This past Monday, Diane was out house-hunting. She checked out a listing for a house that was interesting in part because it was close to a park. After looking at the house, Diane went over to the park to have a look at it, too. This was Sawgrass Lake Park in St. Petersburg, Florida, near I-275 and Gandy Boulevard. She took Ritka, our Vizsla, walking with her. Diane and Ritka were near the water’s edge at about 4:30 PM when Diane saw the water churn. She immediately called to Ritka and started moving away from the water. Ritka’s usual behavior is to run ahead, and that’s just what Ritka did. Diane, though, slipped on the slope and fell to her hands and knees, perhaps in part due to the slip-on “Crocs”-like shoes she was wearing at the time. The churning water was, indeed, a sign of a gator making a lunge, coming out of the water. The gator didn’t connect with anything on his first lunge, but he grabbed Diane’s left calf with his second lunge.
Diane turned and grabbed the gator’s jaw to discourage it from ripping her calf muscle. The gator then released her calf, but when it snapped its jaws shut the second time, Diane’s left thumb was caught there by a tooth. She says that she didn’t care to play tug with a gator, not with just her thumb as the part in the middle. She reached over with her right hand and grabbed the gator’s eye ridge. Diane says that after maybe 30 seconds to a minute of this standoff, the gator opened his jaws, releasing Diane’s thumb. Diane released the gator’s eye ridge. She says that she briefly had considered trying to hold the gator’s jaws closed and using Ritka’s leash to tie it up, but that she didn’t think that she was up to any more tussling with the gator. So the gator headed back to the water and Diane on up the bank and away.
Diane then went back to the van with Ritka, and called to find out about where the nearest medical facility that would treat a gator bite and take our insurance for payment was. She then drove there, to the Morton Plant Bardmoor emergency facility at Starkey and Bryan Dairy Road. Her parents and then I caught up with her there. Her bite wounds were cleaned and dressed, and somewhere around there she had a bout of nausea, sometime about two hours post-attack. The medical staff gave her IV anti-nausea medicine, morphine, and then Vancomycin. They decided she should have observation for the next 24 hours, so they arranged for admittance at Morton Plant Mease in Clearwater. On Tuesday, she received more anitbiotics, since gator bites almost always get infected, and the infections can themselves be fatal. The principal pathogen to be countered is apparently Aeromonas hydrophila. Two orthopedic surgeons had a look and concurred that she would not need surgery. Diane was discharged around 5 PM on Tuesday.
Diane has a couple of weeks of oral antibiotics to continue with, plus twice-daily changes of the wound dressings. We are watching for fever or any sign of infection in the wounds, but so far she is doing fine. She is sleeping a good chunk of the day. That is, when the reporters will leave her alone. She has marks from about two dozen gator teeth on her calf, ranging from scratches through scrapes, tears, and full punctures. She has a pretty big puncture on her left thumb. She had some cuts and abrasions on her right hand.
A second nuisance complaint from the same park was called in Wednesday. A trapper went out and found a gator that had no fear of people at the site of Diane’s attack. He measured it at 6′ 9″ and noted that it was missing about a foot of tail, making it overall about an eight-footer. In looking at past records of fatal attacks, those have been done by gators as small as 6′ 6″. Diane was very fortunate to have come out of this with as little damage as she did.
Here’s some of the coverage of Diane’s story so far:
St. Petersburg Times. This one is slightly inaccurate in places, but was filed before Harwell did an in-person interview with Diane, so we are hoping for a better article later.
Diane says that she wouldn’t mind going to an alligator-free place for a while, so please go vote for our bid to blog an Antarctic trip next February.
Update: ABC News has taken the story to the national audience. Fox News had a segment, but I don’t know if that was regional or national.<= get_option(\'vc_tag\') ?>> = get_option(\'vc_text_before\') ?> 42005 = get_option(\'vc_human_count_text_many\') ?> = get_option(\'vc_preposition\') ?> 8704 = get_option(\'vc_human_viewers_text_many\') ?> = get_option(\'vc_tag\') ?>>
Medical Wesley R. Elsberry on 11 Aug 2009
Sometimes editorials are just a way to prevent a few blank column-inches. Certainly the editors of the Investor’s Business Daily would have been better off with blank column inches than with the screed they actually published. After all, if you are making an argument and cite an example that not only does not work for you, but undermines your entire premise of argumentation, you have done yourself no favors. The IBD (an acronym I know all too well in another context) editors want to make out that a health care system that covers everyone can’t possibly work, and they try to point out an example of where such a system must fail.
People such as scientist Stephen Hawking wouldn’t have a chance in the U.K., where the National Health Service would say the life of this brilliant man, because of his physical handicaps, is essentially worthless.
Uh, hello? Stephen Hawking is a UK citizen. Hawking is known for apologizing for the Midwest accent of his speech synthesis circuitry. In Brit lingo, that’s an own goal. I’d fear more for Hawking if he were stricken with an acute illness while visiting the USA and left in the tender mercies of an overcrowded public emergency room here without a recognized US health insurance plan.
It is long past time when health care is provided universally on a rational basis, and not left to uninsured people having to use last-ditch emergency room care as their sole contact with the health care system. This isn’t rocket science, and if we wanted a system that provides health care to everyone *and* works well, we could invent it. First, though, we have to get past the naysayers with either vested interests or too little compassion for the plight of others.
Hat tip to Lou Shackleton.
Update: Ed Brayton notes that Hawking has taken the editors to task, and that the editors put a disclaimer up to say that their implication that Hawking was not a UK citizens was incorrect. As Ed says that’s not the point, which was that their argument depended on Hawking dying earlier if he was a UK citizen. The fact that Hawking is here to upbraid them means their argument is of the same value as a bit of doggy-doo on the bottom of your shoe.<= get_option(\'vc_tag\') ?>> = get_option(\'vc_text_before\') ?> 37157 = get_option(\'vc_human_count_text_many\') ?> = get_option(\'vc_preposition\') ?> 6832 = get_option(\'vc_human_viewers_text_many\') ?> = get_option(\'vc_tag\') ?>>
Yesterday, the Texas State Board of Education had a hearing on the science curriculum. As expected, the big issue was over evolutionary science and how it would be taught in Texas K-12 classrooms.
Kathy Miller Dan Quinn of the Texas Freedom Network and Steve Schafersman of Texas Citizens for Science did liveblogging from the hearing (TFN, TCS).
The thing that interests me about the content of the hearing is how plainly the antievolutionist board members espoused the standard religious antievolution ensemble of talking points as their “weaknesses”, and not anything approaching any sort of technical content worthy of being considered a “weakness”. As Texas Freedom Network people noted, “Your Weaknesses Are Weak”. Not only that, as part of the standard religious antievolution ensemble of arguments, they go back a long, long ways. These are not just old, but moldy. They represent stuff that was at home in the mouths of the Rev. William Paley in 1802, William Jennings Bryan in 1925, and various explicit creationists, “scientific creationists”, “creation scientists”, and “intelligent design” creationists since then.
Here’s a list gleaned from the liveblog records and listening to the audio:
- Piltdown man (Ken Mercer) [CC001]
- Mercer said that Piltdown Man was held to be “the missing link”.
- Haeckel’s embryos (Ken Mercer) [CB701]
- Mercer: “He drew the human embryo every time.” Mercer is absolutely incorrect; should we talk about Mercer in terms of “fraud” as he tosses it around concerning others?
- Macroevolution not observed (Ken Mercer) [CB901]
- Argument from authority (Paul Kramer, Terri Leo) [CA118]
Leo asked Kramer if the scientists signing onto the DI Dissent from Darwin list were doing so for religious reasons; Kramer said no. Mercer said he hoped they could keep their jobs after signing, reiterated assertion that no religion was involved.
Terri Leo asserted that “skeptics” with multiple degrees are their experts and are more qualified than people criticizing their stances.
- Fairness argument (Paul Kramer) [CA040]
- Nazis, party lines (Paul Kramer) [CA006.1]
- What are they afraid of? (Paul Kramer) [Example: Pat Buchanan]
- Evolution is only a theory (various) [CA201]
- “Academic freedom” (Ken Mercer) ["AF" in Florida]
Mercer makes it clear that he is completely on board with the mis-named “academic freedom” approach. Ken Mercer questioned Joanne Richards, completely ignoring the comparative religion argument she made. He was all over misunderstanding “academic freedom”.
“But in the last twenty years we’ve just had the ability of academic freedom for children to be able to ask questions, and that’s just been a critical academic endeavor where they could raise their hands, and that’s just been there.”
Academic freedom is not the ability of children to ask questions. The Texas State Board of Education has some very confused people on it.
- Evolution is not a fact (witness) [CA202]
- Eminent scientists are rejecting evolution (Cynthia Dunbar) [CA110, CA111]
- When does a theory become a law? (Don McLeroy)
This isn’t specifically in the index to creationist claims, mostly because it is too stupid even for most antievolutionists to take it out for a spin. It is another example of the breathtaking inanity of antievolution argumentation. There is no notion of a formal progression in science from theory to law. Implying that there is one shows remarkable ignorance of the content of science at a very basic level. Laws are observations of relationships that always (or almost always) hold, often expressed in mathematical terms. Laws do not deliver mechanisms, and often indicate places that are ripe for hypotheses and theories to be formed that would explain the regularity that a particular law reveals. Newton’s law of universal gravitation expressed a relationship in physics that has several current theories that are attempts to provide a mechanism that would explain that relationship, none of which has achieved general acceptance in the scientific community.
- Evolution critics are censored (Ken Mercer) [CA320]
- *Polystrate fossils/Lompoc whale (Gail Lowe) [CC331, CC335]
- Science changes (Steve Smith) [CA250]
- Paradigm shifts (Steve Smith)
- This one doesn’t have an entry in the Index. I’ll bug Mark Isaak about this.
- Intermediate fossils between species are missing (Steve Smith) [CC200, CC202]
- Monkey DNA code only leads to monkeys (Steve Smith) [CA640]
- Censorship! Expelled! (Steve Smith) [CA320]
Board member Cargill complimented Smith on ‘sticking to the science’ and specifically endorsed his Gish Gallop as being the sort of “weaknesses” that the board is promoting. This will make an excellent “smoking gun” at any trial that arises in Texas.
- Darwin’s ideas are a sacred idea for scientists (Tom Lancaster) [CA610, CA611, CA612]
- Phillip Skell skepticism (Tom Lancaster) [CA215]
- Sagan said life evolving is improbable! (Board member Lowe(sp?)) [Search on 'Sagan']
- Cambrian explosion (Hannah Weissgerber ["D" 0:30]) [CC300, CC301]
- Miller-Urey experiment (Hannah Weissgerber ["D" 0:30]) [CB035
- Evolution has no effect on medicine (Hannah Weissgerber) [CA215, Relevance of evolution: medicine]
- Ms. Weissgerber expresses absolutely standard religious antievolution arguments and demonstrates her ignorance of her chosen field of study all at once.
- “Origins science” has no effect on science study (Hannah Weissgerber) [CA221, CA230]
- Theory is not a total and complete fact (Hannah Weissgerber) [CA042]
- (D 1:57) Have you ever discussed or studied Borel’s law of probability? (Board member Lowell questioning Sam Scorpino) [Borel's law FAQ]
- [In a book about probability for the lay audience, Emile Borel proposed a rule of thumb that events less likely than 1e-50 never happens. This has been seized upon by the antievolution movement as "Borel's law". Outside of the antievolution movement, Borel's conjecture is essentially a footnote in the history of the study of probability. Thus, Scorpino was probably somewhat taken aback by Lowell asking him about "Borel's law", since unless you have a thing for history of probability or the antievolution literature, you are very unlikely to even have heard of it. It certainly makes Board Member Lowell look like a poseur for trying to appear erudite with her pompous question. I seriously doubt that Lowell herself could do more than parrot the usual antievolution drivel about improbability if questioned about the topic.]
- Pure censorship in the classroom, denying free speech and academic freedom (Jonathan Saenz, Director of Legal Affairs, Free Market Foundation)
- No lawsuit in twenty years. Quotes Edwards decision, can teach scientific criticisms. Lawsuit talk is intimidation. TFN study “A bio prof at Texas A&M said, ‘”Strengths and weaknesses” exist in any scientific theory or paradigm. Scientific skepticism and challenging is central to how science gets done.’. That’s their own report.”
[Fails to fully quote the passage: "Strengths and weaknesses" exist in any scientific theory or paradigm. Scientific skepticism and challenging is central to how science gets done. But this component of scientific methodology is being exploited by the creationists/ID types to attempt to insert their ideas into the curriculum. These attempts are not being done in the professional scientific realm, where they are supposed to be done, but in the political realm, so their approach is a distortion of how science reaches a consensus of understanding. I don’t hear calls for discussion of the "strengths and weaknesses" of quantum theory, or gravitational cosmology.]
Dunbar: If a valid constitutional attack was available, there would be no financial impediment.
Saenz: Policy could not be challenged on its face.
Saenz: About out of state experts: Darwin was from England and Einstein was from Germany.
Saenz: How many of these professors did not respond? Implies non-respondents did not respond due to fear of reprisal. Board member explicitly says that.
Saenz: Elitism and fanaticism in opponents.
Ken Mercer: Points out Saenz’ quote mine of the TFN report. But reiterates that policy has been there 20 years.
Saenz: This is all about science, not religion. They want to ban students from hearing half of what goes on.
Board member notes TFN is there, could they speak to this? McLeroy: No.
- Strengths and weaknesses doesn’t originate with the Discovery Institute (McLeroy responding to Terri Burke)
- [Terri Burke missed a trick here, since "strengths and weaknesses" is used by the Discovery Institute, and the DI's use certainly may inspire people to take up antievolution. The origin of the term is a digression, as Burke's original statement wasn't about its origin, but its use.]
Terri Leo says the Kitzmiller case had nothing to do with the teaching “intelligent design”.
Dunbar: Information pertaining to evolutionary theory better determined by courts or by scientists working in labs?
I’ll expand on these later as I get time.
I get the feeling that there were a lot more of these moldy oldies spouted during the proceedings. Does someone have a recording they can point me to? [I've gotten the recordings and, yes, there's a whole pile of reeking moldy oldies that weren't liveblogged.]
* Hat tip to Nick Matzke. Missed that on the skim.<= get_option(\'vc_tag\') ?>> = get_option(\'vc_text_before\') ?> 13359 = get_option(\'vc_human_count_text_many\') ?> = get_option(\'vc_preposition\') ?> 5405 = get_option(\'vc_human_viewers_text_many\') ?> = get_option(\'vc_tag\') ?>>
Medical Wesley R. Elsberry on 17 Sep 2008
Given the comment on my earlier thread pointing out a surgical alternative to use of CPAP machinery, I’ve been doing some looking into treatment of obstructive airway syndrome (OAS). This evening, I came across another alternative, oral appliances (OAs). These are structures applied in the mouth that are supposed to provide an open airway mechanically, but without the need for a power supply, as CPAP devices require. OAs apparently don’t have as much research behind them as either CPAP or surgery, but it’s a good thing to have some acquaintance with the options before spending one’s limited time in conference with one’s physician. That way, discussion can move on to more substantive issues related to personal treatment rather than being taken up with the physician giving tutorial information about methods.<= get_option(\'vc_tag\') ?>> = get_option(\'vc_text_before\') ?> 11540 = get_option(\'vc_human_count_text_many\') ?> = get_option(\'vc_preposition\') ?> 3739 = get_option(\'vc_human_viewers_text_many\') ?> = get_option(\'vc_tag\') ?>>
Medical Wesley R. Elsberry on 15 Sep 2008
I shared a room with a colleague at the GECCO 2008 conference, and my snoring disturbed him. I brought this up with my primary care physician, who set me up to take a sleep study. This isn’t a new thing; I was experiencing daytime sleepiness back in high school, where my Spanish teacher was confounded by my frequent naps in class despite doing well on homework and tests (and that despite the rotating class schedule so that classes met at different times of the day through the term).
I arrived at the Sleep Center the evening of my study and was escorted to a room. The room was a fairly basic affair, much like your standard mid-America motel room: bed, end tables, dresser, TV, private bath (shower only, no tub). It had some other amenities not usually found (or not usually noticed) in your standard motel room: continuous positive airway pressure (CPAP) gear, IR camera, and various bits of data acquisition setup.
They had me watch a videotape that gave a little explanation of sleep study procedures and a lot of promotional information about a brand of CPAP apparatus. The assumption throughout was that patients would have obstructive airway syndrome (OAS) treatable with mechanical aids, to wit, a CPAP machine or one of the close variants with somewhat more capability.
But first things first… there needed to be a diagnosis. And for that, I needed to be rigged up with a variety of monitoring equipment. In order to assess what sort of stage of sleep I might be in and for neurological data, my nurse hooked up about eight leads for an electroencephalogram (EEG). They also wanted to see cardiac response, so I needed three more leads for an electrocardiogram (EKG). Because poor sleep states often involve excessive leg movement, I needed two leads on each leg for electromyography (EMG). Also, stress that is involved in some sleep deprivation is manifested in teeth clenching or temporo-mandibular joint (TMJ) tension, so I needed another six lines or so of EMG on my face. Pressure sensors at the nostrils would pick up nose versus mouth breathing. Two strain gauges on bands around my abdomen and chest would help monitor respiratory effort, an essential part of distinguishing OAS from central neural system causes of sleep disorders. And, last but not least, a pulse oxymetry device was installed on my right index finger. It took about fifteen minutes to get me tricked out in all the data collection lines. An illustration might help:
OK, after all that, I was supposed to get to sleep. Usually, I don’t have difficulty getting to sleep, even under otherwise challenging conditions. But I did have trouble that night. I also have issues with the aftermath of having had a colectomy. I usually am up once in the middle of the night to make a bathroom trip. That night, I was up twice for that purpose. I recalled awaking four times; I’m not sure how many times the instruments called it. I also recalled about four distinct periods of dreaming; again, I don’t have the details on how much REM sleep I was recorded having. So in the morning, another nurse came in to remove the various leads, leaving me looking ill-used:
I took advantage of the shower and then got out of there.
A few days ago, I got a call from the Sleep Center wanting to schedule my second visit. I hadn’t heard from my primary care physician, but apparently she had ordered the second round. I called in to find out what was up. Apparently, I do have a diagnosis of OAS, with observed episodes of sleep apnea and hypopnea, with my O2 saturation going down to 83% at one point. The second study will hook me up to CPAP and do a titration to figure out just how much pressure is needed to keep my airway open during the night.
I’m joining a common club. According to a survey, about 24% of men in the USA have some form of OAS, and 9% of women. Middle-aged men are more prone to OAS. OAS also has implications beyond the direct sleep-disorder thing: increased risks of heart disease, hypertension, arrhythmias, diabetes, obesity, and erectile dysfunction. Fortunately, I don’t have the laundry list of effects, but arrhythmia is among the things I have manifested. As far as I recall, my previous healthcare team working on what they called idiopathic atrial fibrillation events did not assess me for possible OAS as a contributing factor.
According to the promotional video, many of the people getting treatment for OAS find that a number of quality-of-life issues improve. I’m looking forward to seeing if I get any of those benefits myself.<= get_option(\'vc_tag\') ?>> = get_option(\'vc_text_before\') ?> 13407 = get_option(\'vc_human_count_text_many\') ?> = get_option(\'vc_preposition\') ?> 4629 = get_option(\'vc_human_viewers_text_many\') ?> = get_option(\'vc_tag\') ?>>
This New York Times article talks about a modern work hazard, the stress of blogging for pay. Apparently, a couple of high-profile technology bloggers have kicked the bucket in an untimely fashion. One of them left an email that may stand as his last words: “Have come down with something. Resting now posts to resume later today or tomorrow.” If that were true, it would be a truly astounding technical feat.
While I’m not in the particular always-on rat race described in the article, I can say that having a research position does offer some of the same potential causes of stress. There is the concern that time is passing, and there is always more to do. I’m not putting myself in the reduced sleep-cycle hole that some of the bloggers described in the article do in order to steal a few minutes’ march on the competition. But I have to admit that over the past year, I have often skipped trying to add content here on my blog in order to have more time for the research.
I would be interested, I think, in finding out more about blogging for pay. I don’t think the bleeding-edge news story angle is for me, but I think I could do something in the way of higher-quality considered analysis of various things ranging from technology through media and politics. If you are looking for that sort of person, you know where to find me.<= get_option(\'vc_tag\') ?>> = get_option(\'vc_text_before\') ?> 5481 = get_option(\'vc_human_count_text_many\') ?> = get_option(\'vc_preposition\') ?> 2198 = get_option(\'vc_human_viewers_text_many\') ?> = get_option(\'vc_tag\') ?>>
Diane had it, and it looked like a misery. Rob, my boss, has it now, and he certainly doesn’t look comfortable. I got a flu shot a couple of weeks ago, and until last night I had no symptoms. But within the space of a couple of hours, I went from nothing to severe shivering coupled with muscle and joint pains.
The clinic said they had a treatment to help shorten the course of this stuff, so I need to drag myself to the clinic today.<= get_option(\'vc_tag\') ?>> = get_option(\'vc_text_before\') ?> 13454 = get_option(\'vc_human_count_text_many\') ?> = get_option(\'vc_preposition\') ?> 3827 = get_option(\'vc_human_viewers_text_many\') ?> = get_option(\'vc_tag\') ?>>
The proposed science standards for Florida are different from the old standards. One way in which they differ is that the word “evolution” appears in the proposed standards. There were four previous public meetings for comment on the proposed standards, including one in Orlando.
Well, now there is a media advisory out that just one more meeting is being held for public comment. It’s this next Monday, the 11th. It is being held in the daytime, and the state board of education will be watching the proceedings via webcast or by video recording. I believe that this is the only meeting that has had that sort of guaranteed direct linkage to the board. The decision on adoption will be taken in a meeting on the 19th, at which the public cannot speak.
I have some qualms about the way this came up and was organized and executed. If one were looking for a way to minimize the input of teachers and educators from colleges and universities, I could hardly pick a better time than to hold a meeting at midday on a school day. The other meetings were evening meetings. The location is essentially at the Orlando airport. Will there be out-of-state folks dropping in on the proceedings, and how much advance notice might they have gotten to schedule flights if so?
Needless to say, it is vitally important that the board of education receive a clear message from those interested in advancing the state of science education this coming Monday. If this specially convened forum is conceded to the antievolution movement, it is likely to contribute to years of continued poor science education. Please do not let the antievolution movement appear to take the final public word on the issue. Show up and let them know where you stand on this. Don’t just ask to take off from work; convince your boss to go with you.
If you absolutely cannot make the meeting, please do go, right now, and sign the online petition supporting the proposed science standards. Joe Wolf of Florida Citizens for Science is planning to present the list of signers to the petition at Monday’s meeting, so help give him a longer list to deliver.
Now, about the meeting:
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February 6, 2008
Final Public Hearing on Proposed Science Standards to be Held in Orlando
In addition to the four public hearings previously held, the Department of Education on Monday will hold one final public hearing for Rule 6A-1.09401, Student Performance Standards – Science. Attending the hearing will be Education Commissioner Eric J. Smith, K-12 Public Schools Chancellor Frances Haithcock and Florida’s Office of Math and Science Executive Director Mary Jane Tappen.
Any individuals wishing to address the State Board of Education regarding the proposed science standards are invited to speak at the hearing. Speakers will be allotted three minutes each. State Board of Education members will view the hearing via live Web cast or will be presented with a video recording of the entire meeting. The State Board of Education will consider the proposed science standards at the February 19 board meeting. Time at this meeting will be reserved for board member deliberation only.
A presentation will be made at the beginning of the hearing regarding the process used to develop world-class science standards, including access points for students with disabilities.
The final public hearing for the proposed science standards will take place:
Monday, February 11, 2008
10 a.m. to 3:30 p.m.
Orlando International Airport
9000 Airport Boulevard
To view the hearing via live Web cast, go to www.fldoe.org.
At the University of South Florida, Professor Jay Dean has equipment that synthesizes two exotic technologies in order to examine something very basic indeed: how oxygen interacts with tissues. The two technological bits are a hyperbaric chamber and an atomic force microscope (AFM). This allows Dean and his colleagues to examine, at an exceedingly small scale, what happens when tissue is exposed to oxygen at a variety of partial pressures. The Office of Naval Research is interested; according to the article, the occasionally fatal seizures that divers using rebreathers experience is a major cause of concern.
Hat tip to Sam Blackwood for the link.<= get_option(\'vc_tag\') ?>> = get_option(\'vc_text_before\') ?> 9219 = get_option(\'vc_human_count_text_many\') ?> = get_option(\'vc_preposition\') ?> 3084 = get_option(\'vc_human_viewers_text_many\') ?> = get_option(\'vc_tag\') ?>>
Medical Wesley R. Elsberry on 15 Jun 2007
It’s been a while since I discussed what’s up with my medical condition. That’s actually been good news. I’ve been doing pretty well, with a good deal less pain than when I still had my colon.
But because I no longer have that large intestine, there are some things that become a matter of maintenance for me that other folks don’t have to worry about. I’m currently on two medications, Imodium and Lomotil (actually generics for each), which slows down my gut motility, giving the small intestine some time to absorb some of the nutrients that would otherwise simply pass through my system. It also means that with those two medications I can be spared the caustic effects of base chemistry, which if things were left to themselves I’d have some pretty immediate problems with. The prescription directions have been the same since just after my second surgery: 1-2 tablets taken with meals and at bedtime. That’s for each of those medications.
In California, Kaiser Permanente’s system simply set me up with getting 3 months worth of medications at a time, so I would get 500 pills per 3 month period. That worked out OK.
Here in Michigan, things are not quite worked out. I haven’t yet had my introductory visit with my primary care physician here, but I’ve needed refills on the maintenance medications. I’m having some difficulties getting the clinic and pharmacy on the right page. While a physician did set me up with the same prescription directions, what the pharmacy actually delivered for one month’s worth of medication was 60 pills of each drug. That was about 8 days worth of medication.
I managed to talk to the clinic, and they put in another prescription order. This time, the pharmacy delivered 120 pills each. Now, the way I calculate that out, I basically cannot plan to take more than one pill at each indicated time; there simply aren’t enough pills in my month’s allotment to actually take 2 tablets each at each meal and at bedtime. And generally I do take 2 tablets each when I take them. I don’t always have three meals a day, but I often do, so this is putting me behind the curve. Like I mentioned before, if I don’t manage to keep my gut somewhat slowed down, I do end up with a painful situation.
When I brought up this issue with my pharmacist, there were two arguments he gave for why they only gave a fraction of the pills needed to actually meet the demands of my prescription directions: they didn’t think I needed that much medication, and the specific number of pills is provided by the prescriber, so I should take it up with them.
Now, every time I get a partial prescription, I’m still getting hit with a full month’s prescription copay charge. So this nickel-and-diming is having a distinct negative effect on my finances, not to mention any adverse effects I may run into if I run out of meds before I can get an order filled that actually provides the medication I need at the rate I’m supposed to take it. I’m hoping that I can work this out when I talk to my primary care physician early in July.
So, if there are some health care pros tuning in who can shed light on why I’m suddenly running into difficulty getting my medications here in Michigan, I’d like to hear about it.<= get_option(\'vc_tag\') ?>> = get_option(\'vc_text_before\') ?> 10082 = get_option(\'vc_human_count_text_many\') ?> = get_option(\'vc_preposition\') ?> 3165 = get_option(\'vc_human_viewers_text_many\') ?> = get_option(\'vc_tag\') ?>>
If this news report and the research behind it are accurate, this is a huge story. A tip of the hat to Steve Story, who dropped this link to me in email. I’d say it is comparable to to discovery that most stomach ulcers are due to bacterial infection and not simply stress, except in the other direction. The disease being researched was diabetes, the subject species was mice, and the result was that turning off pancreatic sensory nerves reversed Type I diabetes in mice.
Let that sink in for a moment.
The implication is that Type I diabetes could primarily be caused by a problem in neurology, not simply an auto-immune problem as has been assumed by most physicians. It also opens up possibilities for treatment that go way beyond the current standard of care, insulin replacement therapy.
Of course, there are a lot of steps to be taken, like doing the tests on humans and working up clinical trials for treatments. Even if the research holds up to scrutiny, it will take years before a treatment based upon this new information could become available.
It will not be a surprise, though, if the research does not pan out. In science, there are far more ideas that don’t work than ideas that do. While the process of discovering error is nowhere near foolproof in science, it nonetheless does so reliably enough to cause a strong majority of the population to trust scientists and the work they do highly.<= get_option(\'vc_tag\') ?>> = get_option(\'vc_text_before\') ?> 7796 = get_option(\'vc_human_count_text_many\') ?> = get_option(\'vc_preposition\') ?> 2551 = get_option(\'vc_human_viewers_text_many\') ?> = get_option(\'vc_tag\') ?>>
I am really happy to be around for this Thanksgiving. Two years ago I was recovering from major surgery and wondering what life would be like in my future.
Today, we started things off with a visit to a horse ranch in Jamul where Andrea has obtained permission to take the hawks out to try to make a dent in the rabbit population there. We got there about 6:15 AM and the fog was still pretty thick. Between us, we had four Harris’s hawks and three dogs in the field. I think we saw about a dozen rabbits get chased. It must have really been Rabbit Thanksgiving, though, because nobody caught anything, which certainly surprised us.
We then went off to Chula Vista where Andrea boards her horses. A horse Andrea was leading to an exercise ring became uncontrollable and took about five minutes to run around and calm down enough to be caught again. A far more mellow horse of Andrea’s provided a mount for Diane and I to take a short trail ride. Fortunately, we did it all at a walk and there were no nasty surprises along the way.
That, though, did pretty much exhaust me. My stamina is pretty much the one thing that looks to be permanently lowered post-surgery. I had a bit of a nap.
I headed over to Mark’s place around 4 PM for Thanksgiving dinner. Mark went all out in putting together the traditional feast with turkey, gravy, stuffing, bread, and a dessert. Yams were unavailable, so he substituted a batch of sliced carrots cooked in brandy and topped with marshmallows. Brilliant. We made a small dent in the food, then watched a bit of “Ancient Relic”, a German film featuring time travel. Once the plotline became glaringly obvious, we switched over to “Timeline”, another and somewhat more challenging time-travel flick. We also viewed the “Soup Nazi” episode of “Seinfeld” and the “Inside View” documentary about how that episode came about. In that, it was revealed that the real-life soup chef whose character was the basis of the episode had gone off spectacularly on Jerry Seinfeld when Seinfeld insisted on visiting his establishment after the epsiode aired. it seems that not everyone agrees that any publicity is good publicity.
The big difference I’ve seen since my medical troubles back in 2004 is that I am mostly pain-free nowadays. It really makes a difference not to be in some level of pain almost continually. And I am continually grateful to the folks who have gone out of their way to make a place for me in their lives.<= get_option(\'vc_tag\') ?>> = get_option(\'vc_text_before\') ?> 9691 = get_option(\'vc_human_count_text_many\') ?> = get_option(\'vc_preposition\') ?> 3063 = get_option(\'vc_human_viewers_text_many\') ?> = get_option(\'vc_tag\') ?>>
The New York Times reports on a cheap new device to help people get good drinking water in places where clean water simply isn’t available.
The invention is called Lifestraw, a plastic tube with seven filters: graduated meshes with holes as fine as 6 microns (a human hair is 50 to 100 microns), followed by resin impregnated with iodine and another of activated carbon. It can be worn around the neck and lasts a year.
Lifestraw isnâ€™t perfect, but it filters out at least 99.99 percent of many parasites and bacteria, the demons in most fatal cases of diarrhea.
Vestergaard Frandsen, a Danish company, has invented this device, which costs about $3 per unit, as well as various other items aimed at parasite control in the developing world. The article notes that about 100,000 of the LifeStraws have been distributed so far.
It also notes that the device is ineffective against viruses and the parasite Giardia, which makes its use for US hikers, campers, and hunters not quite as appealing as it might otherwise be. If there were a version that could be used to pre-treat water that could then be hit with one of the Giardia treatments available, it might sell here in the US. A premium price here could help subsidize distribution to developing countries.<= get_option(\'vc_tag\') ?>> = get_option(\'vc_text_before\') ?> 10959 = get_option(\'vc_human_count_text_many\') ?> = get_option(\'vc_preposition\') ?> 3616 = get_option(\'vc_human_viewers_text_many\') ?> = get_option(\'vc_tag\') ?>>
The two press releases linked above report work with broad claims for the control of disease.
The first discusses the production of a bacterial plasmid that undergoes lethal runaway self-replication. The researcher also has developed a bacterial host organism for the plasmid, such that the benign host is able to suppress the runaway self-replication. Bacteria with which it conjugates and transfers the new plasmid to do not receive the suppression property, and thus are killed by the new plasmid. It sounds to me like this technology will likely require specific targetting of disease agents, since the generality of each host will be limited by how picky the actual disease agent is in recognizing other bacteria for conjugation. The press release doesn’t give details about how the suppression of the plasmid is accomplished, so it isn’t clear that this property would always remain safely behind in the host organism. Nor is it clear that the obvious optimism of the researchers that the suppression property is unevolvable in disease organisms is well-founded. Another thing to consider is whether in conjugation, the host organism could be made virulent by what it receives from a disease agent. It is possible that answers to these concerns have already been made, but were not communicated in the press release.
The second discusses a broad treatment antiviral agent against influenza viruses, one that blocks the virus from entering cells in its host. The agent in this case is a peptide. The researchers noted 100% protection against infection with various influenza, including the H5N1 viruses (aka “bird flu”). As an “entry blocker”, the new agent differs from vaccines, which prepare the immune system to mount an effective response on infection with a pathogen. A note at the end of the article speculates that it might be possible to generate vaccine-like action with this entry blocker, if the entry blocker could be tuned to block only most instead of all viruses from entry to cells. The idea here is that the patient would get enough viral load to trigger an immune response, but not so much as to make them more than mildly sick. Vaccine production currently requires quite a lot of work to produce a specific vaccine, and given the rapid evolution observed in influenza, by the time a vaccine is produced, the disease agent in the wild may be considerably different, reducing the effectiveness of the vaccine. Being able to produce vaccine-like action on a short time scale and with a cheaper process could help considerably with response to emerging viral disease agents.<= get_option(\'vc_tag\') ?>> = get_option(\'vc_text_before\') ?> 10224 = get_option(\'vc_human_count_text_many\') ?> = get_option(\'vc_preposition\') ?> 3392 = get_option(\'vc_human_viewers_text_many\') ?> = get_option(\'vc_tag\') ?>>
The research study finds that fully differentiated cells are actually better for the purpose of cloning than adult stem cells. They worked with mice in this study, and one of the things to note about it was that they did a lot of within-study replication.
Surprisingly, the granulocytes were the most efficient donor cells for nuclear transfer among the different lineage cells, with 35 to 39 percent becoming a blastocyst, an early embryo consisting of about 100 to 150 cells, compared to 11 percent for the progenitor cells and only 4 percent for the stem cells. Only the granulocytes were able to produce two live cloned pups, although both died within a few hours of birth. As a control, the researchers performed nuclear transfer using embryonic stem cells; 49 percent developed to the blastocyst stage and 18 cloned pups were born.
This doesn’t look like any dramatic advance, but it does raise some questions about the efficiency of some methods that are currently used in cloning studies.<= get_option(\'vc_tag\') ?>> = get_option(\'vc_text_before\') ?> 5009 = get_option(\'vc_human_count_text_many\') ?> = get_option(\'vc_preposition\') ?> 2039 = get_option(\'vc_human_viewers_text_many\') ?> = get_option(\'vc_tag\') ?>>
The linked article describes research where cultures of nerve cells show apoptosis – a programmed cell death process – when high concentrations of testosterone are present. The link to human medicine is that treatment with testosterone or other steroids may reach concentrations that trigger apoptosis in the human brain. This could explain the various neurological and behavioral changes noted in steroid abusers, like “hyperexcitability, a highly aggressive nature, and suicidal tendencies”.
The testosterone-induced apoptosis described in this study occurs through overactivation of intracellular Ca2+ signaling pathways. Overstimulation of the apoptotic program in neurons has been associated with several neurological illnesses, such as Alzheimer disease and Huntington disease.
So, when someone mentions “testosterone poisoning”, it’s not just a funny saying anymore.<= get_option(\'vc_tag\') ?>> = get_option(\'vc_text_before\') ?> 7957 = get_option(\'vc_human_count_text_many\') ?> = get_option(\'vc_preposition\') ?> 2679 = get_option(\'vc_human_viewers_text_many\') ?> = get_option(\'vc_tag\') ?>>
This morning, Glenn Branch IM’d me a link to the following blog post:
Jake Young follows a quote from the original article with the following:
Crazy town. We should have more programs in animal prosthetics — because animal disability is no laughing matter.
Hmmm. While dolphin tail prosthetics may not have great potential for follow-ons in human biomedical treatment, rather a lot of biomedical progress and medical advances have occurred due to animal models. It seems to me that researchers choosing to work with animals are damned if they do it for the animal’s benefit directly (working on animals is a trivial waste of valuable research time!) and damned if they don’t do it for the animal’s benefit directly (using animals just to help out humans is evil!).
There’s not much that I can see to do about the first; either people get it or they don’t. For the second, though, there is an organization that helps people become aware of the benefits of animal models, the Foundation for Biomedical Research (FBR). Visit their site, consider joining up.
I sure hope that the researchers in Florida do manage to come up with a useful prosthetic. It isn’t a waste of time.<= get_option(\'vc_tag\') ?>> = get_option(\'vc_text_before\') ?> 8115 = get_option(\'vc_human_count_text_many\') ?> = get_option(\'vc_preposition\') ?> 2858 = get_option(\'vc_human_viewers_text_many\') ?> = get_option(\'vc_tag\') ?>>
I’ve been under the weather, which accounts for the paucity of posts here. Yes, I know, I was really under the weather when I started this weblog.
In any case, I started feeling some scratchiness in my throat last week. I started taking some zinc lozenges, which seemed to help with the symptoms at least. I made it through my workshop presentation last week and my sermon at the UU church in Walnut Creek this past Sunday all right. Monday, I could hardly talk at all. This is not a good thing for a guy whose scoutmaster used to call him “Motormouth”.
Things aren’t quite so bad today. We’ll see how things shape up for the weekend. If I’m still scratchy, I’m thinking Friday will be a good day to visit my primary care physician.<= get_option(\'vc_tag\') ?>> = get_option(\'vc_text_before\') ?> 8336 = get_option(\'vc_human_count_text_many\') ?> = get_option(\'vc_preposition\') ?> 2968 = get_option(\'vc_human_viewers_text_many\') ?> = get_option(\'vc_tag\') ?>>
Back when I was in the hospital in 2004, one thing that helped my state of mind was getting online via dial-up to the Internet. I could do email, surf the web, do instant messaging, and generally keep in touch with reality outside the hospital room. Late in my first stay, an administrative type came by and had a cow over the fact that I had a laptop computer plugged into a power outlet, and also that I had hooked up to the phone line. Neither was allowed, she said.
Let me tell you that the time I spent in the hospital when I couldn’t use my laptop, not for Internet acces, not for DVD-playing, not for any personal data project, was pretty depressing.
Now, some of that could just be me. I haven’t heard of anyone else offhand who set up their weblog in recovery within a couple of days of major surgery. But I’m thinking that perhaps there might be some value to making Internet access available to patients stuck in hospital. There could even be some intra-hospital application, as if there were an instant-messaging-like interface to the nurses’ station, I could have simply typed in what sort of thing was up. Messages to the patient could remind them to get up and walk at intervals.
But I think that investigating the value of providing computer access, and especially Internet access, to hospital patients should be pursued. So, if anybody out there is an M.D. or hospital adminstrator who sees some possibilities there, I would be happy to help in discussing the topic and perhaps collaborating on it.<= get_option(\'vc_tag\') ?>> = get_option(\'vc_text_before\') ?> 9700 = get_option(\'vc_human_count_text_many\') ?> = get_option(\'vc_preposition\') ?> 3590 = get_option(\'vc_human_viewers_text_many\') ?> = get_option(\'vc_tag\') ?>>
I’m six foot three inches tall. In 2002 and 2003, I had two instances of idiopathic atrial fibrillation. That last just means that the contractions of the atrial chambers of my heart got out of sync with the rest, and “idiopathic” means that they couldn’t figure out why that happened.
The first time was during a bad flare-up of the ulcerative colitis. My gastroenterologist did about three minutes of colonoscopy and declared me sick. I don’t think he believed me or my medical history until he saw for himself. I was really in a state, because I not only had the ulcerative colitis, but also had a Clostridium difficile infection on top of that. So I went from the usual maintenance drugs for colitis to higher doses of those, a strong antibiotic to deal with the C. difficile, and my first course of steroids, a high daily dose of prednisone. It was after a couple of weeks of that regimen that I was going about collecting the full list of side effects that they warn of in the prednisone patient data sheet (elevated heart rate, sleeplessness, water retention in the feet and lower legs, irritability, paranoia… I swore that if I discovered a “change in menstrual cycle” I was going off the stuff) that I got the first incident of atrial fibrillation. My heart rate went up to about 130 beats per minute and I felt woozy. We went into the emergency room, and after a few hours, they gave me some medication to convert me back to normal rhythm. After about twenty minutes, I synced up again, and my heart rate dropped to the prednisone “normal” of about 90 beats per minute. After that, they gave me a heart rate monitor that I wore for a day, to try to catch any short-term irregularities that would indicate the sort of problems that they knew about treating. Nothing happened. They did an echocardiogram, which showed only a small amount of mitral valve prolapse. Take an antibiotic before procedures like dental work, they said. But otherwise there was nothing that they knew to do about it, except to take a daily dose of aspirin to “thin” the blood a little, making it less likely that I should throw a clot if I were fibrillating and not aware of the fact for more than 24 hours or so.
The second incident was in 2003. Diane and I visited with our friend Janice B. in Albuquerque on the way back from my dissertation defense at Texas A&M. In the morning, we had stopped by a fast-food place and gotten a great big Coca-Cola soft drink for sipping as we drove there. We had dinner, then Janice took us to ride the tram to the observation platform near the peak of Sandia Mountain. As the doors on the tram were closing, I felt my heart doing something different. I told Diane and Janice that I was having another atrial fibrillation episode, then had a lie-down on the floor of the tram as we had about a fifteen minute ride up. It was another thirty minutes before the next tram went down. On the car ride back to Janice’s place, I converted back to normal rhythm on my own. When we got back home, I had another couple of rounds with the monitor, but nothing further was found. I have stayed away from caffeine since that incident, though. Later, my sister told me that, yes, she has that, too, and she’s known to avoid caffeine for years now.
So today I’m looking at ScienceDaily and find an article there titled, “Taller People More Likely To Develop Atrial Fibrillation”. A study at Emory University found that risk of atrial fibrillation increased with increasing height.
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Analysis of data from a registry of patients with left ventricular dysfunction indicates that height is an independent risk factor for an arrhythmia of the upper chambers of the heart, according to a new study in the April 18, 2006, issue of the Journal of the American College of Cardiology.
“Tall stature is a potent risk for the development of atrial fibrillation and is independent of other clinical risk factors. Indeed, the male predominance of atrial fibrillation appears to be explained by the difference in height between men and women,” said Jonathan J. Langberg, M.D. from Emory University in Atlanta, Georgia.
Atrial fibrillation is the most common sustained cardiac arrhythmia. During an episode, the upper chambers of the heart flutter instead of pumping blood effectively. The incidence increases as people age, with a prevalence of more than 5 percent in patients over the age of 65 years.
“Tall patients may need more aggressive attempts to attenuate risk factors. Controlled trials should evaluate stature in treatment and control arms,” Dr. Langberg said.
“Although the paper supports previous evidence of a relationship between atrial size and atrial fibrillation, there is no therapeutically applicable outcome from the study, because you can’t alter your height as a risk factor for atrial fibrillation!” Prof. Feneley said.