Big Tall Bob Used To Reek Geek

He's a giant of a man.  When I first met him, seven years ago, he reeked "geek." He's still shy, but now he's buff, tan, wears the coolest clothes, and his spirit seems to have grown into his height, and beyond it, hovering as icy blue aura, or just making the air shimmer..  He seems to move with grace, even in clunky exam rooms overcrowded with rolling stools and tables full of tape and bandages, and those cotton swabs that top only one end of long, thin wooden sticks.

He's never been paid for his part as "assistant surgeon" in any of the eleven or twelve operations in which he has helped.  The insurance companies write that my surgeries should not require extra assistance.  If I can, and that's a huge "if," I'm going to try and leave him some money in my will.  He would die of Extreme Blushing and Embarrassment were I to do it while alive -- and I love his anti-geekness too much to put him in danger of a return to stammering and crooked glasses.

That makes an elegant segue for my tale of yesterday's appointment with Bob, Brilliant ShoulderMan's Physician's Assistant.  Unfortunately, I need to take a break, grab some frozen strawberries, cover them with fake sugar, and splashes of milk.  This concoction has comforted me several times a day over the last few weeks.  I don't know why -- except that it does cool me down, and I'm starting today's fever.  So I'll be back.  It's also a chance to give Buddy -- who is looking after me this morning -- his favorite treat of bonito flakes, fresh from the one-pound package in the freezer.  (We got the "okay" from the vet to give him as much as he wants, and he wants, and wants, and wants...)

Bob listens to me, and hears me, too.  When I'm stupid, he ignores the babbling.  When I'm glossing over something difficult, he gets very still, a hard thing for a big man to pull off.  He has crystal aquamarine eyes.

We talk cats sometimes.

There have been late-afternoon appointments, over the years, where he and Brilliant ShoulderMan's nurse would both sort of collapse onto chairs or rolling stools, even putting their heads down on the exam table.  I was like a fixture, I guess, and attuned to their fatigue.  These are some hard-working people. Once, I think we all three dozed off.  I remember the nurse shaking herself awake, handing me some pre-op paperwork to sign.  She started to go over each document, then said, "Oh, you know the drill..."  Informed consent at its best!

In the hospital, it is Bob who rounds more than anyone else, so he was the one who got to witness most of my CRPS misery.  He'd drop by between 5 and 6 AM, and I'd be doing well.  Between operations, say around 11 AM, he'd pop in to find me writhing, jerking, cussing.  He heard it all, he heard me say I was giving up, he heard me full of bravado, he saw me when I could not even speak.

When they take me into the surgery suites, I'm always lost.  I cannot see, so I tend not to speak to anyone, whereas they all feel like we're old friends, and come up and crack jokes, say sweet things, explain what is going on.  ShoulderMan and Bob usually aren't in there then, they come swooping in as I am put to sleep, I guess.  But this last time, in June (has it been that long?), there was this unmistakably tall figure moving about the surgical suite, emitting a reverberating voice.

Moving from the pre-op gurney to the operating table is always difficult.  Normally, the surgical staff would help, and the patient would be grateful.  Me?  They knew me so well that should some Newbie reach for a leg to help guide me onto the table, a whole chorus of "Don't Touch Her Legs, Let Her Do It!" rang out.  (Why the nurses up on the floor couldn't grasp the concept, I dunno!)

But this time, my legs were seizing and out of my control, mostly. My left shoulder was shot, hurt horribly with any movement (we shall not intimate that the regional block FAILED miserably!), and that left my right arm as the only available appendage to see to this transfer from gurney to operating table.  Had there been a trapeze, I might have been able to just drag myself over with that one arm, but you can imagine how incredibly crowded it already was in that area... machine after machine, lights, tables full of instruments, and people, lots of people.

I had already led some of the nurses in a sing-a-long during the trip there, and even as we all pondered how this transfer was gonna take place, we were still humming.

Finally Bob's masked face came down to about an inch from my nose.  "Hi Bob," I called out.  I think he laughed.

"We're going to pick you up and move you, and we're going to be quick and gentle."  Before I could bitch and hem and haw, it was done, but not without Bob's face coming back into the one-inch-from-my-nose range.  "Are you alright?"

It would have been one of the easiest entrances into surgery for me ever had not the anesthesiologist screwed up.  I always ask that they please give me good warning before putting me to sleep, as I like to say "thank you" to everyone in the room first.  (Tevye: "Tradition!")  I asked the guy, he said "okie-dokie."

I am difficult to intubate, so much so that they have had to break my teeth in desperation.  I guess that is what he was thinking about.  Anyway, the bleepety-bleep-bleep gave me the paralytic and then couldn't get the tube in, and I was wide awake, unable to suck air for myself, having thanked no one, and was about to come off the table in panic.

Move along, prof, move along.  I am avoiding getting to yesterday.

So... yesterday.  I had an appointment with Bob, one of the interminable "follow-ups." He asked, first thing, how it had gone with World Famous Hip Guy, who was supposed to have done an ultrasound and/or fluoroscope-guided aspiration of my hips, tracking down that wily Propionibacterium acnes.  The journey that led to me losing a shoulder was to begin with my hips.

I picked a spot on the wall behind Bob's right ear.  I told him that World Famous Hip Guy refused to operate on "someone like me" and wasn't eager, therefore, to do the diagnostics.  I told him we were kind of like oil and water.

Then I told him that I was giving up, and relayed the info from the biofilms expert, paraphrasing his "first there is a wound, then they lose a toe, a foot, a leg, and then they die." He did some fast blinking, as did I, and I risked looking at him.  He made it easy:

"So we're going to concentrate on pain control, then?"  blinkblinkblink

"Yeah, I think that is what makes the most sense..."

I was proud of Bob and proud of myself, in that I did not do that awful thing of asking:  "What do you think I should do?"

Somehow, we started cracking bad jokes, the best kind.  And we talked about the carbon footprint of sending a power wheelchair I am trying like hell to donate to someone in Haiti -- where my orthopedic team does mission work twice a year.  There is a local agency that could use it but they won't get their act together and come pick it up and we cannot deliver it for lack of a stabilizing bar for the lift.  BlahBlahBlah.

Suddenly, Bob blew it.  "You're a very special person."  Aw, damn. I, who know me, cannot let that stand, it feels like acid poured on my soul.

I made a rote denial and then managed a "Thank you, Bob, and thank you for everything you have done for me."

More blinking, and that was it.  He made some recommendations for drugs that won't make my stomach bleed, made me promise to come back in 3 months, and blinkblink, I woke the sleeping Fred in the waiting room, where people seemed to be guarding his snoring frame from disturbances.

"Awww." murmured the people, the Greek Chorus, as Fred struggled back to consciousness, cute as the dickens.

We did not speak of the appointment during the long ride home, and I was able to pretend to be bothered by the sun in my eyes.

CRPS and Vaccines

Complex regional pain syndrome following immunization

1. Stephanie Richards1, 
2. George Chalkiadis2, 
3. Raman Lakshman3, 
4. Jim P Buttery1,4,5,
5. Nigel W Crawford1,4,6

-Author Affiliations

1. ¹SAEFVIC, Department of General Medicine, Royal Children's Hospital (RCH), Melbourne, Victoria, Australia
2. ²Department of Anaesthetics and Pain Management, Royal Children's Hospital, Melbourne, Victoria, Australia
3. ³Department of Paediatrics, West Suffolk Hospital NHS Trust, Suffolk, UK
4. ⁴Murdoch Children's Research Institute (MCRI), Melbourne, Victoria, Australia
5. ⁵Paediatric Infectious Diseases Unit, Department of Paediatrics, Monash Children's Hospital, Southern Health, Monash University, Melbourne, Victoria, Australia
6. ⁶Department of Paediatrics, The University of Melbourne, Melbourne, Victoria, Australia

1. Correspondence toDr Nigel W Crawford, SAEFVIC Immunisation Safety Service, Department of General Medicine, Murdoch Children's Research Institute, Royal Children's Hospital, Flemington Road, Parkville, Melbourne, VIC 3052, Australia; nigel.crawford@rch.org.au

• Accepted 26 June 2012
• Published Online First 1 August 2012

Abstract

Complex regional pain syndrome type 1 (CRPS-1) is a clinical syndrome that affects one or more extremities and is characterised by persistent pain disproportionate to any inciting event, and at least one sign of autonomic dysfunction in the affected limb(s). The pathogenesis of this syndrome is poorly understood, but its onset is often precipitated by a physical injury, such as minor trauma, fracture, infection or a surgical procedure. In the literature, there are reports of CRPS-1 following immunization with rubella and hepatitis B vaccines. Here we present a case series of CRPS-1 following immunisation in adolescents, with either diphtheria-tetanus-acellular pertussis (1 case), or human papillomavirus vaccines (4 cases). Enhanced awareness of this syndrome and its potential to occur following immunization in the paediatric population is vital to the prompt and effective management of this condition.

Okay, not the most enlightening of abstracts.  A little research, however, disclosed this 2004 case study available in its entirety in the European Journal of Pain 9 (2005) 517-521:  Complex Regional Pain Syndrome Type-1 After Rubella Vaccine.  It's available through RSDS.org and its impressive library of free research.

It's enough to be on your way...

 Uploaded by Astralionica on Dec 27, 2009

Notes:
JT on Sony.com:

My brother Alex died in '93 on (not for) my birthday. We all went down to Florida to say goodbye. The day after we flew home (the day after his cremation) a giant mother hurricane followed us north through the Carolinas; trashing everything in its path and finally raining record rains on Martha's Vineyard (home).

In Paris, a year later I changed his character to a hippie chick named Alice and the location to Santa Fe; but my soulful older brother is still all over this song like a cheap suit.

Almost Fuck-free. 

The sun shines on this funeral

The same as on a birth

The way it shines on everything

That happens here on Earth

It rolls across the western sky

And back into the sea

And spends the day's last rays

Upon this fucked-up family

So long old pal

The last time I saw Alice

She was leaving Santa Fe

With a bunch of round-eyed Buddhists

In a killer Chevrolet

Said they turned her out of Texas

Yeah she burned 'em down back home

Now she's wild with expectation

On the edge of the unknown

Oh it's enough to be on your way

It's enough just to cover ground

It's enough to be moving on

Home, build it behind your eyes

Carry it in your heart

Safe among your own

They brought her back on a Friday night

Same day I was born

We sent her up the smoke stack

And back into the storm

She blew up over the San Juan mountains

And spent herself at last

The threat of heavy weather

That was what she knew the best

Oh it's enough to be on your way

It's enough just to cover ground

It's enough to be moving on

Home, build it behind your eyes

Carry it in your heart

Safe among your own

It woke me up on a Sunday

An hour before the sun

It had me watching the headlights

Out on highway 591

'Til I stepped into my trousers

'Til I pulled my big boots on

I walked out on the Mesa

And I stumbled on this song

Oh it's enough to be on your way

It's enough just to cover ground

It's enough to be moving on

Home, build it behind your eyes

Carry it in your heart

Safe among your own

\

Uploaded by LivingLegendsMusic on Apr 15, 2008

An exclusive series of Living Legends Music interviews with Livingston Taylor. Part 4 of 10. Recorded on January 12th, 2008 in Vero Beach, FL.

Respite from Romney: Peace is tenacious

Published on Sep 12, 2012 by ifwcny

Produced by News Channel 9 WSYR (Syracuse, NY) and Jim Dessauer.

From Gratefulness.org:  [In the "Fear and Peace" section]  This documentary by Jim Dessauer of Interfaith Works of Central New York honors five people from The Syracuse Area Middle East Dialogue Group who - for 30 years - have been building bridges of understanding that affirm the dignity of all people and all faith traditions.

InterFaith Works of Central New York, through education, service and dialogue, affirms the dignity of each person and every faith community and works to create relationships and understanding among us.

Medical Biofilms, Detection, Prevention and Control: free docstoc ebook download

Medical Biofilms, Detection, Prevention and Control


Edited by:

JANA JASS
Department of Microbiology and Immunology,
The University of Western Ontario, and
The Lawson Health Research Institute,
London, ON, Canada

SUSANNE SURMAN
London Food, Water & Environmental Microbiology Laboratory,
CPHL, London, UK

JAMES WALKER
CAMR, Porton Down, Salisbury, UK

Preface

Biofilms are a complex heterogeneous consortium of microorganisms associated with surfaces and interfaces and have been shown to play an important role both in causing disease and for maintaining health.

Microorganisms growing in biofilms may cause or prolong infections through, colonisation of implants or prosthetic devices and problems resulting from dental plaque formation. Modern medical practices and implant technology have alerted clinicians to the implications of biofilmassociated infections due to their persistence and resistance to antimicrobial treatment. Biofilms are also shown to be important in maintaining health by supporting commensal microflora that may assist in preventing pathogen infectivity.

This book is the first to deal specifically with biofilms associated with different medical areas including: the contamination of medical devices such as catheters, orthopaedic prostheses, renal dialysis, shunts, pacemakers and drug delivery systems; infection of tissue surfaces as in the lungs of cystic fibrosis patients, on damaged tissue surfaces (i.e. burns and surgery), bone (osteomyelitis), cardiac tissue (endocarditis) and genitourinary tract; and dental plaque, the cause of caries and periodontal disease.

For each of these topics the book provides an overview of current research in medical biofilms focusing on detection and monitoring the problems associated with biofilm and current strategies for control and eradication. To fully understand infectious biofilms, a current summary of the basic concepts in biofilm research and future prospects are included.

The editors intend that the book be used as an aid in teaching and research. Persons with an interest in medical diseases will find this book fascinating to read and the format is aimed at complimenting many hospital teaching courses for clinicians as well as medical and dentistry students.

The publication came about due to the increased awareness of the importance of adherent microbial populations in human health and disease, yet lacking a comprehensive text on information and research investigating the problems of medical biofilms, how to detect them and ultimately how to control their presence. Industrial environments have been ahead of the medical profession on their understanding and research progress on biofilms and biofouling of surfaces by microorganisms. The companion volume ‘‘Industrial Biofouling’’ (2000) discusses biofilms as a persistent problem and how to control them in potable water systems, industrial water systems and the food industry.

Dowload the PDF book here:
http://www.docstoc.com/docs/16424965...on-and-Control

Romney, "raw and unplugged": Thank you, David Corn

SECRET VIDEO: Romney Tells Millionaire Donors What He REALLY Thinks of Obama Voters

When he doesn't know a camera's rolling, the GOP candidate shows his disdain for half of America.
—By David Corn | Mon Sep. 17, 2012 1:00 PM PDT

During a private fundraiser earlier this year, Republican presidential candidate Mitt Romney told a small group of wealthy contributors what he truly thinks of all the voters who support President Barack Obama. He dismissed these Americans as freeloaders who pay no taxes, who don't assume responsibility for their lives, and who think government should take care of them. Fielding a question from a donor about how he could triumph in November, Romney replied:

There are 47 percent of the people who will vote for the president no matter what. All right, there are 47 percent who are with him, who are dependent upon government, who believe that they are victims, who believe the government has a responsibility to care for them, who believe that they are entitled to health care, to food, to housing, to you-name-it. That that's an entitlement. And the government should give it to them. And they will vote for this president no matter what…These are people who pay no income tax.

Romney went on: "[M]y job is is not to worry about those people. I'll never convince them they should take personal responsibility and care for their lives."

Mother Jones has obtained video of Romney at this intimate fundraiser—where he candidly discussed his campaign strategy and foreign policy ideas in stark terms he does not use in public—and has confirmed its authenticity. To protect the confidential source who provided the video, we have blurred some of the image, and we will not identify the date or location of the event, which occurred after Romney had clinched the Republican presidential nomination. [UPDATE: We can now report that this fundraiser was held at the Boca Raton home of controversial private equity manager Marc Leder on May 17 and we've removed the blurring from the video. See the original blurred videos here.]

Here is Romney expressing his disdain for Americans who back the president:




At the dinner, Romney often stuck to familiar talking points. But there were moments when he went beyond the familiar campaign lines. Describing his family background, he quipped about his father, "Had he been born of Mexican parents, I'd have a better shot of winning this." Contending that he is a self-made millionaire who earned his own fortune, Romney insisted, "I have inherited nothing." He remarked, "There is a perception, 'Oh, we were born with a silver spoon, he never had to earn anything and so forth.' Frankly, I was born with a silver spoon, which is the greatest gift you can have: which is to get born in America."

Romney told the contributors that "women are open to supporting me," but that "we are having a much harder time with Hispanic voters, and if the Hispanic voting bloc becomes as committed to the Democrats as the African American voting block has in the past, why, we're in trouble as a party and, I think, as a nation." When one attendee asked how this group could help Romney sell himself to others, he answered, "Frankly, what I need you to do is to raise millions of dollars." He added, "The fact that I'm either tied or close to the president…that's very interesting."

Asked why he wouldn't go full-throttle and assail Obama as corrupt, Romney explained the internal thinking of his campaign and revealed that he and his aides, in response to focus-group studies conducted by his consultants, were hesitant to hammer the president too hard out of fear of alienating independents who voted for Obama in 2008:




We speak with voters across the country about their perceptions. Those people I told you—the 5 to 6 or 7 percent that we have to bring onto our side—they all voted for Barack Obama four years ago. So, and by the way, when you say to them, "Do you think Barack Obama is a failure?" they overwhelmingly say no. They like him. But when you say, "Are you disappointed that his policies haven't worked?" they say yes. And because they voted for him, they don't want to be told that they were wrong, that he's a bad guy, that he did bad things, that he's corrupt. Those people that we have to get, they want to believe they did the right thing, but he just wasn't up to the task. They love the phrase that he's "over his head." But if we're—but we, but you see, you and I, we spend our day with Republicans. We spend our days with people who agree with us. And these people are people who voted for him and don't agree with us. And so the things that animate us are not the things that animate them. And the best success I have at speaking with those people is saying, you know, the president has been a disappointment. He told you he'd keep unemployment below 8 percent. Hasn't been below eight percent since. Fifty percent of kids coming out of school can't get a job. Fifty percent. Fifty percent of the kids in high school in our 50 largest cities won't graduate from high school. What're they gonna do? These are the kinds of things that I can say to that audience that they nod their head and say, "Yeah, I think you're right." What he's going to do, by the way, is try and vilify me as someone who's been successful, or who's, you know, closed businesses or laid people off, and is an evil bad guy. And that may work.

(Note: Obama did not promise his policies would keep unemployment under 8 percent, and 50 percent of college graduates are not unemployed.)

[....]

READ THE REST OF DAVID CORN'S FIRST PIECE ON THIS VIDEO FROM THE BOCA RATON FUNDRAISER HERE.

More from the secret Romney video. (Romney tells his donors he doesn't believe in a two-state solution for the Israeli-Palestinian conflict, that resolving this conflict is "almost unthinkable," and that he would merely "kick the ball down the field."): SECRET VIDEO: On Israel, Romney Trashes Two-State Solution 

Here is a surprising and shocking teaser to that second Corn piece:  "Palestinians have no interest whatsoever in establishing peace."  I confess that I am still not over the shock of Romney's remarks made at the end of July, during his Gaffe World Tour:

"As you come here and you see the GDP [gross domestic product] per capita, for instance, in Israel which is about $21,000, and compare that with the GDP per capita just across the areas managed by the Palestinian Authority, which is more like $10,000 per capita, you notice such a dramatically stark difference in economic vitality." Mr. Romney told a group of donors gathered at the King David Hotel in Jerusalem. He added: "And that is also between other countries that are near or next to each other: Chile and Ecuador, Mexico and the United States."  He went on to explain that the marked décalage between the GDP in Israel versus the downright pitiful laziness exhibited in the GDP of Palestine was due to "culture."   I don't understand how the Earth continued to turn on its appointed axis after that statement, but that's just me...

As for Romney's response to the release of the Boca Raton videos [that underscore what everyone already knew, but were striking in the ease and familiarity of tone the Good Guvnor exhibited], the Christian Science Monitor reports:

At an impromptu news conference Monday, Romney offered no apologies, conceding the comments were not "elegantly stated" and were spoken "off the cuff." The Republican presidential nominee said the remarks showed a contrast between President Barack Obama's "government-centered society" and his belief in a "free-market approach." 

"Of course, I want to help all Americans, all Americans, have a bright and prosperous future," Romney told reporters.

Zofran, anyone?

Occupy Posters...

By Occupy* Posters

"And the live show is still our main thing": HAPPY BIRTHDAY, OCCUPY!

OWS One Year Later, Time World
On Sept. 17, 2011, members of Occupy Wall Street (OWS) started camping out in Zuccotti Park in Manhattan’s financial district, and since then the movement has spread to 1,500 cities. One of its most enduring icons has been the Guy Fawkes mask, popularized by the graphic novel and film V for Vendetta and a constant presence at protests worldwide.

If we had any nerve at all, if we had any real balls as a society, or whatever you need, whatever quality you need, real character, we would make an effort to really address the wrongs in this society, righteously.

I read somewhere that 77 per cent of all the mentally ill live in poverty. Actually, I'm more intrigued by the 23 per cent who are apparently doing quite well for themselves.

Constantly choosing the lesser of two evils is still choosing evil.

Stuff that's hidden and murky and ambiguous is scary because you don't know what it does.

And the live show is still our main thing.

-- Jerry Garcia






Uploaded by scottmcfann on Oct 17, 2011   Creative commons Non-Commercial, Attribution, No Derivative Works license. 
Music by: Hauschka, song "Stumm (Kein Wort)"
Music Label: Karaoke Kalk label based in Berlin
http://www.karaokekalk.de/

A Ulysses Kind of Day

Penelope and Odysseus
Relief, from Milo, c.450 BC (stone)
Louvre, Paris

Every now and then, I have a Ulysses kind of day.  Of course, those pixies at the DNC started it all with their video honoring Ted Kennedy, who loved to muck around with Tennyson's Ulysses (below).

Always, though, I end with Merwin's Odysseus, when my heart's strings can withstand the tug (below, below).

Alfred,Lord Tennyson : Ulysses

It little profits that an idle king1, By this still hearth, among these barren crags, Matched with an agèd wife, I mete and dole Unequal laws unto a savage race, That hoard, and sleep, and feed, and know not me. I cannot rest from travel: I will drink Life to the lees: all times I have enjoyed Greatly, have suffered greatly, both with those That loved me, and alone; on shore, and when Through scudding drifts the rainy Hyades2 Vexed the dim sea: I am become a name; For always roaming with a hungry heart Much have I seen and known; cities of men And manners, climates, councils, governments, Myself not least, but honoured of them all; And drunk delight of battle with my peers, Far on the ringing plains of windy Troy3. I am a part of all that I have met; Yet all experience is an arch wherethrough Gleams that untravelled world, whose margin fades For ever and for ever when I move. How dull it is to pause, to make an end, To rust unburnished, not to shine in use! As though to breathe were life. Life piled on life Were all too little, and of one to me Little remains: but every hour is saved From that eternal silence, something more, A bringer of new things; and vile it were For some three suns to store and hoard myself, And this grey spirit yearning in desire To follow knowledge like a sinking star, Beyond the utmost bound of human thought. This my son, mine own Telemachus, To whom I leave the sceptre and the isle— Well-loved of me, discerning to fulfil This labour, by slow prudence to make mild A rugged people, and through soft degrees Subdue them to the useful and the good. Most blameless is he, centred in the sphere Of common duties, decent not to fail In offices of tenderness, and pay Meet adoration to my household gods, When I am gone. He works his work, I mine. There lies the port; the vessel puffs her sail: There gloom the dark broad seas. My mariners, Souls that have toiled, and wrought, and thought with me— That ever with a frolic welcome took The thunder and the sunshine, and opposed Free hearts, free foreheads—you and I are old; Old age hath yet his honour and his toil; Death closes all: but something ere the end, Some work of noble note, may yet be done, Not unbecoming men that strove with Gods. The lights begin to twinkle from the rocks: The long day wanes: the slow moon climbs: the deep Moans round with many voices. Come, my friends, 'Tis not too late to seek a newer world. Push off, and sitting well in order smite The sounding furrows; for my purpose holds To sail beyond the sunset, and the baths Of all the western stars, until I die. It may be that the gulfs will wash us down: It may be we shall touch the Happy Isles4, And see the great Achilles5, whom we knew Though much is taken, much abides; and though We are not now that strength which in old days Moved earth and heaven; that which we are, we are; One equal temper of heroic hearts, Made weak by time and fate, but strong in will To strive, to seek, to find, and not to yield.

Alfred,Lord Tennyson (1809-1892) 1833

FOOTNOTES

1 In this poem, Ulysses (the Roman for Odysseus and the hero of Homer's Iliad and the Odyssey), now an old man, having returned to Ithaca after twenty years absence and much adventure, has grown restless, and is now contemplating setting out with his crew again; 2 a constellation of stars associated with rain; 3 site of the Trojan wars of which Ulysses was a hero; 4 the Elysian Fields, believed by some to be the resting place of heroes after death; 5 Greek hero of the Trojan wars who suffered an early death

Ruthlessly stolen from:



Looking for a really unique gift, or a treat for yourself?  Check this out:

What are Portable Poetries?

Portable Poetries are handmade, customised collections of poetry, small enough to fit in your wallet, purse, or backpocket. They're made with care, designed with the poetry lover in mind, and they make excellent gifts. To get your Portable Poetry, all you have to do is peruse the catalogue of poems, decide which ones you want, select a booklet size, add your dedication and we'll do the rest. You can keep track of your order on the track page. I try to get them out as quickly as possible but the delay really depends on how busy I am - best to reckon on a few weeks but for urgent deliveries, drop me an email atpingin@portablepoetry.com.

***************************************************************

Uploaded by hartistry on Oct 24, 2009
David Hart is *remarkable*....

“Odysseus”

Always the setting forth was the same,
Same sea, same dangers waiting for him
As though he had got nowhere but older.
Behind him on the receding shore
The identical reproaches, and somewhere
Out before him, the unravelling patience
He was wedded to.  There were the islands
Each with its woman and twining welcome
To be navigated, and one to call “home.”
The knowledge of all that he betrayed
Grew till it was the same whether he stayed
Or went.  Therefore he went.  And what wonder
If sometimes he could not remember
Which was the one who wished on his departure
Perils that he could never sail through,
And which, improbable, remote, and true,
Was the one he kept sailing home to?

By: W.S.Merwin 

I love Dr. Anthony Kirkpatrick and it turns out that Ochoa is not the only turd in town...

Dr. Anthony Kirkpatrick has pretty much dedicated his life to bettering the lives of people with CRPS / RSD, and having scoped out some of his other interests, he's kind of into bettering life on the planet, in general.

After many years in Anesthesiology and Pain Management at USF in Tampa, he established there the world's only RSD / CRPS Treatment Center and Research Institute.  If I had some bucks, I'd have been there when the doors opened.

[One of the majorly sucky things about CRPS / RSD 's most effective doctors and treatments?  You have to be monied to have access to them.  Oh, I'm sorry.  That's a universal truth!  I try to expunge the obvious from my posts, but it was a long night...]

I'm also not blind to the down side of such fervor as his, but I prefer it to torpor, and I definitely prefer it to doctors practicing CYA medicine or suffering terribly from Dr. God complexes.  I see him as the obvious antithesis to my archenemy Jose Ochoa, known on this blog simply, eloquently, as The Turd.

Anyway, here is a new Dr. Anthony Kirkpatrick video meant to expose, inform, and help:



Part 2 cannot be embedded, but here is the link to it:  Part II: Do doctors torture patients with CRPS?
Part 3 cannot be embedded, either:  Part III: Do Doctors Torture Patients?

Dear President Obama...

Mr. President:

I learn something new every day.

I'm one of your avid supporters, President Obama, and someone who has benefited enormously, albeit catastrophically, from the Affordable Care Act, most specifically the Pre-Existing Coverage that was made available for me to purchase.  (An aside -- in your campaigning, it would help people to understand PCIP better if they knew that it was not "welfare," that enrollees pay their way.  However, I confess to having blown, all by myself, the national budget for this program, and it is only September!)

I'd be even more avid in my support if you'd push for real and true reform in your next term in office.  That's right -- the public option, true universal coverage, deep, real reform.

But there is also in me a conservative streak, though I prefer to consider it basic common sense.

The medical details are irrelevant in this story of abuse of the health care payment system:  On July 10, 2012, I required emergency transportation from a doctors' building to the emergency room of the hospital across the street.  Well, to call it a "street" is a stretch, since it was more like an alley.

There was no need, as there was no time, for even the taking of basic vital signs, no i.v.s started, nothing. They just put me on the stretcher, took the elevator down to the ambulance, loaded me into it, crossed the alley, and delivered me to the emergency room.  In the interim, they managed to muck up information such as the office we had come from and the reason for the emergency transport.  (The guys said "dislocated shoulder";  In actuality, it was sepsis.)

Because I have passed the catastrophic limit for the year, most of my medical charges are being paid at 100% by PCIP -- for which you have my deepest gratitude.

I still make it a habit, however, to peruse each and every Explanation of Benefits form that comes my way, and there are some almost every day.  It's been that kind of decade.

The EOB for the ambulance ride arrived in today's mail.  PCIP payed them a whopping $963.00, exactly what they billed.

I thought about ignoring it.  Why should I care?  I'm at 100% coverage, my health is "catastrophic," and I had just spent two hours convincing a radiology practice that they would likely get paid if they would file with PCIP and not the insurance company I had four years ago.  But, still, I found myself reaching for the phone.

The first two times I dialed and explained why I was calling, my call was disconnected during the complicated transfer to the billing department.  The third time, I think the Obama-like steel in my voice made the call go through like magic.

I discovered that a nifty way to inflate an ambulance charge is to alter the address of origin for the "pick-up" or rescue, or whatever they choose to call it.  The Big Ride.

My home address was "inadvertently" listed as the originating point of the ambulance ride across the alley. My home address, of course, is in a different city -- not too far away, but still...

Call me a cynic, or nuts (though you'll not catch me conversing with an empty chair), but I suspect this inadvertent confusion of addresses happens with some frequency among the shadier members of the rescue community.  I suggest that anyone taking The Big Ride and facing a huge bill as a result obtain the paperwork designating starting and ending points.

They're going to "investigate" my claim.  I asked them to please reimburse a goodly amount of that charge to PCIP.  I'm doing what I can, President Obama!

I hope your ribs are okay -- I saw that tremendous bear hug you got at the pizzeria this morning!  Good thing you didn't need an ambulance!

Your supporter,
Profderien

Manor Keeping and Blog Chores

There are so many housekeeping chores that need doing to get this blog back in shape.

I promised to follow three things in particular -- news and developments about missing child Lindsey Baum; news and developments about Dr. Scott Reuben; and updated information on CRPS Clinical Trials.

Now, of course, I would add the four cancer kids that I follow, as well as the continuing truth that Dr. Jose Ochoa is a Turd.

And then, well, there is my fascinated hatred for creatures like Dr. Phil and Oprah, and my desire to wrench others away from their mesmerizing bullshit.  These are people of quality who just refuse to trust themselves, who have a tendency to love being on the receiving end of domination.  (What?  It's only the truth.  Domination, even cruelty, equals attention, and they have been denied attention their whole lives.  All they want is to be seen and heard -- no matter that they are being used, pimped, fucked.)

Of course, dealing with osteomyelitis and CRPS (the biggies) has completely taken over elle est belle la seine la seine elle est belle, whether I allow a safari vacation into Amerikan politics, French politics, socialist circles, or even the wild and woolly adventures we have in the various kitchens of Marlinspike Hall. My pus-dripping bones and my wildly contorting legs and hands trump the hell out of the Militant Lesbian Existentialist Feminists, even the three of them who'd switch teams in a New York minute if it meant they could hunker down with my oblivious Fred.  I did not fall off of the produce truck recently and although I was born at night, they had to use pitocin.

I've put life in The Manor and the many fascinating details of maintaining such a landmark on the blog's back burner, too, but, O! There are reasons for that and fear not, as soon as we are covered by the expected extensions of President Obama's Dream Act to us outlanders, Tante Louise will call off the surveillance.. Okay, so we're not young, but we are illegal, and we are immigrants.

We are squatters!

La Bonne et Belle Bianca Castafiore is so head-over-heels in lust with Sven, and they both are steadfastly and stealthily kept in view by Sven's lad Cabana Boy -- and to tell the truth, this has killed some of my desire to write.  They keep the air redolent with stinky tension.

I almost and by complete ACCIDENT killed myself yesterday -- by gentle respiratory depression.  Fentanyl patches, according to the manufacturer, are to be changed every 72 hours.  My pain guru wants me to change them every 48 hours.  I, of course, allow the earlier applied one to stay on an extra day, thereby milking out, or so I hope, every bit of pink-unicorn-fart pain relief.

The things do not stick well to my skin, mostly because I constantly cycle between being hot and dry, having sweats and chills.  Also, I bathe.  I bathe a lot.

Okay, this bothers me, so just let me get it out of my system, as if it were a bit of toxic fentanyl floating around in my psychic innards.  I love a bath.  I haven't been able to take a bath since... 2000.  I shower.  I use a shower chair and one of those wunnerful, wunnerful wand shower heads.  I leave the bathroom sobbing and usually have to take a rescue dose of endocet and climb in bed, praying and crying, snot all over the place, sweating, destroying that fresh, clean feeling a shower is supposed to impart.  Now, due to weakness and spasms, I shower twice a week.  I bathe at the bathroom sink twice a day, usually more often.  I use various antiseptic products, especially the ones that are commonly used as preop washes, trying to destroy any goddamn p. acnes bacteria hanging around.  I've been told this is a ridiculous thing to do, as well as impossible and perhaps undesirable... but I do it anyway.  I stomp on those toxic bastard bacteria.

Whew.  Okay.  Yeah, so bless my Stepmother who inculcated in me an obsession for cleanliness.  Captain Haddock sure gets his money's worth out of my hyperfocus -- there are no cleaner medieval tapestries than the ones hanging on his manor's walls.  I was born a maid.

Okay, let's reword that:  I was born with maid tendencies.  When I took career assessment testing in junior high school, the answer was always, "be a maid."

There are twisted ways that could have gone.  I clean up.  I believe I'd also have been a great assassin.  I used to maintain a list of People Who Need Killing -- but someone, somewhere, must have snagged a copy, because they all just sort of started dying without me doing a doggone thing.  And now, the world has changed so much, so quickly, that I am scared of making a mistake -- so no one has been added to the People Who Need Killing List since Pinochet died.  Six years of no entries.  A rusty assassin is a useless assassin.  Just ask Clint Eastwood, or the chair.

I spent the night screaming.  Pain. Muscle Deformations.  I kept dreaming that my Father, recently deceased, who had been dreamily safely ensconced in a federal prison, had been released and no one knew where he was.  I dreamt he was comin' after me.  Then I would wake to find my right leg jammed into the wheelchair, and my body turned on my left non-existent shoulder.  And so on and so forth.  I finally got up at 3 am, mad.  Mad at whom, I've no idea, but Fred was up, so I treated him to some of the door-slamming he so loves.  He didn't notice a thing, the benevolent abstraction!

So I decided to calm myself and quiet down the door banging by taking a shower.

At which time I discovered FOUR fentanyl patches, all firmly adhering to my skin.  All should have been neatly labelled with the day applied (I put a bandaid over them to help keep them on when the sweats and chills kick in, and write the application date onto the bandaid).

To the best of my muddled recollection, twice I thought the thing had fallen off, and so twice had replaced the supposedly missing pain patch with a new one.  And in each case, it was the bandaid that was gone, not the patch.  Yes, I had opened a new box of Made in the USA bandaids, a pharmacy brand that shall be henceforth banished from this usage, at least.

Yes, my eyes are that bad, also the patches are pretty much translucent.  I had been fretting about the cats, fearing that they'd find the fallen fentanyl "pain systems," lick them, play with them, and promptly die.  Sven, Bianca, and Cabana Boy?  They are more drinkers than druggies.  And Fred laughs at the idea that exposure to fentanyl could harm him.  I also had a good fret or two over the koi, thinking that maybe the patches went flying out some window and down into the moat.

We've banned the carnies and Cirque du Soleil habitués from entering The Manor, so I couldn't see how the true fierce addicts around me could have gotten hold of them -- and lately, they've all been confined to The Barn.  Long story.

Yeah, so I almost died, sorta.  I mean, I guess I could have.  I was certainly drowsy enough and snoring like a giraffe troubled by amplified adenoids -- before all the pain (despite four fentanyl patches) and contractions pushed me from the bed, to work, to a good sweat, to another shower.

The irony is that this week I am meeting with a lawyer to rework my living will, my standard will, my various powers of attorney, and seeking guidance on getting a DNR.

I can tell you that there is NO news about Lindsey Baum, that Scott Reuben chafes under the restrictions placed upon him (I'm sure it is a mystery to him why trust is so hard to come by), and if you want the latest CRPS clinical trials, it's easy -- just go HERE.  The only extra gifts I ever offered in my listings of the clinical trials were my not-so-expert opinions, and adding some suggested reading to better understand what was at stake.  But you, Dear Reader, don't require that.  It was more along the lines of me, as a high school sophomore, "showing my work" on a geometry test.  Yes, a "proof" of some kind.

Of the four young ones fighting cancer that I follow, Hannah is doing great, as is Kate (she shows no evidence of *any* tumor!), Braydon struggles, and the last young man will not live much longer.  I am also following a teenager, mostly because I saw her picture after she had died her hair a beautiful punk pink -- before losing it all, of course, by a new course of chemotherapy. She has relapsed but is kicking cancer's big fat butt by a punked out perky attitude, and by loving parents who never leave her side, and who pray all the live long day.  There are others -- you cannot help yourself, because the kids you follow all have blogging parents who do not cease to ask for your consideration for the kid in the room next door, or for so-and-so who has developed a nagging pain but whose MRI is not scheduled until October...  I can tell you that pediatric oncologists must have a healthy respect for parents and their "gut feelings," their intuition, their "something is not right with my child." In short, my cancer kids are doing better, as a group, than they usually are, and they are inspiring and uplifting, each and every one.

I posted a piece called "Billy" on September 5.  He's not a cancer kid, he's a cancer grown-up!  He has stage 4 lung cancer, and I will save my speeches on smoking, because, as an ex-smoker, I do understand.  No, not true, he continues to smoke, and THAT, I cannot fathom.

Anyway, Dear Readers, Billy and Joyce are an odd couple, getting closer now that it is too late to say their marriage was a good one.  But they do understand one another and they do love each other.  She has carried on her back the welfare of two grown daughters, both of whom refused to leave home, one of whom has three boys, all with what we like to call "issue." Joyce's siblings and other close relatives all struggle with addiction.  She is raising one of her sister's children, which is the working miracle in that child's life, because Joyce never gave in to addiction, never gave in to the lifestyle and values around her.  So Shawna is a star student with a bright future.  Joyce is disabled now, living entirely on entitlement programs, as is everyone in the family, really.

Billy is schizophrenic.  He is a U.S. military veteran.

They have *nothing* but the items in their apartment, in material terms.  No vehicle.  The vast wealth of their benefits tend to run out before the month does.

And now he has been dumped there, in a hospital bed, with oxygen, a walker, and all that good stuff.  Hospice is supposedly on the case, but mostly they have dumped him, too -- telling Joyce to do this, this, and this... and Joyce is sick and tired, and also still overseeing her girls and her three grandsons.  She has to walk everywhere, and most of her pain is centered in her legs and back, so those walks, that she used to love, are now akin to traipsing from Bataan to Corregidor.

Give them some money.  Christina, one of Joyce's daughters, has set up a fundraiser through the very legitimate FundRazr.  Ask questions, if you are dubious.  Give a dollar, two, or three.  That's more than they have, even after digging under the cushions on the sofa.

Listen -- they save stray cats.  They keep those sons and grandsons in scouting, in church.  They guard their innocence fiercely.  They tend to Billy as best they can but are obsessed with not having the money to bury him.  Joyce hates vegetables.  Her other daughter is mentally ill but helping out as best she can.  Shawna's biological mom is back on drugs and as recently as yesterday, Joyce forced her off the premises with the instincts of a good, protective parent.

The problems are a burden even to listen to.  But they're real... and Joyce has begun to turn her life around, and where her life goes, all those other lives glommed onto her for sustenance?  They get turned around, too.
I don't want to see one iota of the beautiful progress this beautiful woman has made degraded by something as obscene as CANCER and a Veteran's Administration that just doesn't give a hoot.

That's about it for me right now.  One of the 843 smoke and carbon monoxide detectors in Marlinspike Hall is chirping, letting me know it's in need of a fresh battery.  I'm going to get The Gun and shoot it.  As soon as I find it....