Posts Tagged United States

Minor Miracles: Fixing the Bikes.

Bike chain and chain tool on the ground

Bike chain and chain tool on the ground (Photo credit: londoncyclist)

Today should have been a very bad day.

It was one of those sunny New England fall days when you just have to get outside.  Since my house is shaded, I had no leaves to rake.  So it was time to get the bikes out for a ride.

Unfortunately, I hadn’t fixed the bikes.  But I had purchased what I needed.  I had a new valve for the back tire of my son’s bike, and I had a doo-hickey to help me shorten the chain on my bike so it doesn’t come unglued every time I go uphill (nothing quite like a chain losing its cool and jumping the tracks when you’re half way up a long hill).

So, feeling smug, I took out my equipment and started.  After all, I have an advanced degree and got a fairly high score on my SATs back when they were the “real” SATs.  So I should be able to master a few gears.

First problem.  My son’s valve doesn’t just not work.  It has broken into bits.  Bits that I proceed to jam down into the tire with a tiny screw driver.  So I do what any man would do.  I move on, leaving the first project unfinished.

Anyone who has tried to shorten a chain will appreciate the following.  Anyone who has not tried to shorten a chain should run screaming from the prospect.  If necessary, purchase a new bicycle before engaging in this particularly brutal form of masochism.

An hour later, I was no closer.  But I’d just been reading Dale Carnegie, so I had that “can do until I’m dead” attitude.  Didn’t help much.

I can only describe the following in miraculous terms.  I hit upon the idea of using one bit of chain to “channel” the bit of steel I needed into the chain I was now trying to repair.  It worked beautifully.  How that idea came to me after an hour of jiggering, I’ll never know.

Looking back at my first unfinished project, I hit upon the idea of simply pumping up the tire, letting the bits of the first valve hold in the air.  It worked.  I have no logical explanation.

So we got our afternoon bike ride.  Not really any thanks to me.  Maybe we all look for “major” miracles in our daily lives, when it is really the minor miracles that matter.


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People With No Sense of Humor Can Prove Laughing Is Bad For You.


laughter (Photo credit: withrow)

In a bizarre twist, I was looking for information on the “Laughter Yoga” movement and happened upon presentation notes (click for link) from a couple who must have faces like lemon eaters and attitudes to match.

Before we enter into this couple’s work, let me say I just attended a Laughter Yoga workshop and you never hurt quite that much doing anything as laughing for fifteen minutes.  Afterward, I felt closer to the people around me and we had a wonderful conversation for several hours afterwards.  But evidently, it was all in my mind.

According to the “lemon-eaters,” I couldn’t possibly have felt better, I just thought I did.  “These results suggest that, although high humor individuals do not seem to have objectively better health, they are somewhat more subjectively satisfied with their health.”

I should cease and desist all laughter, because:

•Past research has shown that extraverted individuals, in comparison with introverts, are
–more likely to drink alcohol,
–more likely to smoke cigarettes,
–less likely to quit smoking,

and more likely to be obese.”

English: Contagious Laughter

English: Contagious Laughter (Photo credit: Wikipedia)

My goodness, it’s horrible, this laughter.  An addiction I tell you!  Quick, join the LA (Laughers anonymous).

But it’s also a terrible use of medical resources, didn’t you know?  “Baptist East Hospital in Louisville, Kentucky has a player piano, humorous books, cartoon albums, and Nintendo game sets for patients and family members to use together.”

Dreadful, dreadful, all this family time and joyful material.  Don’t those parents know that laughter can make their children obese?  They should be very careful putting the material in a hospital, because:  “People have individualized senses of humor, and what makes one person laugh might annoy or insult someone else.”

But do not fear, the lemon eaters have already lost.  “Almost every major hospital in the United States now uses clowns, pets, clergy, and humor intervention as a regular part of their care systems.”  Really, I don’t recall clowns or dogs available in the local ER.

And what are we to make of the inclusion of “clergy” into the above statement.  Are religious ministers inherently funny?  I think adding in clergy gives the lemon eaters a much broader “threat” than if they just included hospitals that had clowns.  I think the clergy were there before the laughter movement took hold.  The tip off here is that the clergy are usually available for condolences for the grieving.  I have yet to see one with a red rubber nose and tiny bicycle peddling for the cancer wards.

So what are we to make of the lemon eaters?  Evidently someone needs a stooges film festival and a whoopie cushion, STAT!


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How Not To Help Your Hypertension. Just Kill The Nerves!

English: indirect blood pressure measurement i...

English: indirect blood pressure measurement in a cat, oscillometric. Deutsch: indirekte Blutdruckmessung bei einer Katze, oszillometrisches Messverfahren (Photo credit: Wikipedia)

In a very disturbing article, frustrated doctors are now recommending destroying the nerves of people unresponsive to blood pressure medication.

How does it work?

Let’s let them explain the procedure first.  (From Huffington Post)

“If there was a snake in the room, all of our blood pressures would go up, appropriately so,” explained interventional cardiologist Dr. Manesh Patel of Duke University.  But sometimes those nerves stay switched on when they shouldn’t be. The hope is that destroying a small number of the nerves could calm an overactive system, relaxing arteries and lowering blood pressure.”

Ok, let me recap.  Stress causes our blood pressures to rise.  It is a necessary part of staying alive.  But in some people, this stress continues to be a problem.  Make that all people, but some of us have more resilient arteries.  So the “new” solution is to cut off the nerve response so your body cannot respond to stress by producing nasty blood pressure raising adrenaline.  Why not just severe the spinal cord and be done with it?  Probably on next year’s list of options:  “you’ll need help to breath, but boy, that blood pressure sure dropped.”

How well does this severing of the nerves work?  In small studies, it takes about 33 points off the upper range, as long as you stay on all your other medications.  And does it work long term?  We don’t know, because we’re just starting larger trials.  And we have no long term results.

I’m going to go out on a limb here and say, yeah, cutting your nerves will work short term in some people.  But long term you keep up that stress, and you’re going to see that blood pressure rise back up.

Heck, you know what really drops blood pressure?  A newsectomy.  Let’s do a side-by-side trial of the people who get this lovely procedure with people who cannot look at the news for thirty days.  I bet you that the newsectomy is twice as effective.

What gets me about blood pressure is that we haven’t shown that lowering blood pressure prolongs people’s lives overall.  A slight decrease in stroke risk, and yes if you’ve had a heart attack.  But take your healthy eighty-year-old with slight hypertension, and you’re not going to see any more life if you control it with six meds.

But that doesn’t matter.  For this procedure, they’re getting fourteen thousand dollars in Europe.  That means about thirty thousand here in the U.S.  So it’s going to be rolled out.

Here’s a truly radical idea.  Let’s give the patients the thirty thousand dollars.  I’m betting that would bring down their blood pressures.  It might even lead them to take a holiday or get out of the situation that is causing the blood pressure elevation.  Let’s do a study testing the procedure versus giving the patients the cash.  I volunteer for the control group!


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Valley Fever: Like, So Totally Serious, Dude.

Geographic distribution of Coccidioidomycosis....

Image via Wikipedia

Ike Davis may or may not have Valley Fever.  But for those of us not part of Valley culture, Valley Fever sounds like something one would get from drinking someone else’s wine cooler.  Maybe Ike borrowed someone else’s unwashed leg warmers for aerobics.  (Are those back yet?  When will retro cool encompass leg warmers?  About the same time the giant airplane-wing size collars come back.)

Being a medical type, I was interested in this Valley Fever.  Was this some new disease striking yuppies, making them retro before their time?  Symptoms include the unnecessary use of the word like, addiction to pastels, and a slight fever – dance fever, that is.

Turns out that Valley Fever is a real disease.  The NIH website first lists it as “Valey Fever” in a rare typo.  I had a momentary image of Valet Fever, an infection caught from exclusively luxury model car keys.  Not to be mistaken for Ballet Fever, the urge to leap up and applaud mediocre ballet performances.

So the REAL name of Valley Fever is coccidioidomycosis.  If you went, oh, of course, you definitely spent time in medical school.  Or taking NPLEX exams for fun (sicko!).  Actually, I kind of liked taking practice NPLEX exams.  It’s Trivial Pursuit for the really intense hypochondriac within all of us.

Coccidiodomycosis is a fungal infection.  If you want to hear the way it is pronounced, Webster’s now has a wonderful audio feature.  Hearing it pronounced makes it sound like something so truly filthy that you could get slapped unless the people you are talking to are intense hypochondriacs.  It sounds like something Barney from How I Met Your Mother would be into.  It might be what J. Lo whispered in Barney’s ear before he had to tell her no and then went and jumped into the river.

But regardless of how it sounds, having it is no fun.  Ike made it sound like no big deal, but having a fungal infection in your lungs at his age is a serious no-no.  That’s the kind of thing you get after you get transplants of other organs and your body is shutting down.

So, either the NY specialists are making an error, or Ike doesn’t want to believe them.  It’s true that a huge number of people have antibodies to the fungus, but very few of them get the disease.  The fungus can go system wide and affect any body organ.  Time to really think about prevention if he did have this pneumonia.  If he developed symptoms, it is likely his body isn’t working at full capacity.

Semin Respir Crit Care Med. 2011 Dec;32(6):754-63. Epub  2011 Dec 13.

Pulmonary coccidioidomycosis.


Department of Internal Medicine, Division of Infectious Diseases, University of California-Davis, Davis, California 95616, USA.


Coccidioidomycosis refers to the spectrum of disease caused by the dimorphic fungi Coccidioides immitis and Coccidioides posadasii. Clinical manifestations vary depending upon both the extent of infection and the immune status of the host. Coccidioidomycosis has been reported to involve almost all organ systems; however, pulmonary disease is the most common clinical manifestation. The incidence of coccidioidomycosis continues to rise, and primary coccidioidal pneumonia accounts for 17 to 29% of all cases of community-acquired pneumonia in endemic regions. The majority of patients with coccidioidomycosis resolve their initial infection without sequelae; however, several patients develop complications of disease ranging in severity from complicated pulmonary coccidioidomycosis to widely disseminated disease with immediately life-threatening manifestations. This review focuses on complications of pulmonary coccidioidomycosis with an emphasis on the management of primary coccidioidal infection, solitary pulmonary nodules, pleural effusions, cavitary disease, acute respiratory distress syndrome (ARDS), miliary disease, and sepsis.

© Thieme Medical Publishers.

PMID: 22167403
Pol Arch Med Wewn. 2008 Jun;118(6):387-90.

Coccidioidomycosis in a 38-year-old man: a case report.


Department of Pulmonary Diseases, Medical University, Poznań, Poland.


The present article describes a case of acute pulmonary coccidioidomycosis in a 38-year-old man, a research worker. The disease started during the patient stay in Arizona, USA, and clinical symptoms persisted after his return to Poland. Acute coccidioidomycosis is one the clinical manifestations of Coccidioides immitis strain endemic infections occurring in the south-western regions of USA including California (mainly San Joaquin Valley), Western Texas, New Mexico and the desert areas of Arizona, and Central and South America. The native environment of Coccidioides immitis is soil penetrated by rodents. People, domestic and wild animals suffer from coccidioidomycosis. The infection rate in endemic areas is about 2-4% a year in the healthy population. Coccidioidomycosis can be observed in non-endemic areas due to population mobility and in immunocompromised patients. The Coccidioides immitis infection is caused by inhaled airborne fungal spores and it may occur as primary pulmonary (acute or chronic) asymptomatic form, meningitis, or disseminated disease. The clinical symptoms of coccidioidomycotis like acute pulmonary manifestations may resemble typical, resistant to empiric antibiotic treatment of bacterial pneumonia. In healthy subjects, pulmonary coccidioidomycosis may occur as asymptomatic infection, which resolves spontaneously without medication. Sometimes, slight shadows like local fibrosis and cavities may be visible on the chest X-ray. The Coccidioides immitis infection in people with immunological deficiency syndromes, e.g. HIV/AIDS, manifests itself as disseminated disease and may lead to severe complications including death.



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Bath Salts Add Flesh Eating to Their Side Effects

English: Computed tomography images of necroti...

Image via Wikipedia

In a turn for the downright macabre, a female bath salts use was partially eaten after her indulgence in injecting bath salts generated necrotizing fasciitis (that’s bacteria eating you alive).

Above is true, below is humor.

Trying to exploit the trend, drug manufacturers are advertising the “piranha soak,” where patients indulge in bath salts while being eaten by actual piranha.  “Man, such a high!” said one recently created amputee.  “It’s like all that adrenaline from being eaten just mixes with the whole crazy paranoia and gibbering that the salts gives me.  It even beats the high I got getting hit by that semi a month ago.”

Medical personnel were vaguely supportive of the new trend.  “Currently it takes eight people to restrain a bath assaulter.  Two for each limb.  Fewer limbs means fewer personnel required per assaulter.”  Other assaulters had this to say:  “the devil man, the devil is in my head!”

Why anyone would want to inject or use this synthetic mix of amphetamines is beyond me.

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The Tyranny of Averages: Imaginary Naturopathic Doctors Who Make More Than I Do.

Presque Isle River

Image by chief_huddleston via Flickr

I was looking about at Maine Naturopathic Doctors, a topic of personal interest.  According to a website that gives averages of salaries for every job, everywhere, Naturopathic doctors in Presque Isle make an average of 56k a year, with options to earn more far more.

Very disturbing, because I know for a fact that we have no N.D.s currently in Presque Isle.  My current location, Augusta, isn’t even listed on the averages charts, so evidently the four of us who practice locally don’t exist.

But in this case I have a very real sounding number, based on absolutely nothing at all.  How much of our current debates about finances and public policy are based on averages that fail to even come close to touching reality anywhere?

Now, I’m thinking about moving to Presque Isle if I can get this averages website to give me some guarantees about my possible salary.

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Wind May Cause Disease.

English: Moon over San Diego. Français : San D...

Image via Wikipedia

In a turn around from “common wisdom,”  scientists are now thinking that wind currents might affect a disease called Kawasaki Syndrome.  In science speak:  “it was possible from their analysis to identify the major anomalous yearly peaks of KD cases occurring in San Diego from 1994 to 2008 as belonging to two main atmospheric configurations.”  In English that would be:  “much wind raises much dust and makes your nose run more.”

In other news. scientists are researching the idea that really cold air might in fact make one more susceptible to stay inside with coughing people and so might be a causal factor for colds.  They also discovered that chicken soup might be helpful.

Luckier researchers have discovered that when mommy kisses a boo-boo, it does make it feel better.

I want to research the possibility that sugar makes children hyper and how much chocolate it takes to stay up all night.  Where’s my government grant?

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