REPOST: in a moment

Odd.  I have many things to write about, several amazing articles and speeches (the articles new, the speeches old, but new to me) to go on about and reprint.  There have been some funny developments in the Walmart Pharmacy saga (O, they are so screwèd!) and I spent the day with medical types, so you know I have an overloaded brain.

And yet, I saw that several readers had called up this post, originally published on 28 June 2011, when I was in the midst of my last shot at a CRPS "cure," via subanesthetic ketamine infusions.  It was a hard time, confusing, rushed, painful -- and then there are all the things such a chemical does to the brain and mind.

From that came this, which, frankly, has left me weepy.  I don't remember writing it.

So, Dear Readers, I give you -- again -- "in a moment"":

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

There is an assisted living facility that we drive by frequently, a very neat and pleasant looking place, in front of which is a sign announcing a "special neighborhood for the memory impaired."

I figure Fred and La Bonne et Belle Bianca will push me out of a slow-moving Ruby, the Honda CR-V, with however much cash might be necessary to buy into that special neighborhood pinned to my lapel.  Fred will have written my name in my clothing with a Sharpie Rub-a-Dub® Laundry Marker.  For her part, Bianca will make sure I've several kilos of beluga caviar, carefully wrapped in my garment-dyed organic cotton tees. Oddly, her enormous cache of the stuff predates the September 30, 2005 importation ban from the Caspian Sea, and the October 2005 ban of the sturgeon roe from the Black Sea basin.

Anyway, they love me each in their own way.  Fred will make sure I've the comfort of my own clean clothes, something familiar when my mind wanders. The Castafiore?  Fish eggs.  *Old* fish eggs.

Bless their bones, I've plum worn them out.  Our lives together were supposed to only nominally be about really, actually, taking care of one another.  It wasn't supposed to be like this.

Anyway (my fallback segue) --

Technically, Ketamine leaves the body very quickly. My point being that I was told there are no lingering effects from the infusions in "normal" people.  Never mind that researchers give subanesthetic doses to elicit symptoms of schizophrenia, to mimic mental illness -- handy, I guess, on that day when we run out of actual schizophrenics amenable to study. 

I know, courtesy of doctors, nurses, and choice literature, that the psychosis and cognitive dysfunction that I simultaneously experienced, explored, and was terrified by, resulted from that one drug running through my veins.  I know that all deleterious effects officially ceased within minutes of stopping the drip -- despite the experiential evidence of dizziness, nausea, confusion, fatigue, and visual disturbances that linger and recur. Despite, despite, despite...

Still -- here I am, five days out from the last high dose treatment, downright obliterated, my sluggish, sloshing brain wrapped in the cotton candy fuzz of Ketamine's metabolites.  Except that that cannot be.

It's hard.  I'm looking and hoping for positive results from this recent approximation of Dr. Schwartzman's Ketamine protocol in the treatment of CRPS (as communicated by Dr. Schwartzman in an email, as delineated in published papers).  I am trying to be objective though that's a much tougher thing to approximate. 

On the up side?  My overall level of inflammation, and its attendant discomfort, is much lower than it was two weeks ago.  My feet and lower legs are less swollen, as are my joints in general.  Whether or not that's at all attributable to the Ketamine infusions, I don't know.  I was overdue a break in the cycle of what I call Red and Blue phases of CRPS, having been in the Red phase for a good while, and tired of it.  People kept enlightening me with helpful alerts like "Wow! The heat is just pouring off of your body." 

So now my feet and lower legs are blue, considerably smaller, and scary cold.  I've entertained giving socks another chance but then couldn't tolerate the weight of a sheet, and so end up slapping the nearest cat and joshing, "Golly Gee!"

I am working on a suitable chortle.

The pain is just as bothersome, though different.  Blue phase CRPS pain, for me, is an unrelenting burn that makes me, if possible, even more wary than usual of the touch of... *anything*.  I start doing all the weird things CRPS patients do -- going to ridiculous lengths to avoid the touch of ridiculous things.  Cringing and crying out just at the sight of one cat chasing another through the room.  Folding the edges of clothing, carefully arranging covers and quilts.  Making the constellation of pillows a task requiring advanced degrees.

Blue phase CRPS -- and again, this is my terminology, and not a generally accepted notion -- is fuelled by fear, heightened anticipation.  Much too much thinking and worrying, with fits of frustration that often involve throwing phones, remote controls, paperbacks, and a slew of assistive devices (like handy-dandy "grabbers"), because inanimate objects migrate, on purpose, threatening to bump hands, arms, feet, and legs.  One day, I will try to explain the peculiar, building, and sinister sensation of *potential* touch.

I can write about This Schtuff here, even as I am actively trying to deceive my Manor Denizens and Mavens.  The first wave of my effort involves biting my tongue instead of using it to mold the shape of my screams.

Yes, I have stopped screaming.  In the same vein that, yes, I have no bananas.*

It wasn't such a huge leap from that to a general shutting up, after all these weeks of methadone and percocet withdrawal, and the attendant chatter:spaz:chatter::scream::scream::chatter:spaz:chatter.

Having been the cause and nexus of so much worry and effort around Marlinspike Hall, I dedicate myself now to the cultivation of a very false front.

The cheshire cat in Lewis Carroll's Alice in Wonderland
drawn by John Tenniel (1820-1914) in the 1866 edition.

The Crooked Grimace becomes the Modest Smile that morphs into a Cheshire Grin.

(And why not invoke Lewis Carroll as one of the Authors of My Being? **)

The Cheshire Cat and the enormity of his grin, companion piece to the Mona Lisa's pursed and lippy near smirk: They aren't exactly lies, more like essential commentary, a reminder that little is as it seems, and if you don't want too much pain, it helps to revel in these snivels of diversion and repression.

[I tried to rewrite that last bit but feel honor-bound to leave it.  It may be that only such a tight sentence will be the key to my exit from the Special Neighborhood for the Memory Impaired...]

Wikipedia notes that "A classical dictionary of the vulgar tongue by Francis Grose (The Second Edition, Corrected and Enlarged, London 1788) contains the following entry: 'CHESHIRE CAT. He grins like a Cheshire cat; said of any one who shows his teeth and gums in laughing.'"

That'd be me. Toothy. Like my long dead grandmother's fierce and false good cheer, though, my laughter seems more a cackle now, mirth so unfunny

I enjoy Wikipedia entries that ache for supporting citations. Next to making scads of money by writing back-of-book blurbs and wine label spots, I'd love a life of writing detailed and mostly true Wikipedia entries just squirrelly enough to want a footnote or three.

Remember: The threshold for inclusion in Wikipedia is verifiability, not truth.

The only thing I enjoyed about my Ketamine hallucinations were snapshots of interwoven longterm memories, no matter how illogical their relationship with whatever visual or auditory wormhole encased the whole affair.  Memory was the touchstone of sanity.

It was also much more pleasant to dive into deep still waters -- a very pretty blue -- than to lie there struggling to remember my middle name and the city, my last address, the date.

Last Thursday morning, down in Cubicle 2, my brain held a slide show, complete with the clicking noises during view swaps, complete with the electrical whir of an old-fashioned projector's vibrating motor and fan. 

How my brothers each came to be such excellent photographers is something of a mystery.  In the years they spent together, and those years were, sadly, not many, there weren't many occasions for shutterbugging, and certainly the evidence from those years is kind of pitiful.  Overexposed.  Underexposed. 

I remember TW shadowing some polo-shirted man with a pot belly, which must have been the summer he spent working as a caddy at the country club.  It wasn't even our country club, as it wasn't our country. Also, TW'd rather die than acquiesce to the foundational notions of the intensely racist area of the world in which we were temporarily housed. We had been foisted upon our grandparents for the summer, at the end of which we three were to fly a few thousand miles to unite with an add-water-and-stir new family.

Brother Tumbleweed made money hand-over-fist, I remember some grown-up clucking.  I don't know TW well, never did, but I doubt he's ever been the least bit subservient, so I assume he really needed the bucks.  I think he saw himself as the sardonic twist in an anachronism, a modern white slave boy ripping off the institution, sticking it to The Man.

Anyway, he's standing slightly behind and to the left of the white polo-shirted pot-bellied man, his head at a jaunty angle and what had to be a very funny joke floating in the vapor before his pursed lips.  It would make sense that he'd have on a hat, but he didn't.  I love his hair because I have his hair.  Curly, a mind of its own.  People were always chopping off my hair so as to make it, and me, behave.  My father used a ruler to measure his sons' efforts at sideburns and the distance between a hair's end and a collar's beginning.

I spent that summer obsessed with a bird -- a baby Blue Jay pushed from a high nest by its mother but lucky enough to land on a soft bed of pine straw in the yard of a beloved neighbor, Dr. Ramsey, who promptly brought scrawny thing to me.  That was my I-wanna-be-a-vet summer.  My grandfather and I nursed him, taught him to fly, and just generally made up rules for the bringing up of an Honest Bird.  He went out during the day, played games with us, followed us around the garden and the woods, and then would come inside the house at night, when called. 

For the life of me, though, I cannot remember where in the house he slept.  (One of my favorite mental exercises is to trace the layout of every house I've ever lived in, sometimes even stretching the parameters to include any house I've ever visited.  I find this richly relaxing, enlivening.  It is my version of one of the Pythagorean Brotherhood's disciplines of memory.  That's what I like to believe, so if you've another suspicion, keep it to yourself, please.  No matter your opinion of the calisthenic, you can see, can't you, how not being able to place this bird within the architecture of that summer's night time is a barbed and sticking point, a cause for anxiety?)

You'd think my jay bird would have been a prime target for homegrown photography, but I only have one picture of him, and it was taken by a features photographer from the local paper.  Word got out about our charming boy when he decided to go to church with us one Sunday, rapping with his beak on the sanctuary door, and creating a hell of a racket.  He pitched a juvenile fit in the presence of those investigative journalists, the Maharidge and Williamson of that region and day, then flew up into the highest branches of the dogwood by the back porch door, and refused to come down.  Actually, he put himself in a pickle, because he didn't quite know *how* to get down, by gradation, branch to branch.  At that point it was still pretty much an all-or-nothing affair when it came to flight.

What we all liked most about Squawky (What can I say?  I was a kid.  The next bird I "rescued"?  I dubbed him Potty Pigeon and stuck him in a shoebox.) -- What endeared Squawky to those of us hanging out on Coffee Road that long hot summer of fly balls and mortgage-buster tomato sandwiches was his dedication to driving my grandmother crazy. 

Grandaddy and I were relieved when Squawky grew out of needing our unique mixture of baby bird formula.  It involved collecting the finest and freshest of morning's beetles and worms, local produce, though probably not completely organic.  I also gathered some (bedewed) berries, swiped some generic birdseed, added a dropper or two of some smelly liquid vitamins, and carefully mashed and ground that yummy goodness in a small white porcelain mortar and pestle that was meant to lend the goo an air of maternal predigestion -- again, all under the tutelage of my sweet pharmacist of a grandpa.  We'd hydrate it a bit so that a Kimax pipette could be put to use to plug up the gaping, griping maw at the center of the then very ugly bald and squawking creature.

Grandmother -- we called her Nana -- kept a clean house.  Our culinary efforts on  behalf of the baby bird about sent her around the bend, but she soon learned that our fine raw cuisine was infinitely preferable to the bird's own feeding habits, once he was over the formula stage.  Squawky loved to snack, it turned out, and didn't trust his humans to collect or store the juiciest of tidbits.  In anticipation of late night munchies, he snuck contraband into the house during those stupefyingly hot afternoons when all we thought he wanted was a bit of shade, and company.  He was a clever little cuss.

Nana's "living room" was more a salon.  It was uncomfortable and full of ridiculous fine furniture, and we were all obliged to sit in it for some prescribed period of time in the evening -- after dinner, after the washing-up of dishes, after ice cream on the dark porch, but before baths and other ablutions, and defionitely before bedtime books.  She was in her element at night, was Nana.  The woman could author and promote all kinds of conspiracy theories as she hustled from bathroom to bathroom, bedside to bedside, as she washed and you dried, as she propelled herself like a wild locomotive even into a child's fledgling sense of privacy.  She'd press folded, sweaty dollars into your palm, her face turned in the opposite direction, the better to disguise the Love Bribe.  She out-Cassandra-ed Cassandra -- condemned to see and know the future, and to be believed, even, but never in an actionable way, never in a way that told her we cared about her information, her future.  Doors you swore you'd locked flew open, and she'd give fierce directives about the disposition of her jewelry after her demise as she scrubbed your already clean back with a stiff brush of boar bristles.

It's from that tiny woman that came my many phobias centered around sleep and whispering -- two things that ought to signify intimacy and privacy.  If you need to witness abject terror, just allow me to fall into a safe, comfortable, deep sleep (*those* were the days!), then whisper my name. 

After which, you'll need to scrape me off of the ceiling.

Anyway, despite various family strategies for defusing the Nana Factor, it took a bird to take her down. I'm not sure how he did it, because I kept a very watchful eye, as well as a pocket full of paper towels to scoop up any juicy bugs or offerings of bird poop. 

Squawky hid bugs -- big ass bugs, we're talking -- precisely where finding a bug would drive Nana insane.  In her austere antique-y salon, under needlepointed pillows and oval doilies, in jugs, midst dried and powdery gray-green eucalyptus. [You've no idea  how much I want -- have, indeed, long wanted -- to reference antimacassars as well as doilies, but no one in that house ever rested the back of their heads on anything but monogramed pillowcases atop improbably tall and postered bedsteads.  In this modest country home, she maintained both clichéd and uniquely weird citations of chinoiserie -- that is, chinoiserie twice-removed -- in her faux Persian rugs, scattered black lacquer pieces, chinese-esque vases with young crackled glazes, but mounted on carved ebony pedestals that had the ring of truth.

Nana had an impressive assortment of cloisonné that lacked the space necessary to its appreciation. I remember thinking that I'd have had a leg up in my career if only she had dabbled in an orientalism both better and spread out over another 1,000 square feet.

Maybe it was the decor, the tiny insects and flowers, the small birds, like oversized bees, fairly buzzing in that cramped overheated room -- something made it the perfect place for a teenaged Blue Jay to strategically stash the kind of munchies that only a teenaged Blue Jay would stash -- avian Twinkies and nachos, topped with slightly smooshed malted milk balls.

Brother Unit Grader Boob didn't take pictures of people very often.  His best works, in my opinion, were vertiginous close-ups of leaves, tree trunks, new wood invading old.  There always seemed to be a swirl, and a question.  I know he recently took his camera up to Morehead City, to Atlantic Beach, to that pier I walked and stalked as a teenager, from where I made my first phone call as an honest-to-God Sovereign Person to my mother, just returned to the States.  It was a hangup.  Meaning, I hung up, my heart in my throat, a man with a bucket of bait slinking past, stinking.

But GB has taken remarkable portraits, nonetheless, particularly of the aforementioned Grandparental Units.

A good ten or fifteen years after that summer of our billetting, he showed up at their door at the end of a casual 500 mile bike ride, the last bit of it ascending the Blue Ridge Mountains, and his hair long, sporting cycling gear that made him even more foreign and therefore undesireable looking.  Of course, they didn't know who he was -- Grandaddy being quite blind from glaucoma by then, and Nana caught up in visions of rampaging hippies.  Good sports, though, they allowed my brother and his gang of bicycling friends to hang around for a few days.

They had the best water in the world there, from their well. 

Sometime the following day, when the place must have been looking like a freaking commune, what with those ne'er do well college students wandering around in a tomato sandwich haze, GBoob snapped a few frames of Grandaddy sitting atop the well cap, timing the pump.  He used a telephoto lens, taking the shots from right where the woods get deep.

Grandaddy lived in "gardening clothes," a uniform of khakis and long-sleeved cotton shirts, the whole topped by his old pith helmit.  He had a thin, austere face.  Patrician.  My memories of him are of a gentle man who was not particularly effusive, but who was essentially good-natured.  That is to say, you weren't going to get him to pose with a plastic smile at the ready.

So it is quite the coup, the smile that my brother caught.  He is lanky, even seated, elbows on his knees, one arm clasping the inside of the other.  He holds his face to the sun, relaxed, smells the growing vegetables, thinks, maybe, of his many bird houses or maybe how he's going to mow a few acres of grass later on, blind as a bat, and smiling like a fool. 

I look to a copy of that iconic photo whenever I ponder the accusations of my aunt, an honest and enlightened person, who tells of him beating her mercilessly, dragging her out from under one of those high postered bedsteads where she had hoped to hide.  "Grandaddy?" I ask.  He persists with that peaceful, laconic smile, counting, I suppose, "one one thousand, two one thousand, three one thousand," waiting for the well pump to kick in.

All of that was there last Thursday morning, though some of it was a hold-over from Wednesday afternoon. 

There was a photo of Grader Boob that served as some kind of place card in the sequence of tripping images.  He played a lot of baseball that summer.  He was pitcher, and so his team photo has him looking sharp in pinstripes, rearing back, getting ready for the wind-up and kick, just as soon as he sneaks a peak at the runner on first. 

You've got to keep those runners honest.

Well, that's all I can remember, and more than I want to know.  Sleep well, don't forget to turn your brain down before you go to sleep...

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

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

* Yes, We Have No Bananas!
[Folk Song written by: Frank Silver and Irving Cohn (1923)]

There's a fruit store on our street
It's run by a Greek.
And he keeps good things to eat
But you should hear him speak!


When you ask him anything, he never answers "no".
He just "yes"es you to death,
And as he takes your dough, he tells you...


"Yes! We have no bananas
We have no bananas today!!
We have string beans and onions, cabBAges and scallions
And all kinds of fruit and say
We have an old fashioned toMAHto
A Long Island poTAHto, but


Yes! We have no bananas
We have no bananas today!"


Business got so good for him that he wrote home today,
"Send me Pete and Nick and Jim; I need help right away."
When he got them in the store, there was fun, you bet.
Someone asked for "sparrow grass"
and then the whole quartet
All answered:


"Yes, we have no bananas
We have-a no bananas today.
Just try those coconuts
Those wall-nuts and doughnuts
There ain't many nuts like they.
We'll sell you two kinds of red herring,
Dark brown, and ball-bearing.
But yes, we have no bananas
We have no bananas today."



**I read some of Lewis Carroll's Sylvie and Bruno late this afternoon.  Time was on my mind -- how very mutable it is, and how,  if it flows like a river, it's no river of my knowing.  You know, the basics, what almost any drug-based trip will teach us!

Walking along in the "real world" of Chapter 22, The Earl tells The Narrator (The narcoleptic "Historian"):

"I have yet another theory for adding to the
enjoyment of Life--that is, if I have not exhausted your patience?
I'm afraid you find me a very garrulous old man."


"No indeed!" I exclaimed earnestly. And indeed I felt as if one could
not easily tire of the sweet sadness of that gentle voice.


"It is, that we should learn to take our pleasures quickly, and our
pains slowly."


"But why? I should have put it the other way, myself."


"By taking artificial pain--which can be as trivial as you
please--slowly, the result is that, when real pain comes, however
severe, all you need do is to let it go at its ordinary pace, and it's
over in a moment!"


"Very true," I said, "but how about the pleasure?"


"Why, by taking it quick, you can get so much more into life. It takes
you three hours and a half to hear and enjoy an opera. Suppose I can
take it in, and enjoy it, in half-an-hour. Why, I can enjoy seven
operas, while you are listening; to one!"


"Always supposing you have an orchestra capable of playing them,"
I said. "And that orchestra has yet to be found!"


The old man smiled. "I have heard an 'air played," he said, "and by no
means a short one--played right through, variations and all, in three
seconds!"


"When? And how?" I asked eagerly, with a half-notion that I was
dreaming again.


"It was done by a little musical-box," he quietly replied.
"After it had been wound up, the regulator, or something, broke,
and it ran down, as I said, in about three seconds.
But it must have played all the notes, you know!"


"Did you enjoy it? I asked, with all the severity of a cross-examining
barrister.


"No, I didn't!" he candidly confessed. "But then, you know, I hadn't
been trained to that kind of music!"

This I add in the spirit of "for what it is worth."   

What Happened to All the Clanging Brass Balls?

Maude: You know, at one time, I used to break into pet shops to liberate the canaries. But I decided that was an idea way before its time. Zoos are full, prisons are overflowing... oh my, how the world still *dearly* loves a *cage.*

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

It's a gritty morning.  I need to do a dozen things, eleven of them clamoring to have been accomplished yesterday.

For once I'll spare you.  I put the Maude quote up top to get that crap out of my system.

So let me tell you about the brief visit with my Hawaiian-shirted, sandal-wearing NeuroMan on Thursday.

By the way, he continues to throw his staff under the bus for having attributed my spasticity to cerebral palsy (though Thursday, he said MS).  He further maligned this poor staffer for having ordered him an artichoke and olive pizza when what he craved -- and he is clearly a man of cravings -- was anchovies and onion.

I forgave everyone again, assuring them that there was not even the opportunity for offense being taken, at which I got the usual strange looks.

I had written out a text for him, as it was also, on Thursday morning, a gritty morning and I needed to do a dozen things, eleven of them clamoring to have been accomplished on Wednesday.  The epistolary version of my appeal to him for help began:

today's visit has several goals and i'm not leaving without answers.
just kidding.

He let me down, he really did.  He made squeaky noises about my need for specialized researchers who have been dubbed by the Queen as acceptable distributors of drugs in off-label uses.  He said, this is something that PainManagement Dood should be in charge of... or anyone... anyone ELSE.  "But I don't know enough, I don't specialize..."

Alarms, sirens, bright lights made my brain hurt.  No one knows, no one specializes, you dimwit hawaiian-shirted, sandal-wearing pseudo-cool guy!  Even the moody medico brave enough to infuse me with vast amounts of intravenous ketamine knew that.

He dared start to lift a lip in a sneer at my exposé on neuroinflammation, neuroautoimmunity, and my multimedia presentation of the DVD "Why am I still sick?" which is about biofilm infections.  If you claim not to know, if you claim to be ignorant, then don't hint at an upper lip tic when presented with information.

So I hit him squarely in the nose and kicked him where his brass balls were supposed to be a-hanging.

Brass Big Boy Nuts

Okay, I either hit him squarely in the nose and kicked him where his brass balls were supposed to be a-hanging or I said, "I need you to step up."  It amounted to the same thing.

Turns out he yammers, too.  So I told him to step up, several times.  It turns out that the thought of my good MDVIP go-to-guy doctor sets off fireworks in my verbiage.  He always steps up.  He takes the risks.  He never yammers, never makes excuses, and the goddamn Queen curtsies to him.  And he doesn't get the money the specialists get (InfectiousDisease Dood?  Oh my God, I am still getting EOBs that are clearly built on the art of upcoding) -- nowhere near.

That may have been the persuasive part -- not my anger at NeuroMan's neutered attitude, but my admiration for MDVIP go-to-guy, and my desire to protect him.

I left the office with 3-months worth of memantine [a med used for Alzheimer's that is an NMDA receptor blocker], and a prescription for dantrolene, mostly used in MS patients for spasticity.  Add that to Tuesday's Mobic, and I strong-armed my way through a fucked-up medical system with some success.  I can now predict that October will not be the month in which I succumb to suicide's sexy call.  Should there be any improvements, you, Dear Reader, will be the first to know.

Countering CRPS Dystonia With 32 Fouettés En Tournant

32 fouettés en tournant (fr. 32 "turning fouettés") is a movement in classical ballet. It is 32 consecutively-performed fouetté en tournant.


One fouetté rond de jambe en tournant is an action where the dancer stands momentarily on flat foot with the supporting knee bent as the other "working" leg is whipped around to the side, creating the impetus to spin one turn. The working leg is then pulled in to touch the supporting knee as the dancer rises up en pointe on the supporting foot. The ability to consecutively perform 32 of these turns is considered a bravura step by the ballerina, emphasizing her strength, stamina, and technique.




War is hell, and in my latest campaign, that means lots and lots of ballet.

The spasms have returned.  There were inklings and insinuations over the past several days, feelings of building electricity, an excess of backlogged potential.  Hints of a twitch that I defeated with long, evil looks.

Is it coincidence that the bone infection symptoms have also returned full force?

At some point during the hospital stays in January and February, my orthopedic surgeon attended a conference in San Francisco, and returned a complete chatterbox.  There was much talk of stubborn post-implant infections and a relatively new concept called biofilm.

If he said it once, he said it twenty times over the next few weeks:  biofilm, biofilm, biofilm.

Still, it wasn't until my conscious self accepted the return of the infection a few days ago that I even bothered to look it up.  I thought it was a cop-out on his part, a saving grace, the excuse we were gonna use to explain this expensive failure.

I'm still trying to wrap my curly head around the Wikipedia entry, which does, I think, a superb job of framing what the biofilm discussion is about, and its scary implications -- without scaring the reader away:

A biofilm is an aggregate of microorganisms in which cells adhere to each other on a surface. These adherent cells are frequently embedded within a self-produced matrix of extracellular polymeric substance (EPS). Biofilm EPS, which is also referred to as slime (although not everything described as slime is a biofilm), is a polymeric conglomeration generally composed of extracellular DNA, proteins, and polysaccharides. Biofilms may form on living or non-living surfaces and can be prevalent in natural, industrial and hospital settings.  The microbial cells growing in a biofilm are physiologically distinct from planktonic cells of the same organism, which, by contrast, are single-cells that may float or swim in a liquid medium.


Microbes form a biofilm in response to many factors, which may include cellular recognition of specific or non-specific attachment sites on a surface, nutritional cues, or in some cases, by exposure of planktonic cells to sub-inhibitory concentrations of antibiotics. When a cell switches to the biofilm mode of growth, it undergoes a phenotypic shift in behavior in which large suites of genes are differentially regulated.

At the bottom of the entry, there are some references, one of which turned out to be pure gold.  There is a Biofilm Community!   No, it's not a chummy chat room and I don't sense too much political intrigue -- though intrigue there certainly is, apparently in the form of lurking corporate presence. (Go figure.  It's a growing problem.  An expensive growing problem.)

The Biofilm Community, then, is a repository.

I haven't immersed myself in the slime talk yet, because as I said, I've been in denial, I mean, I've been twitching.

You probably don't believe that despair comes instantaneously to me when the spasticity hits.  But it does.  Instantly, I am yelling, moaning, cursing, writhing, trying to rock my legs to and fro, to beat the gesticulations at their own game.

Fred slept through most of it -- across the Manor, cuddled with Buddy and Dobby, snoring on the horsehair loveseat in  La Recepción -- remember La Recepción?  

The space that we are in today served [the Haddocks] as Reception Hall during the American Civil War, and for roughly 60 years afterward. Back then, it was worth their Snooty While to allow a more plebeian sort of individual to attend the legendary Marlinspike Hall Afternoon Teas. 

Marmy stuck with me, while the boys were off bonding in a snooze.  She climbed onto my chest and flicked my face with her famed fluffy tail.  Then she *ack-ack*-ed at me in a clearly derisive manner.

"Fine," I countered, between screams, "What would you have me do?"

And with that, she danced the Rose Adagio from Act 1 of The Sleeping Beauty, one of the most challenging pieces for any feline ballerina.  I think she actually did it more effortlessly without the four props, Aurora's rose-bearing suitors.  I loves me an Aurora who doesn't hang on to a Prince's hand, don't you?  Marmy extends from attitude to arabesque, my little kitty Cojocaru, with nary a thought of support.  I'd insert the Cojocaru video -- as I couldn't grab the Flip recorder fast enough to document The Fluffy Butt's rendition -- but YouTube won't allow it to be embedded.

Anyway,in addition to a calm and sovereign Aurora, the cat has a point.

I can lay here flopping around like a detoxing crackhead or I can sublimate my intense pain and existential terror by watching YouTube ballet videos, feeling the power, flex, and release of every step, every leap, every stretch.

The spasms have returned?  Pshaw!  Game on.

[First up in the Distraction Campaign?  Chroma -- a lovely way to pass 25 unmedicated minutes.]

God's Thorny Donations (With Obligatory Cat Video)

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

"Ruddy is closer to red than to rose," intones one who ought to know.
My bolshy red ink comes to mind.

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

Just joshing!

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

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

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

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

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

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

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

Also, sweaty.

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

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

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

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

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

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

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

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

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

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

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

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

Ha!

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

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

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

By Way of Explanation...

This post purports to be about why I have not been posting and how I swear (I swear!) that this lax state of affairs will soon be changing.  But first, this unnecessary remark! --->


It's scary when Karl Rove sounds like the voice of reason.  Apparently, nothing makes right wing assholes drop their feigned rube twang like a bunch of cartoonish evangelical Tea-Partiers making inroads into what had been considered proprietary holdings in bigotry and Social Darwinism.


HALT!  I can't just go around calling people assholes, no matter how much it relieves the crick in my neck, no matter how high, how unerring the degree of my accuracy.  Ever since pronouncing my first ever "fucktard" over the weekend, awareness of my penchant for words best detailed by online Urban Dictionaries in lieu of staid Oxford English ones, has grown.


It's grown uncomfortable.  My speech, my pronouncements, my general demeanor -- all unseemly. In fact, I unleashed what apparently can only be called a Can of Whoop Ass on a tweeting con artist yesterday.  @GR8Vibrations may never be the same.  He'll certainly never claim that Vibration Exercise is a match made 
in heaven for CRPS-sufferers again.  I mean, really, what a stupid claim, given the degree of allodynia and hyperalgesia with which we deal. Nonstop.  All the time.  Every God-damned minute of every freaking day. 
I know that on a good day there is nothing I'd rather do than purposely inflict vibration on the ice cold, edematous, 9-out-of-10-on-the-pain-scale pieces of raw meat that extend from the nubs of my former fine, fine legs.


@GR*Vibrations:  We see this condition a lot have been successful treating it with Physical Therapy and Vibration Exercise.


What a goober. "We see this condition a lot," my sweet ass.  It's a phrase he tweets throughout the day to a selected group of sufferers. Before turning it on the wife of a man with CRPS who was "out of treatment options," this Pimple on the Butt of Humanity was working the Parkinson's Disease Twitter lunch crowd.


"Now Serving 2 Locations! Whole Body Vibration As Seen on 'The Doctors' with Fran Drescher!!!"


Well, this heightened, tightened insensitivity just isn't going to work, is it?  Not on Strategists, Ad Men and Women, ConPersons, Theoreticians, Kingmakers, Queenmakers, Lying Liars, Birthers, Gomers, Policy Wonks, Assholes... whatever the taxonomic home in which you wish to lodge them, these folks are spinning their realities as fast as they can, and who am I to interfere?


I mean, what pleasure do I get from seeing a Bush-era POS like Karl Rove squirm midst the threat of tea-partier spoilers?  Am I so sadistic as to enjoy the reflexive twitches of a fat and dying political breed animal, peering out at the world from behind Waldo geek chic eyeglasses?


I guess I am even more of sicko than anyone knew.  Except Fred.  And Bianca.  Plus a certain wise-acre faction within the Domestic Staff.  


Anyway (my favorite segue!) -- I am sorry not to have posted much of late.  I'm in horrible pain and spend lots of time dealing with spasms -- by screaming, mostly.  And attacking indiscriminately, via handy social media, the type of people who usually target me.  It looks like the infection in my left shoulder prosthesis is back with vengeance, and that, coupled with the failure of my recent flirtation with subanesthetic ketamine infusions to cure or even lower my pain levels from CRPS, has me in something of a personal crisis.


You know, I ask myself questions like:  "Why do you keep trying, when everything is screaming at you to give up, to lay down and die?  Hmmm? Why?"


I have started asking myself, as well, "Whycome?  Whycome?" I think that "whycome" sounds cute.  It's kind of tsunami code for "cute disaster," or  美しい災害-


My legs are so swollen that lymphatic fluid is being squeezed out of my famous third spaces.  My vision is changing so rapidly from uncontrolled glaucoma that I frequently scream when my eyes pop open in the dark and the ceiling fan appears to be 6 inches from my face... and Karl Rove.  That's right, my ceiling fan, fat and round and spinning, appears to me at night as a menacing Karl Rove.'


I suspect that I'm also flirting with kidney failure -- No, that's way too dramatic! It is technically renal insufficiency.  My doctor worries about it, I know, especially since I have become addicted to ibuprofen.  It's the only thing that will break my daily fevers.  I alternate between low-dose methadone (only 10 mg a day now, ever since the great Jump Off experiment in May/June), Percocet (with acetaminophen), and ibuprofen. At least now I stay under 1600 mg a day.


I have the beginnings of 12 good posts in my Draft file.  Some are actually within shouting distance of a refined finish.  In each and every instance, a fierce attack of spasticity murdered the writing impulse and the resultant high doses of Baclofen and tizanidine left me without any discernible muscle tone.


That's what I said -- no discernible muscle town.  Wanna make something of it?  Wanna poke fun at my essential amoeba-ness?


I did not think so.


I also have in mind, Dear Reader, essays about things that speak to our common human condition.


Like the silliness of crossword puzzles.  I mean, is "a college in North Carolina" ever anything but Elon?  Is a literary monogram, or literary initials, ever anything but either TSE or EAP?  It's silly.  I do about three short puzzles a day and these two examples are but the tip of my iceberg.


Like more observations on what it is like to be the spouse of someone with a severe case of ADHD, with a side serving of PTSD.  Even just a list of the things that he claims he will do "tomorrow" would relieve some of the pressure and hammering in mine brain.


Like detailing the contents of the last Gift Box I received from Brother-Unit Tumbleweed. Full of music and some guides to the Canyon.  (He finally wrote me a few days back, which was a relief.  If you are following that saga...)


And more cats.  Always more cats.  Buddy the Kitten has learned how to turn door knobs, Marmy is pooping outside the litter boxes, and Dobby now delivers well-timed bites to Buddy's ears, in a valiant effort to appear stronger, smarter, faster.


"Go, Dobby, Go," we cry!


There are also some vaguely political posts in the works, and I am really sorry about that.


Well, there goes my right foot, and since the scream is about to climb backwards out of my mouth, leading with a wide open vowel, I'll leave you now, hungry and aching for more.  You, I mean.  You're hungry and aching for more.


Jeez.