Technology May Kill Us. Or Not.

REPOST from 2012 -- No need to explain why!


I just had one of those belly-shaking, pew-rocking laugh attacks.  Completely out of the blue.

insane laughter wave
"actor laughing insanely. large diaphragm capacitor microphone direct to sound forge"

Technology is, therefore, good for something.

1.  Earlier today, The Fredster and I were trying to enter the formidable Network Key into our wifi recovery program.  Once we figured out where it was hiding, we each took turns writing it down.  Why?  Because he had a go at it and failed and the yelling began.  I hate the yelling.  So I jotted it down and quietly gave it a go myself.  Soon enough, I was screeching.  Then began The Great Discussion of the "O" versus the "0." At that point, we were on the phone with India.  India was no wiser on the issue but stayed on the phone with us for half an hour.  As I got ready to discard the 3rd-notice envelope and the dirty napkin we'd used for our number jotting, I noted discrepancies.  He had an "F" where I had a "4."  I had a "P" where he had a "5." Did I mention that I have glaucoma and cataracts?  So I put on a third pair of glasses and rechecked the Router-Lord-of-the-Universe Thingy.  First, I solved the O/0 problem.  That helped a lot right there.  Then I replaced the F and the P.  Sneeked past the internet-deprived Fred who was beginning to have withdrawal symptoms.  And voilà: Take that, India.  Fred was happy, all was well.

2.  So I got online to check with UPS tracking on a package that should have been delivered Wednesday.
It appeared to have been sucked into a vortex between two tiny towns about 10 miles apart.  So I had a helpful online chat with a UPS representative.  She solved the problem by referring me back to the sender, Best Buy, which made no sense, so I promptly did it.  Best Buy initiated an inquiry that will take 3-8 days. "Okie-dokie, then. Uff da to ya!" said I, in my best Fargo. Then I filed a report online with UPS.  I am happy to report that all of this consumer proactivism has had the following result:  the UPS online tracking site now reads. "Your package has experienced an exception."

3.  Earlier this week, my half-sister notified me, via the much hated Facebook, that my mother-unit had an appointment with a neurologist to be tested for Alzheimer's. Ever the polite one, I inquired today as to the outcome. I have a weird fear of Alzheimer's as it was the basic cause of death for both my step-grandmother and my stepfather, and my stepmother is showing ominous signs.

I'll give you a minute. 

[toe tap, toe tap, toe tap]

Got it?

Water has been thicker than blood for most of my life, and I still have to research basic kinship terms.  "Nephew, cousin, uncle," and then the linguistic peripherals, "thrice-removed, demi-, half-, step, second, great, long lost..." and the ultra-confusing "in-law, partner, boyfriend, girlfriend, old family friend [wink::wink]." 

Much easier to remember?  Friend / Not-Friend. Water? It quenches thirst like nobody's business and is the most powerful force in the world.

Anyway, the upshot is that Mother never made it to the neurologist.  As she was getting ready, her implanted, top-of-the-line defibrillator started going off. And off. And off.

And by "as she was getting ready," this incredible half-sister further clarified the ever-shifting maternal apocrypha this way: she meant that the sweet mother-unit was in the bath tub. Or shower.

Now, these good kin live in a small town, where, apparently, a favored pastime is listening to emergency scanners -- and my half-sister began getting phone calls at her work place before the ambulance even arrived at our Mother's home, site of this most terrible technological attack..They got her to the hospital, where they repositioned the leads... and gave her some pills to keep the defibrillator from working.  She is okay, but barely.

At a loss for words, I said The Standard, trained in it by this somewhat overwhelming sibling.

Bless her heart.  
I'll pray for her.

And then, a few hours later, I started laughing.

Buddy, the Outrageously Large Baby Maine Coon cat, chewed through the wiring of my brand new heating pad, and for dessert, demolished the Wii Remote. I had planned to reduce the day's stress with a hot game of tennis doubles for bedridden gimps.

Mwa ha ha!

The Universe's message for me today?

"You are experiencing an exception..."

Buddy and his, "What?" Look of Innocence

While I slept for 26 hours...

While I slept for 26 hours, taking a few breaks, apparently, for water and such, our sweet Freakishly Large Maine Coon Kitten, Mr. Buddy, carefully piled on top of my dozing form, sometimes tucking them safely in the folds of one of several quilts, and once placing a sample so close to my snoring mouth, it's a wonder I didn't inhale it --

Toys.  Cat toys.  And small offerings of kibble pieces, as well as two beloved treats.

The message was clear:  Why won't you wake up and play with me?

Two mice.  Two balled up red mohair leg warmers, ready for tossing and a game of Fetch.  A bit of bubble wrap.  Three balls, one felt, one yarn, and one that I contend was meant for budgies, but what do I know -- it's hard and has a bell in it.

I am grateful for all these gifts, except for the tiny seafood treat an inch from my mouth.  Had I inhaled that sucker, all might have been lost.  Hmmm.

In a play for pity, not hearing a sound back here in the soundproof area of Marlinspike Hall -- one of the perks of living* in the executive suites -- I sent Fred an urgent email begging for caffeine.

*Okay, so technically, we are squatters, but since we've been caretakers, as well, of this magnificent manor for years now, and even were mentioned in the Haddock Corporation Annual Review, albeit as a misleading footnote, I think Fred, Bianca, and I can claim to live here, as well.  And since the Feline Triumvirate lives wherever we live, well, they have rights, too.
Which they abuse, constantly, but no one seems to mind.  Fred and I?  We can't get away with nothing...

Mais je divague...

You'd think Buddy would want a heavy-duty, intense play session after loading me down with all his beloved goodies, but no!  He sat there, staring at me, his back about as straight and rigid as a baby Maine Coon can pull off, and said:  "Look, have a little coffee, wake up, think about what you have done, and *then* we'll talk."

I am discovering, via their profound engorgement, lymph nodes heretofore unknown to me.  My respiratory tract is artfully producing colors and textures that Benjamin Moore would die to have in its line.

Once Buddy and my email alerted Fred to my consciousness, he came in to join in the make-fun-of-prof brigade, greeting me this way:  "What's wrong?  Are you sick?" He could barely get it out, it cracked him up so much.  He wasn't laughing after I beaned him with the big blue hard plastic ball we use to hide treats in... that Buddy had tucked into the crook of my elbow during my extended rest.

He makes the best coffee, does Fred.  So now I am wondering where my appetite might be.  It's gotta be around here somewhere.  I know yesterday was a day of yogurt, apples, and pepperoni slices -- ugh, alors.  (The French are all the time saying that.  "Ugh, alors.")  Right now, I am thinking that I will have to consume my daily requirement of probiotic yogurt, but even that usual pleasure makes me nauseous at the mere thought.  "What's wrong?  Are you sick?" Very funny, Fred, very funny.

He is, you know.  Very funny.  With my foreign language background, you'd think I could do a fair imitation of at least most Romance Languages, but no.  I have a great accent when speaking the language, but cannot do the pretend-while-speaking-English thing.  But Fred can, and does.  Often when he thinks no one can hear him, which is the most hilarious.  He bends genders, too.  He breaks into this grandmother's Irish brogue that kills me.  That usually emerges while he's cooking. Then there's a Germanic/teutonic (Viking, Swede, Finn) mélange that every damn body gets to enjoy whenever Fred faces The Moat in the never-ending Algae Bloom Battles.

Lately, he worries about having Alzheimer's Disease.  I never pooh-pooh anyone's health worries -- well, except for ridiculous people who take to Twitter when they think they are dying, in lieu of, O I Dunno, calling an ambulance -- but want to pooh-pooh this one.  Fred is older than me by 15 years, but sharper than a very young Yogi Bear.  No, seriously, his mentation is to be envied, his memory, divine.

On my birthday, when I sent him flying around Tête de Hergé after sundown in search if Indian delicacies, he found himself in an unknown area southwest of the Lone Alp, and panicked.  Just because he is New York City born-and-bred does not mean that he has innate savy taxi driver know-how when in new territory.  Anyway, that started the Alzheimer's Watch.  Kind of like how a soft winter rain triggers Tante Louise's News Outlets to put the entire region on StormWatch 2013.

But in a way, his worry is a blessing, for I am using it -- as women will -- to encourage the scheduling of a check-up.  I feel like a crafty District Attorney, countering the Defense's objection with:  "But, Your Honor, the Defendant opened the door to this line of inquiry with the mention of Alzheimer's Disease." And the presiding judge nods sagely, with eye-brow raised, and curtly notifies my drably-dressed legal opponent, "He did, you know.  Proceed.  Objection overruled."

I'm being gentle about it, thus far.  Of course, thus far, the only thing that my suggestion has produced is that Fred took all three cats to the vet.  Two of them more than a month early.

We'll get there.

What worries me, but not him, is all the falling down around here.  It may be fine with my half-siblings back in the States to let my Mom go *boing* once a day or so, but I have a problem with all the *kabooming* Fred has been doing.  After hours of snazzy contra dancing, he fell down the steps of the high school gym on the way out.  Walking by the bed, he ran into the annoying knobby end and *bam* -- down he went.

Okay, there are extenuating circumstances.  He blames his glasses for the gym steps' descent -- something about how the bottom rim obscures his vision when he glances down.  Hmmm.  Okay, okay.  The bed?  That was somehow my fault, as his immediate response was:  "When are you going to do something about that?" Hmmm. Nope, that's a no go.  The other occasions involved him donning thick wool socks and then rushing over polished floors.  And yes, Bianca has once again fallen prey to the old "wax the stairs" fixation...

Speaking of The Milanese Nightingale, has anyone seen her?  Maybe she felt such guilt after waxing everything within sight that she's run off to hide for a bit -- not wanting to face the pile of orthopedic bills that Haddock Corporation is refusing to pay.  Or... maybe I should check to see if she's been impounded again, like some stray car.  Fred -- oh, how to put this -- Fred "disabled" her bedside alarm clock, which plays "her" aria in an unending loop, after six hours or so of:
"Je ris de me voir..."

Still, she's my girl.  She wouldn't make fun of me right now.  She'd find Sven and Cabana Boy (oy!) and order up some tea and buttered toast, get a Duke F'blastic Ball game on the telly, put on her giant #1 finger, get into a suitable f'blastic ball outfit, and everyone would pile -- ever so carefully -- so as not to cause moi a bit o'pain or spill the Jameson, I mean, the Earl Grey -- in bed with me, the kitty babes included... and we'd all engage in an extensive purr-r-r-r-r-r.

Or I could roll over and go back to sleep.

Probably wake up, this time, with a litter box on my head.

Jack Gilbert: The Dance Most of All

I do not intend this blog to become one long obituary or saga of ills, but one must celebrate the passing of greatness and those things that tug at the heart.

So Jack Gilbert died last Sunday in Berkeley, at 87, after a struggle with Alzheimer's.
[Reminding me of Oppen, also of Berkeley, also taken by that ravaging disease, but at 76.
I am pretty sure the longer struggle with Alzheimer's is no cause for celebration.]

From the NYT' obit:

Mr. Gilbert, who won the Yale Younger Poets Prize in 1962 for his first book, “Views of Jeopardy,” and the National Book Critics Circle Award in 2005 for his fourth, “Refusing Heaven,” was a peculiar figure in the contemporary poetry world in the sense that he wasn’t exactly in it. A restless man who traveled a great deal, lived frugally and occasionally lectured or taught to support himself, he spoke and wrote with enthusiasm about life in the world, without failing to acknowledge its terrors and miseries. 

Famous for eschewing fame, he did not go to writers’ conferences or cocktail parties, gave readings sporadically and did not publish a great deal, either. His output over a half-century included a mere five slim volumes; his “Collected Poems,” which Knopf brought out earlier this year, squeezed the entire oeuvre into 400 pages. Reviewing it in The New York Times, Dwight Garner called it “a revelation, almost certainly among the two or three most important books of poetry that will be published this year.” 

With their blunt-force assertions, their challenging irony, their earthy sexuality and their embrace of life as a big, messy possibility, his poems were for many readers both serious and accessible, connecting to their own feelings of having to endure in an often cruel, unfair world. 

“On the rare occasion when Jack Gilbert gives public readings — whether in New York, Pittsburgh or San Francisco — it is not unusual for men and women in the audience to tell him how his poems have changed their lives,” The Paris Review wrote in 2005. 

His work is redolent of place: Pittsburgh, where he grew up, or San Francisco, where he lived in the 1960s, or Mexico or Greece or Denmark or Paris or other places he called home at one time or another. His poetry expresses a worldview genuinely of the world. One of his best-known poems, “A Brief for the Defense,” opened with these lines about the need to accommodate oneself to tragedy:

Sorrow everywhere. Slaughter everywhere. If babies

are not starving someplace, they are starving

somewhere else. With flies in their nostrils.

But we enjoy our lives because that’s what God wants.

Otherwise the mornings before summer dawn would not

be made so fine. The Bengal tiger would not

be fashioned so miraculously well. The poor women

at the fountain are laughing together between

the suffering they have known and the awfulness

in their future, smiling and laughing while somebody

in the village is very sick. There is laughter

every day in the terrible streets of Calcutta,

and the women laugh in the cages of Bombay.

If we deny our happiness, resist our satisfaction,

we lessen the importance of their deprivation.

Jack Gilbert's last book, "The Dance Most of All," was published in 2010 and this poem, I think, is my favorite, as of now:

He was no Oppen.  Oppen, as his mind got all snarled, gnarled, and shrunken -- I always envision the Alzheimer's brain -- the autopsy still being the moment and means of diagnosis -- as a dried up, beyond chewy pretzel that can no longer hold onto its big grains of kosher salt -- Oppen took to nailing his poems to pieces of wood.

He probably did the same with what I might jot on a Post-It.  "Buy juice but not the kind with food coloring or cane syrup but not too pricey either.  And yogurt, some Kroger low carb vanilla and peach but also some lowfat plain.  The fake sugar in the blue packets, not the pink."  This is what happens when you haven't been in a grocery store for a long long time but you still want what you want and you need to help the people helping you to get it right.

Or not.  I think Oppen stopped eatting.  I'm not sure Gilbert ever did. Eat much, I mean.

Oppen typed, I believe.  Gilbert wrote in big block letters, messy, but with remarkably few corrections.  The pages I have seen photos of looked like the graphic production of a frenetic fourth grader, the poetry flitting across the parameters of the lined paper -- clearly a big tablet of writing paper, with traces of the previous indented.  How often I have read that he was frugal.

"Ovid in Tears" absolutely spanks Marianne Moore's "Poetry." At least today, when it is cold, and pewter. and the gardens in which the brain of Ovid weeps are as far from imaginary as can be.

Low Dose Ketamine and Memantine for Neuropathic Pain

I recognize and respect the frustration that doctors and nurses must experience when patients delve into the internet to obtain medical information, and then bring that "research" in to appointments in full "eureka!" mode.

That said (ar! ar! ar!), one of my MedWorm news feeds, on ketamine, turned this up:
ultra-low dose ketamine and memantine treatment for chronic pain -- specifically, neuropathic pain. As usual, the non-malignant neuropathic pain is represented by diabetic peripheral neuropathy. This use of memantine is off-label (of course) -- the drug is usually used in moderate to severe Alzheimer's disease (Namenda).

In the October 2008 issue of Anesthesia and Analgesia, doctors from the Anesthesia Department of the University of Washington published "Ultra-low dose ketamine and memantine treatment for pain in an opioid-tolerant oncology patient."

This is the abstract of the article that the authors submitted to PubMed:

Patients taking high-dose opioids chronically for tumor-related or neuropathic pain may develop pain that is refractory to opioids. One option for control of such pain is the use of the N-methyl-D-aspartate (NMDA) receptor antagonist ketamine. We describe a case of opioid-refractory pain that responded to a low-dose IV infusion of ketamine in the inpatient setting. The patient was then successfully transitioned to oral memantine for long-term outpatient management, in a novel use of this oral NMDA receptor antagonist. We present recent findings from basic research on pain mechanisms to explain why opioid tolerance, as in this patient, may contribute to the analgesic benefit of NMDA receptor antagonists.


"Memantine Significantly Reduces Peripheral Neuropathy Pain in Diabetics" was the next thing I turned up -- yes! I released the hounds! I let the dogs out! And I dare to call it research... But will I dare to stalk my internist, neurologist, and pain management doctor-dude with the information that I have culled, and will continue to cull?

Yes, I think so. It has been several years, actually, since I have dragged in any articles. Mostly, I read and then present anything interesting in a very brief oral report that inevitably results in the same reaction of "uh-huh." That is not to say there is no interest -- no, the problem lies elsewhere. The problem is that "no one knows" how CRPS / RSD really comes about, sticks around, or is best treated. I feel myself on almost equal footing with some of the more speculative researchers out there, with the difference that I cannot afford -- neither by bank account nor by insurance coverage -- the treatments that are in the pipeline.

Bitter? Moi? Of course not.

Shoot, we just added Forteo as an off-label use -- why not give this ketamine-transition-to-memantine idea a go? I think sometimes that they give me way too much credit. There is this tacit assumption that Retired Educator, succored by Fred, the felines, and La Belle Bianca Castafiore, and living the luxe in Marlinspike Hall, Tête de Hergé, can handle any amount of pain.

Not so. More and more "not so" with each passing day.

(Oh -- for those who don't know, MedWorm is a "medical RSS filter engine" and proves *occasionally* helpful in turning up germane articles -- but only if you feed the worm with very specific and well-thought out search guidelines. You must then bring the full power of your intellect to bear upon the results and vett the weird and unfounded, the scientistic and the industry-driven.)