Wednesday, April 22, 2009

TIA?

Wednesday, March 11, 2009

TIA

I think it was a Transient Ischemic Attack, known in the doctoring trade as a TIA. Whatever it was, it was one of the damnedest experiences I've ever had, with or without the influences of strange medical, commercial, or recreational drugs. It only lasted about twenty minutes, which was long enough, and I do not care to repeat the experience.

There isn't any residual effect as far as I can tell. I can remember my children's names, my address and phone number, and I can look on my wrist to see what day it is. (Wikipedia has an article about TIA.) The experience, for me, was almost entirely visual. I was working on Rene's computer when I lost the ability to look to the left of center, I would have to turn my head to look to the left. I checked, and it was the same with either eye closed. As it progressed, I became locked in, visually, on the close box in the upper right corner of a window. I couldn't look away at anything else for more than an instant, and then my focus snapped back to that little 'X' in the corner. Again, it was the same with either eye closed, which told me that something was probably occurring in the brain, not the eye or optic nerve.

During all this I was able to clearly describe the sensations I was experiencing to Rene'. About five minutes after it started, I was able to start moving my eyes off the little 'X' and look to the right of me. I realized I was sweating profusely and slipped off my jacket. Then Rene' suggested I go to the living room and sit in a reclining chair. I was light-headed, and there was a very loud but inaudible buzzing going on in my head, but I was able to stand and walk about 20' into the next room and sit down in a chair.

After sitting for a while I finally stopped sweating and my vision cleared up. I wasn't dead, and didn't feel like I was dying, so I got up, went out to my car, and drove home. That was a mistake. I didn't run over any dogs or children, but my wife was not happy with me. She thought I should have called her to pick me up. Hell, I figured out I was invincible when I was a teenager, so there was nothing to worry about.

After much insistence by my spouse, I ended up in the emergency room about ten hours after the attack. Becky, the nurse who took care of me there, looked a lot like Julia Roberts, only younger, so it wasn't a bad experience at all. The doc, though, decided I needed to stay in the hospital for a few days. While there I was poked, prodded, scanned, and screwed around, but nothing particularly painful was done.

The main problem was the food. I would rather eat stewed possum than most hospital food. No salt, no fats, and all vegetables boiled for at least an hour before being well cooled and served. Red beans and brown rice would have been a lot more edible.

The admission process was very interesting, especially the part where they tried to compile a list of my current medications. I keep a spreadsheet with my current meds on www.GeezerNet.com. Anybody should have been able to fire up their web browser, point it at GeezerNet, enter the username and password I give them, and navigate straight to my current medications page.

I run GeezerNet, both .com and .US, on a very old server I own that sits in a laundry room in the back of an old building next to the library in Oskaloosa. It is not an ideal setting for a server, nor is the server reliable. The general unreliability of the whole setup became apparent when I went into the hospital, and discovered that www.GeezerNet.com was not available.

With no written record of my current medications available, it was Friday evening and both my primary physician's office and the cardiologist's officer were closed, nor could the ER at Lawrence memorial search access the data sets except by a telephone request from human to human, so it became their duty to somehow extract from me a complete and accurate list of my current medications. Remember, I'm in there because something went wrong in my brain.

The staff was courteous, pleasant, and professional, and I estimated that the average cost for their time was about $150 per hour (that is cost, not pay rate). If that is a valid assumption, then the approximately 90 minutes spent by three nurses, two pharmacists, and two physicians in determining my current medications, cost all of us $225. That $225 never appears on any bill or report, because it is just ordinary overhead, so it is never noticed as an incredible waste of money.

GeezerNet could be hosted on a commercial hosting site for less than $60 per year, so I could have had it in a secure and reliable environment for three years for less money than it cost the health care system to find my current medications. If I couldn't have given them the password to my health records, the primary care physician I see has it, and so does my wife, who was with me.

There is no reason I can see, other than mass organizational myopia, for the records of the hospital, the physicians' offices, and the pharmacies, to not be available to each other and the ER of every hospital. Our health care system does not have a IT infrastructure. By clinging to the same narrow visions of information technology that characterized the decline of the mainframe computer, the health care system has severely inhibited it's ability to develop an information infrastructure. And that is costing all of us money that doesn't need to be spent.

And that was what I was thinking about most of the time I was in the hospital, being examined because something went wrong in my brain.

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Massive Learning Attack

At about age 25 we undergo a process called myelization, during which we grow a protective layer around our neural dendrites. After that, they say, learning is achieved by pruning existing neural connections, not growing new ones. So, I figure that having a stroke, a process that achieves rapid pruning of a bunch of neural connections, could be considered as a massive learning attack, or MLA.
MLA's are tricky rascals. This last one did something to me, but I can't put my finger on exactly what has changed. I think there might be some small gross motor impairment of some sort, but I've always been clumsy. I may be lazier, but I've always been lazy.
It has given me the opportunity to spend a bit of time with some interesting new physicians, a Neurologist and a Vascular Surgeon. Physicians and dairy farmers are generally nuts, I think. Who wants to work that hard, that long, and that carefully? These two guys, the Neurologist and the Vascular Surgeon, seemed to be very bright, very competent physicians, which is generally the kind of people you want whether dealing with MLA or hemorrhoids.
As has been my experience throughout this excursion into the world of MLA patient, the new physicians do not have patient information systems capable of communicating with other systems. Mainframe mindset. Why do all those physicians and staff members put up with non-communicating systems? I might be experiencing a mild stroke, but I am not so vegetative I would put up with their systems.
I have started reading My Stroke of Insight by Jill Bolte Taylor, Ph.D., a neurophysiologist who had a massive stroke. I've seen her presentation on the Ted Talks, and was impressed at the time.

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Sunday, July 13, 2008

Farm News 07-13-08

Sunday morning, after chores,70°
Weight: 204 lbs.


Barn News
Suzette's six bunnies are very cute and cuddly.

Books
I've been a bit sickly for the past few weeks. Hopefully, it's over and I can start doing stuff, again, like writing for Farm News. Although I haven't been writing, I could read. The only notable books were Young Widow and The Adventures of Flash Jackson.

Carleton's Meadow by Lauran Paine
A readable western, available in large print.

The Road to San Jacinto by L. L. Foreman
Another readable western, available in large print.

The Outcast of Lazy S by Eli Colter
Yet another readable western, available in large print.

7th Heaven by James Patterson and Maxine Paetro
The seventh in his Women's Murder Club series. They're pretty good.

Plague Ship by Clive Cussler with Jack Du Brul
A reasonably good thriller, but it needed more careful proofing. Obvious errors, such as using 'opaque' for 'translucent', kept breaking the spell of the chase.

Young Widow by Cassandra Chan
Here is the first novel of a new series of English mysteries. It follows the formula: a Scotland Yard detective, his friend, a wealthy Englishman, a good dog, and a murder in a country house. I liked it a lot.

Lonely Trail by Jackson Gregory
A readable western, but only barely. The language and the characterizations are dated.

Fast Track by Ed Gorman
Another western, but I didn't care much for it.

The Adventures of Flash Jackson by William Kowalski
Anyone who has spent much time wandering in the woods while stoned on LSD will like this book, as will most other people. It's an excellent book and I recommend it highly.

Sunday, June 29, 2008

Farm News 06-29-08

Sunday morning, after chores,
Suzette's six bunnies opened their eyes this week.


I haven't written anything for this week. Laziness triumphs!

Sunday, June 22, 2008

Farm News 06-22-08

Sunday morning, long after chores, 80°
Weight: 208 lbs. Bah!

Barn News

Suzette has six bunnies, born a week ago last Saturday. They should have their eyes open in a day or two.
There are three goose eggs remaining in the incubator after the last candling session with Jesse. He takes the egg into a dark room and then presses a small flashlight against the shell on the side away from him. The light shines through the shell, showing the developing gosling as a shadow. Jesse is quite clever at candling, as this process is called, and I like being able to take out dead eggs before they start stinking.
Last Sunday we sent Dave off on the endless trip. About thirty family and friends gathered at the ranch to wish Dave, “Happy trails.” Several people talked about how nice he was, and he was a nice guy. No one mentioned it, but many people were pleased he had finally quit drinking. Dave was often a maudlin drunk, which became tiresome, but, like many alcoholics, when he wasn't drinking he was a great guy.
We had a new sideshow at the send-off gathering: Dave's ashes were parceled out into small, neatly made packages tied with rattan, each a bit larger than the size of a gift wrapped condom. People attending the gathering took home with them a packet of Dave's ashes. One packet of Dave's ashes will go to the Ware Cemetery at Ware's Grove, Illinois, to join him with many distant cousins. I'd like for the same thing to be done with my ashes, it seems to be a way to sort of 'spread yourself out' after death.

Linux

I've been using Linux for several years to run the GeezerNet.com web server, Geezer1.server. Geezer1.server is an aging Micron Pentium Pro box, upgraded with a modern motherboard and big hard drives. At the moment it sits quietly next to my desk, disconnected from both power and internet. When plugged in, it grinds and growls for a few minutes, and then springs into action, answering internet requests for the web sites www.GeezerNet.com and www.GeezerNet.US.
'Springing into action', in this case, means starting the operating system called Linux. Linux is completely independent of Microsoft Windows. Linux if free, open source, software. For the life of the internet, Linux has been the operating system for most servers, such as dear old Geezer1.server. There, it dispenses web pages and moves email around, operating for years without failures. It's pretty solid, technically, and very stolid in it's appearance.
Recently, Ubuntu 8.04 appeared. Ubuntu is a 'distribution' of Linux, whatever that means, but Ubuntu 8.04 is not stolid. It works, it's straightforward, and you don't have to leave Windows to install it. You can install it like any other program, and the next time you reboot your computer, you will have the choice of rebooting into either Ubuntu or Windows. Choose Ubuntu and your computer boots up Linux.
My primary word processor is Open Office Writer. I use it to write Farm News. Between the time when I wrote the above paragraph, and the time I am writing this paragraph, I rebooted my computer from Windows to Linux. When Linux had booted, I opened up my primary word processor, but the operating system underneath all this is now Linux. Then I went to the folder /host/, which is the same as C:\ in Windows. After fiddling around a bit I opened up this document, the same one I was working on in Windows, and wrote this paragraph.
The point is, Linux accommodates Windows nicely, and, in the cases of Open Office, Thunderbird, and FireFox, the same programs will run on both operating systems. Installing a Linux system is now within reach of non-techies. The most difficult part of the process is creating a CD that will then install Linux on your system. Send me an email if you want me to send you a CD that will install Linux.

Books

Resolution by Robert B. Parker

I like Parker's westerns. This one is a sequel to Appaloosa, which I also liked, continuing the discussion between the lead characters about the ethics of shooting people.

Nothing to Lose by Lee Child

The plot of this book was implausible, as was the setting: two towns in eastern Colorado named Hope and Despair. The action was okay, though, and I'd read another one of his books. He's not one of my favorite authors, even though his implausible settings are, nevertheless, biologically and celestially accurate, i.e., he does not find mesquite growing in Montana, or see a full moon rise after midnight.

Sunday, June 08, 2008

Farm News 06-08-08

Sunday morning, after chores, 80°

Weight: 204 – Two weeks in a row at 204!

I have been experiencing a major attack of laziness and not writing much. Next week I will be attending a memorial for Dave and there will be no Farm News. After that, I hope to become productive, again.

Barn News

This place is becoming overrun by cats. Shotgun is about to wean a litter of four, of which one already has a new home; two more cats are visibly pregnant; and Martha Minor is coming in heat. Kittens are great fun and I enjoy them, but I wish they would arrive one or two at a time instead of four to eight.

Several of the cats have taken to hiding below a low-hanging bird feeder and then leaping up to catch birds. The cats are seldom successful, but I moved the feeder up a couple of feet, anyway. The birds sing and dance for the dinners, which is more than the cats do.

Books

To Begin the World Anew by Bernard Bailyn

To Begin the World Anew, subtitled The Genius and Ambiguities of the American Founders, doesn't seem to make a point. Bailyn discusses the political lives of Thomas Jefferson and Benjamin Franklin, and then looks at The Federalist Papers. With Jefferson, he gives a cursory overview of some of the seeming conflicts in Jefferson's thought. Most of the section on Franklin is devoted to remarks about the paintings made of Franklin while he was in Paris. The section on The Federalist Papers was the most interesting, but it didn't provide any brilliant insights.

I was looking forward to reading about Franklin, who is something of a paper cutout figure in most history textbooks, but I wasn't interested in Bailyn's commentary on paintings of Franklin.

The Second Gun by James Clifton Cobb

This is a good western, suitable for young adult readers. The hero is a plucky teen, an orphan who makes his way from cleaning spittoons in a bar to owning a mining company. In the process he kills only one man, and that act bothers him for the rest of his life. Recommended.

Pecos Crossing by Elmer Kelton

A story of two young cowboys, one grows up and the other doesn't. Kelton always tells a good tale.

Death and Honor by W. E. B. Griffin

Honor Bound is set in Argentina during the Second World War, where the Nazi SS, the US OSS, and the Argentine BIS engaged each other in three-way spy games. It is the fourth novel in the Honor Bound series, which begins with Honor Bound. I recommend reading them in sequence.



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Sunday, June 01, 2008

Farm New 06-01-08

Sunday evening, after chores, the internet link was down all day.

Weight: 204 lbs.

Barn News

Drat! Something took Bobby, the gosling. Bobby was my favorite gosling. He was well educated, having been to school twice, and would eat from my hand. Like all young geese, he looked like a T. rex with a duck's head, but he was friendly and cheerful. I”m tired of feeding the predators and am going to take steps to reduce the toll. I know that unless I do something another gosling will disappear each night until they are all gone.

Insubordination

"No, sir."

Sunshine, a friend, is the most sardonic, cynical person I know. He also is quadriplegic, which inhibits most men from punching him in the nose when he is at his worst.

Sunshine works in a call center, responding to the desperate cries of the of the distraught who are trying to obtain an intelligent response from Medicare. Sunshine, on the telephone, is empathetic, reverberating to the problems of the callers. Thus, when a 90 year old blind wman called, Sunshine became almost blind to the rest of creation.

Everyone who knows Sunshine, including those who work with him, know that he is subject to brief empathetic trances, states where the normal rules of reality do not apply within his space. It's not really a problem, except in a bureaucracy.

It did become a problem when his supervisor sat down to observe his performance. Mr. Supervisor, Sunshine said, had a wife, three kids, a mortgage, and just wanted to keep his job. Thus, Mr. Supervisor was sitting next to Sunshine, performing a monthly performance rating observation, when the 90 year old war widow from Wisconsin called on the phone, crying. And, in a natural, beyond his control, response, Sunshine fell into an empathetic state, and existed only to serve a lonely, 90 year old, befuddled woman.

Gently, deftly, Sunshine began to guide the old woman thrugh the intricacies of indentifying herself and her problem in such a way that she and the problem would fit into the problem-solving capabilities of the call center. Finally, all the boxes were checked and blanks filled, except for the Medicare number on her card. She didn't know the number and couldn't see the card to read it. The number was not essential to resolving her problem, but the script clearly stated that, when the caller couldn't supply a Medicare number, the conversation was to be closed down.

Sunshine looked at his supervisor and said, “No, sir.”

Books

I haven't finished any books this week. That's what happens when I move from mysteries and westerns to non-fiction.

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Sunday, May 25, 2008

Farm News 05-25-08

Sunday morning, after chores, 76° and muggy

Weight: 207, oops!

Barn News

There are ten baby chicks that Jesse hatched in his incubator now living in a brooder in the barn. I moved the ducklings out of the barn brooder and into the bigger brooder in the rabbitry.

Early Thursday morning we had 2.6” of rain, which we needed. I did some tilling in the garden on Wednesday, it was like trying to till up a parking lot, only dustier. Saturday morning we had an additional 0.9” of rain.

Drusilla, one of the bantam hens, has a nest in the same stall where Beth goose has her nest. When I went out to do chores Saturday evening Drusilla was walking around making disgusted, angry sounds. I looked in the stall and, sure enough, there was Beth sitting on Drusilla's nest instead of her own. Beth was possibly influenced by my having removed all her eggs from her nest and putting them in the incubator; I thought she had quit laying. Beth frequently returns to her nest when she is upset, which is a good deal of the time.

A few minutes after I arrived Beth came out of the stall and went back to following the goslings around, worrying like a Jewish mother. Drusilla went back to her nest, but continued to make unhappy sounds. Finally I went back in the stall and chased Drusilla off her nest to see if Beth had perhaps broken an egg.

No, Beth didn't break an egg, but she did leave a very large goose egg in the middle of the nest. When Drusilla tried to sit on the goose egg, she couldn't reach down far enough to cover her own eggs. I moved Beth's egg over to Beth's nest, Drusilla returned to her nest, and, after a few more expressions of disgust, settled down to incubating her eggs.

New FOOL Web Site

All readers are invited to visit www.OskaloosaFool.org, the web site of the Friends of the Oskaloosa Library. I have spent the past month or so creating the site, and then I completely crashed it last week and had to start all over. If you register on the site, you can use it to send messages to me. Also, everyone is welcome to add book reviews.

Books

My gosh! I only read one book last week. The June issue of Scientific American arrived, which took some time. Also, I'm started on a new non-fiction which I might finish this week.

The Big Pasture by Will Henry

A good enough western. And, it's in large print. At one point in the book he lists the different species of wildflowers blooming in a high Montana meadow. One he listed was a late summer bloomer and he had it blooming in the spring, but the rest were correct. He also knows that a moon just past full rises a while after sunset. I appreciate an author who knows what he is writing about.