Thursday, April 27, 2006

Journal: Flappable

The people I most admire almost all share a trait to which I aspire: unflappableness. I envy their composure, and wish I could achieve a state of zen-like composure, riding my various troubles like a little boat floating on the sea. Unfortunately, I seem to be incurably flappable.

When I was a kid, my mom deemed me a "sensitive kid", and I was: deeply invested in any product of my intellect or creativity, susceptible to emotional trauma at the slightest perceived criticism, quick to anger when I felt somebody else was breaking rules I was following. Growing up eased up some of these triggers, but I still feel the same old buttons getting pushed, daily, and before I know it, I'm flapped.

Lately, I've felt especially easily flapped, and I primarily blame MS. Work has been busy, and it seems like the benefits of the Lyrica have been diminishing. It's not yet noon now, and the burning sensation in my thighs is surging in for the day. I've been taking 300 mg twice a day for at least a couple months now. At first, it worked well, but now, not so much. A few weeks ago, I'd felt good enough to try a lower dose (hoping maybe it would help me to shed some weight), but quickly decided to go back to the full dose. After that, I'd forgotten to take my evening pill for a couple days. Did I foul up the drug's effect by dropping the dose briefly and skipping some pills?

It's going to be a long one; I could well be at work for another 10 hours, simmering, sizzling, waiting for the phone to ring, trying hard not to get flapped by a client in a hurry or by discourteous drivers and speeders on the drive home. I wish I could get rid of the pain, get a good night's sleep, get things done, be less brittle.

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Monday, April 24, 2006

In the news: More on FDA and medical pot

In a Slate piece, Sydney Spiesel (a pediatrician who teaches at Yale Med School) confirms my dim view of FDA's recent gratuitous pronouncement about medical marijuana. Snip:
[W]e know neither more nor less about medical marijuana than we did seven years ago, whatever the FDA says. Why would the agency inaccurately claim that the science is settled when it isn't? I hardly need to say it: This isn't a medical or scientific conclusion. It's a political one.

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Friday, April 21, 2006

In the news: FDA rejects medical pot

In a statement issued "in response to numerous inquiries from Capitol Hill" (per NYT 4/21), the FDA says "smoked marijuana has no currently accepted or proven medical use in the United States and is not an approved medical treatment." This contradicts the findings of a 1999 review by the Institute of Medicine, a part of the National Academy of Sciences, which found marijuana was "moderately well suited for particular conditions, such as chemotherapy-induced nausea and vomiting and AIDS wasting."

Remember back when FDA was a trusted guardian of public health, when it could be trusted to let science speak for itself? Back then, a statement like this one would have carried some serious heft. Now, you look at the FDA statement and you compare it to IOM's, and you think about the research that's been conducted (mostly in other countries) since 1999, and you think to yourself, "Well, why would they come to opposite conclusions?" And you have to wonder about the influence that DEA has, and anti-marijuana politicos have, on what FDA says about marijuana.

The message the public gets from FDA today is: "There is no accepted or proven medical use for marijuana." But the other, less publicized, message from FDA seems to be: "And quit looking for one."

I don't know if there's a medical use lurking inside the evil green weed, but it looks increasingly like we're never gonna know, at least not in this country.

Link to WaPo article.
Link to NYT article.
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Thursday, April 20, 2006

Shiny things: Honda Fit test drive

Last night, I stopped by the local Honda dealer to test drive the Fit, Honda's new (to North America) subcompact. The verdict: thumbs up.

I drove a little red automatic Fit Sport with the nifty paddle shifters. It's a tight little car that seems much larger on the inside than you might guess from the outside. In fact, the guy from the dealership that went along on the test drive was probably 6'4" and he seemed to fit in the back seat without much trouble.

I like the way the seats (back and front) can be folded origami-style into several different configurations (though I'm not sure it would be big enough for our two dogs). I also thought it was great fun to drive: tight, reasonably peppy, good visibility, etc., though I'm not sure I would get much use from the paddle shifters. Here's how it works: move the floor-mounted shifter from D to S, then use your index finger to pull the little paddles on the steering wheel. Pull the right paddle and you'll go up a gear (it's a 5-speed automatic), pull the left and you'll go down. If you're in S and you forget to shift, the car will shift for you, up to 4th gear (you'll hafta get yourself into 5th). Maybe it's more of a draw for those who grew up with a Playstation controller into their hands.

Another nifty feature: a gauge that tells you how close you are to needing an oil change. According to the guy from the dealership, it's not just keeping track of mileage since the last oil change, it's also somehow monitoring the oil and filter, so it might be that you'll need an oil change after 2,149 miles (if you drive like one of those maniac Jetta drivers) or you might not need an oil change until 12,149 miles (if you drive like me). I'm interested in reading more about how it works.

I'm thinking maybe the base-level Fit, with an automatic gearbox. No paddle shifters, no "ground effects" or spoiler, no alloy wheels, slightly less stereo, about $1,300 fewer clams on the sticker price. And I'm guessing that with lots of Fits already pre-sold, sticker price is what we'll hafta pay, for the foreseeable future. If you opt for the manual tranny, you'll save $800 off the sticker price, but our dealer says the manuals will be hard to come by, perhaps because they're being directed mainly to foreign markets.

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Wednesday, April 19, 2006

In the glass: Mysteries of Guinness Revealed

I love a pint of Guinness, and we usually have a few of the nitrogen-charged draft cans in the fridge. Beer Advocate online has an interview with Fergal Murray, Guiness Brewmaster. It's an interesting read, even if you're not a beer geek (I swear I'm not). Snip:
Murray explained that the recipe for Guinness has undergone only minor adjustments over the years. Every keg of Guinness Draught imported to the US comes from St. James’s Gate in Dublin (though Guinness Extra Stout is made in Canada). It contains water, malt, roasted barley, hops and yeast - and that’s it. Like many major labels, Guinness relies on “high-gravity brewing,” which involves large batches of wort (unfermented beer) high in fermentable sugars (note to beer geeks: the goal is a final gravity of 1072). Eventually these are watered down to attain a 4.2 percent ABV (alcohol by volume). The brewers also blend batches to aid in consistency, and the beer is pasteurized.

What Guinness wouldn’t confirm or deny is the rumor that a portion of each batch is aged in very old oak tuns populated with Brettanomyces and lactic acid bacteria to lend Guinness its characteristic touch of sourness. Supposedly, it’s then pasteurized and blended into the remainder of the batch.

As for the hops, the vast majority hail from the US, with some European hops to round things out. The brewers look for high levels of alpha acids (these are the source of hops’ bitterness) in order to get more “bang for their buck,” as Murray put it.
It’s commonly believed that dark beer is heavy beer. Guinness’s super-creamy head only adds to its rep for richness. (The head is the result of a special gas blend of around 60 percent nitrogen to 40 percent carbon dioxide; cans and bottles of Guinness include a specially designed widget that disperses a nitrogen blend.) But Guinness has only 125 calories and 10 carbs per 12-ounce serving - fewer than pale-yellow Budweiser.

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Research: Intriguing abstract from PubMed

The article's in Norwegian, but the translated abstract is intriguing. I'm not sure I'd be able to maintain sufficient attention to write poetry.
The poet Elling M. Solheim (1905 - 1971) suffered from multiple sclerosis most of his adult life. The disease forced him to leave his previous occupation as a logger. He became almost completely tetra-paralytic and was chained to his bed through the last decades of his life. Solheim continued to create poetry, although he had to dictate the last books to his beloved nurse. In some of his best poems, the writer shares the impact of the disease on body and mind. The poems of Elling Solheim illustrate the interface between art and medicine: although disease ruins lives, it may also be a catalyst of great art.


Monday, April 17, 2006

Journal: Visiting an old friend

As I've done for the last few years, I paid a visit to an old friend over the weekend. Actually, it's a creek, but it feels like an old friend. It twists its way through sandstone ledges and marshy lowlands under a canopy of big old pine trees in the sandy country an hour or so north of my home town. It's small enough that you could stand on one side and spit across to the other, but in the spring, rains swell it up with just enough water to float a canoe.

We met when I was maybe 12 years old, when my dad took me out in our big old aluminum canoe to do some trout fishing, and I was enchanted. The Creek's swift turns made for exciting paddling for a kid, and I dutifully followed the paddling instructions my dad called out from the back of the boat: left, right, a little steam, please. We'd stop to fish above a deep pool or below a little riffle, and the creek gave up a few fish: a brown, a couple brookies. Below the little dam, I pulled out a rainbow that was big enough to merit a photograph when we got home. My dad showed me how the native trout had salmony pink flesh inside, unlike the pale flesh of the trout that had been stocked.

I don't know how many times my dad and I paddled the Creek--twice? three times?--and I eventually turned into an over-scheduled teenager. But it stuck with me, the memory of my dad baiting his hook with a grasshopper taken from a wine bottle, the smell of pine and moss, the sound of water flowing across rocks, the wind in the pines.

One summer, when I was in college, I went back. I put the old canoe on top of my girlfriend's car. I wasn't sure where to put in, and we ended up upstream, or maybe downstream, of the route I'd traveled with Dad. It was hot outside, the water was low, and deadfalls blocked our way at every bend in the stream. It was a long trip: I felt like an idiot, and though the girl eventually became my wife, I wondered what became of the Creek that trickled through my memory.

I grew up, went to law school, got a job, and moved away. I still loved fishing and paddling, though, and every time in stood in a creek with a fishing rod, I thought about the Creek. I looked for maps or pictures on the Web, some evidence that it still flowed. I heard through the grapevine that fishing had gone downhill, a result of a cranberry operation diverting water from the creek and returning warmer than it should have been.

Eventually, I moved back to the area. A few years ago, I heard that a group from the Sierra Club went for an annual spring paddle down the creek. I'd just bought a new canoe, and I invited my recently-retired dad to join me. I met him at the put-in, and I sensed that he, too, had had the Creek trickling through his memory for the last 15 or so years. That day, I sat in back and called out the paddling instructions. Last year, I paddled the creek with my older brother.

On Sunday, I drove up to the Creek with a couple pals. This year, in addition to a dry bag, some Fig Newtons, and an extra paddle, I brought a cane for extra balance if necessary. My pals sensed that I was a little weaker and a little tippier than the last time we'd seen each other, and obligingly carried the boat and gear down down the steep bank. It was a windy day, with storms in the forecast, but we donned rain gear and put in anyway.

There really isn't anything I'd rather do than float down a little stream. Sex is complicated, eating is fattening, and drinking gets me in trouble, but paddling is bliss, plain and simple. At least, it's periods of bliss occasionally interrupted to haul a canoe over a log. And sometimes it gets cold and wet, which is what happened about 20 minutes after we got started. We were re-embarking after getting out to scout a deadfall, and had the boat turned perpendicular to the stream for just a moment. I lost my balance, shifted my weight to the upstream edge of the boat, and, slowly, fell into the Creek on my butt in 18" of cold, rushing water. I was wearing rubber wellies, which filled up with water, making them so heavy that I almost couldn't lift my legs to move to the edge of the stream. It took me a few minutes to pull my feet out of them and dump the water out.

I had dry clothes and didn't lose any stuff, but I felt like a clutz as I sat naked on the bank, perched on my PFD. I was so exhausted that it seemed to take forever to shed my wet clothes and put on the dry ones. Another problem: what to do with the saturated diaper, which had expanded to the size and weight of a small ham. I wrapped it up in my wet pants and stuffed it into the bottom of the dry bag.

I recovered, though, and enjoyed the remaineder of the day. We did run into what seemed like a dozen snags that required getting out of the boat. I worried, because I wanted my pals to take to the Creek the way I did, that these annoyances would, in their judgment, outweigh the Creek's charms. I wanted them to love the Creek partly because I want to go back next year, and I need willing sherpas to do the heavy lifting. I think they'll be willing to come back.

The balance of the 4-hour paddle was mercifully dry, until about 10 minutes before the git-out, when the rain finally broke. Even that was beautiful, though. At the landing, I stayed behind while they shuttled back for the other car, admiring the pitcher plants on the banks of the Creek, cautiously optimistic that next year I'd be back to paddle the Creek.

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Wednesday, April 12, 2006

In the news: Sushi and Moonies

The Chicago Tribune today ran a fascinating report on the dominance of the seafood industry by a company that is a moneymaker for the Sun Myung Moon's Unification Church. Snip:
Adhering to a plan Moon spelled out more than three decades ago in a series of sermons, members of his movement managed to integrate virtually every facet of the highly competitive seafood industry. The Moon followers' seafood operation is driven by a commercial powerhouse, known as True World Group. It builds fleets of boats, runs dozens of distribution centers and, each day, supplies most of the nation's estimated 9,000 sushi restaurants. Although few seafood lovers may consider they're indirectly supporting Moon's religious movement, they do just that when they eat a buttery slice of tuna or munch on a morsel of eel in many restaurants. True World is so ubiquitous that 14 of 17 prominent Chicago sushi restaurants surveyed by the Tribune said they were supplied by the company.
"I have the entire system worked out, starting with boat building," Moon said in "The Way of Tuna," a speech given in 1980. "After we build the boats, we catch the fish and process them for the market, and then have a distribution network. This is not just on the drawing board; I have already done it." In the same speech, he called himself "king of the ocean." It proved not to be an idle boast. The businesses now employ hundreds, including non-church members, from the frigid waters of the Alaskan coast to the iconic American fishing town of Gloucester, Mass.
Roll that up in your nori and smoke it.

Link to Trib report.

Tuesday, April 11, 2006

In the news: Racial (vitamin) profiling

WaPo has an artcle today about new line of vitamins is being marketed with formulations supposedly tailored to differences among Caucasians, Hispanics, and African-Americans. Snip:
Unique "physiological and metabolic differences" can make certain groups more likely to develop some diseases, said Joseph Lander, president and founder of GenSpec. The small company, which also sells race-targeted weight-loss pills, bases its products on research into key racial health distinctions, Lander said. The company plans to start selling an Asian multivitamin in the next month. While the approach may demonstrate clever marketing, some experts said, there is no gold-standard science showing that members of these groups are healthier if they take targeted nutrients in pills.

Link to article.

On the tube: The Boy in the Bubble

Last night, PBS aired a documentary about the life of David Vetter, "The Boy in the Bubble." David was born about the same time I was, and I remember seeing the images of him. The film on PBS provides the story that goes along with those indelible images, and it seems mostly like a story about the consequences of misplaced optimism. Before David was conceived, his parents had lost an earlier son to the same immune deficiency disease (SCID), and had received counseling from doctors about the possibility that another child would be born with the same disease. The doctors had expressed confidence that, if a subsequent child were born with SCID, they would be able to perform a bone marrow transplant that would restore the child's immune system.

The odds did not, however, support the doctors' optimism. Not the odds as calculated based on the state of medical knowledge at the time, anyway. The doctors' optimism was based on a belief that they would be able to figure something out, that the accelerating progress of medical knowledge would provide a solution to a problem that was not merely possible but likely to occur. It's probably an overstatement to call it hubris, but it has a similar flavor. David's birth and life turned into an experiment, an experiment for which nobody gave (or was capable of giving) informed consent. The boy in the bubble made a significant contribution to medicine, and to our awareness of the ethical issues involved in medicine.

I've never really held out hope that some day a cure will be found for multiple sclerosis. Even before I knew much about it, before I had significant symptoms, it just never really seemed like a possibility. Maybe that has something to do with David's life and death.

Link to PBS page about the documentary.

Friday, April 07, 2006

Shoutout: Dogs and taxes

One of the great things about Site Meter is that it tells you how people find their way to your blog, i.e., 'referrals.' If they started with a Google search, Site Meter reveals the query that led them to Shoester.

So I was peeking at the referrals this morning, and yesterday, someone wandered over by way of a Google search for "Are my dog's medical expenses a tax write off?" I'm not a tax lawyer, and I don't want to give legal advice via Blogger, but no, you cannot take a deduction for veterinarian bills. Or bad haircuts.

For some reason, though, there is a deduction for gambling losses. Isn't that odd? I can't deduct the $10 I spent to see Basic Instinct 2, but the old lady who spends an hour feeding a bag of quarters to a slot machine can deduct every quarter that's a loser. On the other hand, if she wins, she has to report it as income. So it's treated like an investment.

I didn't look very hard for figures, but the Center for Responsive Politics has a couple paragraphs about this one. Snip:
The Treasury estimates that in 1995, more than 1,500 millionaires using the gambling deduction cost the government $377 million in tax revenue.

Tax deductions really boil down to subsidies; they're incentives (some more effective than others) to do something, or not to do something, with your money. Why do we subsidize gambling?

Monday, April 03, 2006

In the news: Midwifery and the law

Where I live, it is not yet legal to practice midwifery. That is to say, delivering a baby and providing pre- and post-partum care constitutes the practice of medicine, which requires a license generally available only to physicians. There's currently a bill awaiting the governor's signature that would establish standards for and legalize the practice.

The NYT reports today on an Indiana case in which a woman is being prosecuted for practicing midwifery. A baby delivered by the midwife died, although both sides apparently agree that the midwife wasn't responsible. I'm not sure whether I think midwife delivery is a good idea or not, although as a male of the species, I'm pretty sure it's none of my goddam business. Snip:
'No one complains until a baby dies or a mom dies,' Professor Tovino said. But once the issue arises, she said, legislatures often become involved as well, with doctors and midwives engaging in a bitter struggle over the proper regulation of midwives, one driven by a mix of motives that are difficult to disentangle. 'There has always been a tension between true quality-of-care concerns and anticompetitive concerns,' Professor Tovino said.
(free reg req'd)

In the news: Tapeworms

Slate's Daniel Engber sheds some light on a subject that's been on my mind lately: What's it like to have a tapeworm? Enger explains that it's unlikely to increase your appetite, and might make you feel crummy as its circular suckers move through your bowels. Thanks, Mr. Engber. Snip:
You probably wouldn't know you had an infection unless you found stray worm segments—called "proglottids"—swimming in your stool. Each proglottid constitutes a self-contained (hermaphroditic) reproductive organ holding up to 100,000 eggs. A tapeworm reproduces by detaching these sections from its tail, so that the eggs can find their way out of your body and into a new host.