Saturday, December 31, 2011

God's Thorny Donations (With Obligatory Cat Video)

Blood-red, ruby-red, cherry-red, my chipmunk cheeks are crimson.
Stippled and florid, these spotted swollen legs -- so violently inflamed -- are vehement, are ruddy.


"Ruddy is closer to red than to rose," intones one who ought to know.
My bolshy red ink comes to mind.
The synonym-driven blurb above is what greeted me when I popped open the spare laptop balanced on my belly, my first reflex upon regaining consciousness.  Other clues to recent activities included peanut halves, both whole halves and crushed halves, two brushes full of cat hair, several strands of which -- perhaps even amounting to a tress -- were up my nose, the ensuing histamine reaction having been the source of this rude awakening. A novel, cracked open to page 174, lay upside down on the pillow next to me, along with a telephone, a television remote control, and a licked-clean 6-ounce container of peach yogurt. That about sums up life as I know it.

Just joshing!

My face has been bright red or, at least, pleasingly pink, because my fevers have gone up a notch. I don't mind overly much because the other gift of the fevers has been an improved capacity for sleep.

I've been hitting and surpassing the temperatures that doctors say to report pretty early in the day -- peaking at around 11 each morning. I don't bother calling in about fevers -- haven't in a long time, even though achieving such fevers while on steroids is a rather remarkable achievement.

The decision to note them, but to ignore them -- absent three clear symptoms of impending death -- was codified at the end of my hospitalization in September. The day of discharge I felt about as bad as I felt the day of admission, and as I sat listening to the Infectious Disease Dood tell me to be sure and return to the Emergency Department if my fever registered above 100.7, the nurse's aide came in to take my vital signs and announced that my temperature was 100.8.

Infectious Disease Dood scribbled in my chart and started talking faster; The aide noted that my temp was up even after an earlier dosing with Tylenol; I started laughing and couldn't stop. When he had run out of the room and she had filled every available container with ice -- a favorite activity among nurse's aides, especially when I request "just water, please" -- I decided that fevers were insufficient cause for painful bumpy car rides or lame telephonic communications at odd hours to medic-types.

Besides, I often felt better with a spiking fever: energetic and focused, bright-eyed.

Until the last ten days or so. Note: I tend to say "ten days" whenever I really have no clue as to how long something has actually been occurring. I know that two weeks is inaccurate and that the change I wish to highlight has existed beyond a week, so "ten days" seems an acceptable bit of imprecision.

Right... So... The temps have gone up over 101 every day lately (What do you think of "lately" here? Does it work well with the "ten day" notion, that particular span of time?). Instead of energizing me, gifting me -- and hence, you -- with wit, I'm about as dull and listless as can be. Sleepy, pouty, and, to get us back on point, red-cheeked, and afflicted with synonyms.

Also, sweaty.

Until the last few days -- a temporal division about which I feel sure -- spasms and tics have also been part of the gift. Despite concerted attempts to emulate the Apostle Paul, to regard them as God's thorny donation to my imperfections*, there's been little ensuing delight in the weakness, difficulties, or hardships brought on by the violent jerks and stabbing electrical impulses flying up and down my legs and, rarely, forearms.

I've railed against this non-epilepsy before. Spasticity in CRPS is little understood, usually glossed over as just another symptom of a degenerative neurological disease -- or, if you are a turd-like individual named Ochoa, these scream-inducing fits are part of the fakery, evidence of people feigning misery in return for the spoils of attention and disability payments.

I shouldn't even continue to bring the bastard Ochoa up... and wouldn't, except that I've no discipline these days (at least not for the last ten or so!). Also, since the research into CRPS-related spasticity and movement disorders is smack-a-sweet-dimpled-baby-butt new, the investigators are also new to CRPS' sordid history, and cite him at least once, for thoroughness' sake, ignorant of his "expertise" in making money as a forensic expert in tort cases by claiming that CRPS does not exist, or testifying that patients have fabricated the symptoms, out to cheat workers' compensation insurance.

Workplace accidents account for many of the traumatic injuries that constitute the noxious event that can initiate CRPS, and so for decades, the only real public discussion of the disorder came in the courtroom, where injured workers sought compensation benefits, almost always without success. Ochoa profited from others' misery, and perpetuated it, in a manner that can only be described as obscene. Like Justice Stewart, I know pornography when I see it. Gladly, his voice has been mostly silenced, but the echos of the past are too often replayed. His opinions, unsupported by research, and evidently for sale to the highest bidder, continue to stigmatize patients with Ochoa's characterization of them as "illegitimate conscious malingerers and individuals with Münchausen’s syndrome."

Several rulings have directed that his testimony be discounted, as jurists, troubled by the lack of scientific foundation to Dr. Ochoa's ideas, and by the fact that someone called on to determine the presence or absence of CRPS had never, ever found the disease present, or issued an opinion in favor of the patient -- not once in hundreds of cases.

Ahem. Okay, so the man makes me nuts. I had rid myself of the Ochoa Plague largely by ignoring the citation of his contributions to medical bigotry. But as The Painful Jerks have become part of my everyday life, and as my doctors professed sympathy but little understanding, I found myself in the familiar position of having to do research in a subject far outside my area of expertise. Many of the papers on spasticity are written by academic researchers, not involved in the clinical management of CRPS, and uninterested in its exploitative judicial history. And so there he is again, The Turd, mocking me from the margins, quoted again in the text, even if just as an anachronistic oddity.

Baclofen worked for a period of time. It still works but just not well. Because I know that the Great Spasms can go on almost continually, I am grateful that Baclofen (or *something*) has reduced the incidence to just a few hours a day. Because I know that I can have both legs and both arms simultaneously flying through the air with the greatest of unease, I am grateful that baclofen (or *whatever*) has largely reduced that focus, most of the time, to one leg.

Is it really doing a darned thing? I don't know! And yet, like every day in recent memory, I am scheduled to take 60 milligrams of it, divided into 4 doses. It makes me loopy, dopey, but when I've stopped it, my subjective interpretation is that the spasticity is worse and more frequent.

Sometimes it is a funny annoyance and not so much painful as astonishing. You probably did not notice that I spoke of using a "spare" computer, a back-up laptop. The large mug of hot coffee with milk that my right hand jerked into the air last Wednesday has something to do with my current need for multiple machines. Sizzle::fry::Sizzle::fry

And Thursday, after two appointments and little sleep, Fred gifted me with pizza, double mushrooms, a wonderful treat that really hit the spot. I was dreaming of one of my favorite breakfasts, cold pizza and hot coffee, and heading to the kitchen to carefully wrap my leftover slices, when ka-blooey! The plate took off, launched like a freaking frisbee. My 4 slices landed upside down and were immediately subjected to fierce cat licking (else I'd have invented some sort of pizza sanitizer).

There have been instances of hot pots slung from stove top to floor, and a few unanticipated knife tricks. My legs have given out mid-trek to the bathroom and according to some legends, I appear to have kicked a few people.

I'm convinced I'm losing brain cells and plan to use the declining quality of these blog entries as proof.

Ha!

Part of that body of evidence? This video from last night, published below.  Clearly, my wayward brain is overloaded and misfiring, because it almost seems like my well-honed cinematic curiosity is now satisfied by the mere presence of one camera and one cat, taking improvisation all the way to the zoo, as it were.

I can match some of the tawnier and fluffier samples of fine feline fur found in my nasal passages this morning to the photogenic Buddy, a juvenile Maine Coon also known as The Freakishly Large Kitten.  He evidently shares my affection for yogurt. With his usual powers of concentration and his proven ability to stick his big little head into just about anything -- so long as food is his just reward -- Buddy goes after the few remaining molecules of peach yogurt with an enthusiasm that I deeply admire and vaguely remember from my own time among the living.


video



* 2 Corinthians 12: 7-10
Therefore, in order to keep me from becoming conceited, I was given a thorn in my flesh, a messenger of Satan, to torment me. 8 Three times I pleaded with the Lord to take it away from me. 9 But he said to me, “My grace is sufficient for you, for my power is made perfect in weakness.” Therefore I will boast all the more gladly about my weaknesses, so that Christ’s power may rest on me. 10 That is why, for Christ’s sake, I delight in weaknesses, in insults, in hardships, in persecutions, in difficulties. For when I am weak, then I am strong.

Friday, December 23, 2011

Ruthie's Christmas Wish 2011



I ran across a blog tonight, as one does.  I highly recommend that you read it.  It's called Ruthie in the Sky.

You know how, on Blogger, when you click on a blog's "About Me"/"View My Complete Profile" section, you are taken to the blog writer's profile?  Right!  And you know how, once there, part of Blogger Fun is being asked a nonsensical (or terribly, awfully sensible) question, to which the blog author jots a quick answer, something wry and, one prays, not too embarrassing?  Right!

Well, in the course of setting up her profile, Ruthie drew this gem to answer:

When your science teacher smashed a frozen rose with a hammer, did you warm the petals to bring them back to life?

And answer the heck out it, did Ruthie:

No. I sang to the petals and they warmed into rubies that glittered with diamond dew.
Just so you'll have one point of comparison, the clever bit of Blogger back-and-forth included in my profile went this way:

BLOGGER: Create a tagline for a new line of plastic bedsheets.
ME:  No. Meh.


Ruthie identifies herself, in general, as a middle-aged woman, a hitchhiker, a blogger, and a photographer.  I suspect that this merely scratches the surface, but we'll respect the limits of self-disclosure, and leave that but-who-*is*-she-really line of inquiry alone.

Well, here.  This is how Ruthie states it at Knol:

I have hitchhiked throughout Alaska, most of the Provinces of Canada and every State in the Continental U.S. This is my eighteenth year on the road (since 1993) and I am now fifty-six. You want to know the truth about hitchhiking in North America? Read on! And check out my blog, "Ruthie In The Sky" (created in 2004) for updates on my latest run on the road.


I have hitchhiked between Montana and North Carolina and Pennsylvania to Colorado, this year (2011) (hitchiked thousands of miles back-and-forth) and I am still posting regular updates in my blog. I am still on the road, as of Thanksgiving 2011 but I might settle in Nebraska for the winter months.

So, I may be a Ruthie Fan, is what I am trying to say, although serious consideration must be given to how swayed I am by romanticism of the highway, the byways, and all the rivers that run to the sea.

I thought, though, that you might enjoy reading her Christmas Wish for this year:


It's almost Christmas and the people in this Country have different ways of celebrating.


Today, I wonder how those who are considering doing something terrible are planning to spend Christmas Day?


We have quite a few children missing, right now. Two men with guns have already taken innocent lives.


And it's only the second week of December.


So, in the true spirit of Christmas, I am going to make this request:


Stop hate.


Because hate hurts and it makes people cry. It breaks hearts, destroys families, takes lives and it makes our Country weak.


If you can't be every person's best friend, at least don't be their worst enemy.


You may find this hard to accept but...love still has a place in the United States.


So give a better part of you away this Christmas. Toss hate in the nearest basket and give out some love, instead.


Every day until Christmas, you will have a choice: Love someone or lose something.


Think about it.


Thank you.


Her update from earlier today is not so heartening, and Ruthie predicts that only in its virtual forms will her Christmas have the "normal" warmth and comforts of the season.


The Christmas Post: Glad Tidings, Good Yule

It's a Christmas tradition ("Holidays, we celebrate them all at Marlinspike Hall!") that some intimate and integral bit of The Manor shall fail right when we believe ourselves through the punishing gauntlet for the year.

Christmas 2011 will be remembered as the year we sent all the plumber's children to college.

Fred and I will be installing one final faucet and mopping up the standing water later today, then we are off to the Lone Alp Outlet Malls to partake of last-minute bargains.  If only people in our social circle would accept my invitation to revise their calendars and set back their clocks, but they don't want to be seen celebrating on December 27, despite the kickass bargains of the day before.

Wusses.  There would be plenty of time to normalize settings for the new year;  No one would have missed even one drop of celebratory champagne.

We are so awash, here, so bloated by an embarrassment of riches -- that I may cancel today's Lone Alp Outlet run.  If there is any need, at present, it is not for stuff.  Well, it's more that the stuff we need turns out to be things like washers-of-a-certain-size, replacement cement gargoyles and new copper gutters, an authentic supply of wattle-and-daub for the crumbling wall common to both the heavily ornamented Baroque Ballroom and the more austere Imperial Sauna -- that sort of "stuff."

Packages have come to us from across the wide world.  No one but me knows where they have been stashed, unopened and unacknowledged.  In my various foul moods, I've tucked a package here, a package there, unless my chocolate detection meter was set off, in which case, good luck ever finding even a trace of cocoa butter from those particular bundles.

The worst case scenario is that I'll have to organize something like an Easter Egg Hunt for our Christmas presents.

One of the packages, though, sits as a bit of ballast for my weird Office Rocking Chair -- the Bent Oak, painted green, that Fred says frightens him.  The weight of the package is perfect for keeping the steam-bent runners poised mid-way, mid-rock. My office, my Tao.

It's not a Christmas gift.  It came in time for the celebration of Winter Solstice, and it is from Brother-Unit TW.  An ugly mix of guilt and regret has kept me from opening it, just as I had hoped to still the passage of time before the downhill side of the axis situation could maliciously make my days fly.

I'm going to go get it now, and we can open it together.

I'll be right back, then.

Whew.  It's heavy.

Okay, first:  TW, your handwriting is eerily similar to Brother-Unit Grader Boob's tiny écriture.  Also, can you hear me channeling the Nana Person:  "$14.95 for shipping? Are you meshugana? What’s this mishegas?"

Let me find some scissors -- or a sacrificial pen -- with which to attack the straps of tape.  All right, here we are, and I am already choking up, for the first thing I see... is TW.

Trim and healthy-looking, mustachioed and shaded (both with glasses and a hat), nattily dressed, standing beside a tent in what looks to be a field of sleeping Dead Heads, none of whom appear to be conscious, much less dressed and ready for anything.  Not like *my* brother!

This is an odd thing to notice... and I cannot defend it with even one descriptor... but TW looks calm, more than anything.  Calm.  The eye of a sleeping hurricane.  Maybe it's just that he is the only put-together human in view, but I get the sense that he is the Go-To-Guy;  He's Mr. Dependable.

Next, a handwritten note, in which he is faithful to the tradition we established a few years back, according to which I am the recipient of riches unimagined.  The tradition began in the winter of 2009, and started this way: "...thinking it would be a way to save money and be a marvelous gift, I asked my two brother-units for used copies of the two books that had been the most formative to the person they each have become."

From that silly request has come so much delight, delight gathered in heavy boxes, then shipped hundreds of miles, and so, to testify against the silliness of purchased presents. My brother Grader Boob never responded to the challenge; My brother TW has never stopped.  For the series of blog posts inspired by TW's gift boxes, enter "gifts" into the search thingy up above the blog title, in the left corner.

Guffaw.  Or just CLICK HERE.  I am so stupid this morning.

Another photo, a real snap shot, of someone mid-climb, somewhere in the Grand Canyon, TW's backyard playground.  I don't think it is him, though. But why would he send an unidentified picture of someone else? ["It's him," said Fred, "No doubt."  Well, okay then.]

A beautiful card -- he never, ever forgets Fred, though he insists on calling him "aitch," and we dare not correct him, Lord knows what all those years of brain-baking sun have done to the lad.  Anyway, he knows, as does anyone who knows me the least little bit, that Fred is, himself, an indescribable and under-appreciated gift.

Christmas is also Fred's birthday, making it a holy day, in deed.

Alfred Lansing's Endurance: Shackleton's Incredible Voyage.  Honestly?  Fred will love it... and I appreciate that it is "a tale of survival."  [Yes, Fred did get the big eyes over it...]

More hand-beaded hippie-chic jewelry, necklaces, medallions:  Yay!  I love this stuff.  Talismans. No... amulets?  Handcrafted anything is lovely, the hint of southwestern indian art/artifact, also sweet.

Another woven placemat (this is fast becoming our first private joke), within which is a beautiful slice of stone -- geode -- of a beautiful translucent round brown.

Also: pearly.  Definitely pearly.

The Grateful Dead Movie Soundtrack, 5 CDs. Cool.

The Pogues: The Ultimate Collection.
A Grand Canyon patch.
Joni Mitchell:  hits.
Ensemble Alcatraz:  Danse Royale (songs and dances from the 13th century).
Tom Waits: nighthawks at the diner.

Nighthawks by Edward Hopper



The Folger Consort: A Distant Mirror, Music of the Fourteenth Century and Shakespeare's Music.
Freddie King is a Blues Master.


E.E. Cummings:  Collected Poems 1922-1938 -- flipped open to the portentous poem on its page 225:


somewhere i have never travelled,gladly beyond
any experience,your eyes have their silence:
in your most frail gesture are things which enclose me,
or which i cannot touch because they are too near

your slightest look easily will unclose me
though i have closed myself as fingers,
you open always petal by petal myself as Spring opens
(touching skilfully,mysteriously)her first rose

or if your wish be to close me, i and
my life will shut very beautifully ,suddenly,
as when the heart of this flower imagines
the snow carefully everywhere descending;

nothing which we are to perceive in this world equals
the power of your intense fragility:whose texture
compels me with the color of its countries,
rendering death and forever with each breathing

(i do not know what it is about you that closes
and opens;only something in me understands
the voice of your eyes is deeper than all roses)
nobody,not even the rain,has such small hands

The Original Soundtrack From the Movie Rockers.
The Seldom Scene: Old Train. Ah, I am precisely in the mood for this.


Seldom Scene on Tommy Hunter Show - "Wait a Minute"
Uploaded by BluegrassLibrary to YouTube on Jul 9, 2008


Wait a minute, did I hear you say
You're goin' far away again?
Try to change it, I can't take
The lonely nights without your love


Do you want the road
To get the music done and move along?
What good does it do
Play your songs for her and hear her say?


Wait a minute, did I hear you say
You're goin' far away again?
Try to change it, I can't take
The lonely nights without your love


Rollin' along and life's been
Good to you but even so
She comes to you, late at night's
The time you hear her say once again




Wait a minute, did I hear you say
You're goin' far away again?
Try to change it, I can't take
The lonely nights without your love


Waitin' for you thirty days
And nights without a rest
I got to hold on, twenty-five to go
And once again or I'll hear her say


Wait a minute, did I hear you say...


Itzhak Perlman: Saint-Saens, Sarasate, Chausson, Ravel
Janice Joplin with Big Brother and The Holding Co.: Live at Winterland '68.  Oh, wow.
The Chieftains: Celtic Wedding.  {unsightly fist-pumping}
"The concept for the album was to musically recreate a 14th century Breton wedding ceremony, and became the first in the musical voyages tracing the influences of Celtic music around the world."

One sealed packet of Lilly Miller Leaf Lettuce Seed, Prizehead.

One ceramic Trader Dicks' Easter Island Head-Thingy, closed with a rubber tub stopper, within which were wrapped:
one rubber magic lamp;
one Grand Canyon National Park 75th Anniversary pin;
more beaded hippy jewelry;
a crystal to hang at the embrasure;
a piece of crumbling sandstone upon which there may be the imprint of feathers -- no, fern fronds (much of which is now embedded in my keyboard, grrr.).

Here is the Christmas Brunch *salad* menu at Trader Dick's Restaurante Orozko, which I invite you to peruse while I get the vacuum. Just the salad part, mind you.  I'm hungry!

Jumbo Prawns Cocktail with Cognac Remoulade 
Seared Rare Ahi with Tobiko Aioli 
Smoked Salmon & Rainbow Trout 
with Condiments and Mini Bagels 
Antipasto Platter 
Marinated Mushroom & Artichoke Salad 
Imported & Domestic Cheese Board 
Nugget’s Caesar Salad 
Dungeness Crab and Fettuccine Salad 
Baby Spinach & Shiitake Salad 
with Warm Sesame Ginger Dressing 
Field Greens with Dressing Selection 
Tomato & Fresh Mozzarella with Balsamic Syrup 
Holiday Waldorf Salad 
Ambrosia Salad 
Crispy Duck Green Bean & Pasta Salad


Okay, all better!  My keys are now pristine and I swiped a burrito out of the fridge.

Next in the box of gifts:

Neal Stephenson, Quicksilver, A Novel (Volume One of the Baroque Cycle).  A Brother-Unit and his historical novels, never enough reality!
Oops, and here is Volume Two -- The Confusion.
Ah, and now I remember that there is a promise of Volume Three in TW's note.  That's good, as the frustration of ending a trilogy on its second part might be soul-crushing.

I'm thinking of starting the journey tonight, as I am struggling through a truly nasty novel at the moment.

Another snapshot, TW in front of a nuclear blast site sign.  He appears to be in the middle of nowhere.  Ummm, and as odd a remark as this is, coming from a sibling, he has gorgeously tanned legs.  This was the era of the short short.

One charred toothpick, perhaps a gift, perhaps not.

The Grateful Dead:  wake the dead.
Women of the World: Celtic II.  From the eighth cut, Pamela Morgan's It Ain't Funny:

His lullaby, the waves outside his window
His father and himself made a wonderful pair
Five hundred years of fishing in his family
Still the government wouldn't listen when he said
"trouble down there"
It ain't funny- it ain't funny no more


Fat cat smirking in the land of plenty
Making jokes about a people from a gentler time
Sanctioned and applauded the whole gang rape of the place
But like any rape they blame the victim for the crime
It ain't funny it ain't funny no more


Now the Newfs are becoming a strain on the Ottawa wallet
There's no need to be nice- what's left is up for sale
And the best small boatsmen in the world are on the dole
Stupid and lazy according to the Globe and Mail


It ain't funny
Nobody's laughing now
It ain't funny
Something has changed somehow
It ain't funny, it ain't funny no more
[From the Newfs in Ottawa Facebook Page:

Newfoundlanders live in houses not shacks.. we eat fish sometimes but are not all fishermen... hip rubbers are convienient but not a provincial fashion statement... we are smart.. we speak funny, loudly and do so with pride... we are friendly...we are free.. we are amazing .. and we are in Ottawa...still fighting the fight to FREE Newfoundland!]

Dylan's Bootleg Series, Vol. 4: The Royal Albert Hall Concert.
Clannad: Banba.
Kate Wolf, An Evening in Austin.
Cumbia Cumbia: A Selection of Colombian Cumbia Recordings
Orchestra Baobab: Specialist in All Styles.
Orchestra Baobab is a Senegalese Afro-Cuban, Son, Wolof and Pachanga band. Organized in 1970, as a multi-ethnic, multi-national club band, Orchestre Baobab adapted the then current craze for Cuban Music (growing out of the Congolese Soukous style) in West Africa to Wolof Griot culture and the Mandinga musical traditions of the Casamance. One of the dominant African bands of the 1970s, they were overshadowed in the 1980s and broke up, only to reform in 2001 after interest in their recordings grew in Europe.
Ella Fitzgerald, These are the blues.
Sarah Vaughn, This is jazz/20.
The Girl From Ipanema, The Antonio Carlos Jobim Songbook.
The Time-Life Treasury of the Blues.
Les Négresses Vertes, Mlah.
Patrick Bell, Celtic Harp.
The John Renbourn Group:  Live in America.
Pietro Mascagni, Cavalleria Rusticana.

One audiocassette recording from 6/22/82, of The Clash at San Francisco Civic Auditorium.

One bit of broken plastic, now further broken, and gone, mostly, after the arrival sur scène of Buddy the Freakishly Large Kitten.  I hope we won't be rushing him to the vet... He looks distinctly proud of himself, with that "mine, all mine" look of puissant pussy cat.

Two snapshots, poor quality, excellent subjects.  A bird in the hand in front of what looks to be the sea wall at the end of the world, backed by a beautiful rainbow -- and some bushy-headed guy in an Ireland tee shirt.

Okay, so Fred pointed out that it is a bit unusual to have electric wires strung in the middle of the ocean.  Another familial holiday gift, the grandfather's glaucoma.  I am blind as a bat.  Apparently, that snapshot is of the brother-unit and his girl feeling one another up in the desert.

Ha!  My world, made of things seen wrong!  Thus far in this blind journey, the corrections have all been amusing, if not always instructive.

Good Yule, all, and thank you, TW.  I hear rumblings out in the common area.  It might be time for me to hold a flashlight and mumble words of encouragement, for I think we've sprung another leak.

Geocentric (Ptolemaic) model of the universe from BibliOdyssey: Celestial Mechanics
The image above is "cropped and cleaned up somewhat from a newly digitised hand-written manuscript, online at Harvard University's Houghton Library: [MS Typ 57] 'La Sphere du Monde..', 1549, by Oronce Fine."

Thursday, December 22, 2011

Free Access: Predictors of Pain Relieving Response to Sympathetic Blockade in CRPS Type 1


Good Thursday, Dear Readers.
Happy Solstice!


I almost passed over the notice I received about this article's publication, irritated by what seemed a blithe acceptance of sympathetic blocks as an always appropriate first-line response in treating CRPS.  If you're a regular here, you know I'm a tad touchy about medicos who don't update their knowledge, who continue old ways based on old understandings.

Good thing I looked closer and saw this was from the good people at TREND (Trauma Related Neuronal Dysfunction), "a knowledge consortium that integrates research on complex regional pain syndrome type 1, and supported by a Dutch government grant."

Better, they address my concern upfront, and first thing. They even manage to be polite about it. So long as folks persist in waltzing down the yellow brick road proclaiming "sympathetic nervous system dysfunction" as the crux of the matter, there will be people subjecting themselves to (no kidding) hundreds of sympathetic blocks, whether they "work" or not. This culture of treatment is crucial to the support of pain management clinics that rake in cash -- hand over fist -- for procedures, procedures, procedures.

I would love to see an undercover investigative report of one of these procedure factories, where many patients are told they will not receive pain medication unless they submit to procedures, procedures, procedures.

Though I had not teased out all the details, this was roughly my situation early on in my CRPS treatment saga. Newly diagnosed, I had been suffering from CRPS for two years at that point. Delay in diagnosis and treatment is too normal, unfortunately. The anesthesiologist in question told me blatant lies about various medications, as well as telling me to stop taking the narcotic pain regimen in the manner of frozen fowl, cold turkey. "Oh, you can just stop taking it. No problem." A few seizures later... Ha! He would not condone taking Baclofen, saying "it's for crazy people." (We've yet to figure that out.) And nuts I must be, because today, seven years later, Baclofen may be all that keeps me from permanent installation at the psych hospital.

[Hell, I no longer look upon my potential for Funny Farm residence as something to be ashamed of... Today, I daydreamed about the relief that might be inherent in going insane, so long as that journey involved immunity to pain, as well as the elimination of the lies and good manners necessary to the oh-so-civilized suffering of pain. Maybe I wouldn't be so obsessed with wanting to bitch slap the sweet people brave enough to stay in my life.]

Anyway, after the Nth sympathetic lumbar block to no effect, as I lay prone waiting for Nth-plus-one, it occured to me to ask why we were continuing, arduously continuing, to do them.

He was scrubbing at the sink, back to me, and had laughter in his voice: "I guess it doesn't make much sense to you, huh?"

I wonder how differently I might have behaved had I missed that joyful (ka-ching ka-ching) tone; Had he been facing me, his serious doctor-face might have made me doubt myself. Because no, it did not make sense to me, that I was being bankrupted for treatments that weren't in the least helpful.

Sympathetic block Nth-plus-one never happened. Fred was grinning from ear-to-ear.

The next pain management guru is the one I am still with, though I believe he'd be happy were I to leave. He turned out to be from the opposite end of the spectrum and believes me so far gone with the disease that the only appropriate modality is pharmaceutical management. Please note that I have tried to soldier on, revisiting physical therapies, going daily to the gym (until my bones started snapping), riding the Ketamine train, et cetera.

There just are not many pain management doctors/clinics that happily marry appropriate procedures with judicious drug maintenance. The procedure joints are like factories without the predictable factory outcomes; The places that just hand out prescriptions are, hands down, best at killing hope.

Back to these good TREND researchers! Their purpose is cleanly delineated -- how to ensure that patients receiving blocks are the patients most likely to have relief from them. And as I said, they immediately address the whole "sympathetically maintained pain" thang -- not dogmatically, but clearly enough.  Emphases are, of course, mine:

Complex regional pain syndrome exhibits some signs and symptoms that may indicate sympathetic autonomic dysfunction, yet sympathetic blockade produces inconsistent improvement in this condition.

In a prospective series of patients with complex regional pain syndrome type 1, the success rate with sympathetic blockade was moderate (31%), and no signs or symptoms predicted block success.


The use of a sympathetic block (SB) for diagnostic and therapeutic purposes in the management of complex regional pain syndrome type one (CRPS-1) is based on previous hypotheses concerning the involvement of the sympathetic nervous system in the pathophysiologic mechanism of this disease. The nociceptive afferent input was believed to cause hyperactive spinal neuron activity, which stimulated the sympathetic neurons to induce arterial spasms, ischemia, and edema.

In certain cases of CRPS-1, the pain may be attributable to a sympathetically maintained form of pain that is classically defined as pain relieved by SB with local anesthetics. Consequently, SB frequently is performed for the management of CRPS. Current treatment guidelines for CRPS-1 limit the role of SB to selected cases that are refractory to conservative treatment with pharmacologic therapy and physical rehabilitation. When a single SB with a local anesthetic (diagnostic block) proves successful (50% or more pain reduction for the duration of action of the local anesthetic), repeated blocks or a more definitive sympathetic blockade using radiofrequency lesions may be considered. A review of the literature shows that SB with a local anesthetic in patients with CRPS resulted in pain relief in approximately one third of patients. Predicting which patients would benefit from SB would assist physicians in patient selection and reduce the number of unsuccessful invasive SB procedures, along with their potential complications and side effects.





Anesthesiology:
January 2012 - Volume 116 - Issue 1 - p 113–121
doi: 10.1097/ALN.0b013e31823da45f
Pain Medicine

Predictors of Pain Relieving Response to Sympathetic 
Blockade in Complex Regional Pain Syndrome Type 1

van Eijs, Frank M.D.*; Geurts, José M.Sc.†; van Kleef, Maarten M.D., Ph.D.‡; Faber, Catharina G. M.D., Ph.D.§; Perez, Roberto S. Ph.D.‖; Kessels, Alfons G.H. M.D., M.Sc.#; Van Zundert, Jan M.D., Ph.D.**


ABSTRACT

Background: Sympathetic blockade with local anesthetics is used frequently in the management of complex regional pain syndrome type 1(CRPS-1), with variable degrees of success in pain relief. The current study investigated which signs or symptoms of CRPS-1 could be predictive of outcome. The incidence of side effects and complications of sympathetic blockade also were determined prospectively.

Methods: A prospective observational study was done of 49 patients with CRPS-1 in one extremity only and for less than 1-yr duration who had severe pain and persistent functional impairment with no response to standard treatment with medication and physical therapy.

Results: Fifteen (31%) patients had good or moderate response. The response rate was not different in patient groups with cold or warm type CRPS-1 or in those with more or less than 1.5°C differential increase in skin temperature after sympathetic blockade. Allodynia and hypoesthesia were negative predictors for treatment success in CRPS-1. There were no symptoms or signs of CRPS-1 that positively predicted treatment success. A majority of patients (84%) experienced transient side effects such as headache, dysphagia, increased pain, backache, nausea, blurred vision, groin pain, hoarseness, and hematoma at the puncture site. No major complications were reported.

Conclusions: The presence of allodynia and hypoesthesia are negative predictors for treatment success. The selection of sympathetic blockade as treatment for CRPS-1 should be balanced carefully between potential success and side effect ratio. The procedure is as likely to cause a transient increase in pain as a decrease in pain. Patients should be informed accordingly.

This article may be accessed for personal use at no charge through the Journal Web site, www.anesthesiology.org.




Author Information
* Consultant Anesthesiologist, Department of Anesthesiology and Pain Management, St. Elisabeth Hospital, Tilburg, The Netherlands. † Research Associate, ‡ Professor, Department of Anesthesiology and Pain Medicine, § Associate Professor, Department of Neurology, Maastricht University Medical Centre, Maastricht, The Netherlands. ‖ Associate Professor, Department of Anesthesiology and Institute for Health and Care Research, VU University Medical Centre, Amsterdam, The Netherlands. # Biostatistician, Epidemiologist, Department of Clinical Epidemiology and Medical Technology Assessment, University Hospital Maastricht, Maastricht, The Netherlands. ** Consultant Anesthesiologist, Department of Anesthesiology and Multidisciplinary Pain Centre, Hospital Oost-Limburg, Genk, Belgium.


Address correspondence to Dr. van Eijs: Department of Anesthesiology and Pain Medicine, Maastricht University Medical Centre, Mailbox 5800, 6202 AZ Maastricht, The Netherlands. f.v.eys@elisabeth.nl.

Magic Movie: Treats In A Ball, A Ball In A Box


I put treats in their Slimcat Food and Treat Dispenser Ball, placed the ball in an empty cardboard drink box, then tossed the whole IQ Test on the floor.  As it had not been long since they'd eaten, the majority response was an underwhelmed feline "meh."

Still, there we were, y'know?

First up, Dobby. Dobby is scary smart -- also, we think, elven (hence the name). The confused and confusing runt of Marmy Fluffy Butt's litter, Dobby is the smallest of the three cats you see. Marmy is the long-hair with the curvaceous sashay and the attitude..

Since Dobby is currently in a too-cool-for-school phase, and Marmy believes in profiting from other's labor, only Buddy the Freakishly Large Kitten took on the box and its promise of a snack.

Buddy is always hungry. Always!

(Buddy is the cat wearing the box.)

This is one of those Flip Video Magic Movies, in which the content is chosen by some miniature cinematic wizard.  So what you have here is the uncritical very short version of our morning's boredom.

My Solstice gift to the menagerie arrived yesterday -- a pound of bonito flakes. What fun I had breaking down the large stinky bag into a dozen or so smaller zip-lock bags. I had no clue the stuff was so pungent.

I predict a bonito flake theme in the next Manor movie.

Dashi, anyone?


video





Tuesday, December 20, 2011

It's gonna be a Rockin' Birthday Eve



After a response time delay that successfully separated my stomach lining from its mother-organ, the assistant to Dr. ShoulderMan called last Tuesday evening with a date for surgery.  It's gonna be a Rockin' Birthday Eve Event on 23 January.

I was able to refrain from asking her to specify the year.

I was, as they say, fit to be tied from the rush to wait.  [I pity the fool who tries to get me into that straitjacket.]

My snark is misdirected, also irrelevant.  Turns out ShoulderMan's assistant, a nurse who is In Charge Of Everything in that particular workshop, had been out of the office the preceding five days.  It was my MDVIP Dr. Go-To-Guy's right hand woman who set me up with expectations... 

I'll let it go, this nonsense, let it float up to heaven tied to the end of a wildlife-smothering mylar balloon with bird-garroting ribbons streaming down, landfill fodder.

[Yeah, that's right, I'm crazed by all the balloon releases that people announce -- as tributes to children dead from evil cancer, usually.  I guess the balloon signifies childhood and the act of watching attached wishes and sentiments rise to the assumptive vault of heaven is cathartic. My vote goes to... I dunno... quilt panels and living memorials of plants and trees.  I'll shut up now.]

I have been brought pretty low of late by things physical, something that is only truly possible by the acquiescence of the mind to things petty.  I've caved in, near implosion, from debilitating sweats, for example, that seem to be accompanied by vicious head and neck aches.  But mostly, it's been the Return of the Spasm that has had me wailing, alone, behind carefully closed doors.

Okay, that's a lie.  I have stopped closing the doors, mostly because every ear in Marlinspike Hall is now entirely immune to the impact of my screams, and never did much react to my cries, anyway, preferring that I announce myself with tasty offerings, via the dinner bell, or with folded clean clothes, after the alarming bark of the dryer timer.

It's not that Fred and La Bonne et Belle Bianca Castafiore don't care;  It's more that no one can sustain the level of pity that I require, especially over an extended period of time.

Thank God for blogging, eh?

Even the Feline Remnant has developed a disturbing catty commentary on my painful inertia.  Dobby has begun leaping onto my blimpy red oozing legs without the least bit of apology, no hint of embarrassment at my yelp of pain.  That glint in his eye had better be a trick of the light.

Personally, I think that with just a tad more dedication and practice, the Indentured Staff, Haddock Middle Management, and Comedic Cling-Ons, all, could whip up sufficient sympathetic fervor -- but that's just me, the hopeless optimist.

The spasms seem to only last about two hours -- that'd be for the one, at most, two, extended sessions of yowling jerkiness per day.  The rest of the time, it's a blitzkrieg sort of experience that clearly derives from techniques of guerrilla and modern urban warfare.  Rapid, apparently disorganized small strikes meant to demoralize as much as disable.  Enmity buried in the ordinary, wide-eyed innocence masking murderous intent.

What?  No, I do not think that the characterization of schtuff (above) is excessively self-important and self-pitying.  What's wrong with you?  Whose blog is it, anyway?

I thought we'd found the formula to defeat CRPS' spasticity, or, at least, the appropriate drug.  It's no surprise -- It's Baclofen.  Also good for hiccups and alcoholism, not necessarily in that order.

Unfortunately, Baclofen can leave me drooling, which begs the important question:  Is life more worth living as a Somnolent Slobberer than as a Total Jerk?  We are trying to ignore the clamor of outside voices, those ninnies who feel no shame in telling me what I ought to do ("Just distract yourself, don't over-medicate!"; "Eat a banana!").  There is always one Ninny who wants to blame a low potassium, who hasn't heard that cantaloupes, prunes, and papaya beat out the banana, or that tomato juice with a baked potato will fill the void, as well.  Be all that as it may, my potassium is fine.

Où est donc le fil de ma pensée? 


Anyway, the Baclofen stopped working, and I cut it back from 80 mg per day to 50-60 mg total, with the result that I no longer spew spittle about The Manor as I twist and twirl and scream.

How is the CRPS, overall?

The Edema Wars continue on, skirmish by skirmish, no real victor in evidence.  I had to spend three days straight in bed to bring down the puffy, liquid nature.of my legs and hands.  It's no longer an extraneous detail, this edema, for when it is uncontrolled, my legs are in the red zone, but with patches both very cold and very hot.  If diuretics, elevation, and rest work their magic and my fingers and ankles reappear?  Then the CRPS slips into deep purples, and every appendage is ice cold.

In terms of pain, CRPS rarely lets up.  The few moments when I am not in pain really are attributable to either unconsciousness or Blessed Distraction.  Unfortunately, pain and sleep are not friendly with one another, so I continue to sleep very little, with the result that pain seems worse, and life, hopeless.  It's wonderful, those occasions when I do get good rest, and simply amazing how much less pain I perceive.  (The lessons of Reality-as-Perception are popular review topics around here.)

Highest on the list of Blessed Distractions?  Books with pace.  The Republican presidential nominees (though we fear their entertainment factor may begin a steep decline as that peculiar segment of the electorate begins to weed, in earnest). Suppression of cat hair in my environment. Cooking and baking.  Crossword puzzles. Counseling the inpatient addicted carnies during their stay in Haddock Rehab (headquartered in the barn).  Short parkour and ballet vids on YouTube.  Bed-bopping and wheelchair-whirling to familiar golden oldies, archaeological rock.  Checking for updates to Pete's Pustulant Pimple over at PopThatZit.  Dobby the Runt, Marmy Fluffy Butt, and Buddy the Freakishly Large Kitten.   Fred.  La Bonne et Belle Bianca Castafiore.  The Crack Whore across the country lane (We sometimes sit and listen to her soliloquize in the middle of the night;  Lately, she has addressed one astonishing speech after another to her Ugg boots.).

There's a new category of CRPS misery -- skin.  Skin that rips and tears, bleeds and blisters, openly weeps and lightly leaks.  Skin that burns, skin that, once broken, refuses to heal.  I suppose my new friend, The Fistula, falls in this category.  The Fistula had stopped leaking and I was full of hope that it would go away, but then I mopped all 27 of The Manor's medieval and early renaissance kitchens last week... and wouldn't you know, the hole in my upper arm turned bright red and produced stringy yellow pus.  The idea that this thing has tunneled all the way from my shoulder prosthesis is so... gross.  *Bleck*!  *Ack*-*Ack*


My right leg is particularly prone to skin weirdness, as well as injury, upon which skin weirdness thrives.  Between cat talon punctures, dropped laptops, and doorway collisions, the leg is pocked with holes and eruptions, and regularly bathed in the terrible brine of lymphatic fluid.  It can be depressing.

Prior to my last visit with MDVIP Dr. Go-To-Guy, I decided to do some heavy maintenance of that leg, and took a brush to it, thinking that maybe the crud and crap could just be scrubbed away.  (Very sleepwalking Lady Macbeth.)  In the shower, perched on the plastic chair [that has a screw poking through its seat right into mine own seat, ouch!], I administered a brief flurry of boar bristles.  Never again.  I still burst into spontaneous fits of bleeding if I leave that leg haphazardly upright, or should I remove the Hello Kitty Band-Aids.  In addition to what can only be described as holes, new pores on steroids, there are shiny, raised, red whorls.

My hands primarily burn, though there are now stabbing pains on the outside of the palm and up the side of the pinky finger, with the foremost complaint-worthy problem being edema and slowness to react, clumsiness.  This puts a real crimp in my legendary culinary knife skills.

We've been keeping Ruby the Honda CRV defrosted, de-iced, juiced up, and just generally ready because the infection in my left shoulder is raging, and there have been a few afternoons when it seemed like I was becoming septic, or, at least, loopy.  I sometimes get hit with chills and sweats simultaneously, cannot get warm, and wrap myself up like a papoose destined for frozen tundra.

So that's the state of things.  My goal is simply to get to January 23 in as great a condition as possible, with a mind prepared for another long haul of seek-and-destroy.  ShoulderMan will team up with another local folk hero, Infectious Disease Dood, and together they'll organize the antibiotic or antifungal (ewww) attack during the post-op period with the spacer in place.  If they are successful, ShoulderMan will be able to regift me with a shoulder (most likely a "reverse" prosthesis) in about three to four months time.

I am so lucky to be in their good hands.

Now... to get there. and with sanity intact!

Sunday, December 18, 2011

How I Learned That Mother Teresa's Nobel Acceptance Speech Was A Hate Crime

While I enjoyed Hitchens, he lost his way.  Or found it.

Whatever.  We diverged when it came to Iraq, and man, O man, has it not come down to Iraq, in the determination of so many things (things in the right now of so many things)?

That has to be said, given the smallness of this honorific, given that I don't drink anymore, though I daydream about single malt scotch, given that Hitchens up and died, damn it, at only 62, damn you, cancer, given that I am Queen of Equivocation, frequently wrong, and fervently so, only 62, still full of suave spittle, what was it like to be so right?

Stupid cancer.

I still think "John Ashcroft a greater menace than Osama bin Laden,"  but could totally get behind Hitchens' disdain for Mother Teresa:

[Mother Teresa] was not a friend of the poor. She was a friend of poverty. She said that suffering was a gift from God. She spent her life opposing the only known cure for poverty, which is the empowerment of women and the emancipation of them from a livestock version of compulsory reproduction.

I just reread her Nobel acceptance speech and my disgust at it is turning my stomach. And it has been years since I last read it, you'd think something in me would've changed -- tempered like bitter chocolate -- maybe even matured.

But just as lovely, silky smooth chocolate will seize at the hint of cold water, I still die to read that "[t]he poor people are very great people. They can teach us so many beautiful things."

This nun stood in Bhopal and begged us to forgive Union Carbide.*

Not only do I no longer drink, I no longer smoke as well, which virtue was much harder to attain.  Most people are saying, index aside the nose, that cigarettes and booze predisposed Hitchens to esophageal cancer -- certainly they must have assisted him in denying the cancer's symptoms until it had reached such an advanced stage at diagnosis.  I don't know.  Cancer sucks.

Forget the nun.  Move along.

Why add to the Hitchens ink on the occasion of his death?

Because Henry Kissinger is a war criminal and we all know it.
Because Ronald Reagan truly *was* "as dumb as a stump."
Because he was probably right about Bill Clinton, too -- but I cannot admit that, cannot discuss that, since Bill Clinton still has his uses to me, and by his atonement, the world will benefit. Like most everyone, I will treat Hitchins-on-Clinton as a bunch of [hauts] bons mots.

But really, why this late post, full of nothing new?  Why more in a week full of a lot, already, about Hitchens, about reading Hitchens?

Because when I read Hitchens then, when I read him now, my hate ignites. Not my conscience, not really (that's my pretension, my particular torque on the truth), but my perky, oh-so-courageous hate.

I can clothe hate in facts, discuss the failure of Mommy Dearest to provide pain relief for the agonized dying** -- never mind treatment for the sick -- while hoarding money. [There is that damned nun again!]  I can accessorize my hate with as many instances as anyone of the crimes of religion, and I'm equipped to snark on God all the livelong day.

This is no obituary, there is no summary "at the end of the day" kind of finish.  My queasy stomach is as equally turned by those praising Hitchens' "brave" and "humanistic" death.

But I do so tire of the automatized contrarian, mostly because rigor is no comfort, and rigor's largest and most hate-filled lie is that rigor is truth.  I don't know where the lie is best knotted, where it is knit together, but I suspect it is at the juncture of rigor and our notions of consistency.

We praise that which is internally consistent.  We reject that which jars.
The iconoclast, too, is held to our schoolkid's standard, and fervently so when the iconoclast needs transformation into a curmudgeon.

If we cannot do that, if we cannot work transformatory magic on Christopher Hitchens and his deep well of hatred, if I cannot do that, and so acknowledge my own profoundly deep well of hatred, then every false step becomes a conscious choice, a studied betrayal.

Reading over this, I am so glad that I know what I mean, and extend you my best wishes for comprehension!

Has the left forgiven Hitchens for his post 9/11 stances?  Can we forgive him what he called his biggest "paradox"?  Does the left feel the twinge of hate at his inconsistency, at his finger poking the puffed chest of its romantic nature?

If we admit we hated Hitchens, must we, like Tariq Ali, be draconian about it, and saw the man in half?  Is it impossible that the Old Hitchens holds an internally consistent structural logic to the Wrong Hitchens of the post-9/11 world?

These are, as they say, interesting questions.

Because it is hate that I think most about when I think of Christopher Hitchens, dead at 62.




**********     *****     **********

* From Mother Teresa: The Final Verdict by Aroup Chatterjee:  



In December 1984, three and a half thousand people died in Bhopal from inhaling toxic gas, leaked by the multinational giant Union Carbide, in the worst industrial accident the world has ever seen. The number of people actually affected cannot be logged as the effects are long-standing and future generations would probably continue to suffer.


Mother Teresa, whose post-Nobel reputation within India was then very high indeed, rushed in to Bhopal like an international dignitary. Her contribution in Bhopal has become a legend: she looked at the carnage, nodded gravely three times and said, 'I say, forgive.' There was a stunned silence in the audience. She took in the incredulity, nodded again, and repeated, 'I say, forgive.' Then she quickly wafted away, like visiting royalty. Her comments would have been somewhat justified if she had sent in her Missionaries of Charity to help in any way. But to come in unannounced, and make an insensitive comment like that so early on, was nothing short of an insult to the dead and suffering. In the wider world however, her image became even more enhanced, as she was seen even more like Jesus Christ, who would turn the other cheek, although in this instance the cheek was not hers. People in Bhopal were not amused; it is said that the only reason Mother escaped being seriously heckled was by dint of being an elderly woman.

Mother Teresa's propaganda machinery handled her Bhopal trip in the following way:

As she was present to the agony of Calcutta, and that of India's other great cities, so Mother Teresa was present to the anguish of Bhopal, a city four hundred miles to the south of Delhi, when a cloud of smoke enveloped a crowded slum on the night of December 3, 1984. The Missionaries of Charity, who had long been working in Bhopal, escaped being among the victims because the death-bringing gas was blown by the wind in a different direction... Even while the dead were being cremated or buried, Mother Teresa rushed to Bhopal with teams of Missionaries of Charity to work with the Sisters already on the scene. 'We have come to love and care for those who most need it in this terrible tragedy,' said Mother Teresa, as she went from centre to centre, from hospital to hospital visiting afflicted people. 7

This is an extremely clever play of words, as 'Mother Teresa was present to the anguish of Bhopal' means literally that; 'teams of Missionaries of Charity' means the couple of nuns who accompanied Mother to Bhopal; but the verb 'work' is employed in a very broad sense. 'The Missionaries of Charity (who) had long been working in Bhopal' is however entirely true, as they have had a small but neat home for destitutes (called Nirmal Hriday, like the one in Calcutta) for many years.

Another of Mother's biographies has a photograph in it with the following caption:'Helping A Survivor of the Chemical Leak at Bhopal, December 1984'8.

The photograph concerned shows Mother daintily offering a marigold flower to a woman moribundly lying in a hospital bed.

** I retch, I retch:

The poor are very wonderful people. One evening we went out and we picked up four people from the street. And one of them was in a most terrible condition- and I told the Sisters: You take care of the other three, I take of this one that looked worse. So I did for her all that my love can do. I put her in bed, and there was such a beautiful smile on her face. She took hold of my hand, as she said one word only: Thank you - and she died. I could not help but examine my conscience before her, and I asked what would I say if I was in her place. And my answer was very simple. I would have tried to draw a little attention to myself, I would have said I am hungry, that I am dying, I am cold, I am in pain, or something, but she gave me much more - she gave me her grateful love. And she died with a smile on her face. As that man whom we picked up from the drain, half eaten with worms, and we brought him to the home. I have lived like an animal in the street, but I am going to die like an angel, loved and cared for. And it was so wonderful to see the greatness of that man who could speak like that, who could die like that without blaming anybody, without cursing anybody, without comparing anything. Like an angel- this is the greatness of our people.

Saturday, December 10, 2011

the virtuosity of his goofiness, i miss it





The old admonition is whining at me again today, the Stones, being all truth-telling and such.


You can't always get what you want
You can't always get what you want
You can't always get what you want
But if you try sometimes well you just might find
You get what you need
Oh, why not?  Take a moment for the music.


Uploaded to YouTube by mariule2 on Apr 21, 2010
The uploader notes:
Probably their pest performance of the song. It [was] recorded in Brussels in 1973. 
Fantastic solos from Mick Taylor and Bobby Keys.


I passed a difficult night, one that culminated in slumber among spilled (or spilt, depending) popcorn kernels.  I don't know that culminating works well, as a word, to convey that itchy, fibre-filled quilt of a slumber-fest, but what the heck?  It's very much a "why not?" kind of a day, as a result.

And, of course, I can hear all you Smarty-Panted Ones out there, crowing:
"How else would culminating work, if not as a word?"

Peppered with Kettle Corn, dosed in sucralose, I dreamed, and also dreamt, about John Hartford.  Not in passing, not in a cursory fashion, no.  He came alive again, he stood profiled against the setting sun, hat cocked -- and that's not a bicorne reference, not even inadvertently, since I'm refutin' it as you read,. before your very eyes!

He shuffle-danced, way more nimble than he was at the end, though the fool kept dancing, didn't he?

A fool, in the fool tradition, that's exactly what John Hartford was in my dream, and is, in my narrow understanding of his genre.  A banjo-picking fiddler, and a shuffling fool.

Here is a sentence I love, written about the English Medieval fool tradition: "The rigid social hierarchies of medieval society relied on these reality maintenance constructs which were closely related to traditional inversionary re-enactments of mis-rule to create a sense of release for and in the population." You gotta admit, that's a sentence that means to pack a wallop.

I'd give you the reference but it's an unpublished document and I'm unsure that the author, one "Bob," would appreciate it.  Also, I think Bob may have picked it up off the floor at some SCA swap meet, or whatever, as his phrasing is rather... errrr, popular. For what it's worth, Bob is part-and-parcel of the San Francisco-based industry of good will Fools For Hire, sort of a project affiliate of the aforementioned Society for Creative Anachronism.

I know, I am bleeding all over the page.  But so it was as I slept, and therefore, so shall it be here.  Lots of grandstanding, and stuff.

Right.  So... John Hartford.  The quality of my mind's reproduction of his music may safely be filed under "Q" for Questionable.  I wonder how the brain manages a trick like that?

Right.  So... John Hartford.  Skimming over the YouTube videos in which he figures, I wanted one with the Aereo-Plain Band, because my wrecked memory keeps telling me that the John I dreamed was that John, of that era, with hair everywhere and aviator goggles. Newgrass, and all that, too, I suppose.

Of course that was the John Hartford of my dreams;  I lack a knowledge base of the Mississippi River Basin.

Here's John at the 30th Anniversary Reunion Concert with the Aereo-Plain Band, November 11, 2000, in Albany, NY. He was pretty doggone sick at this point but the performance warms the heart.

Theme song of my dreams.



Uploaded to YouTube by AcousticBoxOffice on Jan 16, 2009 "...In addition to John Hartford, Tut Taylor, Norman Blake and Vassar Clements [there] were special guests Sam Bush, Chris Sharp and Mike Compton..."

Steam-Powered Aereoplane

by John Hartford

Well I dreamt I went away on a steam-powered aereoplane.
Well, I went and I stayed and I damn near didn't come back again.
I didn't go very fast on a steam-powered aereoplane.
well the wheel went around and up and down and inside and then back again.


Chorus:
Sittin' in a 747 just watchin' them clouds go by,
can't tell if it's sunshine or it's rain.
I'd rather be sittin' in a deck chair high up over Kansas City
in a genuine, old-fashion, authentic steam-powered aereoplane.


Well I dreamt I was a pilot on a steam-powered aereoplane.
I'd turn that pilot wheel around and then back again.
I'd wear a blue hat saying "Steam-Powered Aereoplane"
with the letters go 'round the brim and then back again.





Wednesday, December 7, 2011

Coach K and Pat Summitt: Sportspeople of the Year



Pat Summitt of Tennessee and Coach K of Duke -- the winningest women's and men's basketball coaches in the history of the NCAA -- are the 2011 sportspeople of the year, courtesy of Sports Illustrated.

Krzyzewski joins former UCLA coach John Wooden (1972) and former North Carolina coach Dean Smith (1997) as the only other men’s college basketball coaches to win the award. Summitt, the all-time leader in women’s college basketball wins (1,075), is the first women’s college coach honored.


Passing the Duck Test

Late last week, I opened a blog post with those impossible to live down words:  "i'm sitting here weeping." 

Those words don't cause me shame, that's not the problem.  The lack of capitalization?  No, that could be readily fixed (I'm told).

Once again, it's the absence of heart, or as some WizKid might recast it all: my hopelessness.

Between you and me, I've been sitting around weeping a lot lately.  Of the twelve things most likely to be happening in our bedroom here in the Easternmost of the East Wings of Marlinspike Hall, me sitting whilst weeping is in the Top Four.

It's disgusting and not inspirational of anything except, perhaps, a triple-dose of nausea medication.

I saw my MDVIP Go-To-Guy on Monday, and left his office very confused, for he assured me that I made sense, thought logically, and was not being overly-demanding in my health care requests.

He intimated, even pretty much said, that my reactions, too, were not over-the-top, and that references to the Book of Job were correct within his understanding of the Biblical literary tradition.  Because I am not the type to interrupt my Physician while He is trying to speak, I thought -- demurely, quietly -- to myself, alone: "Doubtless the edition illustrated by William Blake!"


Lo, let that night be solitary, let no peaceful voice come therein (Job iii: 7).

Let the day perish wherein I was born (Job iii: 3)

So they sat down with him upon the ground seven days and seven nights, and none spake a word unto him: for they saw that his grief was very great (Job ii: 13).



In other words, he did the old "if it quacks like a duck" routine in reference to my suspicions that my left shoulder prosthesis remains, or is once again, infected.

He is a kind man, is my MDVIP Go-To-Guy, an excellent doctor, and I am glad we scrape the underpinnings of the more modern furniture, mostly reproductions, in The Manor's public vending areas and grateful that the miniature families on the domestic staff willingly sift the silty bottom of the moat for spare change.  We split the haul, fifty-fifty, because square is square.

You'd be amazed at the number of people who think that throwing things into the moat is an acceptable romantic substitution for tossing pennies into a well or euros in the Trevi fountain.  Of course, given that we sometimes attract a crowd heavily into the religious life, here more for our next door neighbors, The Cistercians, or equally heavy into heroin, hoping to score an inpatient bed at the posh Haddock Family Enterprises Addiction Center, headquartered in our barn -- we don't always come away rich in cast off coinage.

I didn't want to confuse you with haphazard detail, but most of those who drop by the Haddock homestead are also somehow related to the carnival, and are, in fact, often carnies.  Fred thinks its because we exude some sort of Rabelaisian exuberance, that we are, in short, relentlessly robust.  Fred obviously knows nothing of my time spent weeping and the suggestion that that might be one of the chief occupations of his boudoir would shame him.

Fred likes the more complicated explanations.  Me?  I'm all about Occam's Razor.  We attract addicted Catholic carnies because the Haddock Corporation opened a detox/rehab and decided to headquarter it in our barn, next to its tantalizing rope structures (connecting to the Manor proper via the Computer Turret), which fairly sings to those with gymnastic training, which is most everyone.  Oh, right, and we are smack dab next to Abbot Truffatore's Internet Office Supply Center, cleverly disguised as a rather ancient monastery.

Forgive the sarcasm, Abbot!

Anyway, I put every bit of money that we earn, find, and grow on trees into my MDVIP fund each year.  Even when I did not have the money for health insurance, at least, not at the rate charged by BCBS of Tête de Hergé, a cool $1513 per month -- Even then, I found the odd pile of silver so that I could continue under the care of an excellent physician who knew me well and was absolutely dedicated to keeping me out of the hospital and well, if the fates were so inclined.  Now that I have a PCIP health insurance policy, thanks to President Obama's Affordable Health Care Act For Expats Lost In The Heads Of Dead Belgians, I continue the tradition of remaining remarkably poor and still spending money I cannot spare on a boutique-type doctor.

Studies show that my method is both madness and cost-effective.  My MDVIP Go-To-Guy affords me the knowledge base and the organizational support I need as we go tripping and skipping around to the specialists, trying to keep the various disease conflagrations under control.

Like I said, he's a kind man, and an excellent doctor.  He answers his own phone, is forthright, and from what I hear around the custom coffee centre, plays passable tennis.  Add to that list of positives that his nurse has a superb head for politics and can always find a vein, and you've got overwhelming indicators for a fine medical practice of personalized primary care.

Monday afternoon, he was probably thinking, "Don't make any sudden moves... Smile a lot... Support her in her delusions..."

I felt about that crazy.  It's tiring, being led by the nose from one appointment or test to another, believing against the available evidence that you are following some master plan for a return to health, only to have that psychotic rug pulled out from under you.

It can lead to things like a bedroom dedicated to weeping and not wanton pleasure (or, if you cannot sleep, sex).

He carefully went over my lab work from the week before, and after pointing out the abnormal infection indicators, affirmed that I had, indeed, passed the Duck Test, and that he would call my orthopedic surgeon that very afternoon.

[The peculiar reason for which I was weeping in the boudoir last Thursday morning was an early morning call advising me that there was no need to keep my appointment with the surgeon that afternoon, as the (failed) aspiration of my shoulder had grown no pathogens in the lab.  "Great news," was the message.  "Great news, my chapped ass," was my ladylike response.]

Believe me, I know how strange it is to actually want surgery!  I feel downright odd fantasizing about ripping this bloody prosthesis from its slipping anchor, mwa ha ha!  If there were a home-based, non-surgical way to get rid of the infection, we'd have done it... three years ago.  If you are new to the Shoulder Saga, it is best summed up that way:  an infection of my bilateral shoulder prostheses that we are unable to eradicate or control, which is causing much pain and decline in quality of life.  Also, I am not serving anywhere near as many blistering aces as I oughta be.

The damned microbes refuse to show themselves when so invited by certified laboratory personnel.  They're exceedingly shy or something.

You may have noticed, as I sure had, that today was Wednesday.  There's been no crying or gnashing of teeth, but there has been a lot of pain and existing under cover of soft, worn quilts.  A quieter depression instead of a theatrical meltdown. Lots of pain and fever.  When I saw Go-To-Guy, I was at 100.5, and that's after I had taken a pound of Tylenol.  I have been hitting 101 most every afternoon, and feeling charming through chills and sweats, snarling with hypoglycemia, dry as a bone from dehydration, drifting off into polyuric dreams when the blood sugars climb too high from infection and steroids.

In all of those good times, I kept hearing him promise to speak with Surgeon ShoulderMan.  Bless the ShoulderMan's heart -- the infection persists in spite of his great skills.  He did my replacement on the right, then three years later, did a series of seven surgeries, yanking prostheses, putting in temporary spacers, regifting me with new prostheses, all the while managing my several sidetrips to Respirator Land.  It has been nothing short of a miracle, and my gratitude knows no bounds.  Unfortunately, neither does the infection in my left shoulder.

Monday afternoon, Tuesday, Wednesday.  Wednesday afternoon.

Yay!  MDVIP Go-To-Guy's nurse called this afternoon and I answered the telephone as if it were my greatest friend and not the object of my phobia.  She knew to cut to the chase, so she did: "Doc spoke with ShoulderMan.  His office will be calling you later today to set up surgery."

It made no sense that I was tongue-tied, but I was, and still am.  Of course, it is now 8:30 pm and nary a soul from that office has phoned, but maybe they are flying around the world backward on a rainbow jet stream of surgical gel and are experiencing a different time zone.

Maybe Buddy the Freakishly Large Kitten chewed through the landline phone wires again... Hmm.  (Nope, they're okay!)

If the past holds true, scheduling an infected joint "clean out" can be a bear.  They want you to be their last case of the day, so that the surgical suite can be thoroughly disinfected before they operate on anyone else -- but these are kind people and they know that sitting in a waiting room for hours, waiting to be called for major surgery, is stressful, too.  Factor in that it is the holiday season ("We celebrate them all!") and that they have a few gazillion other patients clamoring for action, as well... and it may be Friday before they call with info.

[How's that for pretending to be cool, calm, and collected?]

But there you go, Dear Readers, we are off on another surgical tour of the gunk inside these necrotic bones.  There is, literally, no other option that makes any sense, and even though we've failed in subduing these tiny forces of unrepentant evil thus far, this time we are gonna prevail... or I will come out of the experiment sans shoulders.  At least I know what that is like, now, and am not afraid of living without that thing defined by the area between the arm and the neck.

It's not like my brain is involved, duh.

Thank you so much, MDVIP Go-To-Guy.

No more sitting weeping from frustration.  Maybe I'll give fearlessness a try and give hopelessness a rest.  It could happen.