Monday, May 30, 2011

Master of Contradiction

The grin went ear-to-ear at discovering that ruuscal had used my favorite Stephen Maria Crane poem to illustrate some of his (her?) grand photographic work over at American Idyll.




I saw a man pursuing the horizon;

Round and round they sped.

I was disturbed at this;

I accosted the man.

"It is futile," I said,

"You can never — "



"You lie," he cried,

And ran on.


(PoemHunter.com offers 103 Poems of Stephen Maria Crane for download.)

reefer:::madness

I thought that watching Reefer Madness might enliven this afternoon's bit of methadone withdrawal -- but I haven't had the concentration (o-k-a-y, or mood!) necessary for that to happen. But that doesn't mean that you aren't primed for it!

The details behind my first viewing of this national treasure still boggle my mind.

I was in the hospital with a high fever. High enough that I had been put on a cooling blanket. Reefer Madness popped on the television and as I had been disconnected from the controls, it stayed on. It was a horrible night of chills, sweats, and confusion. Around 9 the next morning, a friend dropped in to see me. He was an engineering grad student at this illustrious university and so I didn't hesitate to enlist his aid -- because despite the reassurances of nurses, I didn't seem to be the least bit cooler from the cooling blanket. He coolly gauged the situation, grasped the cord emanating from the end of the thing, and followed it to the plug's final resting place -- on the floor, by the wall, not the least bit plugged in. So, basically, I had been baking between sheets of plastic all night long, my brain suitably entertained by the delerium of this short flick...

May you enjoy it with some friends, and in better circumstances.




film and notes are courtesy of the Internet Archive (something you MUST check out, iffen ya haven't yet!

Considered THE archetypal sensationalized anti-drug movie, but it's really an exploitation film made to capitalize on the hot taboo subject of marijuana use. Like many exploitation films of the time, "Reefer Madness" tried to make a quick buck off of a forbidden subject while skirting the Motion Picture Production Code of 1930. The Code forbade the portrayal of immoral acts like drug use. (The illegal drug traffic must not be portrayed in such a way as to stimulate curiosity concerning the use of, or traffic in, such drugs; nor shall scenes be approved which show the use of illegal drugs, or their effects, in detail.)


The film toured around the country for many years - often being re-edited and re-titled ("Tell Your Children", "Dope Addict", "Doped Youth", "Love Madness", "The Burning Question"). It was re-discovered in the early 1970s by NORML (National Organization for the Reform of Marijuana Laws) and screened again as an example of the government's demonization of marijuana. NORML may have been confused about the film's sponsorship since one of the film's distributors, Dwain Esper, testified to the Arizona Supreme Court that "Reefer Madness" was not a trashy exploitation film but was actually sponsored by the U.S. Government - a convincing lie, but a lie nonetheless.


That being said, the film is still quick enjoyable since it dramatizes the "violent narcotic's ... soul destroying" effects on unwary teens, and their hedonistic exploits enroute to the bottom.

Also, if you are interested in the rich, uniquely American history of exploitation films, there are two excellent books on the subject:

"Forbidden Fruit - The Golden Age of the Exploitation Film", Felicia Feaster and Bret Wood, Midnight Marquee Press, 1999.

"Bold! Daring! Shocking! True! A History of Exploitation Films, 1919 - 1959" Eric Schaefer, Duke University Press, 1999.

Director: Louis J. Gasnier
Producer: George A. Hirliman
Production Company: G and H Production

Sunday, May 29, 2011

Tinny Quavers: Ukulele Music

I was introduced to Israel Kamakawiwo'ole when the television show ER used his "What a Wonderful World/Somewhere Over the Rainbow" medley.  It was a beautiful pairing -- Mark Green's necessary death in Hawaii and Iz's pristine ukulele, his own gasps and sighs -- fitting, both, under a broad blue sky, floating above an ocean.



Madison Avenue was ahead of the game, casting the song in commercials for deodorant, in several soundtracks, including Meet Joe Black, Finding Forrester, 50 First Dates and IMAX: Hubble 3DAs different markets have been exposed to the medley over a disparate length of time, the work has hit high on various charts in a span as large as 17 years.  First released in 1993, it reached number one in Germany last year...

Beyond Iz, I've never gone out of my way to find the latest in ukulele music.  That truly seemed like a one-time thing, that venture into the guitar's subset.

Enter Eddie Vedder.

My introduction to Vedder as a solo artist came, once again, through television and movies -- Deadliest Catch, Into the Wild and the anthem "Rise."

And there it was, that damned uke.  Unlike a good many instruments, it gives off an aura of strict self-sufficiency -- and that is it's incomplete paradox.  It needs a counterpoint of voice, something to temper its tinny quavers.  Voice and instrument together?  Perfected melancholy, and those diminutive strings that had threatened to go off on their own, brought back in an homage to dispossession, to life on an edge.



I'd never have thought that a ukulele -- played beautifully -- could speak so perfectly to something within, some archetype that sleeps until teased, its strings strummed almost angrily or picked and plucked in a near simper.  It's the perfect vessel for folklore, and for the dispossessed. (Ua Mau ke Ea o ka ‘Aina i ka Pono, indeed...)

Based on I-don't-know-what, the uke has been classified in my sad head as a trite sound, as if it were a toy instead of an actual instrument requiring great skill.  It's one of those "idées reçues" for which I'd love to find the genesis.

Tiny Tim?  Maybe, though I was actually a fan -- a fan hoping to irritate the 'rents, sure, but still, a fan.  He was way more than "Tiptoe thru' the tulips." **

I woke up feeling mighty ill this morning, but musically inclined.  Nothing that I put my hands on fit the bill, however, and I was close to settling for local radio.  My detoxifying brain nixed that notion and I found myself on the NPR website, combing through entries to "First Listen."  

There it was:

First Listen: Eddie Vedder, 'Ukulele Songs'

May 25, 2011

For his second full-length solo album, Eddie Vedder has taken up one of the most useful creative tools available: limitation. It's embodied in a little finger-strummed thing that the Pearl Jam singer picked up during a beer run in Hawaii nearly 15 years ago, an instrument whose limits he never pushes, and which ends up refining and expanding his own range. Ukulele Songs isn't a novelty record; it's a statement of truth. Made calm and open by the ukulele's intimacy, Vedder sounds like someone getting out of his own way and discovering what really matters within his art.

What matters musically, as he's been saying lately in interviews, is melody. The baritone growl that not quite singlehandedly defined millennial American rock transforms here into the lullaby singer's murmur and a romancer's croon. Pearl Jam is a big, noisy band, and in many of its best songs, Vedder has ridden its big waves hard: He's helped many a fan safely unleash un-pretty emotions. Here, though, he asks the listener to pull back with him and pay attention to the tiptoe of his voice as he descends a scale, or the sweetness of slipping into falsetto.

Vedder's song selections are culled from more than a decade's worth of writing he's done on the uke. A Pearl Jam song, the driving "Can't Keep," opens the set and seems like a form of reassurance — Vedder hasn't gone totally soft, Ten Club members! But the craving for escape that the song expresses here seems like a bit of a fake-out. Everywhere else, from tearjerkers like "Sleeping By Myself" and "Broken Heart" to the more hopeful likes of "Without You" to the vintage crooners' favorites that Vedder covers, Ukulele Songs is about staying still enough to feel something calmly and clearly... READ THE REST *HERE*

You can listen to it in its entirety at the NPR website -- but when it is released for sale on May 31, remember to support the artist by buying/downloading it -- perhaps HERE.

I've had my musical fix for the day.  Uh-oh, I'm lapsing into more drug jargon... Mwa ha ha!

Seriously, though, I cannot see that there are any other musical contenders beating down my door to participate in the Ukulele Folk/Rock Division. 

How goes the methadone taper?  Famously, I suppose.  I am holding at 15 mg for a few more days, or for good, I haven't decided.  What I have done, I have done much too rapidly and my body and mind are determined that I should suffer for it.  Last night, around 3 AM, the urge to give up almost won -- due to my version of Restless Legs Syndrome (also known as Wittmaack–Ekbom syndrome).  Methadone doesn't bear the entire burden of blame here, as I inherited an affinity for "jumpy legs" from dear old Dad.  I can still remember him coming home from a mission, dead tired, falling into bed, only to be betrayed by the dread spasms and misfires in his legs.

Wikipedia opines that "[o]pioid detoxification has been associated with provocation of RLS-like symptoms during withdrawal," but what does Wikipedia know?  I also happen to have almost every pre-disposing malady it lists.  Still, the timing is kind of suggestive.  Oh, all right...

Anyway, I did what any person would do in that situation -- I dug up a bottle of trazodone and took it. 

Oh, all right...  I took a whopping 150 mg -- not the whole darned bottle -- which allowed for some sleep until pain woke me at 5 AM.  Got up, baked scones, in the process dumping half a bag of flour on myself and the kitchen floor.  Mopped, washed up, changed clothes, and slept wonderfully from 9 to 10:30 AM, at which time I began the aforementioned search for music, and began this post.

When next I attempt to sleep? I expect a hell of a soundtrack!




**  I can't resist.  This is one of my favorite covers by Tiny Tim (Herbert Khaury):

Thursday, May 26, 2011

Changing the Channel: Court TV and Two Abstracts

I've never been a Court TV junky -- mostly because, you know, I've been busy being some other kind of junky -- Mwa ha ha ha!  Sorry, Beloved Readers, that's Street Drug Humor, something at which I am fantastically adept but have kept hidden as an attribute.  Now, though, I've decided not to hide my light under a basket. A bushel.  A bushel basket. Or whatever.

No, I am not suffering from Hinky Methadone Withdrawal.  What I am suffering from is this twit of a woman, this Casey Anthony person upon whom we are wasting such incredible resources of money, time, and emotion.  Yes, my television is tuned to her first-degree murder trial in Florida, where she is accused of having killed her two year old daughter back in 2008.   

Change the channel, you say?

Oh.  Right!

If I can redirect the miscued energy of a kitten, surely I can train myself to change the television channel -- even {gasp} turn the machine off.  Let's do that, then, and see what happens.

Why, look!  Here are some CRPS updates that I've failed to pass on.  Oh, and there is a Pink Elephant hanging from the ceiling fan!  (Just let me know when you've had enough Hinky Methadone Withdrawal humor.  Why are the lights blinking?)

This first research paper has a very specific target audience -- so, attention all orthopods!



The use of beta-tricalcium phosphate bone graft substitute in dorsally plated, comminuted distal radius fractures.Journal of Orthopaedic Surgery and Research




Michael G Jakubietz , Joerg G Gruenert and Rafael G Jakubietz
2011, 6:24
doi:10.1186/1749-799X-6-24


Published:  22 May 2011


Abstract (provisional)

Background:  Intraarticular distal radius fractures can be treated with many methods. While internal fixation with angle stable implants has become increasingly popular, the use of bone graft substitutes has also been recommended to address comminution zones and thus increase stability. Whether a combination of both methods will improve clinical outcomes was the purpose of the study


Methods:  The study was thus conducted as a prospective randomized clinical trial. 39 patients with unilateral, intraarticular fractures of the distal radius were included and randomized to 2 groups, one being treated with internal fixation only, while the second group received an additional bone graft substitute.


Results:  There was no statistical significance between both groups in functional and radiological results. The occurrence of complications did also not show statistical significance.


Conclusions:  No advantage of additional granular bone graft substitutes could be seen in this study. Granular bone graft substitutes do not seem to provide extra stability if dorsal angle stable implants are used. Dorsal plates have considerable complication rates such as extensor tendon ruptures and development of CRPS.
I know, I know -- where did that last line of the conclusion come from?  Is it really there or am I imagining things again?  Like I said, this has a definite target -- orthopedic surgeons -- and, well, I hope it doesn't keep any of them up at night!

Mwa ha ha ha!

Ahem.

Okay, on to something more "relatable," though not less specialized -- fixed dystonia in CRPS.  Just a few observations:  Classical dystonia is mobile;  Fixed dystonia is usually classified as part of functional movement disorders and is often labelled a contracture -- (though I think a better descriptor is fixed flexion postures)All of that is code for "psychogenic."  Most studies will make quick mention that fixed dystonia happens mostly in females, many of whom suffer from dissociative and affective disorders

Sigh.

(Please note that I am sighing as I look down at my twisted and distorted foot... as I recall the initial days of CRPS, when my left hand looked like the infamous psychogenic claw!  I'm also flashing on some really cool concerts from back in the day, but that could be the DTs.  Mwa ha ha!)

So... once again, if you're a CRPS patient experiencing dystonia, be sure to see someone who is not going to automatically categorize you as a nut.  The authors of the study below are searching for an explanation beyond the easy and lazy classification of "functional," and posit that the neurotransmitters used by interneurons are misfiring or dysfunctional (he he).  If you are like me, you might want to start with this quick intro to interneurons!

Fixed Dystonia in Complex Regional Pain Syndrome: a Descriptive and Computational Modeling Approach

Alexander G. Munts, Winfred Mugge, Thomas S. Meurs, Alfred C. Schouten, Johan Marinus, G. LORIMER Moseley, Frans C.T. van der Helm and Jacobus J. van Hilten

BMC Neurology 2011, 11:53
doi:10.1186/1471-2377-11-53

Published: 24 May 2011

Abstract (provisional)

Background: Complex regional pain syndrome (CRPS) may occur after trauma, usually to one limb, and is characterized by pain and disturbed blood flow, temperature regulation and motor control. Approximately 25% of cases develop fixed dystonia. Involvement of dysfunctional GABAergic interneurons has been suggested, however the mechanisms that underpin fixed dystonia are still unknown. We hypothesized that dystonia could be the result of aberrant proprioceptive reflex strengths of position, velocity or force feedback.

Methods: We systematically characterized the pattern of dystonia in 85 CRPS-patients with dystonia according to the posture held at each joint of the affected limb. We compared the patterns with a neuromuscular computer model simulating aberrations of proprioceptive reflexes. The computer model consists of an antagonistic muscle pair with explicit contributions of the musculotendinous system and reflex pathways originating from muscle spindles and Golgi tendon organs, with time delays reflective of neural latencies. Three scenarios were simulated with the model: (i) increased reflex sensitivity (increased sensitivity of the agonistic and antagonistic reflex loops); (ii) imbalanced reflex sensitivity (increased sensitivity of the agonistic reflex loop); (iii) imbalanced reflex offset (an offset to the reflex output of the agonistic proprioceptors).

Results: For the arm, fixed postures were present in 123 arms of 77 patients. The dominant pattern involved flexion of the fingers (116/123), the wrists (41/123) and elbows (38/123). For the leg, fixed postures were present in 114 legs of 77 patients. The dominant pattern was plantar flexion of the toes (55/114 legs), plantar flexion and inversion of the ankle (73/114) and flexion of the knee (55/114). Only the computer simulations of imbalanced reflex sensitivity to muscle force from Golgi tendon organs caused patterns that closely resembled the observed patient characteristics. In parallel experiments using robot manipulators we have shown that patients with dystonia were less able to adapt their force feedback strength.

Conclusions: Findings derived from a neuromuscular model suggest that aberrant force feedback regulation from Golgi tendon organs involving an inhibitory interneuron may underpin the typical fixed flexion postures in CRPS patients with dystonia.

In other breaking news, "Ketamine induced selective impairments in timing..."

Put that in the No Kidding File. 

Well, folks, I'd better get back to my soon-to-be "Done"-less life.  I do hope you know I'm just joshing around about the difficulties of tapering off of methadone.  I am NOT having a hard time (yet) or experiencing anything I cannot deal with.  Just don't take away my ibuprofen.

Wednesday, May 25, 2011

kind, humble, funny: spectrumom

In the course of reading commentary over at another blog, I came across an interesting one and followed the author back to her place -- this blogosphere is awash with serendipitous linkings.  We're gifted by the stylizations of the juxtaposed!

I read all of spectrumom: Getting all Buddhist and whatnot about autism.  That wasn't hard.  There are only nine posts.

On July 9, 2010, she opens her blog this way:

We have 3 kids: Sam, Nathan and Isaac.


Sam was diagnosed when he was 2year, 7mo with autism. Nathan was born 3 weeks later.


It was a stressful time.


As he grew, it became obvious that Nathan was on spectrum too and I was devastated. I had always wanted a large family and it seemed all I could obsess on was not having more children. Well, in addition to trying to fix what was wrong with my kids, it was all I could obsess on. Eventually, after 4 years, we did decide to have another. At the advanced age of 38, I had Isaac, now 4. And he is neurotypical, the outlyer in our family. The weirdo. Or the normal kid in a family of weirdos, take your pick.

Maybe because her time and spirit are likely... distilled, her prose is very lean, very clean.  Or perhaps she's a practiced writer.  Whatever.  Do I really need to justify the fact that I like her writing, and like it very much?

I won't claim that, through it, I understand autism, or people with autism, or parents with children with autism.  Thank goodness, she hasn't been taxed with my education in her reality.  But she is kind, humble, and funny -- so I am allowed what I can deal with.



Malpensa Airport, Milan 2008

I particularly like "Airport Brain."  She does a superb job of facilitating between worlds without condescending to any of them.  Give it a read, starting below and then clicking your way over to spectrumom

Have you ever been in an airport, or another busy place, but you're by yourself? So your brain decides to separate itself from it's surroundings. You feel separated from those around and there is a hum in your head. It is just an odd feeling. It's called depersonalization by the psych people. And this kind is very mild as opposed to the severe end associated with severe anxiety disorders and PTSD. But it happens to me sometimes when I'm shopping by myself or at a huge convention by myself. I can hear and talk to people and look pretty normal, but I just feel totally separated. Maybe it's just me being weird, but work with me on this idea.


Now imagine you are in an airport in a foreign country and there is the hum of Chinese or an Indian dialect, not an American voice to be heard. Your brain spaces out more as it seeks the familiarity of your thoughts. [CLICK HERE TO CONTINUE]

14 Minutes

image courtesy of addiction search

I'm having great dreams.  My last flirtation with sleep had me at the White House in tennis togs, running up and down a lovely, wide, red-carpeted staircase, happy as a clam.  The President and First Lady were scheduled to renew their wedding vows, and I was serving, of course, as a bridesmaid (a word and concept that makes me cringe).  People were reputed to be lined up outside, dressed to the nines, and upset that the wedding party had spent the afternoon on the courts instead of primping -- we had delayed the festivities when our mixed doubles required a third set.  So President Obama made a charming statement, promising that we'd all be downstairs and completely suitable within 14 minutes.  He repeats the 14 minute reference several times and it seems to be an inside joke, as the press and all the gathered beautiful people are snickering.

What can I say?  It was a dream.  14 minutes.  *These* are the dream details, Dear Sigmund, that I'd love to understand!

Clearly, there is nothing profound going on between the ears.  My brain is simply a little less inebriated than usual:  About ten days ago, I decided to try and be off of methadone and Percocet before the next Ketamine treatments.  If we are going to try and approximate the protocol used by Dr. Schwartzman, and if that's part of what he recommends, well, that's that. 

From a beginning dosage of 40 mg a day, I am down to 15 mg of methadone.  From a usual four pills a day of Percocet, I am down to three. 

I may need to pause here for a few more days, though, and I'm thinking it looks "iffy" that I will make the deadline of "no opiates" by June 13.  Why?  Well, most of all, methadone has a long half life and it surely won't be completely out of my system. 

And as for Percocet -- it helps too much for me to imagine not having to take it.  Judicious use of Percocet and ibuprofen has saved many a day.

I will do what I can do.  Any reduction is good.

In an effort to make it easier, and to control symptoms while attempting this crazy thang, I'm relying more than usual on non-addictive adjunct meds -- amitriptyline, baclofen, Cymbalta. Mostly, though, I am just trying to see the "absolute value" of taking as little narcotics as possible.  A clearer head, a happier gut, and maybe, given the infamous rebound potential of these drugs, less of a certain type of pain.

I can report that I'm not having as much of the burning so much a defining element of neuropathic pain -- but that might be due to the higher dose of amitriptyline (I hate amitriptyline and won't maintain this higher dose much longer).  The rest of my pain is unchanged and if you forced me to pick a number on the Pain Scale, it would be an eight, which is about as high as I ever will claim. 

Let's put it this way:  At my current level of pain, it sometimes takes me up to 10 or 15 minutes to just get out of the wheelchair, and I am likely to be crying by the time I am on my feet.  This morning I had to go without coffee because my shoulders, arms, and hands couldn't tolerate the weight of water.  I'm not suffering any delusions about having a pain free life.

There are whole communities on the internet of people trying to stop taking methadone, and after perusing the goings-on within them, I got really scared.  Weeks and months, even, of withdrawal?  Going through a literal hell? (Also, shouldn't I be referencing "percs" and "dones" so as to better perfect my Addict Persona?)

Among these conversants, though, there are very few who are taking methadone to treat pain.  Most are part of a methadone maintenance therapy that enables them to resist the cravings for other drugs, usually heroin.  It really is awful to contemplate -- to be hooked on heroin, then to be put on another drug to which one invariably becomes dependant?  I get the argument -- it's cheap, it's controlled, it doesn't require a life of crime or victimhood to sustain... Still.  How awful.  

The constant theme is withdrawal, and at what point to consider "jumping off" and going cold turkey.  It is generally agreed that it's nuts to do it above 30 milligrams.  Obviously, the lower the dose at which one jumps off, the better. (And then there is the constant motif of suboxone!) If I had more time, I'd do it all by taper, but I will have to choose a jump-off dose as well, with the expectation of about a week of withdrawal symptoms, probably beginning on the fourth or fifth day.

In other words -- any day now.  I have June 1 in mind. It would be lovely to be at a comfortable 10 mg a day in the next week.  We'll see.  Again, if I cannot do it, I won't see that as a failure, but it will mean going into the upcoming Ketamine treatments under less than ideal circumstances.

For me, this is a fairly straightforward case of diminishing returns.  Higher doses of pain medications that are not terribly effective anyway make no sense.  Finding the lowest, most effective dose seems logical, and along with that, testing the validity of that dose from time to time (I believe in drug holidays).

My poor brain is trying hard to keep up.

The increased sleep is helping.  Who would not enjoy mixed doubles with Michelle and Barack Obama?  Finally, too, I get to wear a bridesmaid dress that is not a gauzy, goopy pastel but instead is a copper-colored raw silk with a clean, clean line.

And I'll figure that 14 minutes reference out one day...

Tuesday, May 24, 2011

To Blog Visitor From Spain (guardamar del segura)

I could not find information specific to DSR/SDRC (RSD/CRPS).  You might find what you need here:

Valencia University General Hospital
Multidisciplinary Pain Management Department
Valencia, Spain
vilanueva_vic@gva.es

You might also consider calling/writing these doctors for more information:

Dr. José De Andrés
Associate Professor of Anesthesia,
Valencia University Medical School
Chairman, Department of Anesthesiology and Critical Care
Director of the Multidisciplinary Pain Management Center
Valencia University General Hospital
Tres Cruces s/n, 46014-Valencia. Spain

Prof. Carmen Gomar
Professor of Anesthesia,
Barcelona University Medical School
Department of Anesthesiology and Reanimation
Hospital Clinic i Provincial
Villarroel 170, 08036-Barcelona. Spain

Monday, May 23, 2011

FAQ For My Students: The Rapture

Brother-Unit Grader Boob forwarded this recent department-approved addendum to his syllabus for English Comp classes at Good Old University, where he quietly and courageously attacks the lethargy and heightened sense of entitlement afflicting today's youth. He must have begun the first summer session, because just a few weeks back he was getting misty-eyed over the end of spring semester:

Howdy--
Just wanted to drop you a line as the grading/cursing here comes near an end.
Have had one student say that I "fucked [her]" and that "[she didn't] care one bit for this shitty class." My response: a bland "Have a nice summer."
I just wished I'd said it sarcastically!
Where's Swift when you need him?
Mucho amore to all.
Grader Boob

From UC-Berkeley's Landscape Heritage Plan
Sather Gate, Wheeler Hall, and the Campanile beyond (ca. 1945). Note that at this time, the Gate
defined the campus entrance, and the adjacent Sproul Plaza was a city block.


FAQ for my Students: The Rapture
Q: With the rapture coming, should I bother working on my final paper?
A: Yes. The odds are you will not be judged worthy of ascent to heaven, in which case your grades will still be a basis of judgment for rewards in this earthly sphere.
Q: What if my instructor is raptured?
A: None of our instructors bear much chance of being judged worthy. However, on the off chance your instructor is chosen, an army of unemployed secular Marxists is waiting to take his/her place.
Q: If my mother/father/grandfather/grandmother/favorite aunt/etc. is chosen, will I be excused from the final so that I may mourn his/her loss?
A: No. They have not died, but been granted eternal life, thus this does not count as a case of a death in the family.
Q: If my instructor is not raptured, is he really fit to judge me?
A: Yes, seeing as you were not raptured, you are still subject to the earthly judgment of the unsaved. If/when you are redeemed, a change of grade form will be automatically processed by heavenly authorities if they decide your grade was unfairly given by one of the damned.
Q: If my computer crashes and my printer breaks and there is no email on account of the rapture, will I be able to get an extension on the paper?
A: Everyone in tech and IT departments is of Satan’s party, so the internet, your computer, and your printer should continue to work the way they always have: sporadically.
Q: How will the rapture affect your curving, particularly if raptured students are exempt from final tests/papers?
A: Final grades are not curved, but students who are taken up in the rapture will be given incompletes, just in case.

Wednesday, May 18, 2011

Autoimmunity and CRPS

The passive transfer of immunoglobulin G serum antibodies from patients with longstanding Complex Regional Pain Syndrome

Andreas Goebel, Mar Liete, Li YangRobert Deacon, Cruz M. Cendan, Andrew Fox-Lewis, Angela Vincent

European Journal of Pain
Volume 15, Issue 5, Pages 504.e1-504.e6
May 2011

ABSTRACT

Background
The aetiology of Complex Regional Pain Syndrome (CRPS) is unknown. Recent evidence suggests that there may be autoantibodies directed against peripheral nerves, but it is unclear whether such autoantibodies are merely biomarkers or whether they cause or contribute to the underlying pathology. The transfer of disease after injection of a patient’s serum or IgG fraction into mice (‘passive transfer’) is the classic way to demonstrate a functional role of autoantibodies.

Aims
Based on previous preliminary results, we wished to investigate whether the transfer of IgG antibodies affected mouse behaviour or produced signs of CRPS.

Methods
We injected purified serum-IgG from 12 patients and 12 controls into groups of 6–10 mice (∼17mg/mouse intraperitoneally) on 2 consecutive days and looked for any evidence for altered behaviour or signs of CRPS. The observer, blinded as to test or control group, measured behaviour in the open field, stimulus-evoked pain and motor coordination, and inspected limbs for autonomic CRPS signs.

Results
Stimulus-evoked pain and autonomic signs were not detected, but CRPS-IgG induced significant depression of rearing behaviour (17.9 rears/3min (n=84) vs. 22.1 rears/3min (n=83), p=0.0004), confirming previous observations in a single case study. Moreover, motor impairment, one of the four cardinal signs of CRPS, was evident in the three CRPS-IgG injected groups tested with a sensitive rota-rod protocol (p<0.0001 vs. control-IgG injected groups).

Conclusions
These results lend support to a pathophysiological role for IgG autoantibodies in CRPS.

REFERENCES:
1.Abrahamsen B, Zhao J, Asante CO, Cendan CM, Marsh S, Martinez-Barbera JP, et al. The cell and molecular basis of mechanical, cold, and inflammatory pain. Science. 2008;321:702–705

2.Birklein F. Complex regional pain syndrome. J Neurol. 2005;252:131–138

3.Blackburn-Munro G. Pain-like behaviours in animals – how human are they?. Trends Pharmacol Sci. 2004;25:299–305

4.Blaes F, Schmitz K, Tschernatsch M, Kaps M, Krasenbrink I, Hempelmann G, et al. Autoimmune etiology of complex regional pain syndrome (M. Sudeck). Neurology. 2004;63:1734–1736

5.Buckley C, Vincent A. Autoimmune channelopathies. Nat Clin Pract Neurol. 2005;1:22–33

6.Cerbone A, Sadile AG. Behavioral habituation to spatial novelty: interference and noninterference studies. Neurosci Biobehav Rev. 1994;18:497–518

7.Contet C, Rawlins JN, Deacon RM. A comparison of 129S2/SvHsd and C57BL/6JOlaHsd mice on a test battery assessing sensorimotor, affective and cognitive behaviours: implications for the study of genetically modified mice. Behav Brain Res. 2001;124:33–46

8.Dalakas M. IVIG in other autoimmune neurological disorders: current status and future prospects. J Neurol. 2008;255(Suppl. 3):12–16

9.Deacon RM, Croucher A, Rawlins JN. Hippocampal cytotoxic lesion effects on species-typical behaviours in mice. Behav Brain Res. 2002;132:203–213

10.Goebel A, Baranowski AP, Maurer K, Ghiai A, McCabe C, Ambler G. Intravenous immunoglobulin treatment of complex regional pain syndrome: a randomized trial. Ann Int Med. 2010;152:152–158

11.Goebel A, Stock M, Deacon R, Sprotte G, Vincent A. Intravenous immunoglobulin response and evidence for pathogenic antibodies in a case of complex regional pain syndrome 1. Ann Neurol. 2005;57:463–464

12.Goebel A, Vogel H, Caneris O, Bajwa Z, Clover L, Roewer N, et al. Immune responses to Campylobacter and serum autoantibodies in patients with complex regional pain syndrome. J Neuroimmunol. 2005;162:184–189

13.Harden RN, Bruehl S, Stanton-Hicks M, Wilson PR. Proposed new diagnostic criteria for complex regional pain syndrome. Pain Med. 2007;8:326–331

14.Inoue I, Yanai K, Kitamura D, Taniuchi I, Kobayashi T, Niimura K, et al. Impaired locomotor activity and exploratory behavior in mice lacking histamine H1 receptors. Proc Natl Acad Sci USA. 1996;93:13316–13320

15.Jones BJ, Roberts DJ. A rotarod suitable for quantitative measurements of motor incoordination in naive mice. N-S Arch Exp Pathol Pharmakol. 1968;259:211

16.Kohr D, Tschernatsch M, Schmitz K, Singh P, Kaps M, Schafer KH, et al. Autoantibodies in complex regional pain syndrome bind to a differentiation-dependent neuronal surface autoantigen. Pain. 2009;143:246–251

17.Maihofner C, Baron R, DeCol R, Binder A, Birklein F, Deuschl G, et al. The motor system shows adaptive changes in complex regional pain syndrome. Brain. 2007;130:2671–2687

18.Mense S, Schiltenwolf M. Fatigue and pain; what is the connection?. Pain. 2010;148:177–178

19.Mills CD, Grady JJ, Hulsebosch CE. Changes in exploratory behavior as a measure of chronic central pain following spinal cord injury. J Neurotrauma. 2001;18:1091–1105

20.Moseley GL. Graded motor imagery is effective for long-standing complex regional pain syndrome: a randomised controlled trial. Pain. 2004;108:192–198

21.Rose NR, Bona C. Defining criteria for autoimmune diseases (Witebsky’s postulates revisited). Immunol Today. 1993;14:426–430

22.Teeling JL, Felton LM, Deacon RM, Cunningham C, Rawlins JN, Perry VH. Sub-pyrogenic systemic inflammation impacts on brain and behavior, independent of cytokines. Brain Behav Immun. 2007;21:836–850

23.Toyka KV, Brachman DB, Pestronk A, Kao I. Myasthenia gravis: passive transfer from man to mouse. Science. 1975;190:397–399

24.Veldman PH, Reynen HM, Arntz IE, Goris RJ. Signs and symptoms of reflex sympathetic dystrophy: prospective study of 829 patients. Lancet. 1993;342:1012–1016

25.Zimmermann K, Leffler A, Babes A, Cendan CM, Carr RW, Kobayashi J, et al. Sensory neuron sodium channel Nav1.8 is essential for pain at low temperatures. Nature. 2007;447:855–858

26.Zlomuzica A, Viggiano D, De Souza Silva MA, Ishizuka T, Gironi Carnevale UA, Ruocco LA, et al. The histamine H1-receptor mediates the motivational effects of novelty. Eur J Neurosci. 2008;27:1461–1474

Tuesday, May 17, 2011

A Good Day For Kate ♥

Psssst!  Kate had good scan results today!  See the journal entry over at CaringBridge...


*kate*
Thanks to CaringBridge and the Tiny Sparrow Foundation *


* The Tiny Sparrow Foundation:  "a non-profit organization dedicated to providing lasting memories through the art of photography to families whose children are facing life threatening illnesses."

And Now for Something Completely Different: [clop clop]

I was going to reference a roller coaster, implying redemptive ups and promising downs -- being taken on a ride, yes, but always well worth it!  Eye on the prize and all that, eh, wot?

But I can't pull it off.  I didn't sleep last night for fretting.  Also for all the hilarious feline antics that seemed to inevitably end somewhere on my body -- Marmy would chase Dobby and so, of course, the only place possible for them to both end up was... on my hip, my knee, my chest.  Anywhere on me.  The FuzzBall Kitten played ferociously with his collection of stuffed mice, batting them around the bed until he'd lose them... somewhere under me -- under my arm, my feet, my head.  Anywhere on me.  This required that he dig, and Buddy Boy hasn't learned the meaning of modulation.  He knows one speed and one intensity, and he loosed both on.... me.

Interspersed with all that running, sliding, and digging were bursts of laughter from Fred's workroom.  I still don't know what he was doing back there -- likely watching videos or a film -- but he clearly couldn't help himself. 

So at about 3 AM, I quit trying and surrendered to the fates.  Twelve hours later, I feel like I have Saran Wrap on my eyeballs.

This Philly Thang?  It's not going to happen.

No, no one has told me it's off.  But the incredible disinterest in making it happen sends a clear message. 

The Party Line hasn't changed:  Dr. Schwartzman is booked through 2013 and the offer of an "expedited appointment" seems to have been a meaningless one.  Like some kind of coupon given out to all comers but never redeemed.

Carol said to me, in a mildly scolding tone, that "she's working on it" but right now there is no way to schedule an expedited appointment.  It feels more and more like I've been caught with my pants down in the middle of a Monty Python skit. 

Maybe this one:

Host: With me now is Norman St. John Polevaulter, who for the last few years has been contradicting people. St. John Polevaulter, why do you contradict people?

Polevaulter: I don't!

Host: But you... you told me that you did.

Polevaulter: I most certainly did not!

Host: Oh. I see. I'll start again.

Polevaulter: No you won't!

Host: Ssh! I understand you don't contradict people.

Polevaulter: Yes I do!

Host: And when didn't you start contradicting them?

Polevaulter: I did! In 1952!

Host: 1952.

Polevaulter: 1947!

Host: 23 years ago.

Polevaulter: No!

(GONG!)

-- The Man Who Contradicts People from  Monty Python's Previous Record



It's equally possible that my role is just to call out a reminder now and then: "I'm not dead [yet!]."

MORTICIAN: Bring out your dead!
[clang]
Bring out your dead!
[clang]
Bring out your dead!
[clang]
Bring out your dead!
[clang]
Bring out your dead!
[clang]
Bring out your dead!
[clang]
Bring out your dead!
[clang]
Bring out your dead!
[clang]
Bring out your dead!
[clang]
Bring out your dead!
[clang]
Bring out your dead!
[clang]
Bring out your dead!
CUSTOMER: Here's one -- nine pence.
DEAD PERSON: I'm not dead!
MORTICIAN: What?
CUSTOMER: Nothing -- here's your nine pence.
DEAD PERSON: I'm not dead!
MORTICIAN: Here -- he says he's not dead!
CUSTOMER: Yes, he is.
DEAD PERSON: I'm not!
MORTICIAN: He isn't.
CUSTOMER: Well, he will be soon, he's very ill.
DEAD PERSON: I'm getting better!
CUSTOMER: No, you're not -- you'll be stone dead in a moment.
MORTICIAN: Oh, I can't take him like that -- it's against regulations.
DEAD PERSON: I don't want to go in the cart!
CUSTOMER: Oh, don't be such a baby.
MORTICIAN: I can't take him...
DEAD PERSON: I feel fine!
CUSTOMER: Oh, do us a favor...
MORTICIAN: I can't.
CUSTOMER: Well, can you hang around a couple of minutes? He won't
be long.
MORTICIAN: Naaah, I got to go on to Robinson's -- they've lost nine
today.
CUSTOMER: Well, when is your next round?
MORTICIAN: Thursday.
DEAD PERSON: I think I'll go for a walk.
CUSTOMER: You're not fooling anyone y'know. Look, isn't there
something you can do?
DEAD PERSON: I feel happy... I feel happy.
[whop]
CUSTOMER: Ah, thanks very much.
MORTICIAN: Not at all. See you on Thursday.
CUSTOMER: Right.
[clop clop]

-- Monty Python and the Holy Grail


For further dissonance, I've got Seinfeld's Soup Nazi between the ears, shouting "No Philly for you!"

Search Words for 5/16/2011


It's so much more than just a list of terms plugged into Google Search by people I will never know.  It's how they got to me, to us, to Marlinspike Hall, and somewhere in the intervening space is a story, are many stories.  It's about how they got here from there, proving not just that you *can* get here but that you come different ways for different reasons -- detours, bridges, toll roads, backseat drivers, and that rare bird of a map reader who interprets west as a left turn (I'm just sayin').

periwinkles and driftwood::This is the way we went to the beach when I was a kid. 
As soon as you hit Kinston, you could smell it. We would stop at the grocery store that sits right there when you come off the bridge from Morehead City to Atlantic Beach -- for bleach and ammonia, hot dogs, and Maxwell House in the big can. We ate Wonderbread at the beach and whole wheat the rest of our lives. Setting the indoor picnic table sometimes just meant spreading out newsprint and big platters of boiled shrimp, salad, and loaves of decent crusty bread.  Garlic butter.  Melons for breakfast, and toast.  No one in the ocean before 9 AM, curfew starts at 9:30 PM, remember to tie a flipflop to the umbrella in case you get lost.  They sent out a search party for me one night after I fell into a huge sand dune and just stayed there, mute, trying to decipher constellations and my Mother, both. I'd just had my appendix out;  Chiggers crawled on my legs, ate me up, I scratched myself raw..  Not chiggers, sand fleas.  My aunt chaperoned a bunch of us for Junior/Senior Weekend -- a boy fell off of someone's porch -- he was perched (backward) on the railing that jutted out over a concrete driveway.  Lois made us all godawful sloe gin fizzes; He died.  He wasn't from our school but was good friends with the Bennetts.  My cousin and I made a chowder out of periwinkles and all the grownups actually ate it.  (It was full of sand.)We spelled it "perrywinkle," wrote out an official recipe in pencil on a lined index card that we stuck in the middle drawer of that old-fashioned enamel table in the kitchen.  I went to the cottage one winter, alone, and sat on the porch, right on the stormy ocean.  They called that The Front Porch.  Visiting the cemetery in Beaufort was important but I couldn't begin to tell you why.  After my summer months there found a rhythm, time fell into bayside days and oceanside days, interrupted by stormy afternoons when we'd pile into the drugstore, where everyone got to buy one paperback, just one.  Dusk.  The running lights on shrimp boats.  The pay phone on the pier.  Swimming past the breakers. Knowing who was boss when the undertow took you twisting down.  Yogurt on sunburn.  Ice clinking, bourbon, scotch, beer.  Hearts, spades, bridge, Scrabble and crossword puzzles.  Turning into the wind.  The stories about my sister Copper being born smack dab in the middle of Hurricane Hazel.  Driftwood fires, sparking.

topiary and gingerbread::I like this road because of that house, the one with all the wild flowers.
I turn left a good half mile before I have to just to see it.  There's the wire form for a bear topiary -- kind of a Pooh -- that sits in the middle of one patch, and they decorate him for the least little holiday.  National Teachers Day, Cinco de Mayo.  Canada Day, Bastille Day, big football Saturdays.  Past Sterling and Oakdale, but before Clifton Road.  One year the yard was overgrown and the bear undecorated.  I mean, he stayed in his Santa duds until they just wore off him.  I think a baby died.  Then, like nothing, the bear grew rich, thick, and green again and there were raised beds of every kind of flower, as if from nowhere.  Can't even recall the house now -- brick, compact.  One of the gingerbreads, big slants to the roof, dark masonry.  Everyone felt special, peeking at those flowers, that bear, like it was a private kiss you'd sneak.  I thought, What if they move?  What will I do then?  Who will change the bear?

 waffle cones and cockapoos::There used to be a Dairy Queen right there.

I would pick up my parents' Saturday evening dinner order on the way home from a day of tennis in the park:  a pound of barbeque, a pound of slaw, and hushpuppies.  Then I'd cut through the dirt lot, through the heady smoke from the pit, and drive on up to the DQ in my 1965 baby blue Cadillac.  It was a minor revolution, delaying that vinegar-heavy chopped pork for a vanilla shake.  That's right, I was every bit as exciting as they were, me and my vanilla shakes.  The vet we liked was right across the highway, on the westbound side of Hwy 70, heading back into town.  I hated going home once they lit the downtown courts -- I could have picked up games all evening, and if Teresa didn't have to babysit, we could play doubles with the country clubbers who forgot to make a reservation.  It'd be okay at home for a little while -- setting sun on the lake, the attack of pastels, the dog chasing geese. I'd follow him down to the water, turn 'round and look back at the house, their dream house, but you could tell just by looking that nobody lived there.  Mom made me a big salad  so that I could keep company while they ate their pound of barbecue, pound of slaw, and hushpuppies.  I stayed a vegetarian for 25 years.  Sometimes she'd ask me to stop at the Dairy Queen and bring home hot fudge sundaes.  I always told her I forgot and kept the extra money for gas, always planning to get in that car, pick east or west, and go, go, go.

We generally find what we're looking for.  My "stats" page says these are the words that brought folks here today after being plugged into Google Search.  These aren't the only pathways and story lines, of course, but they are all I have as clues tonight, and they suffice.

ina mae oxendine
serena williams catsuit
pesach 
venus williams ass
canned peaches al swearengen 
dame marjorie charden 
dr schwartzman rsd 
ketamine coma february 2009
"andrea gianopoulos"
mike vermeer tennis
3 invisible dicks
picture of bouillabaisse 
pollyanna woodward naked
cushingoid
serena williams catsuit
serena williams cat suit 43
serena williams underpants 
lindsey baum 
taiji dolphins
monopoly game pieces 
taiji
focaccia di recco 
anna kournikova tennis skirt
taiji japan
kamasutra 
dr schwartz rsd puzzles
sequential frame spinning back fist
rebecca allwine
dolphin killing
andrea gianopoulos

carrara marble quarry

and

((pfizer or wyeth or johnson&johnson or j&j or "johnson & johnson" or "johnson&johnson" or "j & j" or hoffmannlaroche or "hoffmann la roche" or roche or novartis or glaxosmithkline) and (tsunami or earthquake or erdbeben or quake or japan or japanese)) and (donation or donate or donates or spende or spenden or spendet)

Monday, May 16, 2011

New Nurse

Though I am tempted to insist that she appear at the same time and in the same place with Nurse K, I enjoy reading New Nurse In The Hood's blog.  It's... scrappy.

Also, like the always aforementioned Nurse K, New Nurse reminds me of why you will never find me in an Emergency Room/Department unless my ACTUAL emergency involves lots of blood (and gore, lots of gore) that cannot be resolved by applying feminine pads to my shin. (Please try to keep up.) And even then, I might not go.  I mean, who knows, Dr. Schwartzman's Office Staff might try and call me with a free hair appointment.  Or a gift card for a shopping spree at Amputations R Us.

I'm fine.  Really!

Anyway... New Nurse is good.  And if only 10% of what she relates as happening in her ER/ED (screw WhiteCoat!) actually happens?  Then she is a far better person than I would be under similar circumstances.  Some of these folks qualify for Group Memberships on my List of People Who Need Killing.

Would you HUSH, please?  I said, "I'm fine," and that's what I meant: I'M FINE.

So... New Nurse gives us the run-down in this post entitled "Just an overall poor effort" -- from last Wednesday.  An optional title?  One girl, no brain.  Or something like that. 

It's an old tale, really, as old as time.  Shakespearean in its ridiculousness. 

Yes! Pregnancy games!  How to waste precious medical resources, in human as well as monetary terms!

From reading many an excellent medical blog, I get the feeling that a good version of New Nurse's "poor effort" post could be written weekly by each of them, and from fresh, actual material, too!  That's sad and pitiful.

Without further ado... why not start her post here and then finish it over there at her place?

Just an overall poor effort

Chick checks in last night for nausea x 5 days, with positive pregnancy test at home. Let me pop that in the hood hospital translator for you right quick:
I want a sonogram, and maybe another pregnancy test. Starts going into an in depth discussion with the triage nurse about when she started having sex with this dude that is with her currently. Listen sister, this isn't Maury, we just asked your LMP, next please.
So it was utter pandemonium and fuckery up until about 4 am last night, people were forming human pyramids in the waiting room because there were no more chairs, the line to check in wrapped around the building and everyone had chest pain. I had two dudes who fell off of roofs, like, really actually fell off of them, check in within 5 minutes of one another. One had a broken C2. So, uh, obviously this young woman's complaint was not of immediate concern. So she and baby daddy leave and do some shit at Walmart or whatever and then come back...

Begging and Beseeching, Entreating and Imploring

  “Hope” is the thing with feathers -
That perches in the soul -

Emily Dickinson 1830–1886




Okay, so I'm STILL waiting for a call back from Philly about an appointment with the illustrious Dr. Schwartzman (see previous gush).

After days of some sort of Stupid Attack, I am finally remembering my well-earned expert opinion on... Experts.  Correction!  Make that: I know whereof I speak concerning those experts celebrated by a cult-of-personality-based community.  I've lots of unfortunate experience in this arena -- Derrida, Fish, Foucault, Jameson -- but not near enough, apparently, since here I sit in Marlinspike Manor's Computer Turret instead of the nearest Ivory Tower.

It's really more the Middling Players who are the actual offenders, anyway -- Bersani, Hollier, Lentricchia, Most Poets.  You learn the most from this moderate and scruffy crowd but you also accept more [unwarranted] abuse than is wise.  The accumulated angst and stress of simply sharing a town with them eventually detracts from the information received.

Note to other bloggers contemplating making their own Lists of Four:  Alphabetize.  That's the only solution to the Order Problem.  Well, I suppose you can also opt for a Living versus Dead construction, further subordered by Date of Death.

I am reminded of a conversation with Grader Boob from a few years back.

Grader Boob: Great news. I finished that pain-in-the-ass paper for the Incomplete I got in Misogynous Medieval Literature my last year in grad school. Knocked that sucker out over the weekend.


Me: Congratulations, My Brother-Unit! So what did the prof have to say?

Grader Boob: Not much. He died six weeks ago.

Grader Boob (again): But that's not the point...


I consider myself lucky to only be at the point where my doctoral committee now consists entirely of Emeriti.  Honorifics and Soporifics, that's the name of the game!

Putting my dementia aside, and returning to the present stressor of trying to relieve this soul-destroying pain afflicting my body, and, some might argue, my cognitive powers, as well ===>>

Is it Dr. Schwartzman's fault that there's an attention-starved group of people who share a sharp interest in the pain relief he may be able to offer?  Not in the least! But I wonder if he has a sense of it, really.  Does he feel it in his bones, in his hands?  We're going crazy out here;  We're going nuts for some relief.

In other words, don't screw with me when it comes to Matters of Hope.  Don't deign or feign, just shoot from the hip, be direct, be honest.  I say again:  Don't screw with me when it comes to Matters of Hope.

Is it to Schwartzman's credit that he is equally well known for being a compassionate man, and that compassion complements intellect like no other attribute known to humankind?  Of course it is... particularly since that assessment appears to have held very true over time. He sounds like a remarkable person.  I hope to meet him.

Someday.

Does any of this mean that his Schedule Coordinator gives a royal patootey about me, sitting here in rural Tête de Hergé (très décédé, d'ailleurs), once again pondering a Do-It-Yourself Amputation, though I still haven't solved the problem of how to cut off the last arm without at least minimal assistance?  Oh sure, I could probably rig something up with pulleys and the use of my awesomely muscular lip muscles, but the whole plan goes pfffffttttttttt once I decide that I don't want to bleed out, and that tourniquets are gonna be necessary. 

Errrr, I think not.  Said Scheduling Coordinator surely has separated herself from the needy tentacles of the thousands of patients seeking an audience.  She guards the gate, keeps the dates, protects the doctor, gets it done.

If the cult-of-personality-based community of CRPS sufferers were a wealthy community, things would be different.  We'd have decent DIY Amputation Kits, already! The right vises would be included, there'd be extra hardware, sharper blades, and clean-up would be a breeze.  Appointments would be made, and made reasonably.  For instance, I confess to thinking that there MUST be someone else in the Neuro Department with at least a faithful simulacrum of Schwartzman's skills, having been trained by him -- and with whom I might have an appointment within a reasonable period of time.  I am redefining "reasonable period of time" daily.  Right now, it means "within a year." Yesterday, it meant "around six months." Last Thursday, when I made First Contact, it meant "any day now, possibly tomorrow."

Yes, so... the Gatekeeper of Appointments has laid her foundation -- I gasped, suitably, when immediately reminded that the "next available" appointment with the Famous Doctor was in 2013.  Right.  Got that.  Knew that years ago.  Part of why I never bothered.  Y'know?

But, yes, so... I gasped.  "REALLY?  YOU'RE KIDDING?" It was passable.  She seemed satisfied that I was suitably in awe.

Because, of course, The Personality has thrown me the bone of a promise of consideration, of being worked into the packed planner.  I recognized Emily Dickinson's Thang avec Feathers right off the bat.

Then it became a matter of her never having heard of my health insurance coverage, you know, that coverage initiated by My Hero, President Obama.  Of course, me yelping at her about how it is administered by "JEFE" instead of the correct "GEHA" did not promote my cause in the least.  I do this regularly, Friends.  I don't know why JEFE strikes me as the thing to yell out in the identical manner that I might scream BINGO, but it does. 

By the time I was able to mutter GEHA, it was too late, I was relegated to the Hinterlands, to a I Will Call Back Tomorrow Morning Status.  Also informing that decision was her strange assertion that "the computer won't take your insurance's 800 number." I was tempted to follow up my calls of JEFE, GEHA, and BINGO with OVERRIDE, but thought better of it.

Enter Buddy the Kitten.

Oh, hush.  You knew he was going to snake his little squirrelly self into this mess.

He was apparently back at chewing wires on Friday and the phone was out most of the morning.  Therefore, I choose to believe that she tried to call me, and could not, due to the dastardly deeds of this reprobate kitten.  Still, I had the phone in my shirt pocket the rest of the day, even as I worked with doughs and slippery cold dead fowl (but never at the same time, oh no, never at the same time!).

Fine, thought I, slamming shut the oven door on the last batch of chicken carcasses.  Monday, she's gonna call Monday.  Monday is rapidly disappearing as I waste time writing this dejected post.

Why don't I call back?  Well, I am going to, thankyouverymuch.  I have established an artificial deadline of 3 PM, at which time I turn into someone with a backbone.

Unfortunately, my extensive experience with cult-of-personality situations and the gatekeepers thereof tells me that I will be dealing from a position of weakness, as I am in the position of begging and beseeching, entreating and imploring. 

That was Fred's contribution to the process thus far:  "Have you, ma chère prof, sufficiently begged, beseeched, entreated, and implored?" 
The answer is NO.  I haven't cajoled enough, haven't made my case, haven't had, in fact, the least bit of interest in going down that road. 

Am I supposed to announce that my pain score is stalled between 7 and 9 -- when I actually don't even believe in or understand the God-forsaken System of Misery Measurement?  Am I supposed to have my doctor make the call, so as to invoke preening, primping, fawning, and immeasurable posturing?  Should I weep over the telephone, sob a bit?

Well?  Yes?  No?  Never! Maybe?  It all depends?

I go back to consult with the doctor who prescribed the ketamine infusions for me here on Thursday.  It's going to be a chess match of a conversation.  Hopefully, I will have, by then, a date for evaluation in Philly, which would give me a bit of a conversational edge.  I want him to know how much I appreciate the effort he's made here but I also need him to accept that a different protocol is in order.  It's not that he is not as "good" as Dr. Schwartzman;  It's an issue of specialization and experience.

I don't feel badly about how this all got started.  In fact, I need to remember that -- all I did was email The Expert with a real question about how to get the most from these lower dose and infrequent versions of subanesthetic ketamine infusions. 

And The Expert knew compassion and said Why don't you come?  And what all of THIS is (waving my hands around in an effusively inclusive way)?  This is ME, TRYING.

Darned cat.
It's all Buddy's fault.


 

fouetté rond de jambe en tournant, avec poulpe



The Elder Brother-Unit, Tumbleweed, maintains several blogs. I only follow American Idyll with regularity. It turns out, of course, that I've been missing good stuff on the other sites.  He illustrates himself, is all I can say, and I'm hungry for each glimpse.

The video below is mesmerizing.  The best meditations skew vanishing points and horizon lines, twist sinewy, all sinewy, soft strong form, the shape of water.  If you've missed me these past few days, that's the where and what of it.  I've been contemplating dancing sea creatures.





Uploaded to YouTube by RSNOOI on Mar 31, 2009, who wrote:

This white octopus was filmed with a high-definition underwater video camera at 6600 feet depth 200 miles off the coast of Oregon in September 2005 as part of the VISIONS '05 expedition led by Professors John Delaney and Deborah Kelleyof the University of Washington. Little is known about the deep-sea octopuses that live in proximity to the hydrothermal vent fields associated with theunderwater volcanoes of the Juan de Fuca Ridge in theNortheast Pacific Ocean.


This video features the Grimpoteuthis bathynectes species. Sometimes nicknamed the Dumbo octopus, its ears are really fins that help it move through the water.


Primary sponsors of the VISIONS '05 Expedition were theNational Science Foundation,W.M. Keck Foundation, NOAA Coastal Services Center, University of Washington, and the ResearchChannel.


Special thanks to Jerome M. Paros and Elaina Jorgensen.


Music courtesy of Bryan Verhoye.


Video production by Nancy Penrose
© University of Washington, 2009



While my mind was still all wavy and without perspective, I ran into this bookend of a dance video, a production by the Moldova Ballet School:




Eugen Garnet/ Massenet. Meditation
Uploaded to YouTube by MrViorelMIRON on Apr 27, 2010

moldova ballet school