one can do with the French subjunctive, although I think collecting near-rotten fruits and vegetables for the students to throw in their inevitable frustration is an idea not without merit.

Adults learning a foreign language are very inhibited -- unwilling to throw caution (not to mention near-rotten fruits and vegetables) to the wind and make mistakes. The Effortlessly Poopy and Fluent Child is forever touted as the paradigm for the Tied-Up-In-Knots and Constipated Adult. Unleash that inner child, learning specialists cry, and language acquisition will have a recuperative and restorative effect (not unlike some revolutionary scheme for toilet training).

Those wacky learning specialists!

The idea, of course, is to trick the staid adult into risking just a little mimicry of the Crazy Educator in the hope that the over-the-top instruction would draw them out precisely to the point of what is correct.

Teaching language was always fun -- except when it was tedious, and even then, I [hope I] never let the tedium show. "Teaching" literature and a more enlightened form of contemplation, the critical essay, however, was perilous and nearly always tedious.

No, not so much tedium -- more like being flailed alive.

Like many people, I love En attendant Godot, Waiting for Godot. Beckett gives me shivers of delight, frissons of recognition. For some reason, we think his work is easily accessible and we offer it up on platters to new literature students, mint jelly on the side.

Class discussion of the play was abysmal. This being my first go with "teaching" literature at the university, and given my incurable optimism, I had done minimal direction of the discussions, vowing instead to follow my fearless students anywhere. Yes, I forgot that they were hopelessly constipated.

They talked about homeless people. Yes, Didi and Gogo served as exemplum of this "scourge taking over our cities and parks... " (I bought Maalox.)

Then, they decided to talk about the role of desire. (I contemplated a purchase of champagne.) However, this quickly devolved into a discussion of how brave it was for Beckett to present such openly gay characters. (I rolled a few joints, drank some more Maalox.)

What's the best way to "teach" Beckett's En attendant Godot? Certainly not by letting go of the reins and liberating student discussion! The next semester, I relied heavily on performance value -- we watched three different theatre presentations, we read it aloud as a class, not permitting anyone to fall behind in either reading or understanding (jusqu'à un certain niveau). They began to know Estragon et Vladimir, Pozzo et Lucky, understand the oblique references, and be comfortable in the silence of what they could not know.

I was psyched. The final papers were about to burn a hole in my briefcase. I pulled them out, stacked them neatly on my cleared dining room table, grabbed a Diet Coke. Found an ink pen, got a fresh legal pad. Deep breath of excitement.

"Vladimir and Estragon are two homosexual homeless men..."

How do I get in touch with this Mad German Doctor Dude?
In the interim, I find great comfort with the Parisian Sock:

Wednesday, July 23, 2008


La Belle Bianca Castafiore ici! And the tired retired educator, too!

This blog was to have the airy nature of an aria, the skittishness of a morbidly obese diva tottering along on remarkable stilettos. Ah, but even La Belle Bianca turns up in a terrycloth robe and scuffy slippers of a morning, inclines her head my way and is, au fond, a good, dear friend.

We share this space.

CRPS/RSD was not to be a cornerstone, a building block, a brick, nor any other form of organizational control!

La Belle Bianca s'en moque de moi. She yells: "Ah! je ris de me voir, si belle en ce miroir" ("Ah! I laugh to see how lovely I look in this mirror!") It's a stock phrase, a rich phrase. It is Bianca Broth! It is a reminder about stuff -- like perception and reality, arrogance and fluff.

I need Bianca in my life, especially, I admit, in my life with CRPS/RSD.

You've likely seen the movie Harold and Maude, yes? Who doesn't love Maude? Who doesn't wish to be so free?

HAROLD: You hop in any car you wantand just drive off?
MAUDE: Not any car. I like a variety. I'm always looking for a new experience.
HAROLD: Maybe... Nevertheless,I think you're upsetting people. I don't know if that's right.
MAUDE:If people get upset because they feel they have a hold on some things,
I'm just acting as a gentle reminder,here today, gone tomorrow.
So don't get attached to things. Now, with that in mind,
I'm not against collecting stuff.
I've collected quite a lot of stuff in my time.
This is all memorabilia
but it's incidental, not integral,if you know what I mean.

That's what my friend does for me -- even if her reminders are not so gentle, even if she is -- well, l'emmerdeuse...*

Welcome, then, to any reader involved with CRPS/RSD -- you'll find here the usual kvetching and lamentable weakness -- ah! but you will also perhaps find distraction and fantaisie: just what the doctor ordered.

*Comme un entomologiste, l'auteur [d'un livre sur La Belle Bianca] observe la lente transformation de la cantatrice;
"Au début, elle est ridicule, commente-t-elle. Mais, ensuite, elle se nuance,
devient meme une héroine, comme dans L'Affaire Tournesol." [...]
Au bout de son considérable travail de recherche,
Moons pose la question qui divise les tintinophiles: «La Castafiore est-elle une
emmerdeuse?» L'auteur affirme que l'emmerdeuse, c'est «celle qui entend se
positionner comme une femme à part entière, non comme une moitié. Elle
assume le risque de ne pas plaire, ce qui est une expression d'honnêteté
personnelle». Haddock n'aurait pas pu mieux le dire.

Monday, July 21, 2008


Simply because I can -- my rationale for almost everything these days -- I subscribe to MedWorm and receive a news feed for "CRPS" and a few other stray acronyms, synonyms. Every afternoon, I cull through whatever the offerings are. Usually, though, I will have already been alerted about things of substance by an email from Jim Broatch, Executive Director of RSDSA, a man with whom I have never spoken, and with whom I have never corresponded. Our doings are all one-way. Some time later, from a few days to a week, I am apt to receive some overlapping information from Anthony Tobin, grandfather and researcher extraordinaire. By the time I hear from Tony, another man with whom I have never spoken, and with whom I have never corresponded, the material referenced has the advantage of having been vetted by a number of "experts."

There is a difference, of course, in the content coming from Broatch & Tobin, and that sent winging my way by a random news feed.

Consider what I received today from each source.

Jim Broatch forwards an article from RSDSA's interactive content editor Jennifer Hlad entitled "Spinal implant helps Marine deal with pain from Iraq injury." I was immediately reminded that one of the rare positive results of war is a rapid advance in the treatment of traumatic injuries, and of wounds inflicted by whatever horrid new weapon has had its way in the current round of atrocities. The U.S. - Iraq War will be remembered for countless brain injuries and the emergence of PTSD as a terrible time bandit. IEDs have made severe orthopedic and neurological injuries to extremities an everyday threat. I remember wondering whether the incidence of CRPS would rise due to the prevalence of those potent and insidious homemade bombs. I guess it did.

It is not coincidental that the first sustained modern notice of CRPS dates from the Civil War.

Anyway, here's an excerpt of Hlad's article, which can be found at the RSDSA website:

Beep. Beep. Ahhh.

Bobby Joseph straightens his back, letting out a sigh of relief as electrical signals pulse through his leg, giving him respite from the piercing pain that has racked his body since Nov. 11, 2006.

"Oh, yeah," he says, grinning.

Before the surgery, 27-year-old Joseph woke up in pain every morning. Every step with his left leg brought with it a "shocking, stabbing pain." The drugs and the nerve blocks helped, but they didn't make the pain go away. Still, when Dr. Rick Foltz first proposed implanting a device in Joseph's spine to send pulses through his body, Joseph was skeptical.

"I've seen Robocop ... I was like, I don't want to be half man, half machine," he said.
Then he did the seven-day trial.

"I felt like I was Superman," he said. "I loved it. I wanted the real thing right then and there."

In early July, Foltz and another surgeon put the device in Joseph's spinal cord. Wires and electrodes send electric signals to his nerves, changing the way the pain is transmitted to the brain, Foltz said. Joseph controls the signals with a remote device, changing the pulses based on whether he is sitting, standing or walking.

"It is basically tricking your brain, so there's no pain there," Joseph said. "It is like a pulsing massage."
Joseph was three months into his fourth deployment, patrolling a street in Anan, Iraq, when the bomb went off. The blast blew him from the road's median, as shrapnel pierced his legs, his face, his arms.

"It ripped me apart," he said, showing off the massive scars on his left thigh and calf.
[....] Literal walking is a different challenge. Joseph suffers from complex regional pain syndrome, a syndrome in which a patient has pain that is disproportionate to the wounds. The syndrome is more common in patients with severe injuries, and Foltz said he sees more of it in wounded warriors because of their injuries.

In addition to the pain, patients may be so sensitive they can't even stand to have a bed sheet brush their leg or arm, Foltz said.

"It's very difficult to treat," Foltz said. "If we don't treat it right away, it can turn into a debilitating, long-term pain syndrome. So when the wounded warriors come back, we want to be very aggressive in the treatment, to get them better as fast as we can."

That's the nature of an electronic alert from Jim Broatch -- news of
progress, legislation updates, research fundraising efforts, or maybe the sharing of a new blog by one of those Obnoxious Incredible People With CRPS.
Although I've not heard from him for a few weeks, I might get some of the same from Tony Tobin of Essex, England, who was for a long time my sole source to research and the inner workings of the virtual CRPS world. He runs a news service through Yahoo! -- the impetus for which was: "Have started research into RSD after my 9 Yr old Granddaughter was diagnosed with it. Update. Said 9 yr old is now 13 and is doing well. I am proud of her." I said "some of the same," but really, what comes from Tony are vetted things -- things that he has personally looked into, things referred to him perhaps several times over from people he trusts. He is into whatever works, and is open to arguments about an idea's potential. From Tobin I get things like information on Mirror Box therapy, a journal paper, Lymphocyte Subsets and the Role of Th1/Th2 Balance in Stressed Chronic Pain Patients as well as an invitation to discuss the role of medicinal marijuana in controlling CRPS pain.
When I am fielding the posts from the RSDSA Executive Director or the Research Grandfather Extraordinaire, I have a feeling of connectedness. Sure, I know that much of the time, material is being dumbed down for me... assumptions of my capacity for unpacking anything remotely scientific are made, and I am presumed lacking. To that end, I have my purely scientific sources. To wit: my various little Med Worms.
This afternoon I went from wanting to tie yellow ribbons around oak trees, and checking out the vibrant blogs of lithe young blond people mastering pain by sheer force of will and disposable income to... well, that place you go when you are sent this, an abstract of an article in Mediators of Inflammation:
Case Report
Expression of Endothelial Nitric Oxide Synthase and Endothelin-1 in Skin Tissue from Amputated Limbs of Patients with Complex Regional Pain Syndrome

Background and Objectives. Impaired microcirculation during the chronic stage of complex regional pain syndrome (CRPS) is related to increased vasoconstriction, tissue hypoxia, and metabolic tissue acidosis in the affected limb. Endothelial dysfunction is suggested to be the main cause of diminished blood flow. The aim of this study was to examine the distribution of endothelial nitric oxide synthase (eNOS) and endothelin-1(ET-1) relative to vascular density represented by the endothelial marker CD31-immunoreactivity in the skin tissue of patients with chronic CRPS. Methods. We performed immunohistochemical staining on sections of skin specimens obtained from the amputated limbs (one arm and one leg) of two patients with CRPS. Results. In comparison to proximal specimens we found an increased number of migrated endothelial cells as well as an increase of eNOS activity in distal dermis specimens. Conclusions. We found indications that endothelial dysfunction plays a role in chronic CRPS.
One arm! One leg! Arg! There is a reason why I am more suited for the scientistic.
(Marmy adds a particularly strident Ack! Ack! La Belle Bianca Castafiore has been stricken with tonsillitis, and her neck is wrapped in flannels, the world temporarily stripped of her opinion. Nous esperons tous qu'elle se sent mieux bientôt! N'est-ce pas? tousse tousse N'est-ce pas?!)