Saturday, April 18, 2009

WTF




I have tried to avoid falling into the blogging trap of "What the Fuck?" postings -- because, really, one could spend all one's time going "What the Fuck?" these days.

Still, this morning's mail provided a great WTF opportunity. I just can't figure this out.

S. Clusterfuck, M.D. -- Medical Director, Vice President of Clinical Programs with Bull Crap Bull Skeet of Tête-de-Hergé -- wrote me the following letter:

Dear Retired Educator,

Maybe you've avoided tests ever since your school days. But did you know that getting medical tests when you need them is one of the best ways to protect your health? Regular checkups can uncover any new developments early in the game. And that gives you and your doctor the best chance of preventing or controlling problems.

To take charge of your health, talk with your doctor about these ideas:

The microalbumin test checks for early signs of kidney damage by measuring the amount of protein, called microalbumin, in your urine. Damage to your kidneys may cause you to need dialysis treatments.

We're available 24 hours a day, seven days a week to help you live a healthier life.

Sincerely yours, and a pat on the derrière to La Bonne et Belle Bianca Castafiore,
S. Clusterfuck, etcetera etcetera...


I ask, with equal sincerity: WHAT THE FUCK?

Friday, April 17, 2009

I am the ostrich, Goo goo ga joob

Oh, Happy Day!

My heart is basically unchanged from the last echo in August 2008. Hooray! The same doctor who called me last year, and managed to scare me to death, called a few minutes ago. He chose his words carefully and I asked no questions -- it was a refreshingly short and sweet conversation.

If you read just a few of my posts, you know that I am obsessed with detail, as if by managing them all, I might bring order out of disorder. (You know, *that* old trick!) So why approach the echocardiogram results in the manner of a head-in-the-sand ostrich**?

Because it is something I cannot control. Because I have decided to trust the cardiologists. Because I made myself ill yesterday, wondering what having an aortic dissection might feel like, if -- that is -- I were so lucky as to survive long enough to feel anything. Because I entertained notions of having endocarditis again, or left ventricular failure -- that which left me with severe cardiomyopathy a decade ago. (And from which I spontaneously recovered! Turned out to be lupus-related.) I remembered how difficult it was to do anything as strenuous as, say, turning over in bed! Remembering that has been good for me, reminding me that the fatigue I feel now is oh-so-benign in comparison.

I was also very passive because just going to that hospital triggers reliving the traumas of May 2002.* In the aftermath of that horrid, life-altering, and criminal experience, I think lies were told to my cardiologist -- a man that I highly respected. I know now, after getting my medical records, that my heart doctor was the one I should thank for my survival -- he did the initial resuscitation and got me from the orthopedic floor to the ICU. I am so thankful to him and suspect (read: *know*) that the orthopedic surgeon (Carson) and the Head of Anesthesia told him I was suing, that I blamed him, or something. Because he completely changed.

[[The Anesthesia Chair? Sweeney Todd? At the time, he doubled as my pain management doctor, unfortunately -- God did he turn out to be a conniving, self-involved, heartless bastard -- and yes, I would slap the "criminal" label on him, too. Maybe more easily than anyone else besides Carson. He was in a position to do lumbar blocks and early intervention physical and drug therapy *immediately*. How dare he not report what state investigators eventually decided was a Sentinel Event? How dare he make light of what they all did to my effing life, choosing to moan to me, instead, about the changes investigators insisted be made in his department? Above all? How dare he not diagnose and treat my CRPS for over 19 months? In the days before yesterday's echo? I dreamt about meeting Sweeney Todd and Kelman in the elevator at the Doctor's Building. I was mute. Unable to speak. When we all exit the elevator, the doctors start to walk off. But Sweeney Todd turns around, walks over to me, sneers {He kinda looks like Cheney} and whispers: "What was that, Retired Educator? I can't hear you..."]]

I have asked The Fredster repeatedly if my memory is correct -- the memory of this same cardiologist telling me that I no longer needed to be followed, that I need not make another appointment. Fred was there, you see, and sometimes I need confirmation that what I remember is correct. Because this memory makes no sense! Of course, I needed to be followed, and, of course, I needed to make more appointments -- this was part of what the guy who called today was screaming at me last year. ("Why haven't you been seen? Why haven't you been having yearly echos?" and other pithy observations, such as -- when I asked what symptoms to watch out for with this aortic aneurism thingy -- "There won't be any symptoms. There won't be time." Oy! I thought I felt the very heart under discussion sink.)

This year? In a matter of minutes, I was literally breathing easier. My neck seemed to untangle itself, along with a disparate collection of sensitive internal organs. I felt like a walking miracle. Except for the walking part, I believe I am!

The aortic valve is maybe a little more "thick," the aortic insufficiency still moderate, and the aortic "dilatation" is just a smidge larger (+.14 centimeters to 4.79) -- but these observations don't amount to any real important clinical change or call for any intervention. I am "good to go" for surgery on the 27th. No growth on the valves -- that was also a concern, given the bacteria floating around in me.

An infinitely better reaction than that of last year:

dear all,

would anyone like to borrow some trouble?

i had my echo at 8:30 this morning. i asked the tech how it looked and she gave me a thumbs up and a "looks good to me." so we go home and i plan to pay some bills, declutter my piles of paper, etc.

ring ring ring.

it is one of the cardiologists. he is talking fast, and i cannot understand the words.

so... my heart is pumping well. i still have my usual aortic regurgitation from my bum aortic valve. and then there was that other thing. oh what was it?

oh yeah! where the aorta attaches to the heart ("the aortic root"), well... it is kind of dilated. like in an aneurism. i become a regular chatty cathy -- i ask if this precludes me having the surgery on monday and he says, no, that will be fine. then he starts to yell at me about how i need to have echos regularly -- that they found this dilation back in 2003. i don't *remember* that! (after i hang up and am talking to a weeping fred, he reminds me -- my cardiologist told us that it wasn't as bad as it looked on the echo -- and that i did NOT need to foillow up with him anymore! fred remembers that vividly.)

anyway, it measures 4.65 centimeters. i ask what needs to be done about it -- and the guy fairly hoots! (he actually was very nice) "major open heart surgery," says he.

well, what kind of symptoms should i be looking out for? and i am getting a chill just typing his response.

"you won't have any symptoms."

as in, it blows, i die. (hence, the weeping fred.)

there must be something extremely wrong with my mental health, this all seems like a great big joke to me! whahaha! what's gonna happen next?

i told fred that this is definitely an incentive to live in the moment.

so -- i guess it is a good thing i don't have hypertension.

whahahahahahahahaha!



******************************************************************************************************************* * Should you, Dear Reader, deign to click on the hyperlink and go visit the post over in Happy the Hospitalist's Land, please also note this comment I added as a sort of amendment. Then, as now, my tiny case of PTSD was rearing its ugly head:

La Belle et Bonne Bianca Castafiore, here. I serve as the willing public persona to one Retired Educator -- retired precisely due to the événements detailed above. We failed to provide a few details, not because they were not salient, but because it is difficult to type without shoulders!

**There was a third surgery to that illustrious hospitalization. When my cardiologist was working on me, he inserted a line in my femoral artery. A hefty little embolus formed a day later and emergency surgery was necessary as my leg was pulseless and a lovely ciel blue. *That* complication? Blameless and completely acceptable by me, something that occured in the order of things. Unfortunately, in the aftermath, our relationship was sacrificed to the Medico Brotherhood of Paranoia.

**My surgeon disappeared for a week after the ICU fall. I asked to have a new surgeon -- that request was both squashed and denied. I asked to see a patient advocate and was told that there were not any, but would I care to speak to a nun? Wile E. Coyote had nothing on these people. When I left the hospital, we thought that I had made three complete incident reports, and I *trusted* that there would be some record made in my chart. Dumb. Dumb. Dumb. What did I recommend in those lively conversations? Inservice education about adrenal insufficiency and how to spot the admittedly vague symptoms in patients undergoing surgery. Dumb. Dumb. Dumb. Legal action? Not even on my radar. I was being told that the incredible sensitivity and horrible shooting, burning pains in my leg and arm were the result of "too much pain medication" [?] and/or "a psychological problem." Would I care to see a psychiatrist? Rather than be offended, as I was, I should have said "yes." The nun, the shrink, and I might have really hit it off. Add a social worker and we had 4 for bridge.

**This ought to interest everyone. I was thrown into a Hell after all this happened -- I kept returning to the same doctors because my trust was not eroded. (Okay, so I am an idiot.) I thought and expected that people would be honest with me. When I finally went to a new neurologist, he left the exam room after about 5 minutes and came back with a heavy tome that had pictures of "classic" presentation of CRPS. Those photos might have been of me, they were that similar. He is wonderfully direct, and even though part of the same system as my former neurologist, quickly laid out the apparent plans for obfuscation that I was up against. Apparently, it was expected that I would sue. I would love to have sued... but had no capacity to handle anything but getting through the day. My friends and loves were angry with me... they would apparently have felt better were I to receive money. Go figure. Anyway, New Neuro Man tried to throw all available treatment at my CRPS, then still confined to the right leg and the left arm, and I tried to find some peace. I did, though, contact the state and report what I felt was a pretty awful state of affairs, and the previously mentioned Sentinel Event was declared, and investigators descended on the joint for a few days. Following that, I was dropped like a hot potato as a patient by everyone except my internist and my newly acquired neurologist. There is a 2-year statute of limitations for legal action. I had contacted the state medical society about the surgeon's various bizarreries (I cannot write about them, cannot take that stress), and they answered that he could not be censured or even investigated based on the information given. Whatever. I had completely given up trying to get the hospital to even pay those few bills it promised to cover (ambulance, bed, PT), and was living on 2/3 of my teaching salary -- the pay out of my longterm disability insurance. We had bought a house just a few months before this surgery -- a place to slum when we strayed from
Marlinspike Hall, deep, deep in the Tête de Hergé. Ten days before the statute would expire, I received a call from the Legal Dept of the hospital, asking me to please submit any outstanding bills relating to that hospitalization. I was of (at least) two minds and told them so. "Here are the bills you promised to pay," I wrote, "and here is what you ought to feel compelled to pay, because it would be the right thing to do." Negotiations began and they gave me a [very] small settlement.

Have you ever heard of an unsolicited settlement before?

**The last thing I have to say is that it is true that an apology and openness and Real HELP would have met all my needs, and might have saved my life from being ruined. Please, doctors, nurses, and administrators -- give that a try before you mire yourselves in heartless paranoia and ugly assumptions.

**I am not sure that you've done me any favors, making a post of my info -- but I am having to relive it anyway, given that today's circumstances link up with those of yesteryear. Did a hospitalist save me? Yes, though no doubt my internist would have come through, stud that he is. I never met the man. I have a smudged and bent card with his name on it and am told by the Fredster that he was incredible and that I am lucky he was there. If this is the kind of thing you do, Happy -- well... God bless you.

December 22, 2008 5:10 PM
__________________________________________________________________________________________
**
"Ostriches have three main strategies when attacked. They can run away, they can kick, or they can try to hide (eg, when nursing the eggs). When hiding, they will sometimes lay flat on the ground, with the long neck and head also on the ground. In the rippling heat haze of their native Africa, they can look just like a grassy mound.

The myth that an ostrich will stick its head in the sand, in an effort to hide, may have begun with that great Roman thinker, Pliny the Elder (23-79AD). His real name was Gaius Plinius Secundus. Pliny was a man of intense curiosity about the world around him. His nephew, Pliny the Younger, wrote about him, “He began to work long before daybreak. He read nothing without making extracts; he used even to say that there was no book so bad as not to contain something of value. In the country it was only the time when he was actually in his bath that was exempted from study. When travelling, as though freed from every other care, he devoted himself to study alone. In short, he deemed all time wasted that was not employed in study.”

In 79 AD, Mt. Vesuvius erupted - and covered and then preserved the city of Pompeii. While most people ran away from Vesuvius, Pliny went straight into the danger zone to look, learn and rescue survivors - and died in the attempt. In his honour, the most violent volcanic eruptions (such as Krakatoa) are called ultra-plinian.

Before his death, Pliny had almost completed one of the earliest comprehensive encyclopaediae. His Natural History, in 37 books, was a remarkable attempt to summarise all the knowledge known to the Romans. He claimed that he covered some 20,000 topics, which he partly got out of some 2,000 books, which in turn were written by some 100 authors. In fact, he was one of the first writers to acknowledge other authors from whom he quotes, and also one of the first to have a table of contents. His Natural History remained a fundamental source of knowledge to the West through the Dark Ages.

So what did Pliny have to say of ostriches? In Book 10, Chapter 1, he writes, “…they imagine, when they have thrust their head and neck into a bush, that the whole of their body is concealed”.

Historians assume that this single sentence is the root of the myth about ostriches burying their head in the sand."

Wednesday, April 15, 2009

As the World Peeks

I love sites like this one: "The Cleveland FalconCam is an entertaining and educational project that follows a pair of peregrine falcons nesting on Cleveland's historic skyscraper, the Terminal Tower."

Many thanks to William the Coroner, a new member of the He's-A-Very-Good-Boy Club. Don't ask me to release The Members List as it is protected under some amendment or other and you'd have to climb over my dead body to get it.

Stop harrassing me! Stop harrassing me, I say! Start your own damned He's-A-Very-Good-Boy Club Chapter! It's not hard -- I mean it's not like there are scads of candidates just waiting for this coveted nomination. Guillaume-dissèqueur-des-cadavres? He's only #15 (order is by Date of Inclusion and does not imply any sort of Ranking by Very-Good-Boy Values).

The most costly items to get your Chapter started? Definitely the uniforms, sashes, and badges.

Okay, du calme, du calme.

When you are a confirmed world traveler, it is a shock to the system to be stuck at home, even a home as splendid as Marlinspike Hall, deep, deep in The Tête de Hergé. Brother-Unit TW -- soon to be a Birthday Boy -- keeps my lungs expanded and my feet tucked in imaginary hiking boots with his blog, American Idyll -- illustrated by his photos of the Grand Canyon.

I bet most blogonauts have wholesome webcam favorites of the natural history sort -- another that I love to watch -- you know, on a slow day? Le collectif des écureuils (squirrels) -- either at the blog or over on Facebook. It's not exactly a webcam dealie -- more a family story along the lines of Meerkat Manor.

We love Meerkat Manor and used to watch it religiously -- until we decided to do a Meerkat Manor Festival and discovered that, yes, it *is* possible to get sick of meerkats.

Less wholesome, but nice with a glass of wine, is the panoramic view from the restaurant atop the centrally located Printemps department store. Someone tried to stick their tongue firmly in their cheek, but there was apparent slippage -- the cameras sit in Restaurant Déli-Cieux: Ouch.

And yikes.

Of course, you can find something for everyone over at EarthCam.

Today, they are featuring New Yorkers running for the Post Office to get those taxes mailed...
Yes, it is Tax Day Cam!

2009 Achilles Walk for Hope & Possibility in NYC


RSDSA at the 2009 Achilles Walk for Hope & Possibility in NYC
June 28, 2009 Central Park

Online Registration and Forms are now available!

Walker and Virtual Walker Registration Available
Click here for more information

Team Co-captains: Jackie Drake and Marsha Tyszler

Since RSDSA promotes public and professional awareness of CRPS, a neurologic syndrome characterized by severe and persistent pain that can lead to disability, we are charged with educating those afflicted with the syndrome, their families, friends, insurance and healthcare providers about the potentially-disabling pain it causes.

We have teams in the Achilles Walk for Hope & Possibility to promote awareness and encourage support for people with CRPS and their family and friends. Our participation highlights the disabling part of the syndrome and offers hope to those who suffer from it.

You can participate in the walk and raise pledges, or put together a corporate team. Perhaps your company has a matching funds arrangement for not-for-profit fundraising events. Visit the website or contact us to get started!


Susan Boyle

Perfect song choice for the world right now, and for all the bleary-eyed U.S. Americans staring at tax forms...

She is obviously trained. I mean, the diaphragm just doesn't start to do that on its own -- forget her vocal cords. It is so hard to believe she is just now being discovered -- and that is the story we want and long for -- an honest, unassuming person rising out of obscurity, referencing a life of "hell," singing from Les Mis! Mwa ha ha! Brilliant, absolutely brilliant.

Well, hmm. This is the most I've been able to find out about her, since *she* is the story:
She is a veteran of abuse. She was starved of oxygen at birth and has learning difficulties as a result. At school she was slow and had frizzy hair. She was bullied, mostly verbally. She told one newspaper that her classmates' jibes left behind the kind of scars that don't heal.

She didn't have boyfriends, is a stranger to romance and has never been kissed. "Shame," she said. Singing was her life-raft.

She lived with her parents in a four-bedroom council house and, when her father died a decade ago, she cared for her mother and sang in the church choir.
One of the best comments I saw as I cruised around, searching for credible information about the talented Ms. Boyle (and, for some reason, I seem to want her last name to be "Hodges," as I entered that errant search term over and over, perplexed...) -- anyway, this still being in the moment, I laughed to read this:

"I prefered the heavy guy with the funny teeth who sang opera." I'm thinking he means Paul Potts. I'm also thinking he could use a few moments of reflection.

Well, there was also this... and anglophiles everywhere may now call out a hearty "spot on!" --

"Are we really patting ourselves on the back for recognizing that an unattractive woman over the age of 30 might be talented at something?"

Mr. GetAGrip said, "[T]he only thing more cynical than writing her off based on her looks is elevating the performance based on her looks..." Pshaw! Taking all of the circumstances, or at least all we know, it is a great performance.

I know it made my day.

And besides, here at elle est belle la seine la seine elle est belle? Cynicism is a four-letter word.

Earnings










GOOG announces tomorrow.
Let us pray...










Extremism on the rise

Yesterday, Fox News put this out -- along with many other news outlets. So I had my choice of where to steal, um, lift, uh, where to *get* this info.

I was impressed by the integrity with which Fox relayed the story -- my stereotyping of that particular source being rather strong and negative.

Contrary to some other versions, the Fox story, after dealing with the gist of things, goes on to question assumptions.

What about extremism among the leftists?

The Homeland Security folks were ready -- referencing an earlier study done of those liberal numbnuts.

Fox did seem a little put out that the leftwing version of extremism à la The Homeland Folks concentrated less on the potential for violence and more on their propensity to understand and use technology.

Just a small dig.

Heh.

Seriously, though -- this assessment is not exactly a surprise to most of the citizenry. God bless, in fact, those for whom it *is* a shock, for they are surely... remarkable people --

Who most likely have their living room furniture covered in plastic and freezers full of what they call "TV Dinners."

I am afraid for Obama. I fear the people so rocked by race as to turn to the inflammatory reflex of violent response.

The growing degree of want and sense of loss for some U.S. Americans, particularly those whose losses are compounded by personal devastation, sacrifice, and, perhaps, war, will also drive extremist impulses -- and how to track these people without empowering Big Brother? (I know, I know. How many times have I already figured in FBI tapes -- those funloving people sporting videocams back in the days of my 'maintes manifestations'? I always posed full-faced and smiling.)

The question/thought I hope we all continually reflect upon? Whether or not, in order to preserve First Amendment rights (as we diversely interpret them), protection of the fringe elements of the extreme right and left must constitute the line in the sand.

The Department of Homeland Security is warning law enforcement agencies
that recent news is helping "right-wing extremist groups" recruit new members
and could lead to violence, and warns about the possible recruitment and
radicalization of returning veterans.

The report, issued last week, is part of an ongoing review of extremists on both ends of the political spectrum.

The latest assessment by DHS' Office of Intelligence and Analysis found
no specific information that domestic right-wing terrorists are currently
planning acts of violence, but right-wing extremists may be gaining new recruits
by playing on fears about the recession and the election of the first African
American president. The office called them "unique drivers for right-wing
radicalization and recruitment."

"Right-wing extremists have capitalized on the election of the first African American president, and are focusing their efforts to recruit new members, mobilize existing supporters and broaden their scope and appeal through propaganda, but they have not yet turned to attack planning," the assessment reads.

"The current economic and political climate has some similarities to the 1990s when right-wing extremism experienced a resurgence fueled largely by an economic recession, criticism about the outsourcing of jobs and the perceived threat to U.S. power and sovereignty by other foreign powers.," it continues.

The report also suggests that returning veterans are attractive recruits for right-wing groups looking for "combat skills and experience" so as to boost their "violent capabilities." It adds that new restrictions on gun ownership and the difficulty of veterans to reintegrate into their communities "could lead to the potential emergence of terrorist groups or lone wolf extremists capable of carrying out violent attacks."

"Proposed imposition of firearms restrictions and weapons bans likely would attract new members into the ranks of right-wing extremist groups ... The high volume of purchases and stockpiling of weapons and ammunition by right-wing extremists in anticipation of restrictions and bans in some parts of the country continue to be a primary concern to law enforcement," the report says.

The assessment notes that right-wing recruitment grew in the 1990s
but subsided after increased scrutiny by the government following the 1995
Oklahoma City bombings.

It does state that in 2009 "threats from white supremacist and violent antigovernment groups ... have been largely rhetorical and have not indicated plans to carry out violent acts."

"Nevertheless, the consequences of a prolonged economic downturn-including real estate foreclosures, unemployment, and an inability to obtain credit-could create a fertile recruiting environment for right-wing extremists and even result in confrontations between such groups and government authorities similar to those in the past," reads a key finding in the assessment.

DHS spokeswoman Sara Kuban said the April 7 assessment is one in an ongoing series published by DHS "to facilitate a greater understanding of radicalization in the United States."

"DHS has no specific information that domestic right-wing terrorists are currently planning acts of violence, but right-wing extremists may be gaining new recruitments by playing on their fears about several emerging issues," Kuban said.

Tuesday, April 14, 2009

Nice People: What should I get the Brother-Unit TW for his birthday?

I've noticed it happen chez other bloggers, so why am I surprised? The slow and steady erosion of my distinctly tough outer shell due to the influence of...

nice people.

You know who you are.

Thank you for looking past my whines, thanks especially for laughing with me -- it's always appropriate. Sure, maybe there is a *smidgen* of laughing at me -- again, always appropriate, but I can sometimes hear the guffaws and snorts flying around rooms and cars, spacious mansions and cute efficiencies. (I have rented my share of cute efficiencies -- and "rooms" located in various odd relationships to the central housing [basements, "wings," garages])

I imagine them as angel farts. Gaseous Tinkerbells.

So, my little gaseous tinkerbells, my darling angel farts -- Will you do me a favor? (Ay caint heeeear ewe, gashush tenderloins!)

You will!

Wonderful, thanks a lot.

My brother-unit TW's birthday is April 20. We have an incredible story, I suppose, though the more people I come to know, the more I learn that "estrangement" is the common exception that proves a bunch o'rules -- like "absence makes the heart grow fonder" and "home is where the heart is." I would say "blood is thicker than water," but I don't want to malign TW.

Oh, that photo up there is one of TW's -- he works and plays and loves as a guide to Grand Canyon serious trekkers. In the colder months, and to make enough money to feed his cats, he labors as a bookie. This photo is from a blog post of his called A Parable of Immortality (Thomas Wolfe).

He was basically abandoned by my original nuclear family (yes, we were armed) -- as a young teenager, and at a time and place that was simultaneously wondrous, dangerous, and mythologizing. He spent some time following The Dead. He was shot in the gut by a deranged CIA operative. He ate out of garbage cans, was homeless. He is BRILLIANT and KIND and the only way he could have turned out that way is through the good gifts of being receptive and generous.

Through the years, we weren't allowed to speak of him. His name and my Mother's name were anathema and a person could be punished or their suitcases retrieved from the attic for speaking their names. He changed his to Tumbleweed. Oh, yeah, and I am pretty sure he's been very wasted from year to year, but then, haven't we all? I bear my Mother's name as my middle name, I guess because I was born on her birthday... but still -- after all these years -- under duress about these god-forsaken names, I say: My name is Retired mumblemumble Educator.

I love him a lot. I wish there were more to offer than the meager "Gee, I'm sorry we left you a continent or so away, alone -- oh, and hungry -- maybe in a little danger. Glad you survived, there, good buddy. Made a man of you, didn't it!"

I forgot probably more about him than I really knew. I had a rich fantasy life and both of my brother-units filled in as Superheroes. I didn't even know his mumblemumble name, just the first name, discarded. But I always remembered that he was born on Adolf Hitler's birthday, April 20.

Will you help me figure out a gift for him? I know you can't, really. But would you try? He's very well read, so I am afraid to get him books. We share a lot of the same musical taste, so there'd likely be a redundancy if I sent music. There was a sentimental item I hoped to send at some point, but I ran over it and cracked it with my wheelchair as I was chasing The Felines out of my office.

Our grandfather's pith helmet. It still smells like salt and loam.

TW has been clear that he's not interested in frilly reunionesque drama... me, neither. I have had two dreams -- the same dream, twice -- where I held something in my hand and was reaching out to give it to him -- so I know that somewhere in me, there is a real notion of "gift." There is something that I am supposed to give him.

Do you know what it might be?

Thanks, friends. (As for such matters as price range? Well, I used to be brilliantly rich, enormously laden with gold and lucre of all kind, but now am essentially destitute, dependent on the good Captain Haddock for food and shelter. So I am thinking $50-$75. Ar!)

I worried some of you by posting in so much pain and anger a few days ago. The pain is down a notch but it does appear that I am in a new phase (or whatever, as the kids say...) of disease with CRPS. No one really knows. There is always the worry of what the infections are doing. Also of what the infecting organism is! And *where* it is! Thursday morning, I am having another echo done to check my funky junky valves and see how my aortic aneurysm is doing -- I am too tired to get out of bed many days, have developed the disgusting habit of passing out now and then (more like going momentarily "black" -- a cold tunnel sort of thang) and my bloodwork sucks. That's suspicious, I guess, for my aortic insufficiency to perhaps have worsened. We'll see on Thursday. And, as confusedly related earlier today, the infection and the steroids have caused my blood sugar to rocket out of control. (At this very moment, I am in awe. IN AWE, I say! How can a person be simultaneously nauseated to the nth degree and starving? I have almost stopped eating the last 4-5 days... I suppose it's not all that inexplicable -- pain as I'd forgotten exists, blood sugars weirded out, fever, worry, fear, added-on pain meds. Oh, yeah, and all of that prednisone...)

This pain... sorry, I'll stop.

Is that what I *am* -- all of that krap jumbled together as a woe-is-me? Am I become "woe"?

Better than "woo," I suppose!

From the Skeptic's Dictionary:




Woo-woo (or just plain woo) refers to ideas considered irrational or based on
extremely flimsy evidence or that appeal to mysterious occult forces or powers.

Here's a dictionary definition of woo-woo:

adj. concerned with emotions, mysticism, or spiritualism; other than rational or scientific; mysterious; new agey. Also n., a person who has mystical or new age beliefs. When used by skeptics, woo-woo is a derogatory and dismissive term used to
refer to beliefs one considers nonsense or to a person who holds such beliefs.

Sometimes woo-woo is used by skeptics as a synonym for pseudoscience,
true-believer, or quackery. But mostly the term is used for its emotive content
and is an emotive synonym for such terms as nonsense, irrational, nutter, nut,
or crazy.










Most of the time, I align myself with The Skeptics. My nature, I guess. It's not a way of being that is all that wonderful, and I am trying to change. But, in the shift from Konstant Skeptick (say that, fast, twenty times) one must beware the allure of woo-woo.

Ahem. Excuse me while I whack the butt, oh-so-rhythmically, of Our Little Idiot, Dobby. He loves it -- and we will all be in jail should some representant of the SPCA drop by. (Yeah, but "dropping by" ain't all that easy, here at Marlinspike Hall, deep, deep in the Tête de Hergé. The roads are frequently out, and we have an impressive, and recently renovated, moat.)

I'm back. Where is my train of thought? Choo?
Oh, a b'day gift for Tumbleweed.

Once, when he returned home after a brief run-away, I didn't see him standing there looking down on a bunch of us kids organizing a baseball game. And when I did see him, it was clear that It Was A Moment In Time. Like it was yesterday and not 40 years ago, I see him. When I first saw the cover of Nashville Skyline, Elliott Landy's famous photograph, I gasped -- that's TW standing there -- a fuller face, less of a nose, more sensual lip -- but the same attitude, dress, guitar, expression. A traveler on the road, knowing something.



That's TW: a traveler on the road, A Song of Myself. A paean of all that could be.

Shit. I've made myself sad. Oh, what to get him? Maybe I will sleep tonight. Maybe I will dream dreams, and see what I have in my hand for my brother.

My BS

Major Boogers! Captain Secretions! Holy Hay fever!

No, not allergies, just a random outburst, but with a theme.

I am being put on sliding scale insulin. [Late breaking update! No insulin! Yay! He is adding Amaryl. Wise Choice, Wise Choice...] Too bad I have never paid much attention to the uptight and innately irritating Diabetes Educators that come to my bedside whenever I'm in ICU. Given that I only learn well in cement-blocked classrooms, where I sit in the back, huddled with a caffe latte, it was always a waste of breath.

Fred just sketched the major points again for me -- in a matter of 2-3 minutes -- and wasn't condescending or obtuse or nothin'.

It's the infection that has caused my blood sugars to go schizophrenic. That's what I was told. I don't understand how or why that could be, but if so, at least I will be able to stop the insulin when the infection(s) is cured. Right? "Before" -- I was put on Starlix because steroids were elevating the blood sugars. Now infection gets the blame.

Wanna hear how wacky these readings are? (Ha! Whose blog is it, anyway?) Let's see... Oh, and before every meal, I take 2 120 mg Starlix, an oral med designed to help keep this krapola under control.

Sunday -- at 8 am it was 135. Around 2 pm, I ate one boneless, skinless nuked chicken breast with herbs, had sugar free Jello with one dollop (about 1 tablespoon) sour cream. Four hours+ after eating that? 286.

How about the creepy fact that if I test blood sugar between 10 and 11pm, the readings are always between 240 and 250?! Is that not creepy?

I don't sleep much. Several times late at night, I have tested because of an inexplicable weird feeling (a host of generalities) -- to find readings in the 300+ range. It was my understanding that hyperglycemia didn't really have any symptoms --but I seem to have some sort of sensor -- vision is blurry, thirst, and a vague sense of not feeling well.

One day when I was really hit with fever and pain -- 252 was as low as I could get --even with an almost zero carb diet and starlix. I hope Dr. Go-to-guy's Nurse can explain this schtuff to me.

This morning, my fasting reading was 195.

Shoot. I don't wanna give myself shots. Cure the freaking infection.

Monday, April 13, 2009

Doctor Scott Reubin: Reprise


I bet you thought he'd faded from my memory -- me and my mind like a steel trap. Wrong! There is just a dearth of information out there, which means, I fear, nothing good.

It is odd to me that only non-medical people seem to be urging the precise and intense application of criminal charges on the hide of Dr. Scott Reuben, fraud extraordinaire.

Tufts, where do they stand? Patients, colleagues? Those innocent "co-authors"? The, cough, innocent, gag, drug companies? The FDA?

Who really believes that he did all the work of conducting fake clinical trials and the resultant fake articles and fake peer reviews and all the other fakiness... without help?

We cannot afford to let this case fade from attention.

To refresh the particulars of the case, here is an excellent take on the crime, found over at e-patients.net, "Dr. Reuben deeply regrets that this happened."

"Dr. Reuben deeply regrets that this happened." Isn't that a riot? Isn't that the most insulting response imaginable?

Back on March 23, Gilles Frydman put together a post on what he tongue-firmly-in-cheek called
"the third... in the unfortunate series about conflicts of interest":


In truth the quote is from one of his attorneys. Dr. Reuben, a world-famous anesthesiologist and former chief of acute pain management at Baystate Medical
Center, Springfield, Mass, one of the campuses of Tufts University School of Medicine is accused to have fabricated over 13 years at least 21 medical studies
(and perhaps many more among the 72 papers written by the good doctor) that
claimed to show benefits from painkillers like Vioxx and Celebrex, 2 drugs since
withdrawn from the U.S. and worldwide market due to safety concerns of an
increased risk of cardiovascular events (including heart attack and stroke).
Most, if not all, of these articles are in the process to be retracted. The
wonderful Dr. Reuben also wrote to the Food and Drug Administration, urging the
agency not to restrict the use of many of the painkillers he studied, citing his
own fabricated data to prove their safety and effectiveness....

Even better Dr. Reuben published fabricated studies showing the great effectiveness
of a combination treatment using 2 drugs from Pfizer, Celebrex and Lyrica. No
one paid attention to the fact that, like Dr Robinson and Dr. Ridker et al. Dr.
Ruben was regularly paid by pharmaceutical companies. In fact he was active as a
member of Pfizer speakers bureau until recently and received, from 2002 to 2007,
5 research grants from that company. Besides the evident culture of greed that
has infected a lot of the medical research activities, there must be something
even deeper that can convince doctors that it is OK to put many lives at risk by
falsifying results.

Flummoxed? Wait, there is more! Dr. Reuben’s attorney also said there were extenuating circumstances! I kid you not. As usualno one is really talking. Dr. Reuben is on extended medical leave. Tufts University doesn’t seem to know him anymore. I guess everybody is trying to get the story to disappear under some heavy duty carpet. But this story cannot disappear....

The fraud didn’t stop at the published articles but was also used in
multiple letters in response to valid scientific articles to destroy the
scientific findings of honest researchers....

The clinical impact of the fraud will be profound. Jacques Chelly, MD, PhD,
MBA, director of the Division of Regional Anesthesia and Acute Interventional
Perioperative Pain at the University of Pittsburgh Medical Center (UPMC), said
that the fraud has left multimodal analgesia “in shambles”. He added

“the big chunk of what people have based their protocol on is gone.
we have stopped giving celecoxib and pregabalin to surgery patients until we
have some very formal evidence that we should do something else. In this day and
age, doing multimodal [therapy] is expensive. Any institution is going to look
at evidence-based clinical decisions, and unless we have very strong data, it is
a problem. Since most of evidence is now unreliable you really don’t have any
evidence that the combination is working...."

Photo Caption, Anyone?



I knew that life had profoundly changed when my holiday wish lists last year were taken from dog-eared, well-thumbed medical supply catalogs.

For my birthday -- January -- close friends and family were able to avail themselves of end-of-the-year specials, discontinued items, and free shipping, the gift-givers dream come true.

I got a 10 inch Sacro-Lumbar Support with crisscrossed structure, Velcro ® closures, two angle pulls and stays (who does not love stays?) from Mom. It was beautifully gift-wrapped, but she left the price information inside -- "by accident," I'm sure. She's a little on the shallow side.

Not to be outdone, Step-Mom, the pinnacle of taste, gave me a lifetime supply of tubular gauze and orthopedic stockinettes. Kind of goes with her major personality quirk wherein everything must be well-contained in its proper place and clean, clean, clean and then: more better clean, with Clorox.

Grader Boob, one of my older brother-units, gets embarrassed by all the Excess of the Personal, and used the Dart Method of catalog shopping. He gifted this wheelchair-bound sister with a Primo Pedometer. Still, it was discounted to $23.75 from $29.99 -- a real steal.

My other brother-unit is a parttime bookie in Vegas and a guide for folks wanting to trek the more challenging and remote areas of the Grand Canyon. A year and a half or so back, he injured his shoulder. Given that half of the time I don't have shoulders, I was thrilled to get the unparalled Universal Posture and Clavicle Support -- from Scott Specialties, Inc. no less! Unfortunately, there was not enough room provided for my boobies. The girls found the front buckle closure convenient... but the padded "pliable" metal stays? Busting out all over my... circumference.

We haven't "met" yet -- the last time he saw me I was eight years old, and had no circumference! I have seen photos of him -- from his blog -- one that I adore -- called "fool in a pool" has him happy and waving from a natural pool at the bottom of a natural waterfall somewhere in that natural canyon. I am pretty sure he is nekkid under all the sparkle. The thing is... he looks, to me, just like he did the last time I saw him -- bearded, tan, thin. Considerably happier, though. I don't resemble my Self from even a few years back. I am a moon -faced, buffalo-humped monstrosity! Boo!

My best friend, The Iranian Lesbian? She's *such* a fashionista and it shows in her gift-giving: Medichoice disposable Paper Bibs -- with a debris-catching pocket along the bottom edge.

Anyway.

What's on my wish list now? More exotic stuff, like Conductive Aloe Vera Gel (for when Sparky-the-TENS Unit shorts out), a Memory Foam Seat Cushion (for my tired tush), and transfer boards made of your finer woods (I'm thinking some zebra wood or black palm -- lacewood or knobthorn -- with an extra-smooth, if not super*slick* finish).

You got that, family and friends?

My email queue is gone all crikey, and now I receive tantalizing offers such as the one above -- at least four or six times a week. Nothing if not regular.

Please tell me what they are so out-and-out *ecstatic* -- about?

"hooray, ma! no more poop on the floor!"

"look, aunty, a million ways to immobilize your relatives!"

"gramma! moisture-sensing bed pads -- attached to a miniaturized electrification device thingy! now that's an effective way to stop bed wetting, eh!?"



How does your caption read?

Sunday, April 12, 2009

Don't Bargain With God -- You'll Be Played For A Fool

Hard choices. But my choices.

Medicated out the wazoo. Until the pain in my right leg goes down a few notches. There is nothing else in my world right now -- no room. It's on fire, it's delivering jolts, it is in contracture to the point of pure misery.

Left unsaid: I want to go to the Emergency Department, where they keep the Emergency Rooms and the people that I trust to help should things go south in a hurry, as they have these last few hours.

Out loud: I spent a few hours just crying (mostly in the bathroom), but trying to stay calm and distracted because I didn't want to go to the Emergency Department, where they keep the Emergency Rooms and the people that I [stupidly used to] trust would help should things go south in a hurry.

[Before beginning to read the medical blogosphere, I thought it safe to go there for help. Not so, not how they talk about people in pain. Fuck them.]

This is supposedly one of the most painful of diseases -- Whatever, all I know is that it has not hurt like this for years. Years that I consider completely lost. I am terrified that I won't come out of this -- evolve, settle back to my normal pain levels.

Trust me -- I can't do this.

Last night was hell. I don't want to do tonight. I can't do this.

About 6 weeks ago? I think. I cut back from 4 10 mg of methadone a day to 3 10 mg of methadone a day. Too sleepy and stupid. I am adding it back starting NOW -- and also, I am giving myself permission to dick around with percocet until I get a measure of relief. It's just that simple. If that does not work... I don't know what to do. Doctors sure don't have the least inkling. I talked to Fred about amputation, he said, "It will just make it worse." And when did he start knowing anything about this shit? He got me water and some food and then disappeared. He cannot take much more of this. Bless his bones; Bless his beautiful heart.

I told God a while back, three-four years ago, that I would take whatever He felt like dishing out if He would just help me to be humble. I mean, it was clear that I was in for Deep DooDoo, Paradise Lost to Dame Constant Pain. Humility. That was the deal. It was our Bargain Power Hour.

The Son of a Bitch. Fuck Him, and His Little Dog, too.

Fun With News!

Spencer Bachus Makes List of 17 Socialists in Congress

Not too long ago, Congresswoman Michele Bachmann was on Hardball [see below for clip], calling for the media to investigate her Congressional colleagues to "find out if they are pro-America or anti-America." Well, it turns out that someone has taken up Bachmann's call on a proactive basis! His name is Spencer Bachus and he has made a list -- a secret list! -- of the socialists in the House of Representatives. Or so he told the Birmingham News. Who are the seventeen socialists? That's the secret part, apparently.

From The Hill's Briefing Room:

Rep. Spencer Bachus (R-Ala.) puts the number of socialists in the House at 17.

"Some of the men and women I work with in Congress are socialists," Bachus told local government leaders on Thursday, according to the Birmingham News.

Bachus gave the specific number of House socialists when pressed later by a reporter.


By the way, I can't wait until someone tells Bachus about how "only 53% of American adults believe capitalism is better than socialism." He is not going to take that news well, I imagine.



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Just 53% Say Capitalism Better Than Socialism
Thursday, April 09, 2009

Only 53% of American adults believe capitalism is better than socialism.

The latest Rasmussen Reports national telephone survey found that 20% disagree and say socialism is better. Twenty-seven percent (27%) are not sure which is better...

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From Mary Ann Akers Washington Post Blog, The Sleuth:

Spencer Bachus's Past With Socialists (4.10.2009)
You may have heard, Rep. Spencer Bachus (R-Ala.) is keeping tabs on socialists in Congress. There are 17 in the House alone by his count.

But get this -- it turns out Bachus was for socialists before he was against them. At least he cosponsored legislation with one of them, the only known socialist in Congress: Sen. Bernie Sanders (I-Vt.).

That's right. In 2003, Bachus co-sponsored a measure with then congressman Sanders and Rep. Carolyn Maloney (D-N.Y.), which Sanders called a "tripartisan amendment." It sought to prevent credit card companies from jacking up interest rates on cardholders who have bad credit reports because of late payments and loans and such.

But that was then, this is now.

This week Bachus is making headlines all over the Internet for his comment during a speech to locally elected officials in his district that "some of these guys I work with, the men and women in Congress, are socialists."

Later, Bachus clarified to The Birmingham News that he counts 17 members of the House as socialists. But he could only name one: Bernie Sanders.

Sanders, who considers himself a Democratic Socialist (not affiliated with the Socialist Party) declined through his spokesman to comment on Bachus's once warm embrace.

"What with the recession and all the unpleasantness on Wall Street, I don't want to gang up on the capitalists," Sanders' communications director, Michael Briggs, said wryly....

[Yep, the bolding and italics are mine!]