Saturday, July 7, 2012

Greyhound's Zero Tolerance

Gleefully discovered over at madness: tales of an emergency room nurse:

Have a great trip, folks!

Tu-whit, tu-who: Cute Overdose

I try to avoid {cough::ack::ahem} posting stuff that I find CUTE but... La Bonne et Belle Bianca actually snorted her morning shot of Tamarind Pok Pok Som up through that babalicious bulbous nose of hers as she was cruising videos at the morning table -- a habit which we cannot seem to break, to which we are as hostages held, to wit, to woo.*

But really, this is pretty darned CUTE.

*Kathryn Miles has a beautiful blog called "To Wit, To Woo: The Silence of Owls" within the intriguing A Journal of the Built and Natural Environments.  Okay, so I guess "blog" is the wrong designation.  Try:  Series of pleasant articles.  Anyway, she's something.  Check this out:

Kathryn Miles is the editor-in-chief of Hawk & Handsaw: The Journal of Creative Sustainability; she also serves as director of the environmental writing program at Unity College. Her work has appeared in a variety of publications, including Ecotone, PMLA, and Best American Essays. Most recently, she is the author of Adventures With Ari: A Puppy, a Leash, and Our Year Outdoors (Skyhorse/W.W. Norton). You can find her at

Unfortunately, she opens with H.D. Thoreau:

I rejoice that there are owls. Let them do the idiotic and maniacal hooting for men. It is a sound admirably suited to swamps and twilight woods which no day illustrates, suggesting a vast and undeveloped nature which men have not recognised. They represent the stark twilight and unsatisfied thoughts which all have. All day the sun has shone on the surface of some savage swamp ... but now a dismal and fitting day dawns, and a different race of creatures awakes to express the meaning of Nature there.
   — Henry David Thoreau, Walden
In my right now, feed me "I rejoice..." and I go all Ash Wednesday and TSE on you, more likely to be thinking, parenthetically, "(Why should the agèd eagle stretch its wings?)" than about her barred owl in the ash tree.  And just forget "to wit, to woo"!

*More on wit and wooing:

WINTER. [Love's Labor's Lost, Shakespeare]

When icicles hang by the wall
And Dick the shepherd blows his nail
And Tom bears logs into the hall
And milk comes frozen home in pail,
When blood is nipp'd and ways be foul,
Then nightly sings the staring owl, Tu-whit;
Tu-whoo, a merry note,
While greasy Joan doth keel the pot.
When all aloud the wind doth blow
And coughing drowns the parson's saw
And birds sit brooding in the snow
And Marian's nose looks red and raw,
When roasted crabs hiss in the bowl,
Then nightly sings the staring owl, Tu-whit;
Tu-whoo, a merry note,
While greasy Joan doth keel the pot.

Friday, July 6, 2012

67 Bodies, No Autopsies

I'm not awake -- Bianca and Sven came home, thankfully via the Celebrated Famous Historic Underground Passages from our local "downtown" pub district, so that Fred didn't have to do drawbridge-and-dunderhead duty, at around 4:43 AM -- but am sipping on a lovely cup of Italian roast mixed with about a half-teaspoon of espresso, brewed 9 minutes in my 4-minute café presse.  Yes, with a dollop of milk, as it does a body, even this body, good.

One of the first things I read as I scan the "world" news?  This:

Unidentified Illness Kills 61 Children in Cambodia
An unknown illness has sickened 62 children in Cambodia since April, all but 1 of whom has died, according to a global alert from the World Health Organization. 
The illness is characterized by high fever, followed by neurologic and/or respiratory symptoms, then rapid deterioration of respiratory function. Patients died within 24 hours, the New York Times reports.
The illness does not appear to be spreading through person-to-person contact, according to news reports, and there have been no apparent clusters of cases. Pneumonia and avian influenza are unlikely. The WHO and other organizations are investigating.
"Since April"?  Children dying within 24 hours?

Jesus God Lord Holy Guy Almighty, Already.

As I said, it was one of the first reads.  The actual first read was a blog post so stupid I almost cried, descrying the use of the phrase "kill Romney" by the Obama camp -- or not, I was so disgusted by the death of word smithery and what passes for common sense, even common political sense, that my fingertips were stabbing blindly at the keyboard, trying to make it change, I didn't care how, just get this stupid drivel off my screen.  Yes, I am one of the intelligentsia that never thinks to just unplug a misfiring bit of electronics, or to slap a lid on a flaming sauté pan.

Right, so I'm trying to figure whether you throw flour on dying Cambodian children or whether smothering the inferno with a tight lid is more efficacious.

To be fair, I haven't looked around in the "mainstream" ["*ack*-*ack*-*ptooey*" -- Don't worry, it's just Marmy delivering a hair ball] media for coverage of this outbreak.  I found it stuck inside a health summary dodad I get daily, listed right after the helpful and timely, hot-hot-breaking news article that began: "Unintentional ingestion of wire bristles from grill-cleaning brushes led to six adults presenting to a Providence, Rhode Island, emergency department over the past year..."

So, gimme a minute here.  A few sips of this excellent but rapidly cooling brew, a quick brush of the Dobster (or he will start tossing things onto the floor from the desk -- not kidding...), and some crackers --  ♪ ♫ I love prednisone in the morning... ♪ ♫ -- and I will peruse what other coverage and info is out there about these poor children.

Well, it appears that most of the information actually was just released.  Again: Jesus God Lord Holy Guy Almighty, Already.  Here is CNN's take on it:

Hong Kong (CNN) -- The World Health Organization is helping the Cambodian Ministry of Health investigate the cause of a mysterious illness that has killed dozens of children in the country since April.
A joint statement from the WHO and the ministry, released Wednesday, said 61 of 62 children admitted to hospital had died from the disease. The majority of the reported cases came from southern and central Cambodia.
"[The Ministry of Health] and WHO are currently investigating the cases," Mam Bunheng, the Cambodian minister of health, said in the statement, "possible causes of the disease are being considered, but definite identification of the cause and source may take some time."
Initial reports from the Cambodian government indicate that the unknown illness struck children under seven years old.
"The symptoms include a mixture of respiratory illnesses, fever and generalized neurological symptoms, including convulsions in some of the patients," Dr. Nima Asgari, a team leader of the WHO country office in Cambodia, said in an email to CNN.
The children were brought to hospitals in the capital, Phnom Penh, and the northern tourist hub of Siem Reap -- the two biggest cities of Cambodia -- but most of them died within 24 hours upon admission.
"This can be a mixture of a number of known diseases -- virological, bacterial or toxicological -- which have been reported as one syndrome or something new," Asgari added.
"While the labs are excluding the various pathogens, we are providing support to [the Ministry of Health] to make sure that an in-depth analysis of cases is done to identify possible causes or exposures which will give us a better picture. The investigation is ongoing."
So far, there were no signs of contagion or clusters of cases -- patients who had contact with each other and fell sick together -- a telltale warning sign of a highly infectious disease. But Asgari admitted the high mortality rate in such a short time was extremely worrying.

Well, given the reporting issues for this region [remember how China just JUMPED all over SARS?]... I will surely believe that there are no clusters, no Patient Zero... ♪ ♫because the Bible tells me so....♪ ♫

Bloomberg's offers the most specific information my quick scan can find:

Unknown Disease Killing Children Across Cambodia, WHO Says
By Jason Gale - Jul 6, 2012 3:26 AM ET

Victims of a disease that’s killed dozens of children in Cambodia were from more than half the country’s provinces, a World Health Organization official said.

The first 57 patients were from 14 of Cambodia’s 24 provinces, with most coming from the southeastern provinces of Kampong Cham, Kampong Speu and Prey Veng, said Joy Rivaca Caminade, a technical officer with WHO’s Regional Office for the Western Pacific in Manila. The Ministry of Health was first alerted to the cases by Kantha Bopha Children’s Hospital in the capital, Phnom Penh, Caminade said in an e-mail today.

Health officials are searching for the cause of the deaths, which may be the result of a combination of different diseases, according to Caminade. Surveillance in the Southeast Asian nation hasn’t picked up anything of this scale in recent years, she said. So far, there is no evidence of clustering of cases that could indicate that it’s spreading from person to person.

The undiagnosed syndrome has been reported in 67 hospital patients since April, 66 of whom have died, said Aphaluck Bhatiasevi, a WHO spokeswoman, in a telephone interview from Phnom Penh today. It’s unlikely influenza is the cause, she said.

No Autopsies
“No autopsy was done on any of the cases,” said Nima Asgari, the leader of the WHO’s emerging disease surveillance and response team in Cambodia.

Health officials are reviewing hospital records and treatments provided, as well as surveying relatives of patients, to understand the events that occurred from when the children fell ill to their hospitalization. The information is then being matched with laboratory data, he said.

“As you can imagine, this will take time and we are still at the data analysis part,” Asgari said in an e-mail today.

Children admitted to the hospital with symptoms including high fever, breathing difficulty and neurological problems saw their respiratory function worsen quickly, Caminade said yesterday. A review of 57 cases found 46 of them died within 24 hours of admission, with the rest suffering the same fate within three days, she said. The stricken children were aged three months to seven years.

The United Nations health agency is working with Cambodia’s health ministry and has offered support and access to international experts in areas such as epidemiology, she said. The WHO is on standby to provide support for clinical management and supplies of medicines if requested.

To contact the reporter on this story: Jason Gale in Melbourne at
To contact the editor responsible for this story: Phil Serafino at

67 bodies, no autopsies.

Well, good morning, Good Readers.

Thursday, July 5, 2012

"Let's be careful out there...."

I offer this because it showed up.  May I suggest, however, a good look at protocols used (or not used), and the myriad missing details, such as how the cohort was chosen.  I know, I am asking a lot from a mere abstract.  But, for chuckles, compare it with other abstracts, like this one from 2008, "Treatment of patients with complex regional pain syndrome type I with mannitol: a prospective, randomized, placebo-controlled, double-blinded study," which concludes "[t]his intervention is not more effective than placebo in reducing complaints for CRPS I patients and provides no addition to already-established interventions for CRPS I."

Sometimes I feel like a version of Sgt. Phil Esterhaus. "Let's be careful out there..." -- in that world of quick and easy, fast and loose CRPS research.

Orthopedics. 2012 Jun 1;35(6):e834-42. doi: 10.3928/01477447-20120525-21.
Four treatment strategies for complex regional pain syndrome type 1.Lee SK, Yang DS, Lee JW, Choy WS.
AbstractComplex regional pain syndrome (CRPS) poses a dilemma for many clinicians due to its unknown etiology and largely unsuccessful treatment modalities. The purpose of this study was to compare the clinical results of 4 treatment modalities for CRPS type 1. A total of 59 patients were divided into 4 groups based on treatment modality: group A, an oral nonsteroidal anti-inflammatory drug (NSAID) (n=10); group B, oral gabapentin (n=12); group C, intravenous (IV) 10% mannitol and steroid (n=11); group D, a combination of IV 20% mannitol and steroid with oral gabapentin (n=26). The patients remained under medical supervision after discharge and were evaluated either once a month or once every 2 months until final follow-up at a mean of 8 months. Patients in group A showed improvement in pain level, finger range of motion, swelling, and grip strength, without statistical significance (P=.076, P=.062, P=.312, and P=.804, respectively). Patients in group B showed significant improvement in pain level (P<.001), and patients in group C showed improvement in pain, finger range of motion, and swelling (P=.127), which rendered functional impairment unchanged. In comparison, patients in group D showed recovery of grip strength and improvement in pain level, finger range of motion, and (P<.001, P=.016, P=.031, and P=.047, respectively). Based on these results, a protocol including a combination of IV 20% mannitol and steroid with oral gabapentin is an acceptable and effective treatment for CRPS type 1.
Copyright 2012, SLACK Incorporated.

Tuesday, July 3, 2012

Cheat Sheets

I'd like to think that actually participating in one of the ACA's already enacted programs -- PCIP -- gifted me with lots of useful info and insight into the health insurance and health care access crisis in this country.  You'll have noticed, Dear Readers, that I mention it often enough.

But my official cheat sheet has often been Shadowfax over at Movin' Meat.  His Blogger "about me" consists of:

I am an ER physician and administrator living in the Pacific Northwest. I live with my wife and four kids. Various other interests include Shorin-ryu karate, general aviation, Irish music, Apple computers, and progressive politics. My kids do their best to ensure that I have little time to pursue these hobbies.
I think it's the "progressive politics" that hooked me, along with a healthy respect for an excellent wonk.

Anyway, take a look at two of his latest posts if you are just now starting to give this whole crisis stuff a thought.  Shadowfax is a good place to start, and then to continue, and then to hone your critical thinking skills -- you may have to jump around the blog a bit but that's no waste of time, either.

Here's one:

So this is great news and a great day. My quick reactions: 
First of all, CNN & FOX. Once again proving that being first is a higher priority than being right. How embarrassing. At least their soon-to-be-fired producers will be able to get health care coverage. 
Second, Roberts: I have to give him a little credit. I fully anticipated him to be a partisan hack and invalidate the law. Perhaps the burden of history weighed heavily on him, perhaps the delegitimization of the court influenced him, or perhaps the sheer radicalism of Scalia's dissent drove him to uphold the law. Regardless, he got it right. Make no mistake, though, he did what he could to advance his long-term agenda by slowly restricting the reach of the commerce clause. 
While most of the focus centered on the the Heritage-Foundation-developed mandate (aka the greatest threat to liberty ever), it's important to note that the 4 conservatives wanted to invalidate the entire law, and there is far, far more than the mandate in Obamacare. 12 million Americans will get rebates from their insurers this year based on the ACA's insurance regulations. Rescissions of policies is now prohibited. In a couple of years, pre-existing conditions will be covered under the guaranteed issue provisions, and the moribund individual market will be resuscitated by the insurance exchanges. All of these huge reforms survived and will transform healthcare in a good way. 
The mandate itself may work, or people may prefer to pay the "tax" penalty and go without insurance. We will see. If enough people opt out and insurers are experiencing serious adverse selection in a few years, perhaps the partisan rhetoric will have died down enough that Congress can tweak the incentives at bit. One can hope, anyway.  [READ THE REST HERE]

And here's the other:

From a contributor at the Daily Dish: 
This. This is exactly the right approach.
I do not understand why Democrats don't embrace the newly defined "tax", saying: you bet we raised taxes, but not on the hard-working, responsible middle class. This is a tax on those deadbeats who don't pay for their own insurance but still expect care when they show up at emergency rooms. It's a tax, all right, and I think we should agree to raise it even higher so they have more of an incentive to buy their own damned insurance and leave the rest of us alone. Let the Republicans protect the rights of deadbeats; Democrats are fighting for people who play by the rules.  [READ THE REST HERE]

As I said, peruse the dood's writings on health care policy, they're instructive, they're even-handed, I agree with them, and so, they are right.  [Hey, I've had a rough day!]  A big "thanks" to Shadowfax for sharing his inside info and his insightful analysis, too, on this... schtuff.

Monday, July 2, 2012

Loving on American Idyll

Sometimes my Brother-Units fill me with awe, sometimes with a seemingly long-awaited nod of the head, sometimes both.

Both, as in TW's recent post at American Idyll: I Must Go Where It's Quiet.

I've thought of his offerings there as collage, pastiche, satire, tour à tour.  To create, to decorate, to commentate, to put all in question, sometimes to scream, sometimes to laugh, I love watching what he does there (and ruuscal, too!).

But this one... yeah, big nods to Dylan, thank you to Joan, appropriate recollections of their story, a few wonderings about this convergence and that... but mostly, this, to me, is TW.

Here, as a temptation, is one of his photos from this post -- stolen.  I didn't ask permission.  It's his, and it might be him in it, I dunno.  Or her.  A pilgrim.  Go now and enjoy the rest -- don't do as I did and steal.

"the sky is embarrassed
and I must be gone..."

PILGRIM ABOVE HERMIT CANYON by Tumbleweed, Beloved Purveyor of Idylls

Since I am for some despicable reason so overwrought this day, I hope the American Idyll team won't mind me swiping a few pics of the feline Poncho.  Poncho reminds me, like a punch in the stomach and a tweak of the cheek, of our dear Little Boy, better known as Uncle Kitty Big Balls.  It's uncanny -- sometimes more in the attitude than in appearance, sometimes I actually have to look twice.  We miss Little Boy, and my dear Sam-I-Am's loss is palpable as the anniversary of euthanizing him arrives.  He was my Love Buddy.  I got more (and better!) kisses from Sammy than from any man I ever smooched.  But he did get a slightly unnerving ardor in the eyes that made you know Sammy was more Casanova than gigolo.  Discrete, but whoa... a true lover.  Smooches to you out there, my Sammy.

Uncle Kitty Big Balls was truly Fred's boy -- they were pals.  "They" were the reason I realized recently that naming Buddy "Buddy" was a huge error on my part.  UKBB was Fred's "buddy," and answered to it.

Anyway, the history of how we ended up with Marmy Fluffy Butt, Uncle Kitty Big Ball's sister, who gave birth to Dobby... it's fascinating reading and THIS POST sums it up as well as I can sum up any darned thing.

Here's ruuscal and TW's Poncho, the cutie pie who oozes soul:

Poncho by ruuscal

Poncho by ruuscal, at American Idyll -- check out those beautiful eyes...

The Old Yadda Yadda on CRPS Diagnosis and Treatment Criteria

Here is a commentary in IASP's journal PAIN, titled "The diagnosis of CRPS: Are we there yet?" -- by

R. Norman Harden
Center for Pain Studies,
Rehabilitation Institute of Chicago,
Chicago, IL, USA
Northwestern University,
Department of Physical Medicine and Rehabilitation,
Chicago, IL, USA,
Tel.: +1 312 238 5654; fax: +1 312 238 7624.
E-mail address:

The content of the commentary is... predictable, but needs to be said at least a few times a year, so "thank you," Dr. Harden.  He beats the drum for diagnostic criteria with regularity and is the author of COMPLEX REGIONAL PAIN SYNDROME: TREATMENT GUIDELINES.

If you read enough of this blog ("My eyes!  My eyes!"), you'll know that I much prefer Dr. Kirkpatrick's Treatment Guidelines, available HERE.

$3 Million

What a morning.  Don't trust surgical paper tape to hold your PICC line thingies firmly attached to your forearm, and forget that ridiculous webbed fabric designed to hold everything in place.  I woke to find my two ports and their attached plastic tubules all a-wandering around the bed, one even under a Maine Coon.

For the record, I've decided that Buddy was misnamed, by me.  Instead of following Fred's advice of waiting for the cat to name itself, I rushed and forced "Buddy" upon him.  He is clearly a "Bubba." Whatever the case, he answers to bonito flakes.  We are actually concerned now that he is not putting on sufficient weight to compensate for the alarming length he has acquired.  He's a thin guy, not a swarthy molecule to my Bubba, no.

The great thing about finding blood in your PICC lines for the third or fourth times, is that it is the third or fourth time, and you didn't expire during those first few incidences, so likelihood is in your favor.

Also, I was all wrapped up in this warm dream about being offered $3 million by some lawyer that my infectious disease dood introduced to me, in a meeting with him, both of my PAs (Jacqueline and Susan), the wondrous on-site pharmacist (Lauren), and yes, this swell dude in a three-piece tweed suit and a bowler.  No shit!  Very clever and full of excitement, I had Fred drive us to the Best Credit Union West of the Lone Alp in Tête de Hergé.  He was pretty pissed (in real life as in my sleeping version) at me for bossing him around, didn't want to go to the Credit Union.  I don't know why, they love him there.  He shows them his sweet, shy side and is sweet on Ruth, the Head Credit Union Honchette.

They have lots of rocking chairs, braided rugs, beautiful quilts on the walls, chocolate cookies and milk in one corner, also a cage for toddlers disguised as a welcoming play pen.

Anyway, I zoomed into my banking institution, gave Ruth the eye, and she and I left Fred in a rocking chair with a spare Credit Union cat and an experimental latte (they're trying out a bikini barista -- bikinis à la Annette Funicello).

Framed art print for sale at eu.artcom
So Ruth opened a few dozen accounts, some for me, some for Fred, one for Bianca, one each for the Brother-Units, one for a few former best friends.  I gave Ruth a big freaking tip which she deftly tucked into her G-cup over-the-shoulder-boulder-holder.

Then I make Fred drive us to a car dealership.  Not just any car dealership, but the one that sells the car of his dreams.  You know, the old Pagani Zonda dealership.  You can find them, usually, near a KFC.  Anyway, yes, the order is in for one Zonda 760LH, (convertible).

The dream ended there, almost.  The last memory I have of it is receiving a phone call from Doctor ShoulderMan who told me two things:  that he had bought me a home of  my own, where I could live, comfortably, safely, and happily alone, and that in it he had put a very special bed that would ease much of my pain.

Then I woke up.

Back to the bloody PICC lines, the Former Buddy, a sweet-natured Dobby, and the echo of a slammed bathroom door that I assume came from the aforementioned Fred.  Marmy Fluffy Butt's tail drifted in and out of my sclerotic vision.  Sven, no doubt tightly spooned with La Bonne et Belle Bianca Castafiore, gave an angry yell at the door slam, then apparently lapsed back into the redemptive, cushy love of our Diva.

I am tempted to give Fred a new name, too.   And it ain't "Bubba."

So hauling my ass out of this bed without the use of one arm, and with both legs currently in awful shape -- the right refusing to bend at knee or hip for a good few minutes, mostly from swelling, partly from spite -- and with none of the expected orthopedic help apparatus in place.  You know, like a trapeze bar.  Mostly that.  I could do wonders, I could qualify for the Olympics were there a trapeze up there. Marta Károlyi, herself, has said, sighing, "Prof, dah-link, working with the over-bed trapeze would make you incomparable in uneven bars, and with just a little make-up and disguising do-dads, we could slip you into the men's still rings, maybe even the pommel horse.

Marta Károlyi is disappointed in me.  Hey, Marta, gimme $3 million and a decent gourmand for a coach, and I'm your girl/guy.  Kisses to Bela.

I use my wheelchair, parallel-parked by the bed, a cane, and sometimes a grabber, to achieve an upright status.  Lately, frustration has led me to also use a fair amount of force on the underside of the bedside table. This is likely a poor idea, as all things give, all things give way.

Careful to keep our small wing of The Manor steeped in good quiet, I squelched my way to the Medieval Kitchen, stoked the fire (in spite of forecasts of temps above 100 for the day), started the coffee, retrieved a 200 ml medicine ball of daptomycin, three saline flushes, two heparin flushes, two alcohol wipes, and washed the singularity out of my hands.  Wash, wash, wash, clean towel.  

The mewling, meowing, and outright cat screaming interrupts the PICC process and kibble is presented, to each according to the proper bowl, each with its own protocol.  

The kettle whistles precisely in the middle of the PICC flushes, and I opt for quieting the overly excited Paul Revere, since Sven may de-spoon from The Castafiore and come kill me, and Fred might make a fast break to lower the drawbridge, as -- when rudely wakened -- he mistakes loud noises for requests to cross the moat.

So my huge scoop of Italian roast is sitting in its nice hot water in my café presse, and I start the 9-minute timer in my head.  That's right -- I steep the stuff for 9 minutes, despite the expert admonition to stop at four. I'm a freaking radical.

So there are two ports, one purple, one red.  Because daptomycin only needs to be given once a day, we cleverly use the purple port for all infusions and the red one for all blood draws.  Red::blood, get it?  Because, yes, unbelievably, when we had to do twice-a-day infusions, and alternate ports, we'd get confused.  But now, all I gotta remember is red is for blood.  

This morning, though, both ports are streaked with blood, and the coffee isn't ready.  So I flush them both, using the whole saline and heparin repertoire, twice.  I have no idea if this will impact anything -- I doubt it, when I stop to think about it, after having done it, after having a few sips of excellent 9-minute café presse Italian roast with a good splash of milk ("It does a body good!").  

Finally, I hook up the stupid medicine ball, which is the whole point.  I am wearing scrubs (great pajamas) because the pockets are perfect for holding medicine balls.  The technical term for these med balls is "elastomeric device," and they look like this, when fresh from the fridge:

See?  So you just tuck the sucker in a large pocket and before you know it, poof!  It's a shrunken bit o'plastic and all the medicine is running around your body, curing you of whatever.  And you've been ambulating, catapulting, scrubbing, and pruning tree branches that loom way too close to a Chagall stained glass that we just discovered this spring.  

This disposable plastic dodad is the kind of inventions that I really admire.  I am not at all sure, but the clever inventors seem to be:

Thompson, Thomas C. (Dallas, TX)
Center, John L. (Dallas, TX)
Stocton, Paul M. (Clarendon Hills, IL)


Ah, clearly, I have lost le fil de ma pensée.  What a shocker.

Because I haven't even told you about the invasion.  The ant invasion.

I keep a clean Manor, damn it.  There is no sugar being all sexy on my counters or floors.  The honeysuckle is strictly kept in line with the out-of-doors.

So it was that my eyes bugged out to see a four-lane highway of teeny, tiny ants marching, marching, marching, with clear intent and purpose, across the floor of our communal craft room (you know how I feel about scrapbooking!).  

All right, it is not an interesting story and hardly a catastrophe, but for a woman who has yet to take her pain meds, with bloody PICC lines, and who has just rolled her wheelchair through a fresh heavy-on-kibble and very wet hair ball, it wasn't packaged happiness.

Fred, who knows a lot about a lot, later explained to me that sometimes a heat wave will inspire these annoyingly cute little insects to up and move their home base somewhere cooler.  This "somewhere cooler" for our crowd was a certain spot under a large throw rug.  Careful inspection of their destination revealed nothing special -- no spills, no nothing.  Just a huge rally of a few thousand peewee ants.

It took me three hours to feel comfortable that they'd all been eradicated -- and greenly, safely, so as to pose no danger to man, woman, or beast.  I followed their highways and byways, swept, mopped, wept, swept, and mopped some more.  I washed the offensive section of the rug.  I vacuumed the whole damn rug -- each side.

And when I was done, sometime around 2 PM?  Everyone got up, stretching, meandering for the bathrooms, searching for good coffee, murmuring vague "good mornings" to the bloody, red-faced, mop-wielding me.  Only Sven paused to listen to my exciting tale and wonderings about formic acid, scratching his crotch as if a few of the invaders had somehow invaded him.

In my next dream, when I meet with Ruth at the Best Credit Union West of the Lone Alp in Tête de Hergé in order to deposit my $3 million, I get all the money, in cash, and Fred doesn't even have to drive me to the border.  I'll take a cab.

Ruth still gets the wad of bills to stuff in her bra, though.  Fair is fair.