Friday, September 10, 2010

Ces petits riens::L'alcool

a little bit o'slick stacey kent for a friday breeze. lyrics, of course, by serge gainsbourg

Mieux vaut n'penser à rien
Que n'pas penser du tout
Rien c'est déjà
Rien c'est déjà beaucoup
On se souvient de rien
Et puisqu'on oublie tout
Rien c'est bien mieux
Rien c'est bien mieux que tout

Mieux vaut n'penser à rien
Que de penser à vous
Ça ne me vaut rien
Ça ne me vaut rien du tout
Comme si de rien
N'était je pense à tous
Ces petits riens
Qui me venaient de vous

Si c'était trois fois rien
Trois fois rien entre nous
Cà ne fait pas beaucoup
Ce sont ces petits riens
Que j'ai mis bout à bout
Ces petits riens
Qui me venaient de vous

Mieux vaut pleurer de rien
Que de rire de tout
Pleurer pour un rien
C'est déjà beaucoup
Mais vous vous n'avez rien
Dans le cœur et j'avoue
Je vous envie
Je vous en veux beaucoup

Ce sont ces petits riens
Qui me venaient de vous
Les voulez-vous ?
Tenez ! Que voulez-vous ?
Moi je ne veux pour rien
Au monde plus rien de vous
Pour être à vous
Faut être à moitié fou.

and why not some serge gainsbourg while i pause at this café, under this lacy blue sky, and drink to you?

Mes illusions donnent sur la cour
Des horizons j’en ai pas lourd
Quand j’ai bossé toute la journée
Il me reste plus pour rêver
Qu’ les fleurs horribles de ma chambre
Mes illusions donnent sur la cour
J’ai mis une croix sur mes amours
Les p’tites pépées pour les toucher
Faut d’abord les allonger
Sinon c’est froid comme en décembre

Quand le soir venu j’ m’en reviens du chantier
Après mille peines et le corps harassé
J’ai le regard morne et les mains dégueulasses
De quoi inciter les belles à faire la grimace
Bien sûr y’ a des filles de joie sur le retour
Celles qui mâchent le chewing-gum pendant l’amour
Mais que trouverais-je dans leur corps meurtri
Sinon qu’indifférence et mélancolie
Dans mes frusques couleurs de muraille
Je joue les épouvantails

Mais nom de Dieu dans mon âme
Brûlait pourtant cette flamme
Où s’éclairaient mes amours
Et mes brèves fiançailles
Où s’ consumaient mes amours
Comme autant de feux de paille
Aujourd’hui je fais mon chemin solitaire
Toutes mes ambitions se sont fait la paire
J’ me suis laissé envahir par les orties
Par les ronces de cette chienne de vie

Mes illusions donnent sur la cour
Mais dans les troquets du faubourg
J’ai des ardoises de rêveries
Et le sens de l’ironie
J’ me laisse aller à la tendresse
J’oublie ma chambre au fond d’ la cour
Le train de banlieue au petit jour
Et dans les vapeurs de l’alcool
J’ vois mes châteaux espagnols
Mes haras et toutes mes duchesses

À moi les p’tites pépées les poupées jolies
Laissez venir à moi les petites souris
Je claque tout ce que je veux au baccara
Je tape sur le ventre des maharajas
À moi les boîtes de nuit sud-américaines
Où l’on danse la tête vide et les mains pleines
À moi ces mignonnes au regard qui chavire
Qu’il faut agiter avant de s’en servir
Dans mes pieds-de-poule mes prince-de-galles
En douceur je m’ rince la dalle

Et nom de Dieu dans mon âme
V’là qu’ j’ ressens cette flamme
Où s’éclairaient mes amours
Et mes brèves fiançailles
Où se consumaient mes amours
Comme autant de feux de paille
Et quand les troquets ont éteint leurs néons
Qu’il n’ reste plus un abreuvoir à l’horizon
Ainsi j’ me laisse bercer par le calva
Et l’ dieu des ivrognes guide mes pas

The One Where I Hum "Qué Será, Será" Like Doris Day On Ketamine

Hullo, all. It's been a busy week; I'm exhausted. So straight to the most recent CRPS MedWorm offering. It's a case study, is all, but a good reminder that sometimes the "cause" of CRPS can be a seemingly insignificant event:

Complex regional pain syndrome (CRPS) is a chronic progressive disease characterised by severe pain, swelling and changes in the skin. Precipitating factors include injury and surgery, and a variety of causes have been described. We present the case of a 68-year-old lady who presented with features indicative of a CRPS following steroid injection for a ‘trigger’ thumb.
--Published in the October 2010 issue of the Journal of Plastic, Reconstructive and Aesthetic Surgery, Volume 63, Issue 10

Something equally innocuous can cause "spread" of CRPS, as well, which is why someone with the disease can be particularly anxious about injections, blood draws -- and, needless to say, things like surgeries.

I have wanted to politely bop a few nurses and lab techs on their pointy little heads for rolling their eyes at my concerns about being stuck in a CRPS-afflicted limb. Even my top-notch, worldclass, wunnerful::wunnerful surgeon doesn't follow all the established precautions for preventing spread... I have shared with him the protocols I find, which include early admission for i.v. infusions and pain meds (yes, ketamine is involved!) and similar infusions afterward -- something that purportedly stops spread and prevents "flare." [These are the recommendations at the Hospital for Special Surgery, an orthopedic Mecca.]

If anyone doubts how far reaching the Dr. Scott Reuben scandal is? One of the often recommended articles on prevention of CRPS spread during/after a surgical procedure is called, nattily enough: Preventing the Development of Complex Regional Pain Syndrome after Surgery
and yes, the author is "Reuben, SS."

He pops up again with Perioperative Pregabalin Reduces Neuropathic Pain at 3 Months after Total Knee Arthroplasty (TKA) and if you are certain that he is not simply a mercenary in his promotion of Pregabalin, then you are a trusting, simple, stupid soul.

On the other hand, the level of my distrust might be excessive.

[It could happen.]

The ideas posited in Surgery on the Affected Upper Extremity of Patients with a History of Complex Regional Pain Syndrome: The Use of Intravenous Regional Anesthesia with Clonidine are considered indisputable, or were, given Reuben's ghoulish signature on the work.

I look forward to the day when baby and bathwater can be carefully and correctly identified, separated -- and the cold, scummy liquid discarded.

In the meantime, take all the precautions that you can when someone approaches your CRPS-afflicted regions. At the very least, say "Stop! Don't touch..." and then take a moment to talk things out with the person in front of you, readying to wield some invasive tool -- because as much as I have maligned nurses and phlebotomists, I have encountered some who were very well informed and who promptly took preventive measures (using the smallest of butterflies, avoiding nerve-rich areas, etc.).

What is immeasurably valuable is the relief that comes from dealing with a health care professional who is familiar with this bug-a-boo syndrome.

The very best advice about surgery in people with CRPS? Avoid it.

Don't get me wrong... You *can* rely on certain truths in this world, in this life.

Scott Reuben is still a dirtbag, and Jose Ochoa remains a big, fat turd.

Thursday, September 9, 2010

"If it quacks like a Duck and sets a Quran on fire then it must be a Republican"

God Loves A Good Book Burning
by: Helen Philpot | September 9, 2010

Margaret, did we really expect anything less? Religious intolerance has defined the Republican Party for almost 30 years now. A culture of life. Family values. America’s Christian Heritage. The sanctity of marriage. Gays in the military. Prayer in school. A mosque in Manhattan. For goodness sakes, the current leaders of the Republican Party (Palin, Limbaugh, and Beck) have been screaming about a Muslim family in the White House for months now. It was only a matter of time before someone called for a good ‘ole fashion book burning. Does it really matter if that book is the Quran instead of The Catcher in the Rye?

There is just one thing I haven’t been able to figure out yet. How many more groups of people does the Republican Party have to hate before its members finally call for a new platform? Those signs they carry at their rallies are getting pretty full. The print will have to be pretty small at the next Beck rally to fit God Hates Gays, Jews, Blacks, Muslims, Clinton (him and her), the Liberal Media, Obama, Pelosi, French Fries, Activists Judges, Environmentalists, Feminists, Mexicans, and small puppies. Maybe they can just print up a sign that simply says God Hates Everyone Who Isn’t Like Me.

And trust me Margaret. The minute Matthew puts this on that web page blog of ours, a bunch of jack-asses are going to tell us that God hates us too and we shouldn’t generalize all Republicans like that. Well all I have to say is if it quacks like a Duck and sets a Quran on fire then it must be a Republican.

If you vote Republican today, what exactly are you voting for? It’s certainly not smaller government. If you vote Republican today you are telling “Pastor” Terry Jones that fifty religious fanatics are more important than any chance for world peace. You are telling Sarah Palin that when it comes to the presidency - pretty is more important than smart. You are telling Glenn Beck that honesty isn’t really necessary if you have your own cable news show on Fox. You are telling Michele Bachmann that hearing voices in your head isn’t cause for alarm. Hell, if you vote Republican today you might as well just shove a few more dollars in Rush Limbaugh’s pockets and a few more pills in his mouth. It’s all very entertaining, I’ll give you that. But considering what they did when we gave them the keys to the car the last time, are you really ready to put them behind the wheel again so soon? I’m just not sure there are that many more countries we can bomb, world religions we can vilify and oil wells we can drill before the rest of the world calls us on our bullshit.

Here’s a thought. If Pastor Jones is so dead set on burning a book he should just wait until The George Bush Memoirs come out. After all, everyone knows the only thing God loves more than a good book burning is a burning Bush.

If the Democrats can’t muster enough votes to beat this bunch of yahoos then we deserve what we get on November 3rd. Besides, Harold said we could move to Canada and you know how much I love Anne Murray.

Vote Republican and burn a Quran. Same difference. I mean it.  Really.

The blog Margaret and Helen, comprised mostly of Helen Philpot's right-as-rain commentary to her friend Margaret Schmechtman, is my absolute favorite bit of wit on the web.  From About Margaret and Helen:

My name is Helen Philpot. I am 82 years old. My grandson taught me how to do this so that I could “blog” with my best friend Margaret Schmechtman who I met in college almost 60 years ago. I have three children with my husband Harold. Margaret has three dogs with her husband Howard. I live in Texas and Margaret lives in Maine.

If you haven't checked them out, you are missing a lot of truth and laughter. Don't worry about possibly being offended or nonplussed or whatever, because these ladies are as easygoing and nonsectarian as it is possible to be.

I mean it.


Monday, September 6, 2010

Combining Ketamine With Astrocytic Inhibitor

Well, I know how hard it is for me to go without news about ketamine.  It's been a few days since I last spoke of this panacea, this club drug gone antidepressant, this animal tranquilizer deemed curative for CRPS/RSD.

It's going to take a lot of research, duplicated, peer-reviewed, and sanctified, thrice, by a Comprehensive and Integral Ad Hoc Committee Assembled by the Creator of the Universe, for me to get on the Ketamine Bandwagon. 

It could happen.

Today's offering comes from a group of scientists from the K. K. Leung Brain Research Centre of the Fourth Military Medical University in Xi’an, China, and is published in Molecular Pain.  The authors come from the Departments of Anesthesiology and Anatomy. 

The folks hailing from Anesthesiology are further specialized as "stomatologists." "Ewww!" was my first thought, closely followed by curiosity about CRPS of one's stoma... but it turns out that stomatology is the study of the mouth and its diseases:  dentistry, in other words!  I guess an anesthesiologist/stomatologist represents -- in Western formulations -- someone with a DDS who has done post-graduate work in anesthesiology.  What it means in the Chinese context, I dunno.  Perhaps it includes acupuncture.

That there is a décalage between Western Dentistry and Chinese Stomatology is clear:  For instance, like the American Dental Association, the Chinese Stomalogical Association declared that fluoride toothpaste helps prevent tooth decay... but C.S.A. did it in 2007.  I guess the actual availability of fluoridation plays a big part in that evolution, and further realize that the issue of fluoridation is not as clear cut to some as it is to me.  If you believe that fluoride causes cancer, then the topic of fluoride in your communal water supply is not a lighthearted topic.  [Okay, moving right along... don't wanna get lost... too late?  Is it too late?]

Rather quickly, I am wondering about the quality of translation in this work.  The current PDF version at Molecular Pain is provisional, with a promise of a fully formatted/full text version to be available soon.  I hope that can include scrutiny of translation from Chinese to English.  For instance, I am sure this sentence can be improved upon:

However, the present clinical therapeutics is still just concerning about neuronal participation.

And just because, I would like one of the authors to expound upon this:

Combined administration obviously relieved mechanical allodynia in a quick and stable manner.  [How?!  How did they know?!  I mean, my assumption is that we're talking lab rats here...  Was it that deep sigh of relief?  The fading furrows on the brow?  That certain sassy swish to the tail?]

Hmmm?  The claim?  The object of the study?  Jeez, but You Readers are demanding.  Is that a Burgeoning Sense of Entitlement rearing its ugly little head? 

Combining ketamine with astrocytic inhibitor as a potential analgesic strategy for neuropathic pain

Molecular Pain 2010, 6:50   doi:10.1186/1744-8069-6-50

Published: 6 September 2010

Background: Neuropathic pain is an intractable clinical problem. Intrathecal ketamine, a
noncompetitive N-methyl-D-aspartate receptor (NMDAR) antagonist, is reported to be useful for
treating neuropathic pain in clinic by inhibiting the activity of spinal neurons. Nevertheless,
emerging studies have disclosed that spinal astrocytes played a critical role in the initiation and
maintenance of neuropathic pain. However, the present clinical therapeutics is still just concerning
about neuronal participation. Therefore, the present study is to validate the coadministration
effects of a neuronal noncompetitive N-methyl-D-aspartate receptor (NMDAR) antagonist
ketamine and astrocytic cytotoxin L-α-aminoadipate (LAA) on spinal nerve ligation
(SNL)-induced neuropathic pain.

Results: Intrathecal ketamine (10, 100, 1000 μg/kg) or LAA (10, 50, 100 nmol) alleviated
SNL-induced mechanical allodynia in a dose-dependent manner respectively. Phosphorylated NR1
(pNR1) or glial fibrillary acidic protein (GFAP) expression was down-regulated by intrathecal
ketamine (100, 1000 μg/kg) or LAA (50, 100 nmol) respectively. The combination of ketamine
(100 μg/kg) with LAA (50 nmol) showed superadditive effects on neuropathic pain compared with
that of intrathecal administration of either ketamine or LAA alone. Combined administration
obviously relieved mechanical allodynia in a quick and stable manner. Moreover, down-regulation
of pNR1 and GFAP expression were also enhanced by drugs coadministration.

Conclusions: These results suggest that combining NMDAR antagonist ketamine with an
astrocytic inhibitor or cytotoxin, which is suitable for clinical use once synthesized, might be a
potential strategy for clinical management of neuropathic pain.

Direct Correspondance to:

Dr. Li-Xian Xu at
Department of Anesthesiology, School of Stomatology
Fourth Military Medical University, Xi’an, 710032, China
Tel: 86-29-84776115 Fax: 86-29-84776115 E-mail:

Dr. Sheng-Xi Wu at
Department of Anatomy, Histology and embryology; K.K. Leung Brain Research Centre, Fourth
Military Medical University, Xi’an 710032, China
Tel: 86-29-84773074 E-mail:

Dr. Yun-Qing Li at
Department of Anatomy, histology and embryology, K. K. Leung Brain Research Centre, Fourth
Military Medical University, Xi’an, 710032, China
Tel: 86-29-84774501 E-mail:


Molecular Pain is an open access, peer-reviewed, online journal that encompasses pain research at the cellular, subcellular and molecularlevels.

Molecular pain is a growing research field that represents an advanced step from conventional pain research, addressing physiological and pathological pain at the cellular, subcellular and molecular levels.

Molecular pain research integrates pain research with molecular biology, genomics, proteomics, modern electrophysiology and neurobiology. The field of molecular pain research has great promise for the identification of highly specific and effective targets for the treatment of intractable pain.

Sunday, September 5, 2010

The Taiji Slaughter Set to Begin, Again

The photo above has NOT been ‘Photoshopped’ – that is the actual color of the water due to the annual slaughter of tens of thousands of dolphins in a secluded cove in TAIJI, Japan. You can see several of the killed dolphins in the boat. That’s all blood – a sea of blood.

The coastal village of Taiji, Japan, is home to the worst dolphin massacres in the world, motivated entirely by greed and fueled by the ignorance of the local people and the Japanese government. The bloody red waters of Taiji, Japan are only the beginning of this story...

From blog Taiji, Japan

If you've not seen the documentary The Cove, you should. 

La Bonne et Belle Bianca rented it, by mistake, one hot summer night last year.  It was Movie Night at The Manor, just a little something we do on behalf of Management and Domestic Staff Relations -- to bring everyone a little closer, build a little camaraderie.

It was the last hot day of ManorFest 2009. We were inundated with Monks taking advantage of Last Day Specials -- especially the discount to Walk the Labyrinth.  The sun was setting and there were still some 55 Cistercians wandering around the Marlinspike Manor Maze, which they consider a spiritual exercise.  The Brothers who had already found their way out lined the rear arc of the amphitheater, killing time with a movie while their colleagues quietly cursed the falling darkness inside the serpentine boxwood.

(Our Rescue Teams would lead them out during Intermission.)

The Castafiore thought she had snagged a film of The Kooks in concert and -- given the amazing way in which sound carries in our open-air stadium -- disrupted the first ten minutes of The Cove with Fierce Mutterings:  Oh! Dieu, que de bijoux-oux-oux!  Ah... ah... ah... je ris de me voir-r-r si belle en ce miroir-r-r!

Kind of hard to ignore, I admit, but we've had years of practice.

Eventually, even Bianca was drawn into the strange world of Taiji, Japan, and its accusatory eyes and barely concealed evil.  The Monks would have heaved Big Sighs, if that were allowed.  Those moments when Prayerful Intercession runs smak dab into Active Need are hard to reconcile.

That's not to say that this movie's Call to Action fell on completely deaf (or tonsured) ears.  A good many emails went out, righteously indignant.  None were answered, and there were no second volleys of indignation on our part.

It's easier just to forget.

But we've ordered time so that it cycles for many reasons, one of which is annual remembrance, recurrence.  Yesterday, I read:

These are dark days in Taiji, Japan, as far as conservationists are concerned, because this week marks the beginning of the annual dolphin hunt in the remote village made famous last year by the Academy Award-winning documentary, "The Cove."

The hunt began Wednesday despite widespread international opposition and protests in Tokyo.

Ric O'Barry, who trained dolphins for the 1960s show "Flipper" and helped produce "The Cove," traveled to Tokyo and delivered a petition of opposition, signed by 1.7 million people from 155 countries, to the U.S. Embassy. The activist, who also has produced an Animal Planet miniseries called "Blood Dolphins," was forced to cancel a trip to Taiji amid alleged threats from an ultra-nationalist group.

"I wish all these people could be in Taiji," O'Barry told The Associated Press. "It was too dangerous. The big losers are the people of Taiji."

Most of the dolphins corralled into the cove during the hunts are killed and processed for meat, but some specimens are sold live to aquariums. Japan allows the killing of about 20,000 dolphins a year and claims the hunts are an important part of the nation's culture and tradition.

Taiji, a community of about 3,500 and the birthplace of Japanese whaling, accounts for about 1,500 dolphin deaths annually. Its "oikomi hunting" practice of banging on metal poles to create a wall of sound to herd dolphins into the cove in preparation for slaughter is what drew worldwide criticism after "The Cove" was released.

"We will pass down the history of our ancestors to the next generation, preserve it. We have a strong sense of pride about this," town Mayor Kazutaka Sangen told the AP. "So we are not going to change our plans for the town based on the criticism of foreigners."

The first victims, about 20 bottlenose dolphins, were herded into the infamous cove on Thursday. The cove, with the help of netting, will serve as a holding pen. The actual killing of dolphins won't begin for about two weeks...
-- Despite swelling opposition, dolphin hunt begins in Taiji, Japan
By Pete Thomas,
Friday, September 3, 2010 9:33am PDT

This video about the dolphin killing in Taiji was made by in late 2006: