Sunday, December 12, 2010

Oh, that bothersome bot!

graphic by creativeNERDS
Good evening, Friends of The Manor, Minions of Marlinspike!  

I am doing my darnedest to breathe. Fred has passed along his illness, and as is my wont, I am taking it to new heights. As in flirting with, if not in the actual throes of, pneumonia.

Lacking that, I have at least achieved a striking bronchitis.  Marmy Fluffy Butt and I have been performing *ack*-*ack* duets, our pink noses in air.
This self-limiting respiratory virus will serve as my latest excuse, the raison du jour for my absence from the virtual realm.

In such a condition, with its predictable accompanying mood, I decided to check email before gathering with Fred and The Castafiore to sing, all in a jumble, our nightly rendition (in the round) of "plop, plop, fizz, fizz... oh, what a relief it is..."  Marmy scats her *acks* as a sort of background vocal.

Unfortunately, I got pissed off by the very first piece of electronic mail. It was my MedWorm feed report for the term CRPS -- all the news on that funkylpated addlemucked crap of a disease that is fit to spread around like fresh, pungent manure.

The vast majority of the time, the Medworm CRPS feed turns up research just published within the confines of academia. It is remarkable when what pops up derives more from the personal, as in a blog.

And it is regrettable when the singularly personal blog merits reportage for an offhanded and uninformed remark. That's when you remember that it is not so much intelligence that is at work as it is the intestinal contents of a bot.  *

Anyway, you know me (and, again, I'm sorry about that!), I have to read it all. So I dutifully click on the link provided, tap my heels and toes together like a spastic Nazi, and arrive at:
(B)e(LO)n(G), OT -- the blog that the bot bit.

Under the title, blogger Karen appends this description:

I recently made the transition from occupational therapy student to occupational therapy PRACTITIONER. That's right, I am an occupational therapist now, dum dum dum. This blog is having a hard time following me in the transition so bear with me!
Reading this, I am already thinking that turning the computer on at all was a mistake.  My phlegm confirms it, but I figure I'm halfway home, maybe this neophyte has an insight that'll take me to school...

I read on -- it doesn't take long -- and discover that the following passage is what has so commended this woman's blog to the CRPS Medworm bot:
We had a lady come in today, 3 months post carpal tunnel surgery, who is still having a LOT of pain in her L hand and is babying it (her non-dominant hand). She doesn't move it much because it hurts. Her scar is healing well although hypersensitive, and her hand isn't swollen or red, so it doesn't seem like its CRPS/RSD, but something along those lines. To me CRPS/RSD seems like it is directly correlated to the level of depression/anxiety a person has. The more depression/anxiety a person has, the more likely they end up with CRPS [my anecdotal experience]. I was trying to think of ways to handle her pain and I wish I had more of my OT resources here. Oh well.
The unknown but now fully vested OT Julie has managed to offend me which is, of course, ridiculous, as her blog is just another blog, ho hum.  But this blog met the bot and therefore pretends (in the French sense of prétendre, and no, I am not being snobbish, I really cannot find the equal phrase in English), therefore lays claim to a sort of research nobility which its actual bastardized nature cannot support.

Do I need to chase down and reiterate... Do I need to be the counterweight, countering voice?  Do I have to care?

You ought to be able to deduce the answer from the fact that I am writing this while wheezing and bulbous-nosed, head aching and face raw.  Yes, damn it, I have to care.  I did a little reading of Karen's blog and she's definitely talented, definitely dedicated... but she blew it with this broadened (haphazard and unsought) publication.  Because for her every mention of prostheses, I've got mine (both the mentions and the prostheses themselves, eh wot?!) and for her doomed reference to anecdotal experience... well, en garde, chica, en garde

No, in all seriousness, it sound like Karen is dedicated and immersed in helping people obtain and acclimate to prosthetic limbs and the various sundries that go with disability.  And yes, I am sure that is an understatement of all that must be involved.

As long as the truth is going to be contained in winked-out citations of [not-much] experience, people with diseases like CRPS will remain disadvantaged by health care professionals who prefer their truths watered down.  It doesn't matter what you know, wink::wink, it only matters what you KNOW, if you get my heavy handed drift...

In sum, as I need to go evacuate my lungs, please, young professional, newly minted OT, bone up a bit, do some reading -- but just know that how you choose to deal with the psychosocial factors associated with any disease process... well, it shows, and not just in your blogging, and it can serve as a sort of casual litmus test for your patients.

It's funny, Karen, but as I reach the end of this ridiculous post, this rant, I find I kind of like you.  I took some time out to deal with the gastrointestinal sequelae of antibiotic therapy (yes, folks, I am now on the SECOND course of abx, the osteomyelitis experiment continues midst a budding pneumonia!) and to reflect on my personal dealings with occupational therapists, my own anecdotal evidence, of sorts.
It is not for nothing that part of the introductory packet of information sent out by Reflex Sympathetic Dystrophy Syndrome Association ( is a a fairly dense article written in 2003 by E. Daniela Hord, MD and Anne Louise Oaklander, MD, PhD -- Complex Regional Pain Syndrome:  A Review of Evidence-supported Treatment Options.

Because of the discrepancy between the subjective complaints
of pain of patients with CRPS and the limited
objective evidence of underlying pathology, some authors
in the past have suggested that psychiatric factors are a
major cause of CRPS. Although many patients with longterm
CRPS battle depression and anxiety, these conditions
usually are a consequence, rather than a cause, of their pain
[18]. It is clear that experiencing significant ongoing pain is
a major adverse life event that will challenge the coping
skills of even the most well-adjusted patient. Clinicians
should be aware of the high rate of secondary psychiatric
problems in CRPS and refer patients for counseling and
medical treatment as needed.

Bottom line!  (And good luck in what I know will be an awesome career helping people, OT Karen!)

*****     *****     *****     *****     *****     *****     *****

*  What is a bot?  Well, first of all, it is not a botfly, fascinating as those creatures can be.  If you are into botflies, you might enjoy this "compilation," much treasured over at Pop That Zit.

Sometimes a bot (or zombie) refers to a type of malware.

But what I am referencing are --
Internet bots, also known as web robots, WWW robots or simply bots... software applications that run automated tasks over the Internet. Typically, bots perform tasks that are both simple and structurally repetitive, at a much higher rate than would be possible for a human alone. The largest use of bots is in web spidering, in which an automated script fetches, analyzes and files information from web servers at many times the speed of a human.
Specifically, I'm on about RSS Bots -- "a web-crawling robot [that] collects RSS, RDF, and ATOM feeds from the internet to build a searchable index..."

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