Saturday, September 4, 2010

Kirsten of Christchurch

Blogger Kirsten of Christchurch, New Zealand, just got home after major surgery, ready to rest up and begin a great recovery.

Major Surgery?  Meet Major Earthquake.

AP Press reports:
Buildings collapse, 2 injured in powerful NZ quake
By ROB GRIFFITH, Associated Press Writer

CHRISTCHURCH, New Zealand – Chimneys and walls crumbled to the ground, roads cracked in half and residents were knocked off their feet as a powerful magnitude-7.1 earthquake rocked New Zealand's South Island early Saturday. The prime minister said it was a miracle no one was killed.

Only two serious injuries were reported from the quake, which shook thousands of people awake when it struck at 4:35 a.m. near the southern city of Christchurch. There were reports of some people trapped inside damaged buildings — though none appeared to be crushed by rubble — and a few looters broke into some damaged shops in the city of 400,000.

Power was cut across the region, roads were blocked by debris, and gas and water supplies were disrupted, Christchurch Mayor Bob Parker said. Chimneys and walls of older buildings were reduced to rubble, and Parker warned that continuing aftershocks could cause masonry to fall from damaged buildings... [continued here]

Kirsten's blog, Urinary Diversions, formerly Neo-Conduit, is an interesting mix of information, both personal and abstracted, about surgical urinary diversions, as well as her frustrating experiences with the medical system in New Zealand. She is an activist on behalf of patient rights, women's rights, and has a love affair, too, with fuzzy, furry domesticated animals.

So, yes, she just got home after a big surgery, after which she had some complications and was in clear need of rest and relaxation. At least she had a few quiet days before Mother Nature made the earth tremble.

She went for a walk with her daughter, in search of bottled water, and posted some photos of the damage in her neighborhood. Go take a look!

Thursday, September 2, 2010

Shawnna's Con

Editorial reflection:

I wrote this post on January 24, 2009. That is neither here, nor there, but was, it happens, a significant date. That is my birthday.

This tells me, and I am telling you, in turn, that the circumstances in the post must have been very upsetting. This is not the kind of thing about which one wants to be thinking on one's birthday.

Today, having an additional 20 months of riotous living under my belt, I know that the story I am about to tell is not at all unusual. That's terribly sad, but is, as they say, what it is.

You cannot and should not trust that anyone is who they say they are, is how they claim to be. Unless, of course, you have the means to verify stuff. Unless, of course, you just don't care. Unless, of course, you are one of those people who are brimming-to-overflow with forgiveness.

To update "Shawnna's Con," her latest claims are that she is awaiting a heart transplant, that she had a stroke on Easter Sunday, that her HIV+ daughter is now having her fourth child since diagnosis, and that she, Shawnna, is raising three of those children, that she never made it to Tennessee, but remains in North Carolina. (Note to Self: There seems to be an inordinate number of internet shysters residing in North Carolina. I love N.C. -- I lived there when I was in high school, taught and studied at Duke, and have a long love affair with Atlantic Beach/Morehead City -- so it pains me to say this.)

I decided to use my subscription to an information agency again -- the last time I used it was to discover that my half-siblings, newly admitted into my life, had quite the criminal record. Guess where they live? And before that, it was to discover the deviant goings-on with my cyber-stalker... Who, I kid you not, lives about a half-hour from my sterling half-relatives! What a state!

People with criminal records don't necessarily end up on some sort of exclusionary list of mine. Gauging from the dates of arrest, it looks like my sibs went through a very hellish period, during which they may have been trying to establish some kind of financial independence from The Mother-Unit, although they benefited from having an absolute saint for a father. My Mother is, as the saying goes, a piece of work. Had they ended up hardened felons, incontinent of urine and stool, with needles hanging out of their arms, and their hair all mussed -- I would have understood.

Even my cyberstalker's legal troubles are understandable, stemming as they do from terrible poverty, and, I think, a terrible lack of decent role models and self-esteem. Unfortunately, her daughters now have records, too, for the same reasons. It is a sign of hope, though, that they must suck at thieving, for they've all been caught.

"Shawnna," however, is a con artist and seems to enjoy reeling people in on her fishy lines of drama, trauma. She invades your heart, heartlessly. She has a substantial area dedicated to her crimes on the N.C. Master List of Master Criminals, one arrest coming on the same date of her last claimed thrust-and-parry with Death -- Easter Sunday ("They had to Life Flight me..."). 

Resurrection Jealousy.

I can find no proof online that her recently deceased husband ever existed. Nonetheless, his name has been altered, as well as hers.

The fact that every "disturbed" person I've encountered were met over at the Dr. Phil website is just something I present to you, without commentary. {Though you should see my eyebrows wiggle...}

Hard luck stories are the bread-and-butter of the con, I guess. And I may as well confess, not for the first time here, that I am the World's Easiest Mark. It is great sport among my family and friends to see just how much junk they can get me to believe. I melt at a low temperature, cooing "Oh no, really?" upon hearing their sad, sad sagas.

But I think I am wising up! At least with Fred. He has some "tells" that I can now identify, chief among which is the statement: "This is a true story." But, oh, how it delights him when he can reel me in. I am not going to embarrass myself by laying out the far fetched things I have come to accept as true -- but I recently made mention of one, so I'll reuse it. My former bestest friend in the whole wide world is a gorgeous Iranienne Lesbian (but not, praise Jesus, one of the Militant Lesbian Existentialist Feminists). We met as undergrads, roomed together for a while, and -- even though I screwed up our relationship in recent years -- had a wonderful life together. She just could not believe the extent of my gullibility. One day, we were working on homework in the French Dept. lounge, trying to come up with paper topics for our 17th century lit class. She hit on something she thought I would like -- having to do with that famous classicist Oussama Mon Chénier.

Chenier is a Cajun term, referencing a:
beach ridge, usually composed of sand-sized material resting on clay or mud. Chenier is the Louisiana French term for the oak tree belts that mark the distribution of the ridges in the Mississippi Delta region. In that area there are several sets of cheniers, each separated from, and slightly unconformable to, the next. Some of the ridges have been reworked by waves, and several show a blanket of peat growth (indicating a regression of sea level) covered by marine sediments. The arrangement and composition of these cheniers are taken as evidence of a fluctuation in sea level and have been correlated in time with similar evidence in other areas of the world. (from

The Shah-Meister regaled me with fond memories of her relationship with this 17th century naturalist, and how she spent many a rainy afternoon stretched out on her bed, thumbing through his great and marvelously illustrated work:  L'Histoire Naturelle des Animaux Sauvages (The Natural History of Wild Animals).  She had never understood why it was such a beloved reference work in Persia but unknown to Unenlightened Westerners.

By the time she convinced me to go and interrogate Professor Aronson là-dessus, I was frothing at the mouth at the thought of the academic wealth awaiting my investigation.  I will just let you imagine my horror at the kindly sad smile which my respected professor assumed about 10 seconds into my presentation of my awesome paper topic...

And then there was the Incident on the Berkeley Pier.

But "Shawnna"?  She's on a whole other level of malevolence.  Given her recent re-emergence (we surmise that she may just have gotten released from prison), I decided to go ahead and post this.  Should you come upon it, Lashy?  I am a Born Again Skeptic, as well as Very Certain Friend to the Woman You Are Trying to Snooker.  So back the fuck up, woman.  I mean it.

It's beyond disconcerting: beyond it, though, to I don't exactly know what.

The popular initial reaction seems to be "disappointment." That surely was the killer reaction that worked best on me as a child -- nothing hurt so much as when a beloved adult would calmly (with maybe a Touch of Glum) express disappointment in me and in whatever behavior I had perpetrated.

For 18 months, this woman Shawnna interacted almost daily with me and several other people in an online group that dealt with the vagaries of living with chronic pain.

Oh, put your eyes back in your head! Stifle!

This group put up with *me*, remember. How much time do we spend talking about pain? Almost none. How much time do we spend bitching about doctors and tests and drugs and such, ka-ching? Okay, well, maybe 27% of our text might be so appropriated. Another 52% is dedicated to regaling one another with stories that sometimes tested the boundaries of decency. Roughly 20% of the time, we deal with people who will most likely not be sticking around to become a regular. They are panicked by passing discomforts, angry at the world, desperate for sympathy and compassion, and, occasionally, really in big trouble -- that's when we function like a well-oiled machine and produce names, numbers, web links, contacts, straight up info.

The remaining percentile? In-de-fin-able! That cachet of a certain je-ne-sais-quoi...

There is a woman in this group who keeps me sane. Her latest daily adventures include stealth feeding of two groups of horses that belong to her neighbors -- or, to be precise in one of the instances, the girlfriend of a neighbor who is billeting her horses there for the duration of the love affair. This friend is an animal lover, but not in the extreme -- these horses were not being fed daily and did not have access to [unfrozen] fresh water -- and I think she has reacted as most of us would. Well, not quite. I would be on the phone reporting these neighbors -- in a heartbeat. I do not, apparently, understand the dynamics of life in rural Wyoming, as such an act might well, she tells me, push her neighbors over sanity's edge... and then what would she do?

So, she does the only logical thing.

Excuse me while I laugh a little.

She and her 80-something mother take hay to the two separate pens. I don't know the story of the other neighbor. They wait for the cover of darkness and deliver hay and water. The horses apparently go ape shit every time they see either of the two women, or even their truck.

She has a good heart.

So I am going to go way past "disappointment" and charge on down the path all the way to ANGER. Not at her, no!

At the woman who has fooled her, and me, and lord knows how many others. We nicknamed her Shawnna. She was thrilled when she was given a nickname. It made her "one of us," one of the gang, party to the inner circle, whatever -- it marked the moment when she had definitively snookered us all.

I spent part of the day digging up every post she had ever published at the web site that hosted our laughter-loving chronic pain support group. Somehow, she never expected anyone to piece all the disparate parts together. Well, I got right to it, didn't I? It just took me a year and a half.

This is the story she has written, in bits and pieces, some meant for one group, some for another:

She is 43. She just recently lost the triplets she was carrying -- made it to 6+ months, though. There are several posts about her inability to go into the nursery and pack up the tiny clothes and take down the cribs, maybe throw a little paint on the walls, scrape those silly stencils off, try to sell that stupid rocking chair on eBay.

That was mostly for an online grief support group that rallied around her as she faced the anniversary of the triplets' death, and with whom she went on to share her childhood experiences of incest. Eventually, I guess, there was a strong sense of incongruity, and she moved on to the more appropriate Childhood Sexual Abuse Survivors Group, never speaking of the dead babies again.

About that same time, she approached us with a need for advice about having, or not having, a hysterectomy. The reason given was "pelvic pain." For reasons that I could never figure out, her surgery was supposed to take between 6-8 hours and might result in her death, or a colostomy. (Tonight, I relish that symmetry: her death or a colostomy. I like those odds.) She said she'd had 15 previous abdominal surgeries.

Let's see... She suffered from cardiomyopathy and a well-controlled seizure disorder, although she had a seizure on the operating table during her last operation and... you got it! Almost died.

"I almost died" could have been the chapter heading for most of her revelations.

She had three adult children. Her son was in prison for murder. Oh. As it happens, her brother was going on trial as a serial killer, and she lived in dread of having to testify. Her oldest daughter was a heroin addict with two small children. She popped into the narrative as a regular character when Shawnna decided she should have AIDS, abandon her kids (the long suffering Shawnna and her husband Rudy dedicated themselves to raising them, of course), and run off to New York with a no good man.

Shawnna's youngest daughter was a straight-A student, finishing her first year at college, and had never caused, or been in, any sort of trouble, ever. With the now added burden of two toddlers to raise, we suggested to Shawnna that her "good" daughter might be able to help out on the weekends. "Oh no," we were told, she did not want to be a burden to this young one who was doing so well.

Not even after her surgery went awry and she was mostly bedridden and living on methadone and percocet (Hey! I resemble that remark!) would she consider asking her daughter for help. She would carry on, somehow -- taking care of those two grandchildren, volunteering at their schools, working at the funeral parlor (part-time) and taking care of what she called her "wifely duties" with Rudy. [Prior to working at the funeral parlor, Shawnna said she owned a Home Health Agency, which she loved, as it allowed her to use her training as a *nurse*! I guess that is not an altogether uncommon move, to go from the healing arts to the death business?]

Of course Shawnna's surgery did not go well! This was surprising, as it took place at UNC-Chapel Hill (those slouches!). Would you believe that the numb nuts left a sponge inside of her? She ended up needing more surgeries because of their horrid oversight.

Then began the Saga of the Vaginal Bleeding. I know that it stretches the bounds of your credulity, but it was only at this point that she lost me as one of her dedicated cheerleaders. Because she kept bleeding and bleeding, going in and out of the hospital several times a week. I have also had a total hysterectomy and my crude understanding of anatomy informed me that there just are not that many sources for such bleeding... Somehow, I assuaged my suspicions with the reassurance that I apparently did not know everything, and that Shawnna was surely cursed and being used by God to do a rewrite of the Book of Job.

(Book, shmuck! I forgot to mention that she is an author of two books. No, I haven't been able to find either one.)

Oh, I grow weary.

Well, what is left to Shawnna's Tale? Ah, yes. Rudy almost passed away about a year ago -- he had a major stroke at the age of 33. He up and died a month or so ago -- he was out mowing the lawn and had a massive heart attack.

My tenderhearted Wyoming friend prepared herself for service -- a plane ticket, her own home and hearth in order -- and waited for details. Waited and waited. Shawnna was impossible to reach.

Suddenly, she posted a message saying that she was going to relocate to Memphis, Tennessee. I had begun searching for a death notice, checking obituaries in her area, then anywhere, then under any mistaken spelling of the poor dead man's last name. Nothing, nada, zilch. I asked her about it, finally, and was told that her world was turned upside down (understandable) and that Rudy's adult son from a previous marriage was handling those details.

Okie-dokie, then!

After a bit, she reappeared, reintroducing herself this way in an email, afraid, it seems, that the various plots of her story might have become stale:

I know that it's been a very long time, I'm fine. I have 4 grandchildren now, and all by the same daughter. I have three of them. I had a stroke on this past Easter Sunday but I must say that with some physical, and speech therapy I'm doing much better, I have been missing both you and M but I almost lost my  mind girl after my husband passed away. I'm much better know, and I've learned to cope with it. I love you just the same as I did one year ago girl!


Finally, a period of relative calm, with only occasional hospitalizations for congestive heart failure interrupting. She was off to her new life in Elvis Land.

Except that we heard nothing and could not reach her. Finally, we received a message that she had suffered a major heart attack while driving...

With a familiarity that suddenly *was* breeding a major pile of contempt, we could not contact her at the hospital she was supposedly at and so on and so on and so forth.  In the past, her "good daughter" would appear online at these times of crisis, and promise to relay messages, etc.  There appeared to even actually be such a daughter that my friends were able to reach by phone.  Something in that precious mother-daughter relationship became irrevocably strained at this point, however, because Lashy wrote, out of the peculiar blue:

She  is  doing well, she is studying at The University of Winston-Salem now. She is in her 5th year of schooling. She is still studyimg to become a Psychologist. But guess what? She doesn't even call me, come to see me. She didn't even come to the hospital after I had the stroke, and I had been life-flighted there to Winston-Salem!!!!! I was sooooo hurt. I just couldn't believe that she didn't come to see me. I haven't heard from her now in almost a year. I just this information from her father. But  I am not going to sit and worry about what is going on, I love her, have done not one thing for her to treat me the way she's been, and one day she'll regret the time that we didn't share together.

There is, of course, no University of Winston-Salem, so I assumed it a reference to Winston-Salem State University.  But it, of course, has no graduate program in psychology, but does have a good-looking undergraduate BA degree in the field.

It was a great set up.  Now Good-Daughter-Turned-Mean-Child could not be relied upon as a benevolent player in Shawnna Land.  You can't trust her or believe a word she says!

That fix was apparently not enough, however, because Shawnna went on to have Good-Daughter-Turned-Mean-Child suffer a stroke, herself, and be put, herself, on the "transplant list." Again, Lashy was kind enough to provide all sorts of contradictory written information, though she never seems to completely hoist her own petard.  This is a letter she sent to my good friend during Scene 4 of Act 3, or whatever we are to call this internet con drama.  It's one of her more elaborate, and the construction is interesting, particularly the opening gambit.  Hi, it's been forever, my dying-with-AIDS daughter is such a whore... my Good-Gone-Bad-Now-Redeemed-Again daughter is in ICU... all summed up by the telling, "Oh my God girl!!!! What more can I deal with huh?"

I don't know the requirements for receiving hospice care, but apparently they are not as stringent as I believed!

----- Original Message -----

Hey Girlie,
I know that it's been a while that we've spoken. How has everything been going for you? I have some very disturbing news. I just found out very recently that my last granddaughter is not my daughter's husband's daughter!!! No, her father is some other low-life piece of shit that roams the city of Fayetteville! The DNA test just came back last week. I am so through with my daughter do you hear me! So now we've got to try and find this someone to let him know that he is now a Father. I spoke with my daughter and asked her what the hell is she thinking? Not only were you unfaithful in your marriage but you had unprotected sex with someone that you really don't even know!!!! She tells me that she's been knowing this man for a year! whole year!. Please, give me a break!

Plus the fact that T (my youngest daughter) is in ICU and has been for the last past four days, we found out that she has inherited my cardiac condition. She has an enlarged heart and went out to the emergency after feeling very ill. She was having difficulties breathing and was having some swelling in her legs and hands. Oh my God girl!!!! What more can I deal with huh? But the good news is that she's doing better and the Physician told me that he'd be able to step her down off of the milirinone lactate and put her on an oral medication at this point. So hopefully she's be discharged at some point this coming week. 

I always feared one of my three children inheriting my cardiac condition and the one that has her shit together is the one that has been crippled with this enormous problem. I'm very afraid that this will limit her ability to have children one day when she's ready. All I can do is guide her and show her how to deal with this cardiac problem. They have put in a picc line so that she can be administered the milirinone, the same medication that I use on a continuous basis here at home. My picc line has been sewn in place though.

**[Lashy simultaneously posted elsewhere that Good Daughter Gone Bad was comatose, had had a stroke and suffered severe neurological deficits.  Milirinone (sic) lactate?!  Yowza!  In the little bit of reading I did about the drug, one thing was pretty doggone clear:  "treatment with this drug usually does not exceed 5 days..."  This archived drug label made it clear that this warning against longterm use was not lightly made:

Whether given orally or by continuous or intermittent intravenous infusion, milrinone has not been shown to be safe or effective in the longer (greater than 48 hours) treatment of patients with heart failure. In a multicenter trial of 1088 patients with Class III and IV heart failure, long-term oral treatment with milrinone was associated with no improvement in symptoms and an increased risk of hospitalization and death. In this study, patients with Class IV symptoms appeared to be at particular risk of life-threatening cardiovascular reactions. There is no evidence that milrinone given by long-term continuous or intermittent infusion does not carry a similar risk.]**

I was in the hospital for my birthday, (7th January). I was in CHF and renal failure. I am better now and hopefully I won't have another hospitalization for some time.

I allowed my daughter to come over to spend a few hours with all of the children during the holiday and she didn't even think or consider buying either child anything for the holiday! I was very disappointed in that too. I have just come to realize that my daughter will always be selfish, bottom line.
Have you talked with M lately? I would like to go and see her for my 1-week vacation this coming April once the kids are out for Spring-break but I haven't heard back from her to confirm. I would like to come see you one Spring/Summer as well.

I really miss you guys so much. I feel so bad sometimes girl that it takes all I have just to get up and move around each day. My cardiac health is slowly declining, and I can really feel the change. I have hospice coming in each day and they've helped me aloft as far pain relief, and making dr's appt's for me.  And I have a CNA to come out each day for three hours. She helps with laundry and running errands for me.
I just wish that I could feel 30% better.

I had a difficult time yet again this year during the holidays because as you remember Rudy passed on the 6th December. I must admit that having friends and family here for the holidays did distract from the depression that I was feeling but, It was still difficult and I guess that it will never really go away.
Well Sweetheart, I've taken up enough of your time with my whining so I just want to let you know that truly I love you very much and because I may not post or send messages as often as I did before, doesn't mean that you're not on my mind. I look forward in hearing from you soon....Talk later
P.S Have you heard from Prof? If so, please give her my hello's.......................
[Prof, here, chuckling...]

Somewhere in all the chaos, Lashawnna began to mention LVADs, and it was never clear whether she had one, but it became something of an obsession, but -- as you might expect -- the LVAD stories came with their own healthy quantity of red flags.  Small flags, maybe more of a bled pink than a screaming ninny of a cerise.  Things like continued smoking, something that I'd think one might give up if faced with left ventricular failure.

I was contacted by a very nice guy who is an authority on LVADs and whose blog is dedicated to helping others learn about the life-saving devices.  Shawnna was driving him a bit mad, contacting him repeatedly with requests that he call her, and performing her typical zero-to-sixty insistence on intimacy.  You know what I mean!  She glosses over the normal periods of making acquaintances so as to rapidly insert herself and her confusions into the mark's life.  Unfortunately, she just came off sounding weird to him and he did an internet search... finding, eventually, "Shawnna's Con."

An aside:  What a wonderful guy, what a wonderful attitude!  He is steeped in gratitude, and it shows -- well beyond words, it shows in pictures and videos, it shows in how he reaches out to give others a hand up.

My capacity for playing the fool has amazed me. I still want the thousand dollars back that I gave to someone I "met" online in an osteonecrosis support group.  I did not hesitate to help her pay her electric bill so that the utility could be turned back on, keeping her young children warm. One of her sons was very ill, she said, and she couldn't afford to take him to the doctor.  Are you sitting down?  Turns out she had other uses in mind for my money, uses that were more in the line of "entertainment."  Well, we are all deserving of fun... Right?

I never gave Shawnna anything material.

No, I cried with her, listened, tried to help and advise, pitied and prayed for her -- and for "hers," who were always so deep into trouble, lost without her able help and guidance.

I cannot even laugh at myself as I begin to seriously fret over who is taking care of those beautiful, innocent grandkids.

Because I cannot know what tidbits are true, which are false, which are more properly interpretations.  She may have a failed heart, her daughters might be equally ill -- one sticken with Lashy's own disease, an inheritance, the other with AIDS, Lashy's emblem for "bad."

The proliferation of grandchildren, all born to an HIV+ woman, is at the heart of this con's tale.  Babies, some of them dead (her opening at Dr. Phil's, remember, was that she had just lost triplets), all of them displaced, are what's the matter.

I wish I understood.

It turns out, I believe, at least, that Shawnna has an accomplice. So I -- and others, especially one kind spirit in Wyoming -- are waiting for the other shoe to drop in the saga of Shawnna's con.  She wants to set a trap, and has, probably.  I just want to issue a Public Safety Announcement -- which is what I suppose this post was supposed to be.

But oh, Dear Readers, there was one wondrous development, just a few months ago, and I will end this rambling "cautionary tale" by copying below a rare moment of love and warmth between myself and this con artist.

You can imagine how thrilled I was to be able to notify Shawnna, in January 2012, that there had been a resurrection, good news of the miraculous sort:

lashawnna wrote: 
"Morgan and Dianah I know that it's been a while since I last spoke to either of you, I have been really having a hard time dealing with the death of my husband, so much so that I had to relocate to another home, too many memories.[...] Prof, I have really had you in my thoughts and prayers and I hope that all is well with you. I have had to really dig deep for my sanity, for a time there, the walls started to close in on me and I felt as if I was losing sight on reality. I couldn't sleep because I was in constant thought of Rudy. I have lost 39 pounds. When I first started posting, I wore a size 14 pants, now I am wearing a size 5/6."

i, profderien, wrote: 
hi lashy,
long time, girl, long time!
but i am so glad to be able to come to you with good news.  
heck, it's great news!  
are you sitting down?  no?  well, take a second and sit yourself down, because i don't want you to faint and hit your head, thereby sustaining a life-threatening subarachnoid hemorrhage or possibly fracturing the medial epicondyle of your humerus (the "funny bone"!).  heck, the joyful shock of what i am about to disclose to you, our dear loving lashy, might cause your cardiac muscle to shift into overdrive.
it's PHENOMENAL news!  it's put-it-on-the-doctor-phil-show-it's-so-good news!  (seriously, my friend, you would make a fascinating guest.)
ready?  are you sure?  okay, here goes:
RUDY IS ALIVE AND WELL AND WORKING AT WALMART!  It's a freaking miracle of humongous proportions.  
no, i am not pulling your tiny size 5/6 leg!  it's time to have a really big, fattening meal in celebration -- but cardiac-friendly, of course, maybe an arugula salad dressed with balsamic vinaigrette, some poached salmon over a lovely parsnip purée. (i'm hungry.)
you probably don't believe me, i know what a stickler you are for truth, justice, and the american way -- and here i am, saying rudy (by whose grave you wept and loss scads of weight) -- that scumbag who pretended to stroke out while mowing the lawn -- here i am saying that your husband rudy is flaunting his status as a living organism... all over facebook!
i wasn't sure, and again, out of respect for your reliance on honesty, i asked someone who knows what rudy looks like to take a gander at his profile picture.  i was assured that "yep, that's him!  the no-goog pretending-to-be-dead bozo!" 
i know, this news is really a mixed bag.  part pure relief (He Lives!) and part ultimate frustration (How Could He Let Me Grieve and Waste Away to a Size 5/6?).
but you are nothing if not a strong woman, accustomed to adversity (good lord, when i think of the tragedies your family has suffered... the loss of your triplets, your brother's murder conviction, your son's murder conviction, your daughter's HIV, your other daughter's cardiomyopathy, your own cardiomyopathy, your multiple and simultaneous needs for a heart transplant... why, it boggles the mind, if not one's credulity!).
i gotta say, though, lashy... i believe i would divorce the bastard.  no doubt you have moved on in these intervening years, and some other lucky man has scooped you up.
well, that's about all.  i hope you can get over the shock of it.  this is a great place to vent, though, you know?  everyone here is like FAMILY, gullible as all get out, willing to lend you sympathy, understanding, love, and probably a ten spot or two.  you can say *anything* here.  it's a safe place, where no one trolls for victims to exploit, where no one even considers playing a con.
all the best,

Another Oil Rig Blast

There have been an excess of WTF? moments lately.  Here's yet another:

Coast Guard Reports Blast on Oil Rig in Gulf of Mexico
Filed at 12:17 p.m. ET 9/2/2010

GRAND ISLE, La. (AP) -- An offshore petroleum platform exploded and was burning Thursday in the Gulf of Mexico about 80 miles off the Louisiana coast, west of the site where BP's undersea well spilled after a rig explosion.

The Coast Guard says no one was killed in the blast, which was reported by a commercial helicopter flying over the area Thursday morning. All 13 people aboard the rig have been accounted for, with one injury. The extent of the injury was not known.

Coast Guard Cmdr. Cheri Ben-Iesau said some of those from the rig were spotted in emergency flotation devices.

Seven Coast Guard helicopters, two airplanes and three cutters were dispatched to the scene from New Orleans, Houston and Mobile, Ala., Ben-Iesau said. She said authorities do not know whether oil was leaking from the site.

The Department of Homeland Security said the platform was in about 2,500 feet of water and owned by Mariner Energy of Houston. DHS said it was not producing oil and gas. (continued at New York Times)

Wednesday, September 1, 2010

My Day

It's been a long, hard day.  CRPS, as I experience it most of the time now, comes to me in its Blue Phases -- not *quite* as mesmerizing a thing as Picasso's blues and roses, but remarkable nonetheless.

My Blue Phases are cold, cold, cold -- to touch my legs is to touch ice.  My arms are a pale violet, cool, like evening.

The pain is burning, shooting, stabbing, throbbing -- quite a counterpoint to the cold, cold, cold at the innermost core.

Today, I woke to find both legs involved in a major shift, the left up to the knee, the right about 8 inches above the knee, to mid-thigh.   Red, bright bright, blood red.  Holding your hand inches above the skin, you feel the heat radiate out. 

Lobster red.

Swollen as if pregnant, and not in a fluid-y kind of way.  Solid swollen.  I tried to walk alone to the bathroom and broke down, broke down like a car breaks down, broke down like an insane woman pushed too far breaks down.  Lobster pregnant swollen red red get your red hot here, Edema!

photo courtesy of Practical Neurology

At 9 am, I was already over 100, could feel -- behind the eyes, in the smallsmall joints -- the temperature rising. 

I was fasting before some testing, so I couldn't even indulge in a calming coffee.  Coffee does calm me, and when I am AttackingFever, it gives an extra kick to the Tylenol and ibuprofen.  Or -- I just like coffee, okay?

Today was a first -- I complained about my wait at my MDVIP doc's office.  I was there to donate lots and lots of blood, so that when I go in next week we have an idea of where I am at with these infections, with the systemic inflammation, how my kidneys are holding up, and whether my liver is still unhappy.  I came very close to not going because things were just very very very bad.  Then I remembered that phenomenon common to us all -- the toothache that disappears on the way to the dentist, the sore throat that disappears after you argue your way into an open appointment slot, the car that purrs with perfection after you've lamented its clanking to that very impressive and stern mechanic with the great moustache... Oops.

So I said to myself I said, "Self?"


"We have to go.  How many times have we wished someone could get a sample of our blood when this Weirdo Weirdo Production goes haywire at 4 am?  Here we are, actually scheduled to go in, with insurance, too -- and we feel like grainy, tasteless applesauce that has been liberally sprinkled with Olde Blackened Wash Water, allowed to cool, and then warmed to lukewarm over a Sterno flame.  Served over a half-cooked shitake mushroom cap that has been oversalted."

So Fred stepped into that Regrettable Role of Loving CareTaker, helped me navigate the Grand Canyon gaping between my wheelchair, curbside, and the bleeping passenger-side seat of Our Ruby, the Honda CRV.  I moaned and cried, I embarrassed myself.

He regaled me with stories about His Girls, the Militant Existential Feminist Lesbians, and their latest shenanigans -- and Fred made the bouncing Ruby fly, as only Ruby can, so that we got there right on time. 

Eighty minutes later, I was writhing.  I writhed.  (Now that's a sentence one never plans on writing!)  And suddenly I decided I was tired of always being the Understanding Patient.  I often get passed over in the wait order -- "because we wanted to clear a special block of time for you";  "because we know you understand how backed up we get";  because, because, because. 

I said to Fred, I said:  "Fred?  Don't they get that it hurts me to have to sit here like this?  I am in effing pain, effing pain," I say!

And Fred, damn him, looks up, coolly, from his second rate novel, and says:  "Apparently not."

So I put the speed on my machine on UberHigh and Zoom over to the receptionist.  I use the Ancient Plain Speech of My People:  "I am having a hard time waiting due to pain.  When can I get back there for a blood draw?"

Unfortunately, she speaks one of the Minor Languages of a Now Extinct Species.  "She said she'd be with you pretty soon, I know I heard her say that.  I think she is waiting to get you into a really good room where you will be most comfortable."

Some things don't translate, as any Foreign Language Teacher will confess to you, if drunk.

Like:  I am here for a blood draw -- you can do it in the hall for all I care.
Like:  I. am. in. pain. So. do. it. Do. it. now.

Alright, yes, there should be kudos for my doc's nurse -- because she is deft and brilliant and the only person who can get my blood without aggravating youknowwhat.   And she is, without doubt, a person of only good intentions. 

Still.  I think I need to dispel this myth that because I am disabled, contorted, and crammed in a chair, sick, that I have no problem spending the day hanging out in a doctor's office.  I am not a piece of furniture.  It happens, to be honest, more at the orthopedic surgeon's office than anywhere else.  They do things like put me in the cast room, "because we know you don't mind waiting..."  Just because I was practically living there, having 7 surgeries in under 18 months, doing either pre-op crap or post-op crap, or what-the-fuck crap... does NOT mean that I do not mind waiting.  Being a frequent flyer by no personal fault shouldn't condemn you to lower standards of hospitality (it's the only word I can think of, but it is not right).

By the time we got home, down the drive, over the moat and beyond the drawbridge... I was almost delirious with fever.

I think I still might be though I have an Annoying Sweat going, that I hope heralds a break in the heat.

Comfort ye, comfort ye, my people. 

This will all have been worth it when we get some illuminating information back from the lab.

Oh. Yeah.  I am way febrile!  When I grabbed the laptop, it was with the intention of directing you, once again, over to Margaret and Helen, that wonderful blog.  Helen Philpot is ranting about the Beck/Palin Revival last week in a post titled 100 Grand Bore.

Allow me to tempt you with its beginning:

Margaret please tell Howard that 100,000 people will show up to a tractor pull if the entry fee is cheap enough. Big deal. I’ll tell you what I’m going to do. I’m going to ignore them and have some pie.

As I see it dear, if more than a hundred thousand dead civilians in Iraq and Afghanistan can be dismissed, so can slightly less than a hundred thousand peckerwoods at a Beck rally.

If the civil rights of millions of gay and lesbian Americans are not important, then neither are the pathetic rants of almost a hundred thousand Palin addicts.

Now, go read the rest!

In other news, there's been yet another meltdown over at Pop That Zit!  This time, it involves a couple of veterans, with one of The New Breed mixed in, for confusion's sake. 

It's funny, and yet not, how a good subset of those who post vids over there decide to confound their own worth with the "value" of their postings.  It's puerile, and says a lot about our messed up notions of "authorship," and... as I have stated a few times, totally BizarroWorld assertions of "ownership."

Well, I am gonna try and convince My Shadow and Near Appendage, Miss Marmy Fluffy Butt, to detach herself momentarily from my dripping side and fetch me some lowfat plain yogurt, mixed with a hint of vanilla, some fine cocoa, a kiss of cinnamon, and 5 packets of fake sugar -- all nicely wisked together.

Then I am gonna imagine myself a balmy lake, and read the rest of this John Irving novel (now I am on A Widow For One Year).

I hope you had a nice day.  If you did not, let's both of us look to tomorrow, with hope.

Tuesday, August 31, 2010

Poststroke CRPS and Even More Ketamine

Good evening. I just watched President Obama clench his jaw and look like his head was going to explode, as he "turned the page" from the War-That-George-Started, which prompted neglect-and-wreck of our financial, health care, and educational systems... all of which he inherited.

All together now: Thanks, yes, thanks a lot, George W.!

All together now: Please, oh please, President Obama, don't have a stroke over George W.! Turn that dang page, dang it!

Why, speaking of strokes... the first of today's CRPS installments deals with Poststroke CRPS. Feeling much like Sergeant Schultz -- "I know nothing!" -- I did a little background reading. I recommend:

Complex regional pain syndrome underdiagnosed: CRPS type 1 is an under-recognized problem in limbs recovering from fracture or immobilized post-stroke
Journal of Family Practice, June 2005

From thalamic syndrome to central poststroke pain
G D Schott
Journal of Neurology, Neurosurgery & Psychiatry 1996 61: 560-564
(You can register at and have free access to articles before 2006)

If you aren't already confused about terminology, one web site I scoped out informed me that CPSP (Central Post Stroke Pain) is a type of CRPS... that used to be called Thalamic Pain Syndrome (also known as Dejerine-Roussy disease, of course!).  If Wikipedia's description of Thalamic Pain Syndrome is accurate, I am not sure that it so, despite a similarity of symptoms.  If *you* can clarify this for me, please leave me an elucidating comment!

Thalamic syndrome (or thalamic pain syndrome) is a condition that can be associated with inadequate blood supply from the posterior cerebral artery. It is a rare neurological disorder in which the body becomes hypersensitive to pain as a result of damage to the thalamus, a part of the brain that affects sensation. The thalamus has been described as the brain’s sensory relay station. Primary symptoms are pain and loss of sensation, usually in the face, arms, and/or legs.

Pain or discomfort may be felt after being mildly touched or even in the absence of a stimulus. The pain associated with thalamic syndrome may be made worse by exposure to heat or cold and by emotional distress. Sometimes, this may include even such emotions as those brought on by listening to music.
In all of the hour's worth of reading about Post-stroke CRPS, there was a disturbing reiteration of things like "sympathetic blockade" -- about which I have raled before.  Progress in understanding the etiology and processes of CRPS is now directing the treatment response away from a focus on sympathetically-mediated pain.

Anyway... here is the abstract for this latest contribution to the topic:
From Topics in Stroke Rehabilitation. 2010 May-Jun;17(3):151-62.

Poststroke complex regional pain syndrome

Chae J.
Department of Physical Medicine and Rehabilitation, Case Western Reserve University, Cleveland, Ohio MetroHealth Rehabilitation Institute of Ohio, MetroHealth System, Cleveland, Ohio.

Poststroke Complex Regional Pain Syndrome (CRPS) affects a significant number of moderate to severely impaired stroke survivors. Until recently, advances in the assessment and management of CRPS have been limited due to the lack of a consensus on diagnostic criteria; however, with the development of the International Association for the Study of Pain diagnostic criteria, the medical and scientific communities are poised to make significant strides. Biomechanical factors and microtrauma to the hemiparetic shoulder may have a significant role in the genesis of CPRS, although the exact pathophysiology that links these triggers to the observed disease manifestation remains uncertain. Sympathetic dysfunction has historical importance in the CRPS literature. However, this appears to be only one of several possible pathophysiologic mechanisms; somatic nervous system dysfunction, inflammation, hypoxia, and psychological factors are also likely contributors to the disease process. There is no definitive treatment for CRPS, and most patients are treated empirically. Nevertheless, there is consensus that the treatment approach should be interdisciplinary with the goals of edema and pain control, maintenance of joint and muscle biomechanics, and functional restoration. As more rigorous clinical trials emerge, the treatment approach will become more rational with selection of interventions based on a specific mechanism or a combination of mechanisms responsible for a given individual's disease manifestation.

The second of today's articles is exciting, in that Dr. Schwartzman and ketamine research are in play. The journal, like most things these days, is beyond me -- Chirality. These are the aims and purposes of the journal:

The main aim of the journal is to publish scientific work on the role of molecular asymmetry in both biologically active and non-biologically active molecules in respect to their pharmacological, biological, and chemical properties. Drugs, pesticides, and other xenobiotics will be a major interest.

Papers on the chemistry (physiochemical, preparative synthetic, and analytical), pharmacology, clinical pharmacology, toxicology, and other biological aspects of chiral molecules will be published.

Among the topics to be covered are stereospecific synthesis, stereoselective analysis, preparative separation of chiral molecules, the influence of chirality on pharmacokinetics (absorption, distribution, protein binding, biotransformation, etc.), the influence of chirality on pharmacodynamics (drug-receptor interactions, pharmacological and toxicological activity), and the influence of chirality on clinical pharmacology (therapeutic index and response, bioavailability, adverse drug reactions, drug-drug interactions). Papers will also be published on regulatory and legal aspects in the development, testing, and marketing of chiral compounds.

Okay, I will 'fess up. I haven't a clue what a chiral compound is, and I am not in touch with the chirality that I was born with... although I think they might worship it off the western shores of Estonia, on a small island in the Gulf of Riga.

Hmmm? What? Oh. Right!  On to the Reference Works!

It turns out that chirality is a fascinating concept/thing/compound/word, derived from the greek for hand.  Of course, yes, I got lost in the term, but just for about twenty minutes.  Have you ever wondered whether it is eye or hand chirality involved when leaning your head aside to drink water straight from the tap?

A chiral molecule is a type of molecule that lacks an internal plane of symmetry and has a non-superimposable mirror image. The feature that is most often the cause of chirality in molecules is the presence of an asymmetric carbon atom.[1][2]

The term chiral (pronounced /ˈkaɪrəl/) in general is used to describe an object that is non-superposable on its mirror image. Achiral (not chiral) objects are objects that are identical to their mirror image. Human hands are perhaps the most universally recognized example of chirality: The left hand is a non-superposable mirror image of the right hand; no matter how the two hands are oriented, it is impossible for all the major features of both hands to coincide. This difference in symmetry becomes obvious if someone attempts to shake the right hand of a person using his left hand, or if a left-handed glove is placed on a right hand. The term chirality is derived from the Greek word for hand, χειρ (cheir). It is a mathematical approach to the concept of "handedness".

In chemistry, chirality usually refers to molecules. Two mirror images of a chiral molecule are called enantiomers or optical isomers. Pairs of enantiomers are often designated as "right-" and "left-handed."

Molecular chirality is of interest because of its application to stereochemistry in inorganic chemistry, organic chemistry, physical chemistry, biochemistry, and supramolecular chemistry.
And here you were thinking that I was gonna stay on topic, regaling you with yet another surge forward in CRPS research!  Ahem...

As I said, Dr. Schwartzman is involved, so you know ketamine cannot be far behind!  (That's unfair... but I am tired.)

From the journal Chirality. 2010 Aug 27

Enantioselective pharmacokinetics of (R)- and (S)-ketamine after a 5-day infusion in patients with complex regional pain syndrome.
Goldberg ME, Torjman MC, Schwartzman RJ, Mager DE, Wainer IW.

Cooper University Hospital, Department of Anesthesiology, UMDNJ-Robert Wood Johnson Medical School, Camden, New Jersey.

Introduction: This study determined the pharmacokinetics and pharmacodynamics of (R)- and (S)-ketamine and (R)- and (S)-norketamine following a 5-day moderate dose, as a continuous (R,S)-ketamine infusion in complex regional pain syndrome (CRPS) patients.
Materials and methods: Ketamine was titrated to 10-40 mg/h and maintained for 5 days. (R)- and (S)-Ketamine and (R)- and (S)-norketamine pharmacokinetic and pharmacodynamic studies were performed. Blood samples were obtained on Day 1 preinfusion, and at 60-90, 120-150, 180-210, and 240-300 min after the start of the infusion, on Days 2, 3, 4, 5, and on Day 5 at 60 min after the end of infusion. The plasma concentrations of (R)- and (S)-ketamine and (R)- and (S)-norketamine were determined using enantioselective liquid chromatography-mass spectrometry.
Results: Ketamine and norketamine levels stabilized 5 h after the start of the infusion. (R)-Ketamine clearance was significantly lower resulting in higher steady-state plasma concentrations than (S)-ketamine. The first-order elimination for (S)-norketamine was significantly greater than that of (R)-enantiomer. When comparing the pharmacokinetic parameters of the patients who responded to ketamine treatment with those who did not, no differences were observed in ketamine clearance and the first-order elimination of norketamine.
Conclusion: The results indicate that (R)- and (S)-ketamine and (R)- and (S)-norketamine plasma concentrations do not explain the antinociceptive* activity of the drug in patients suffering from CRPS.
*reducing sensitivity to painful stimuli.

Ah, well.  That's science, that's the way the cookie crumbles, and c'est la vie. So the antinociceptive activity of ketamine remains elusive! It is good that they are working hard to tease out the mechanisms of its effectiveness, so that, one day, we can follow the bread crumbs back home...

I have a number of posts near completion, but keep losing my energy in the penultimate paragraph.  I promise to try and do better, or to trick myself, somehow, into finishing them.

And President Obama?  Good job, and thank you. 

By the way, I don't know if you've heard -- it may not have been included in your daily briefings -- but my Pre-Existing Condition Insurance Plan kicks in at midnight and tomorrow I go for my first battery of tests since they put the left prosthesis back in last year.  Gotta feed that high deductible (because you were willing to take on my high risk)!  So... yes, from the bottom of my heart: good job!