Tuesday, September 22, 2009
Where Boots Go to Die
Along the blue highway north of Malad City, ID. The display continues for several miles.
Monday, September 14, 2009
Three Fine Years - 27 August 2009
My grandmother didn’t approve of me pointing. I was in my early 30s when she died and I was going to live forever. Or at least follow her example with an active life well into my 90’s when the coffee, beer, and vanilla Swiss almond Hagen Daz would finally do me in.
But at the end of May, 2006 I noticed that my shoulder hurt. I noticed it when I pulled a shirt over my head, when I reached for the stapler at work, and when I picked up a bag of groceries. The pain was worse at night and it often woke me up.
By mid June pain had spread to my back, hips, and neck. Walking was difficult, so I drove more. Driving was more difficult, too: I needed both hands to turn the key in the ignition and I could no longer look over my shoulder when merging.
Dressing, preparing food, and using the toilet became protracted and painful struggles. (Try hooking your bra, slicing potatoes, or using the toilet without using your hands or twisting your body.) Graduate students wrestled open bottles of water for me and friends retrieved silverware I dropped during meals.
That July two of my fingers swelled to resemble sausages and became largely immobilized, half straightened and half bent. I could neither straighten my fingers to wave “Thank you” to drivers who stopped for me at crosswalks or wrap my hands around a warm mug of coffee in the morning. And I certainly couldn't point at anything.
Oh, yes, I did see a doctor: an orthopedic surgeon, a sports doctor, and a neurosurgeon each recognized my condition. Each recognized it as something different and suggested a different treatment.
Showing my newly swollen and bent fingers to the sports doctor, on a repeat visit, sent him out of the room for a few minutes of research. He returned and suggested psoriatic arthritis, a form of spondylitis, which is an autoimmune condition similar to rheumatoid arthritis. I would need to see a rheumatologist.
The three month wait for the next New Patient slot with a rheumatologist drove me to calling the office repeatedly and asking, in a quaking voice, if there had been any cancellations and wondering if I would lose the use of my hands before my appointment.
My primary care physician referred me to a hand surgeon while I waited for my rheumatologist appointment. The struggle to fill out another set of forms in his waiting room brought tears to my ears and made my nose run. I waited in my assigned cubicle until the hand surgeon, a slender, intense man with dark hair, came in. He complained at some length about the bureaucracy, looked briefly at my hands, twisted and pulled them in a short game of “Does This Hurt?" and left.
He reappeared with a Jim Cramer look-alike, who carried the gravitas of someone who gives advice on health, rather than investments. The hand surgeon introduced him as Dr. Knibbe, the rheumatologist from across the hall. Dr. Knibbe looked at my hands, then twisted and pulled them in another game of “Does This Hurt?". He said, “Come with me. Walk this way.” and performed the Marty Feldman bit from Young Frankenstein as he left the cubicle. I did both, after hurriedly thanking the hand surgeon, who had succeeded in getting me an on-the-spot rheumatologist appointment.
I walked the Marty Feldman walk with my rheumatologist on 27 August 2006. I was being treated for psoriatic arthritis later that day after Dr. Knibbe squeezed my appointment into his lunch hour. Two days later I described my improvement in an email to him:
I can make Minute Rice in 30 seconds, leap tall buildings in a single bound, and red lights turn green as I approach. I am now smarter, I’m better looking, and small children stop quarreling and smile as I walk by.
Although steroids improved my condition immediately, the heavy lifting was done over several months by one of the new biologic drugs. It took about the same length of time to stop my immune system from trying to detach my ligaments and tendons from my bones (the mechanism of the spondyloarthropathies) as it did for my immune system to largely immobilize me.
Although TV commercials for the biologic drugs (Enbrel, Humira, and Remicade) include a breathlessly long list of potential side effects including serious infection and lymphoma, I have developed none of those listed. "Poverty" is not mentioned in the commercials, although many who use it (especially those who are self employed, as I am) suffer terribly from this side effect.
It also took time for my muscles, atrophied from disuse, to strengthen. After a few days of steroid use the pain in my right wrist had subsided enough that I could remove the wrist support I had worn for the previous several weeks. This revealed my skeletal hand, complete with the "ash tray" (yes, that's the medical term) divot that had developed between my thumb and forefinger. It was not an attractive sight, judging by the reaction of people around me, but for me it was pure joy to see my hand functioning again.
Now, three years on, I am as astonished at my good health as I was after the first flush of steroids. The new biologic treatments for inflammatory forms of arthritis (psoriatic arthritis, rheumatoid arthritis, ankylosing spondylitis, etc.) have transformed these painful afflictions into treatable conditions. These drugs make it possible for inflammatory arthritis patients to lead normal lives without the crippling deformities and disability that stalked sufferers in the past.
Now, three years on, I have my life back. I can do everything I could do before I became ill including sweating in 100 degree heat while struggling up and down canyons under a pack full of equipment, measuring the sagebrush and grass while I hang on to it keep from tumbling downhill. I can do the work I did before I became ill.
Now, three years on, I wake each morning without pain and each day seems like the first day of summer vacation. Many people describe deep lessons learned after a bout of serious illness. But for me, recovering from an illness is like beating you head against a wall: it feels wonderful when you stop.
Even though my hands no longer hurt, I still can’t point straight at anything. My grandmother would be so pleased.
But at the end of May, 2006 I noticed that my shoulder hurt. I noticed it when I pulled a shirt over my head, when I reached for the stapler at work, and when I picked up a bag of groceries. The pain was worse at night and it often woke me up.
By mid June pain had spread to my back, hips, and neck. Walking was difficult, so I drove more. Driving was more difficult, too: I needed both hands to turn the key in the ignition and I could no longer look over my shoulder when merging.
Dressing, preparing food, and using the toilet became protracted and painful struggles. (Try hooking your bra, slicing potatoes, or using the toilet without using your hands or twisting your body.) Graduate students wrestled open bottles of water for me and friends retrieved silverware I dropped during meals.
That July two of my fingers swelled to resemble sausages and became largely immobilized, half straightened and half bent. I could neither straighten my fingers to wave “Thank you” to drivers who stopped for me at crosswalks or wrap my hands around a warm mug of coffee in the morning. And I certainly couldn't point at anything.
Oh, yes, I did see a doctor: an orthopedic surgeon, a sports doctor, and a neurosurgeon each recognized my condition. Each recognized it as something different and suggested a different treatment.
Showing my newly swollen and bent fingers to the sports doctor, on a repeat visit, sent him out of the room for a few minutes of research. He returned and suggested psoriatic arthritis, a form of spondylitis, which is an autoimmune condition similar to rheumatoid arthritis. I would need to see a rheumatologist.
The three month wait for the next New Patient slot with a rheumatologist drove me to calling the office repeatedly and asking, in a quaking voice, if there had been any cancellations and wondering if I would lose the use of my hands before my appointment.
My primary care physician referred me to a hand surgeon while I waited for my rheumatologist appointment. The struggle to fill out another set of forms in his waiting room brought tears to my ears and made my nose run. I waited in my assigned cubicle until the hand surgeon, a slender, intense man with dark hair, came in. He complained at some length about the bureaucracy, looked briefly at my hands, twisted and pulled them in a short game of “Does This Hurt?" and left.
He reappeared with a Jim Cramer look-alike, who carried the gravitas of someone who gives advice on health, rather than investments. The hand surgeon introduced him as Dr. Knibbe, the rheumatologist from across the hall. Dr. Knibbe looked at my hands, then twisted and pulled them in another game of “Does This Hurt?". He said, “Come with me. Walk this way.” and performed the Marty Feldman bit from Young Frankenstein as he left the cubicle. I did both, after hurriedly thanking the hand surgeon, who had succeeded in getting me an on-the-spot rheumatologist appointment.
I walked the Marty Feldman walk with my rheumatologist on 27 August 2006. I was being treated for psoriatic arthritis later that day after Dr. Knibbe squeezed my appointment into his lunch hour. Two days later I described my improvement in an email to him:
I can make Minute Rice in 30 seconds, leap tall buildings in a single bound, and red lights turn green as I approach. I am now smarter, I’m better looking, and small children stop quarreling and smile as I walk by.
Although steroids improved my condition immediately, the heavy lifting was done over several months by one of the new biologic drugs. It took about the same length of time to stop my immune system from trying to detach my ligaments and tendons from my bones (the mechanism of the spondyloarthropathies) as it did for my immune system to largely immobilize me.
Although TV commercials for the biologic drugs (Enbrel, Humira, and Remicade) include a breathlessly long list of potential side effects including serious infection and lymphoma, I have developed none of those listed. "Poverty" is not mentioned in the commercials, although many who use it (especially those who are self employed, as I am) suffer terribly from this side effect.
It also took time for my muscles, atrophied from disuse, to strengthen. After a few days of steroid use the pain in my right wrist had subsided enough that I could remove the wrist support I had worn for the previous several weeks. This revealed my skeletal hand, complete with the "ash tray" (yes, that's the medical term) divot that had developed between my thumb and forefinger. It was not an attractive sight, judging by the reaction of people around me, but for me it was pure joy to see my hand functioning again.
Now, three years on, I am as astonished at my good health as I was after the first flush of steroids. The new biologic treatments for inflammatory forms of arthritis (psoriatic arthritis, rheumatoid arthritis, ankylosing spondylitis, etc.) have transformed these painful afflictions into treatable conditions. These drugs make it possible for inflammatory arthritis patients to lead normal lives without the crippling deformities and disability that stalked sufferers in the past.
Now, three years on, I have my life back. I can do everything I could do before I became ill including sweating in 100 degree heat while struggling up and down canyons under a pack full of equipment, measuring the sagebrush and grass while I hang on to it keep from tumbling downhill. I can do the work I did before I became ill.
Now, three years on, I wake each morning without pain and each day seems like the first day of summer vacation. Many people describe deep lessons learned after a bout of serious illness. But for me, recovering from an illness is like beating you head against a wall: it feels wonderful when you stop.
Even though my hands no longer hurt, I still can’t point straight at anything. My grandmother would be so pleased.
Sunday, September 6, 2009
Digital photos: as easy as 1, 2, 3
1. Start taking photos 30 years ago.
2. Buy a digital camera. You can buy a very good one for less than $500. Having kids is a plus, as they can read the manual and teach you how to use the camera. (You need to have started having kids a dozen years earlier.)
3. If you’re a scientist, you’ll want to know exactly where your photos were taken, so you’ll need a GPS unit. Follow the same learning path as for your camera, up to downloading waypoints.
4. Downloading waypoints. If your new GPS has a serial connection, your children probably will not recognize it. Your laptop may not know what to do with a serial connector either.
5. Go to the computer store to buy a serial-to-USB adapter. If the person at the computer store looks as though his mother drops him off at work after school, he won’t recognize a serial connector. If you’re female he won’t believe that a serial-to-USB adapter exists. Spell “serial” for him (it starts with an “s”, not a “c”). If you’re female and your mother hasn’t dropped you off anywhere in 35 years, you will have brought along your GPS cable as a teaching aid.
6. While you’re at the computer store, pick up an armload of external drives. You’ll need them when your photo backups metastasize to fill up your computer hard drive, your external drive, your other external drive…
7. You are now ready for a day in the field. Have fun and take lots of pictures: the camera can make all the decision for you; you just keep pushing the shutter. No film to buy! No film to process! Take dozens of shots of everything to be sure that you capture just the right angle and lighting. If you’re a scientist, you’ll be collecting GPS coordinates at each stop. You’ll soon devise a system for naming the waypoints (8 characters maximum) in order to match them to the photos.
8. When you’re back home, download your photos and start editing. This will include cropping your photos and adjusting the brightness, contrast, and perhaps the color. Both PCs and MACs include software to do this. Set aside many hours for deciding which of the dozen photos you took of those beautiful wildflowers is really the best one.
9. At the end of the first day, when you're sneezing from the wildflower photos and have broken out in hives from the sagebrush photos, you’ll realize that you need to make a list of your lovely photos so that you can find them again. Open up a spreadsheet. If you’re a scientist, you’ll want to include the GPS coordinates. Your spreadsheet should also include the file number of each photo, the date it was taken, where it was taken, plus a short description of the subject(s). If there are people in the photo, you’ll want to include that information, as it’ll save time looking through thumbnails, which get smaller and fuzzier each year.
10. After a few years of taking digital photos someone will ask you for copies of your photos because yours are so very very good and they need a photo exactly like the ones you took on the tour that one time, they just can’t put together their Powerpoint/flyer/brochure without your photos. They’re not sure which photo(s) they need or what exactly they’d like a photo of but they know that one from the tour would be just perfect, could you just send them all?
11. Return to the computer store for CDs and padded envelopes. Pretend you were kidding about the padded cell when the person at the computer store, who looks as though his mother hands them his Binky when she drops him off, looks confused and frightened.
12. Once you’re back home, with the six pack you picked up at Circle K on the way:
* Search your spreadsheet for the photos from the tour. The spreadsheet works great as long as you keep it up to date.
* Locate the photos on one of your external drives. One that hasn’t crapped out yet.
* Create a small spreadsheet, containing information for the photos from the tour.
* Burn the photos to a CD. Dang, why can’t you add another file to the CD? Toss the CD in the trash and burn one with the photos AND the spreadsheet.
* Label the CD, put it in a case, then in a padded envelope and seal.
* Google the person who requested it, to find their snail mail address. They didn’t bother to give you that information.
* Address the envelope.
* Take it to the post office.
* Stand in line.
* Strike up a conversation with the person in front of you in line.
* Mail the letter.
* Exchange business cards with the woman you were talking with in line.
* Stay in touch with her and learn that you have friends in common.
13. Go home to wait for the photo recipient to thank you.
14. Continue waiting.
15. It’s been three months now: stop waiting.
16. Enjoy seeing your photos in Powerpoints, flyers, and brochures. Swell with pride when they appear without attribution. Become ecstatic when you see your photos in print with someone else’s name on them.
See how easy digital photos are?
2. Buy a digital camera. You can buy a very good one for less than $500. Having kids is a plus, as they can read the manual and teach you how to use the camera. (You need to have started having kids a dozen years earlier.)
3. If you’re a scientist, you’ll want to know exactly where your photos were taken, so you’ll need a GPS unit. Follow the same learning path as for your camera, up to downloading waypoints.
4. Downloading waypoints. If your new GPS has a serial connection, your children probably will not recognize it. Your laptop may not know what to do with a serial connector either.
5. Go to the computer store to buy a serial-to-USB adapter. If the person at the computer store looks as though his mother drops him off at work after school, he won’t recognize a serial connector. If you’re female he won’t believe that a serial-to-USB adapter exists. Spell “serial” for him (it starts with an “s”, not a “c”). If you’re female and your mother hasn’t dropped you off anywhere in 35 years, you will have brought along your GPS cable as a teaching aid.
6. While you’re at the computer store, pick up an armload of external drives. You’ll need them when your photo backups metastasize to fill up your computer hard drive, your external drive, your other external drive…
7. You are now ready for a day in the field. Have fun and take lots of pictures: the camera can make all the decision for you; you just keep pushing the shutter. No film to buy! No film to process! Take dozens of shots of everything to be sure that you capture just the right angle and lighting. If you’re a scientist, you’ll be collecting GPS coordinates at each stop. You’ll soon devise a system for naming the waypoints (8 characters maximum) in order to match them to the photos.
8. When you’re back home, download your photos and start editing. This will include cropping your photos and adjusting the brightness, contrast, and perhaps the color. Both PCs and MACs include software to do this. Set aside many hours for deciding which of the dozen photos you took of those beautiful wildflowers is really the best one.
9. At the end of the first day, when you're sneezing from the wildflower photos and have broken out in hives from the sagebrush photos, you’ll realize that you need to make a list of your lovely photos so that you can find them again. Open up a spreadsheet. If you’re a scientist, you’ll want to include the GPS coordinates. Your spreadsheet should also include the file number of each photo, the date it was taken, where it was taken, plus a short description of the subject(s). If there are people in the photo, you’ll want to include that information, as it’ll save time looking through thumbnails, which get smaller and fuzzier each year.
10. After a few years of taking digital photos someone will ask you for copies of your photos because yours are so very very good and they need a photo exactly like the ones you took on the tour that one time, they just can’t put together their Powerpoint/flyer/brochure without your photos. They’re not sure which photo(s) they need or what exactly they’d like a photo of but they know that one from the tour would be just perfect, could you just send them all?
11. Return to the computer store for CDs and padded envelopes. Pretend you were kidding about the padded cell when the person at the computer store, who looks as though his mother hands them his Binky when she drops him off, looks confused and frightened.
12. Once you’re back home, with the six pack you picked up at Circle K on the way:
* Search your spreadsheet for the photos from the tour. The spreadsheet works great as long as you keep it up to date.
* Locate the photos on one of your external drives. One that hasn’t crapped out yet.
* Create a small spreadsheet, containing information for the photos from the tour.
* Burn the photos to a CD. Dang, why can’t you add another file to the CD? Toss the CD in the trash and burn one with the photos AND the spreadsheet.
* Label the CD, put it in a case, then in a padded envelope and seal.
* Google the person who requested it, to find their snail mail address. They didn’t bother to give you that information.
* Address the envelope.
* Take it to the post office.
* Stand in line.
* Strike up a conversation with the person in front of you in line.
* Mail the letter.
* Exchange business cards with the woman you were talking with in line.
* Stay in touch with her and learn that you have friends in common.
13. Go home to wait for the photo recipient to thank you.
14. Continue waiting.
15. It’s been three months now: stop waiting.
16. Enjoy seeing your photos in Powerpoints, flyers, and brochures. Swell with pride when they appear without attribution. Become ecstatic when you see your photos in print with someone else’s name on them.
See how easy digital photos are?
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