Cataracts?

Car Headlights

I drove to the hospital Tuesday morning at o'dark thirty and a couple of cars I encountered looked like this. I suspect I may be getting cataracts, I am getting old, so it's a possibility. But then again, maybe it's just the stupid headlamps on new cars. I was kind of surprised because I don't go out much at night. And how would you get a picture like this? I suspect your typical phone-camera is just going to show a couple of bright spots, it won't fill your whole field of view with starbursts.

Hip Joint Replacement Surgery

My Hand, Festooned With A Needle and an Electronic Doo-Dad

Left the house at 5AM yesterday morning and got home around 7PM with a new hip joint. Dr. Elizabeth Lieberman from the Orthopedic and Fracture Specialists performed the operation at St. Vincent's Hospital in Beaverton. While I was there I was almost entirely under the care of women. I think I only had two guys dealing with me. Let's see how many I remember:

• the receptionist greeted me, collected $455, and started putting data in the computer,
• the nurse who guided me to the surgery preparation room
• Rosh prepared me, which seemed mostly to making sure she had the right person and the right operation, i.e. lots of typing on the computer
• a vampire to stick the needle in my hand so they could pump me full of drugs
• Dr. Li, the anesthesiologist came by and introduced herself,
• her assistant, a man, came by and talked to me,
• I think Rosh wheeled me and my stretcher to the operating room. I can't be sure it was her, but then lying flat on my back I couldn't see who was pushing my stretcher.
• Did Dr. Lieberman's surgery nurse come by before I got to the O. R? Probably, but once I was in the O. R. she got me on the operating table (carefully covered with a sheet) and got me in position so the anesthetists could stick c spinal tap needle in my back.
• And that is all I remember before I woke up in recovery, where another man checked my vital signs and entered more data in the computer. I was still pretty out of it, I don't recall anything else about that, I wasn't there long.
• Then it was off to Short Surgery Care Center / Unit (?) where I spent several hours sleeping and occasionally eating Kellogg graham crackers. That was a high point. I've been working on losing weight for a while and cookies are pretty much verboten. When you have been deprived of cookies for a while, even graham crackers are a treat. I ate at least six.
• Kathleen was my primary nurse in the SSC. Rosh also came by. She got to insert a catheter into my urethra to drain 560cc of urine out of my bladder. I had no sensation down there. Not draining the bladder could cause big problems.
• Around 3 or 4PM Jerri, the Physical Therapist came by and ran me through various exercises for the feeble, like getting out of bed, walking across the hall to the restroom where I was able to urinate by myself (only 250cc this time), walking down the hall with a walker, and climbing the world's shortest staircase (3 steps). She seemed to think I should remember all the rules from last time as it was only three years ago that I got my right hip joint replaced. I vaguely remembered going through the motions, but the rules? Not a clue. The big one is 'if in doubt, knees out'.
• While we were out of my room (number 7), someone came by and stole my stretcher, so they had to activate the movers, a crew of, I dunno, half a dozen lovely young women to pull a bed out of another room and wheel it into mine. I suppose there is some difference between a 'bed' and a 'stretcher' but the only difference I noticed was that the safety rails were chrome steel tubes on the stretcher and plastic panels on the bed,
• Next was the Occupational Therapist. I think the big deal here was getting dressed.
• Now I get one more nurse to go over my rules for when I get home. Fortunately my wife was there to absorb all that so all I had to do was smile and nod.
• Lastly, a cute young woman (a CNN maybe?) got me in the wheelchair and wheeled me to the Phil and Wife Nike Entrance where my wife was waiting with the car. She gave me a little help getting my feet in the car.

Every time I met a new person I had to tell them my name, birthday and why I was there. Then they collected my vital signs (pulse, blood pressure and temperature) and entered it into the computer.

That's all for now.

Smartwatch

Samsung Galaxy Watch 4

I have atrial fibrillation (commonly called afib). My heart beat is irregular and sometimes very fast. That's what put me in the hospital 20 years ago. They gave me some drugs and my heart slowed down, but it's still irregular. I'm still taking the drugs. Seems like I am getting worn out more easily these days. It could just be because I am getting old, but rumor has it that some of these drugs might be slowing me down. I wanted to see if my heart was always being flaky, or whether it might sometimes revert to a normal rhythm, so I looked at heart monitors. I was looking for one that could record my heart beat for extended periods, but the more I looked, the less I found. Lots of Smartwatches offer heartrate monitoring, but most of them are for people with normal heart rhythms, you know, exercise fanatics. This Samsung watch will record a rudimentary electro-cardiogram which is step up from simply counting the number of beats. It was only $70, so I thought I would give it a shot.

Samsung 30 second ECG

The watch makes the recording, sends it as a PDF to my Samsung smartphone via Bluetooth, I 'share' it via email but don't send it. Now the mail is in my gmail drafts folder. Open this message on my desktop, download the file to my computer. Open the file, take a screenshot, edit it to remove the extraneous noise and then insert it in this blog post.

I have made a half a dozen recordings and they all show an irregular heartbeat.

Then I come across this cool video on YouTube:

Your Smartwatch is even more incredible than you think
Steve Mould

Fun with doctors and plumbing

Yesterday morning I went to see Dr. Schmidt, the urologist. Mom went with me. He listens to my tale of woe and prescribes Oxybutinin. I'm already taking Tamsulosin to cope with an enlarged prostate gland. When the prostate gets enlarged it becomes more difficult for it to relax enough to let urine flow, so the bladder, a muscular organ, has to work harder to push the urine out. The Tamsulosin lets the prostate relax so the bladder doesn't have to work so hard. Near as I can tell, after a long period of having to deal with the recalcitrant prostate, the bladder gets to be in a state of constant tension. So now I've got Oxybutinin which is supposed to relax the bladder. I took this once before, about a year ago, for a month, and it helped, but now the same problems have returned, so it looks like I will be adding one more drug to the handful of pills I take every day.

Get done with all that and doc asks me if I want a prostate exam, cancer screening you know, and mom says yes. I'm pretty sure I had one of these a year ago, but with the two of them ganging up on me I submit. It's annoying and unpleasant, but it only takes a few seconds and I should be good for a couple of years. I suspect the doc offered to do it because he knows that medicare will pay him $25 for the exam and it will only take a minute. $25 for a minute works out to $1500 an hour, which is pretty good pay in anybody's book.

After 30 years the stopper in the sink in the upstairs hall bathroom bit the big one. Found one on Amazon for $5 and had it delivered. In the drawing above, note how the Pivot rod goes through a little ring at the bottom of the stopper. The ring had broken loose from the stopper but was still on the Pivot rod. The Pivot rod goes through a hole in the side of the drain pipe and is held in place with a nut. Unscrewing the nut allows the Pivot rod to be removed, but when you do that the ring is going to fall off into the P-trap. If might get flushed down the pipe and out the sewer, but it might just hang around there collecting other bits of trash and eventually block the trap. 

P-trap

Best to get it out. Normally, the P-trap can be easily removed, but because our custom cabinets have drawers underneath, there is a shelf directly under the P-trap, so in order to remove it I had to unscrew the down pipe that contained the Pivot rod access hole, which slid into the P-trap and allowed me to pull the whole thing out. Of course water pours out when you open the P-trap, but my brain was operating so I had an old towel on hand to mop up the spill. The back of the shelf had water stains that appeared to come from the shut off valves, but the valves were dry, so I just put everything back together. 

I'm working blind getting the Pivot rod into the hole in the new stopper, but must have I got it right  one because it's working.

This morning we drove out to North Plains to let the shutter man into our old neighbor's new house. They decamped for Palm Desert, and the shutters hadn't yet made it to shutter man, so we got to be the good neighbors. The shutter man got the worst of it. We had a ten minute drive from our house, but he had an hour and a half drive from Oregon City. Morning rush hour through some of the most congested highways. Normally that drive would take half that time.

We stopped at McDonalds and got a couple of breakfast burritos and coffees and it cost like $10. You order from a big flat-panel touch screen. Tap, tap, tap, tappity tap, tap, tap. Every item takes at least 3 taps, and final check out takes several more. It seemed a bit ridiculous, but we got through it. The only people we saw was one person behind the counter, one person mopping the floor and the person who delivered our order to our table. I don't know if I like this, but the food was fine and the price was excellent.

Now we head over to Providence Hospital on the east side where the striking nurses are out in full force. The parking garage was fuller than usual today. We parked on level F and took the elevator down. Sign by the elevator says level D for the skybridge, level C for walkway to main entrance. Get down to level C and find we have to take the stairs down one more level to get to the street level.

Mom gets checked in and the fire alarm goes off. Very loud and very obnoxious and everyone has to leave the building. Me, fearing the worst, suggests we start walking. I mean, who knows how long we are going to be stuck outside, and it's freezing. Maybe we can find a coffee shop. We walk two blocks and indeed we find a Starbucks where we order a couple cups of coffee and a couple of the smallest scones in the world for $15. Meanwhile, mom gets a message from her doctor in the same building, so she calls her back and finds that the fire drill is over and we can go back inside. Seems that was the third fire drill this morning, and it's only ten o'clock. If we hadn't gone to Starbucks we would still be standing outside, freezing, because god hates us.

The dexascan reports that mom's bone density has gone up, which is good. It looks like that her expensive personal training regimen is paying off.

I stop in the bathroom on our way out. I'm sitting on the toilet thinking I ought to send a note Providence to compliment the janitor for keeping the restroom so clean. Then I lean over, the toliet flushes and squirts me in the butt. Dang it! Apparently I leaned over far enough to trigger the automatic flush trigger. Bah. 

Wash my hands (at the sink) and reach for a towel. There is an automatic, wave-at-me towel dispenser. It  rolls out six inches of paper towel. Wave again and I now I have two pieces of paper towel, each six inches long, barely enough to qualify as one sheet. Try the other dispenser. It rolls out a nice long sheet, at least fifteen inches. So not all automatic gadgets are junk.

Back home we head to Walgreens to pick up my drugs. It looks like there are half a dozen spaces in the parking lot, but they're all allocated for special people. There is the requisite handicapped double spot, a spot to pick up online orders and two spots to charge your electric car. Is there an ordinary empty parking spot? Oh yes, there is! One. Bueno.

We go inside, I go to the pharmacy to pick up my drugs. They have some, but not the whole order. Serrrano tells me that the rest will be here this afternoon. I know his name is Serrano because he has it written in big letters on his forearm and when I asked him about it he told me.

I'm done and go look for mom. She's waiting in line to buy toothpaste. The only reason we're buying toothpaste here is because because Medicare or our health insurance gives us $25 a month to spend on stuff, presumably health related. Shoot, if you're gonna give me money, I'll take it. You'd have to be in pretty bad shape to need money for toothpaste, but I imagine there are scads of people who have been driven into the ground by effing Biden and his commie cohorts. The line is long, and I'm gonna have to come back anyway, so we head home, eat tuna salad for lunch and write this story.

Brains

4 arteries supply blood to the brain
Sam Webster

That is quite the model.

Walking the Dog

Dog Water?

I have upped my walking to 30 minutes. It's been a year since I got my new artificial hip joint installed and while I could walk comfortably since shortly after the operation, walking for a few minutes would cause the joint to start aching. After a while I was able to walk around the block (ten minutes), but this summer I have started tackling longer distances, like three or four miles. Great achievement, but it left me so wiped out I would need a couple of days to recover. Sad, very sad, as the great and benevolent Donald likes to say. But now I've been doing 30 minute walks every morning and all is well.

I go early in the morning, before breakfast and before I've taken a shower because if I wait till those two chores are done, life takes over and a walk takes the back burner which means it doesn't happen. While I am out, I will usually see about a dozen people, some are working (roofers and landscapers mostly), some are just out walking and about half of these are walking their dogs.

Today I noticed this little puddle adjacent to a paved walking path. Been by here every day for a week and today was the first time I noticed it. It looks like someone deliberately made this hole for drinking water for dogs, but it has a definite brown tinge from the adjacent asphalt paving. Doesn't seem like a good idea, but if it was really bad I suspect dog's wouldn't drink out of it.

Talking to Jack about his dog Ruthy yesterday. It seems like Ruthy likes to eat cherry pits she finds on the ground. Jack's neighbor has a cherry tree that hangs over the fence, and there's a cherry tree at a nearby school where they go for walks. So what's the big deal? Dogs eat all kinds of garbage, that's how they get that wonderful dog breath. Well, seems cherry pits are full of cyanide. If you just swallow them whole it's not a big deal, but if you crunch them up it doesn't take more than a dozen to send you to your maker. The crunch is the key, but dogs like crunchy things, so, yeah, you wanna take precautions.

Wasn't there a tune called Walking the Dog? Yes, yes there was:

Rufus Thomas - Walking The Dog (1964)
Reelblack One

Under the Weather

Under the Weather

I was feeling pretty rotten yesterday evening. I drank a couple of cans of ginger ale and I was able to get some sleep. I am feeling a little better today, not 100%, but better. The only reason I mention this is that it seems to happen every couple of months and I thought I ought to start keeping track. Yes, I could put it in my calendar, or in a separate log somewhere, but the next time it happens I would need to remember where I put that note. If everything is in this blog, then there's only one place to look for anything and that's right here, so here it is.

Coincidentally I saw the doctor yesterday for a Medicare 'wellness checkup', which mostly asks a bunch of questions like 'are you dying?' I suspect they feed this into their great computer which will chew on this data and spit out some recommendations, which the yahoos in charge will turn into some kind of political propaganda. 

They drew some blood and they will test it, but I expect that all they will find is that my potassium is low, as usual .

From The Wager by David Grann, we get this bit about the origin of the phrase 'under the weather':

(When ailing seamen were shielded belowdecks from the adverse elements outside, they were said to be "under the weather.")

 

Sauerkraut

Making Sauerkraut

IAman reports:

I would like to try to make sauerkraut at home. Hence I need a crock.  I've been reading Captain Cooks biography and it impressed me on the importance of Kraut on a extended sea voyage (over 30 days the human body loses the anti-scorbutic levels of vitamin C) .  Through fermentation, it seems more vitamin C is produced than naturally occurs in green cabbage. (correct me if I am wrong)  Though land-locked  I still like kraut with sausage and apples,  also on sandwiches.   Yes I can buy kraut at Walmart for 9 cents a ounce, $1.44 lb, which is what cabbage costs, but why do that when I can chop, ferment and watch it bubble for a week?  I have a plastic container,  but would rather use a non-reactive stoneware,  but buying one from Ace hardware at $65 for an experiment goes against my frugal instincts.

From Wikipedia:

It is a high source of vitamins C and K; the fermentation process increases the bioavailability of nutrients rendering sauerkraut even more nutritious than the original cabbage.

Peddling Across Norway

My Electronically Enhanced Gym

I've been riding an exercise back lately. I got tired of the built in videos that Peloton provides, so I thought I'd try YouTube. There might be a way to get YouTube on the Peloton screen, but maybe not. Not my Peloton, so I don't want to mess with it. Besides there's a big screen TV on the wall. I think the girls had the idea of turning this into an exercise studio, but I think I'm the only one using it. I'm using my laptop to play a YouTube video over the HDMI cable, and YouTube Music to play tunes using the headphone jack which is connected to an old soundbar I had laying around. Both audio and video are coming over WiFi, but the Peloton is connected to the internet with a wire. It's supposed to have WiFi but for some reason the WiFi doesn't want to cooperate.

The video is the view out the front of a train as it travels from Trondheim north to the Arctic Circle. It's 10 hours long. At the rate I'm going I should be there by summer. I posted a short excerpt from a trip from Birgen to Oslo.

I used to ride real bicycles outside in the real world and it was great, some of the time. Then my heart flaked out and I realized why it was only some of the time, so I gave it up. Also meant I wasn't out playing in traffic which always made me a little nervous. I mention this because I drove over to St. Johns today and because the weather was pleasant the bicyclists were out in force. I don't like having to watch out for them, it's a little nerve racking to be bombing along a country road and have a cyclist suddenly appear on the scene. Where there is a straight road without much traffic, it's not too bad, but the road to St. Johns (Germantown) is neither straight nor low traffic. Nobody in their right mind would take a bicycle up Germantown road, but today they were there, lunatics anonymous, peddling their little hearts out. 

The Crud

Tuesday, February 7

My wife and I have both come down with some kind of bug. She was running a fever of 100 degrees yesterday and feeling pretty miserable, so I suggested she might want to take a couple of aspirin or something. She declined, saying running a fever was beneficial. Now I was confused because I remember hearing both what she was telling me and recommendations to take drugs to reduce the fever, so I asked the Google and got this back:

Evidence shows that fever is beneficial to the healing process, triggering the immune response and preventing viruses and bacteria from replicating. One study showed that flu sufferers who suppressed their fevers with medications were sick for more than three days longer than those who took no medication.

So now I remember that it is high fevers that are dangerous, like 104 degrees. A piddly little 100 degree fever is nothing to worry about.

Wednesday, February 8

Suja Organic Immunity Defense Shot With Turmeric And Probiotics - 2 Fl. Oz.

Last night I was feeling pretty miserable. Osmany gave a little bottle of magic juice. Tasted yucky. Next morning I was feeling pretty good, but that only lasted for a few hours and then I got worse than ever. Next couple of days were pretty miserable. Took some Nyquil and got some sleep, not much mind you, just enough so that I thought I might survive.

Saturday, February 11

Feeling much better today. Still kind of weak, but well enough to shower and cook a batch of sausage patties.

We went to see a play at Portland Center Stage on Sunday. They want everyone to wear masks. On the way home my wife started feeling bad. Stupid. No one else except medical offices require masks. Did our wearing masks prevent anyone else in the theater from getting sick? I doubt it.

The worst part about wearing a mask, besides being stupid, is that no matter how I futz with it, they don't seal around my nose so I get a constant stream of warm air being directed at my eyes.

Was it COVID? I don't know and I don't care. What would knowing whether it was COVID or garden variety cold/flu have done for me? Nada. Same treatment regardless, rest and sugar water in several flavors. Intolerance for solid food makes my suspect it was the flu and not just a cold.

Mosquito

Gustavo Bravetti - Mosquito (live)
gustavo bravetti

This isn't much of a tune, some people would probably not even consider it music, but for getting you moving it works pretty well. I've started riding my daughter's Peloton exercise bike and it's making a big difference in how well my legs work. The Peloton has a video screen, exercise programs and music. It's basically overpriced ridiculousness, but it's here and it's available and I needed to do something, so I've started using it.

My back got screwed up a couple of years ago (from climbing stairs with steps that are like four inches extra tall, if you can believe it) and it's been giving me all kinds of grief ever since. Go to the doctor and they recommend a battery of exercises. They would probably help, but I am very bad at doing them. They are boring and they take work, so stupid. I used to ride a bicycle quite a bit, probably up until I ended up in the hospital with heart problems. That's when I found out why riding was such a chore and I wasn't get any of the euphoria normal, healthy people got from vigorous exercise. The root cause seems to be atrial fibrillation. That and an enlarged aorta and then the general hazards of riding a bicycle on the same roads as 18 wheelers convince me that bike riding was stupid and I wasn't going to do it anymore.

I did have a good time when I was riding, at least when I wasn't effing struggling up some stupid 50 foot hill. So the exercise bike suits me well. I've been doing ten minutes a day and now I can go up and down the stairs without having to hold onto the hand rail. Cool.

Smell Training

Big Nose

Liz Hinds has a post up about her olfactory abilities, or lack thereof. My nose doesn't work too well. I used to get sinus infections annually and some of them were pretty bad. One went on for so long that I got double vision. I suspect something in my head swole up and was pushing on my eyeball. It went on for so long that I got a pair of glasses made to correct it. After a while (six months maybe?) it went away and my vision returned to normal.

Anyway, somewhere along the way I seem to have lost my sense of smell. My wife will notice an odor and tell me about it, but I will smell nothing. I do pick up faint whiffs of odd things occasionally, so my nose isn't completely dead.

But that whole sense of smell never seemed that important to me and there aren't any smells I particularly miss. Some things smell better than others, but I don't get any particular enjoyment out of them. I can still smell smoke, which is good. Probably a very primitive survival instinct which may be why I haven't lost that ability.

I kind of wonder if smell training would help me, but I already have several regimens that I fail to keep up with. Don't really need another one.

Anxious

Stolen entire from Doctor Grumpy in the House:

Dr. Grumpy: "This is Dr. Grumpy, returning a page."

Mr. Lacune: "Hi, thish ish Dave Lacune, you shaw me at the hoshpital a few days ago, when I had a shtroke."

Dr. Grumpy: "Yes sir, are you okay? Your speech is pretty slurred, and I don't remember it having been affected by the stroke."

Mr. Lacune: "I'm fine. Look, you preshcribed Nomocva to me, to keep me from having another a shtroke, but I read about all itsh shide effectsh, and sho now I shtopped it and I'm afraid to take it."

Dr. Grumpy: "I'm kind of concerned you've had another stroke, sir. Your speech is pretty slurred."

Mr. Lacune: "Nah, my shpeech ish like thish because I've been doing tequila shotsh and shmoking weed all night because I'm anxioush."

Pause

Dr. Grumpy: "What are you so anxious about?"

Mr. Lacune: "Becaushe I shtopped Nomocva, sho now I'm worried I might have another shtroke."

I'm taking Eliquis because some people I know are worried that I might have a stroke. The doc prescribed it because I have an irregular heartbeat, which means my heart might not be doing a good job of emptying the chambers every time it beats, which might lead to blood pooling and then coagulating into clots and then the clots might get pumped out into the circulatory system and when they get down to the small blood vessels, they would jam, and if that jam happened in the brain, that would be a stroke.

Eliquis is ridiculously expensive. Retail it runs about $600 a month. I have some kind of health insurance, so I'm not paying full tilt, but it's still enough to notice. It costs that much because the patent hasn't expired.

When I got out of the hospital (ten or twenty years ago), previous doc put me on Coumadin (also known as rat poison). It's cheap but it's kind of persnickety. They want a blood test every week or two. I did that for a while, but the results always came back the same, and since the blood tests were annoying, I quit going as often as I should. Eventually my doctor noticed and took me off of it because I "was a bad patient". Eventually he retired, and I started seeing his replacement who wanted me to start taking this fancy new drug that didn't require a blood test. The price annoyed me, but my daughter the nurse made a fuss, so now I take it.

Never heard of Nomocva and neither has Google. I imagine the two people talking knew what they were talking about.

COVID-19

I've got a theory about this whole COVID-19 and Fauci's fumbles. Rumor has it that the US was funding a research laboratory in Wuhan China to conduct gain-of-function experiments on certain virii. Then a new virus starts making people sick in that same Wuhan China. Now you're the guy charge with protecting the health of the 330 million people living in the USA, whatchya gonna do? Shit, if this shit that's making people sick came from that lab, this could be really bad. Bad as in 14th Century Black Plague bad. Better go to the public health equivalent of DEF-CON 4 and close all the windows, bolt the doors, and proclaim panic: the bugs are coming!

The problem with any new disease is you don't know how bad it's going to be. Is it going to be annoying or deadly? How contagious will it be? How will it be transmitted? By intimate contact?  By droplets floating in the air? They might only be dangerous until they dry up. Or maybe even dry particles could transmit the disease. Nobody knows until somebody does some research, or until people a bunch of people start showing up dead, and then it's pretty much too late. Better to clamp down early and clamp down hard. Better be safe than sorry.

Turns out that COVID-19 is not all that deadly, maybe 50% more deadly than the regular flu, so in hindsight, the draconian lockdowns and mask requirements were overkill, and there seems to be some doubt that they had any beneficial effect at all. And what about the regular flu? Haven't heard a word about it. That strikes me as kind of weird. Might just be an effect of our distorted news reporting system. Nobody cares about old stuff that might kill you, we want to hear about the new stuff that might kill you.

Back before COVID-19, there was a new variety of flu every year and every year you had to get a new vaccine. You were supposed to anyway. I never got one. I thought it was stupid. Maybe because we didn't have flu vaccines when I was growing up, of maybe I had the flu once when I was a kid and I was sick for a couple of days but it was so long ago I forgot how bad it was. Whatever. But now it's 2021 and I just got vaccinated for COVID-19, a bug that is two years old. Of course we've got new varieties of COVID popping up here and there and I expect we're going to start seeing new vaccines showing up here along with noisy obnoxious campaigns to get everyone vaccinated with the latest and greatest goop. No thanks. It's been five days since I got my second Pfizer jab and while I am walking and talking, I am still not right. I have a low grade headache all over the outside of my head, what feels like a sinus infection behind my left eye, my left eye is prone to watering and I have a red spot on my cheek. I only mention the last because my family noticed and pointed it out to me.

I had no intention of getting the vaccine, but I had a conversation with my wife about it. She is a bit anxiety prone, so I agreed to do it to alleviate her concerns. So all this trivial suffering is my own fault for being agreeable.

P.S. I remember hearing about gain-of-function when I was reading The Demon in the Freezer by Richard Preston, which was about the campaign to eliminate smallpox. It's kind of fucked up.

Who was that masked man?

who was that masked man
Since I am unable to escape the barrage of un-information about the Corona Virus, I thought I would chip in my two cents. Actually, two cents I stole from Occupational Health & Safety

A Comparison of Surgical Masks, Surgical N95 Respirators, and Industrial N95 Respirators
May 01, 2014

The most important thing to remember about surgical masks is that they are not designed to pass a fit test. Their purpose is to help protect the environment and nearby persons from the wearer's contaminants.

It is easy to confuse a surgical mask, a surgical N95 respirator, and an industrial N95 disposable respirator with one another. They look similar, and the words "respirator" and "mask" are often used interchangeably when discussing respiratory protection. However, in fact there are many differences between them. This article is intended to educate the reader on the differences between surgical masks, surgical N95 respirators, and industrial N95 respirators.

Purpose or Intended Use
Surgical masks

• May include masks labeled as surgical, laser, isolation, dental, or medical procedure masks
• Are primarily intended to protect the patient, not the wearer, from the wearer's saliva and respiratory secretions
• May also help protect the wearer against exposure to microorganisms, body fluids, and large particles in the air but are not tight fitting and likely have substantial inward leakage for particles and organisms
• Are designed to cover the mouth and nose loosely but are not sized for individual fit
• Are not NIOSH (National Institute for Occupational Safety and Health) approved

Surgical N95 respirators

• Surgical N95 respirators are designed to reduce but cannot eliminate the wearer’s exposure to airborne biological contaminants. They do not eliminate the risk of illness, disease, or death.
• Form a tight seal over the mouth and nose.
• Require fit-testing and must be adjusted to your face to provide the intended effectiveness of filtering 95 percent of particles with a mass median diameter of 0.3 micrometers.
• Employers and users are required to follow the OSHA Respiratory Protection Standard, 29CFR 1910.134, as well as other state or local regulations, as appropriate.
• Have specific use instructions, warnings, and limitations for use in health care environments.
• Are NIOSH certified.
• Are fluid resistant to a certified level measured against a stream of artificial blood directed at the respirator.

Industrial N95 respirators

• Are designed to reduce but cannot eliminate the wearer's exposure against certain airborne particles and aerosols free of oil.
• Form a tight seal over the mouth and nose.
• Employers and users are required to follow the OSHA Respiratory Protection Standard, 29CFR 1910.134, as well as other state or local regulations, as appropriate.
• These respirators (without valves) also can help prevent exhalation of contamination by the wearer to others in the work environment.
• Require fit-testing and must be adjusted to your face to provide the intended effectiveness of filtering 95 percent of particles with mass median diameter of 0.3 micrometers.
• Have specific use instructions, warnings, and limitations for use in industrial environments.
• Are NIOSH certified.
• Are not certified to be fluid resistant.

Approval and Certification
Surgical masks

The U.S. Food and Drug Administration (FDA) clears surgical masks for sale in the United States. FDA does not test and certify the respirator. Instead, they clear the respirator for sale after reviewing the manufacturer's test data and proposed claims. The manufacturer performs and submits the results from several tests, including particle filtration efficiency, bacterial filter efficiency, fluid resistance, etc.
The particulate filter efficiency gives an indication of the quality of the health care surgical mask. However, this rating is completely different and far less rigorous than the NIOSH N95 filter efficiency rating and should not be used as a comparison between the two.

Surgical N95 respirators

Surgical N95 respirators are approved by NIOSH as to their respiratory protection efficiency and resistance and other NIOSH requirements. They are also separately cleared by FDA as medical devices. FDA clears surgical masks for sale in the United States but does not test and certify the respirator. Instead, the agency clears the respirator for sale after reviewing the manufacturer's test data and proposed claims. The manufacturer performs and submits the results from several tests, including particle filtration efficiency, bacterial filter efficiency, fluid resistance, etc.
The biological filter efficiency gives an indication of the quality of the health care surgical mask. However, this rating is completely different and far less rigorous than the NIOSH filter efficiency rating and should not be used as a comparison between the two. Surgical N95 respirators and N95 industrial respirators share the same NIOSH requirements. NIOSH also has other efficiency certification levels for industrial respirators (see below).

Industrial respirators (including industrial N95 respirators) and Surgical N95 respirators

In the United States, NIOSH is responsible for testing and certifying respirators to be used in the workplace. NIOSH not only reviews the manufacturer's test data, but also performs its own independent tests on the respirators in NIOSH's governmental laboratories to verify the manufacturer's results. The tests include filter efficiency, degradation, and flow rate, to name a few. In addition to testing the respirators during the submittal process, NIOSH also will periodically purchase respirators in the field and test them to make sure the respirators are performing to their original certification.
Once the respirator is initially approved, NIOSH will certify its classification as N, R, or P and its filter efficiency as 95 percent, 99 percent, or 99.97 percent. It is also important to note that even though a respirator just by its use often helps to prevent the wearer from contaminating the environment; it cannot be considered a surgical mask unless it has been cleared by the FDA.

Surgical masks

The most important thing to remember about surgical masks is that they are not designed to pass a fit test. As explained above, their purpose is to help protect the environment and other nearby persons from the wearer's contaminants. When many surgical masks are worn, they will have gaps around the edges that allow many small particles to enter the respiratory system of the wearer. Even tighter-fitting surgical masks will have some gaps that allow small particles to enter the wearer’s respiratory system.

Surgical N95 and industrial N95 respirators

Respirators are designed to seal the respirator to the face and pass a fit test. Under Respiratory Protection Standard 29 CFR 1910.134, the Occupational Safety and Health Administration requires the wearer of a respirator to be fit tested before he or she can use the respirator in a contaminated environment. OSHA also requires the wearer to perform user seal checks on the respirator before each use, as well as comply with the other elements of a comprehensive respiratory protection program in accordance with 29 CFR 1910.134.
If the wearer is unable to obtain a proper fit, he or she must not enter the contaminated area. For more information on this standard, visit the OSHA website, www.osha.gov.
A properly fit-tested N95 respirator will greatly reduce the number of small particles that will enter the wearer’s respiratory system, as compared to a surgical mask that is not NIOSH approved. The extent of that reduction is a function of the fit of the mask, its filtration efficiency level (with respirators available from 95 percent to 99.97 percent filter efficiency), and the wearer’s proper donning and wearing of the respirator according to the training the employer provides as required by OSHA regulations.

Length of Wear
Surgical masks

While each facility has its own policy, surgical masks in general are discarded after each procedure. They are typically worn only for specific procedures.

Surgical N95 and industrial N95 respirators

Respirators must be put on and taken off in an area outside of the contaminated area. Putting a respirator on or taking it off even for a few seconds in a contaminated area can expose the wearer to significant levels of hazards. Each facility has its own policy on disposal of the respirator, depending on use conditions and the type of hazard that these products are being used to protect against.

Cronometer

Cronometer Calorie Counting Program

I am trying to lose weight, again. For me, it's entirely psychological. Perhaps if I had an all consuming hobby or project, I wouldn't eat so much, but as it is, eating is one my favorite things. I have managed to lose some weight before. The only thing that seems to work as far as losing weight is if I write down everything I eat. That isn't too onerous. I did it for a while. But then I would look up the calorie content of the food and enter the data into a spreadsheet and that took time, so much time that this project fell by the wayside and since then my weight has climbed back up to 250 pounds.

escali digital kitchen scale

Spring has sprung and I am making another go of it and this time younger son recommended Cronometer. I have a Chromebook I keep in the kitchen so I can enter what I eat right there. The program works pretty well. It seems to know all about all the foods and has 47 different ways of measuring them, so you can pick whichever one works for you. I use an escali scale to weigh everything. My wife bought it a while back. I considered it a frivolous purchase, but it, along with Cronometer and my Chromebook enable me to keep track of what I eat. We shall see how long I can keep this up.

Theory of Fat

Mmmm, Cheeseburger
Getty Images/iStockphoto / Vladimir Vladimirov

I am on a diet, sort of. I'm trying to lose some weight. I was up to 265 pounds a couple of years ago and got down to 225 last summer, but now I'm up to about 240. Then today I saw a story by Carrie Dennett. It's the first story about this whole business of eating that made any sense. I recommend it to your attention. I suspect my biggest problem is that I am not sleeping well. Lately I've been resorting to Benadryl, which knocks me out for about four hours which is great if I am still awake at three in the morning, but it's not like getting a real good night's sleep.

Diagnosis Wenckebach

Diagnosis Wenckebach
I am sure I posted this once before but I cannot-a-find-it Cap'n, so I'm posting it again. This time in honor of dutiful daughter doing a stint on the cardiac floor at OHSU.

Toothache

I have a toothache. It started with a pain in my cheek last Thursday. At first I thought it was a tooth, but then I thought this feels a whole lot like sinus pain, which I am more than familiar with. But there was also a twinge coming from my lower jaw, just below the main pain.

I went to the dentist on Friday. They took a digital X-ray and photographed a suspect tooth with a very cool magic wand kind of camera. He looked and then he got out the cold probe, one of the nastiest pieces of equipment in the dentist's armory, and started testing teeth in the upper jaw. All of them reacted instantly to the cold, all except one which seemed to be completely immune. He left it the probe on long enough that I could feel the tooth getting cold, but I never felt any pain and I certainly did not get a sharp reaction like I did with the other teeth.

I left there with the problem unresolved. Maybe it's a tooth, maybe it's a sinus. If it's a tooth, he was confident that it would reveal itself shortly, and sure enough on Monday it did. I sat down to eat something and when I took a bite, Zingo! That smarts! It got so bad that by dinner time I was not able to eat even a single slice of pizza. Even by using only the other (left) side of my mouth, if the bad tooth even came in contact with the opposing tooth I would get an intense pain. And this is while I am taking 2 Naproxen every 12 hours.

I went to the dentist again today and she takes an X-ray and it looks like the sheath that covers the roots of the troublesome tooth has gone missing from the very tip of one root. The only solution is a root canal, which basically involves removing all of the living tissue from the inside of the tooth. I have an appointment with the specialist on Friday. Meanwhile I'm on a mostly liquid diet, though I did manage to eat a couple of slices of pizza this evening.

How did people manage in the bad old days, the days before we got real pain killers? Oh, just like now, because you can't get real pain killers any more because of some jackasses in congress stirring up shit for some kind of political game. My dentist won't even write prescriptions for real pain meds any more because of all the paperwork involved. I am really beginning to hate the government.

Maybe I need to make friends with my local pusher. Medical insurance won't cover the expense, but you can bet there won't be any bureaucratic bullshit.

Mirror Images

Enantiomers

Dustbury rightly complains about Xyzal. How do you pronounce that anyway? Seems to me that most words that start with X, like Chinese Names, not techo-terms like X-Ray, are pronounced like they start with a Z, so why couldn't they name Zyzal? Probably because X is the new Z.

Anyway, this Xyzal sounds a whole lot like Zyrtec (which I take), so why would I want to change? Well, maybe because it works better. Claritin, like Zyrtec, is supposed to help with allergies, but it doesn't work for me.

Now we get into the chemical structure and David W. comments:

A slight error in your post: Zyrtec is actually both enantiomers while Xyzal is just the biologically active one. 10 mg of Zyrtec contains 5 mg of Xyzal and 5 mg of mirror-Xyzal. It’s a patent ploy. Although theoretically the non-active component could have side effects with no corresponding benefit, if that were the case here we’d have seen Xyzal much earlier.
D/L vs R/S is explained by Wikipedia, it’s a question of whether you’re looking at the whole molecule or just the chirality center: https://en.wikipedia.org/wiki/Dextrorotation_and_levorotation

What's an enantimomer? Google fills us in:

In chemistry, an enantiomer, also known as an optical isomer, is one of two stereoisomers that are mirror images of each other that are non-superposable, much as one's left and right hands are the same except for being reversed along one axis. Wikipedia