Sacroiliac Joint

Sacroiliac joint of the male pelvis, posterior view

I've heard the word 'Sacroiliac' before, but I had no idea what it meant. Bayou Renaissance Man has a post up about his ongoing back problems and the sacroiliac joint figures prominently. And now I know what it means.

Tuesday Lunch Show and Tell

VILIM Vibration Therapy Ball

Jack got hisself a new toy - a VILIM Vibration Therapy Ball - to help with his essential tremor. Kinda spendy at $300, but like Dennis said - that's less than a dollar a day before Jack will be able to see a specialist about his problem.

Field Mower Jackshaft and Failed Tapered Roller Bearing

Seems like every week Dennis reports more trouble with his mowers. He's got at least two, one for the lawn and one for field. Parts are on order so we expect him to have it up and running before too long.

New Ear

Still Machine - Echoes Within (Official Music Video)
Someoddpilot Records

I dunno about this tune. It's not pop-rock with snappy lyrics and a cool beat. Atmospheric is what I say now. We shall see. But this story on Willamette Week is why I'm posting the tune:

Portland’s Salvo Beta Releases New Music for the First Time in Decades by Daniel Bromfield

A cochlear implant has inspired Sean Wolfe to try making music in a new way.

Salvo Beta, the project of Portland electronic musician Sean Wolfe, just put out its first new music in nearly 25 years. And in order to make it, Wolfe had to learn to hear music in a totally new way.

His two remixes of the Chicago band Still Machines’ song “Echoes Within” are directly inspired by his experience with a cochlear implant, or CI—a surgically implanted prosthesis he received in 2024 after losing most of the hearing in his right ear.

“There’s basically a wire with a bunch of electrodes, and each electrode only triggers a certain frequency band,” Wolfe explains. “The in-between sounds are kind of weird.”

In order to achieve the desired effect on the remix, Wolfe manipulated a Moog synth sound through spectral shaping, a production technique that allows producers to alter individual frequencies. The result sounds something like a bell pinging underwater; the post-punk source material is clear, but the music sounds waterlogged.

“One of the things that really kind of shaped how I started making the music is inferring how frequencies can be shifted and perceived by someone like me, who has one of these CIs,” he says.

Surgery Notes

St. Vincent's Hospital Now

Wrote most of this three months ago just after my hip joint replacement surgery. Taken me this long to get around to finishing it.

Most of the people I saw were pretty women with a variety of personalities. Connected with some, did not connect with others.

Nurse Jerri thinks I sound like Kevin Costner.

New Operating Room

Remodeled operating room. Last time I was here the surgery center and the operating room were all very industrial looking like something out of Star Wars. This time it was all soft pastels like a modern doctor's office.

St. Vincent's Hospital Ten Years Ago

Remodeled exterior. When we arrived, I walked out of the parking garage and saw this big, shiny, new building (top) and I thought 'this wasn't here before'. Turns out they just put a new facade over the old one (above).

Aisles in new garages are narrower than in the old one which is why I prefer to park in the old garage, even though I have to walk a hundred yards farther to the hospital entrance.

Masimo Root Patient Monitoring and Connectivity Platform

Numerous connections while I am lying in bed after surgery:

• Intravenous line
• Electronic pulse monitor
• I think there was an oxygen level monitor as well, but I don't recall where that one was connected to me. Might be combined with the pulse monitor. The other end was connected to a fancy looking machine that didn't seem to do much (above).
• Warm air hose connected to hospital gown
• inflatable bladders wrapped around my lower legs to reduce the chance of blood clots and / or cramps. The ran on a cycle of about a minute - Inflate on one leg, then deflate, then repeat for the other leg. Funny thing was I noticed when it was inflating on my left leg (the surgery leg), but I had to pay attention to notice it on the right leg.
• How many times did they take my blood pressure? I wouldn't be surprised if they measured it dozen times.
• remote control for the TV. Not connected to me, but it was tied to the bed so I would be able to retrieve it. Not a problem until they started changing beds on me.
• There was nothing on there that I was the least bit interested in watching. Or listening to.
• The controls for the bed were built into the hand rails, so they didn't need to be disconnected or reconnected.

None of these connections were a problem until the gals from Physical and Occupational therapy showed up and wanted me to get out of bed. I suspect a lot of this was just protocol. Problem is I don't know how sick I am. I could be well on the healthy side of the hill, but then again I could be walking on a knife edge where one little glitch could send plunging into the abyss. So I didn't complain other than to commiserate with the njurse who had to struggle with warm air hoses. I don't think I needed any of it, but if I was just a little older and/or feebler, they could have been important. The last thing the administration wants to hear about is a catastrophic outcome to a routine procedure. Or a complaint from a Kevin that his feet are cold.

Sphenoid Bone

Sphenoid bone

Younger con is taking a class in Anatomy & Physiology. Last week they were looking at bones of the skull. He's telling me about his class and then he mentions this one weird bone that is like in the middle of your head called the Sphenoid Bone. New to me.

Oxy

Oxycodone
My pills are the one at top left.

I took (53) Oxycodone tablets, 5 mg each, since my surgery on January 13, 24 days ago. Divide 53 by 22, since I quit taking Oxy 2 days ago, you get 2.4 tablets a day. At first I was only taking 1 or 2 day, probably because I was still full of the anesthetics from surgery, but a week later I was up to 3 and then 4 tablets a day. A week after surgery I dropped down to 2 tablets a day.

The instructions on the bottle say 

TAKE 1 TO 2 TABLETS BY 
MOUTH EVERY 4 TO 6 HOURS
AS NEEDED FOR PAIN

At 2 tablets every 4 hours, my bottle of 40 tablets would only last 3 days.I guess different people have different pain nerves.

Middle of last week I would start feeling cold 6 to 8 hours after I took an Oxy. Found if I took another Oxy the cold went away. Now I am beginning to suspect maybe I should stop the Oxy, so I did, and for two days I couldn't sleep for shit, so I started the Oxy again and two days later, about 9PM, I started feeling cold, colder then I have ever felt, even when I was at winter camp with the Boy Scouts, back in 1963. I spent the night camped out in the recliner in front of the gas fireplace, piled high with blankers. OK, that's it, no more Oxy.

That was two days ago and I am finally starting to feel human.

When I went in for my two week checkup, a week ago, I got a refill script for Oxy. When I was filling in the intake form I selected Walgreens on Cornell as my pharmacy. Well, it's on Cornell, if you forget that Cornell makes two 45 degree bends before it gets to the Walgreens on 10th. So we went to the Walgreens on 10th and Baseline, waited in line at the drive up window for 15 minutes, only to be told we were at the wrong pharmacy.

Huh, here I thought a script was a script. I mean you have to pick up prescriptions for narcotics in person at the doctor's office and then hand carry it to the pharmacy. I'd never seen a script like this, it was printed in color on some fancy paper, it was almost like the title to a car. Great, now we get to drive four miles to the Walgreens on Cornell and dropped off the script. 

It was going to be a 20 minute wait so we went and had dinner at the Copper River restaurant. This place has kind of weird layout. The front door opens on to Cornell Road. It's 35 feet away from the curb, so you aren't stepping into traffic. Meanwhile, it's 100 feet from the parking lot. I suspect this is because of the plague of cuteness infecting city planning. Somebody has got the idea that everyone is going to walk everywhere and no one is going to drive cars anymore so we need big fat sidewalks and no parking for automobiles. I'll give them that it's cute, but it's also very stupid.

After dinner we head back to Walgreens to pick up the script, and miracle of miracles, they have all the paperwork in order so all I have to do is identify myself. Did I have to show my driver's license? Don't remember, probably.

There were some times early on when I would get into a very pleasant dream state. I would like to go there again, but not at the risk of feeling cold as ice.

The Ice King

Why Cold Drinks Were Lethal before 1914
Veritasium

Now I wonder which business was bigger - the ice business or the railroad box cars cooled with ice.

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.

The Cranial Nerves Song

The Cranial Nerves Song
Chuck Pergiel

I'm thinking I should get Linux up and running on my computer, I mean I bought it a year ago for that purpose. I've been sluffing along on Windows since then so I started looking through my old hard disks looking for a suitable candidate and came across this video, so I thought I'd share. Search on YouTube  for The Cranial Nerves Song returns several videos, but they all seem to be just portions of this one.

Dry Eyes

Dr. Rynerson - REVVE Patient Education Video
BlephEx LLC

A friend of mine is dealing with dry eyes. It's irritating and annoying. They've been going to a specialist for treatment. It's been expensive, but they seem to be making progress. Apparently this is the next step.

The Medicine Business

Drugs & Money - Bloomberg

Zerohedge points to this story:

Is Modern Medicine a Sham? by Attorney Bobbie Anne Cox

Wherein I found this paragraph:

Did you know that the largest lobby we have in the United States is the pharmaceutical industry? It is the largest, by a long shot, as it solidly towers over all of the others. Let me share some numbers with you. Pharma spends approximately $380,000,000 (three hundred eighty million) every year lobbying Congress. To give you some perspective, the second largest lobby industry in our nation is the electronics manufacturing industry, and it spends about $250,000,000 million a year lobbying Congress. The third largest is the insurance industry which spends about $150,000,000 million a year lobbying Congress. All the other industries that lobby simply pale in comparison. These statistics alone reveal so much.

$380 million is almost $1 million per congress critter, which is roughly the same amount we spend to put an infantry man on the front lines for one year in one of our foreign wars.

All this noise about money and medicine is mostly just that - noise. The more noise, the less room for rational thought.

Drugs can be amazing. There are many drugs that are very effective at curing, or at least alleviating the symptoms of, a disease. Problem is that people come in a variety of flavors and no matter how well a drug works for most people, there are going to be people for whom this drug is ineffective, or worse yet, causes an adverse reaction.

How much do we spend on drugs? Google knows:

• The United States has the highest per capita prescription drug spending among comparable nations, averaging $1,432 per person in 2021.
• Total spending on prescription drugs in the US reached $378 billion in 2021, making up almost 9% of healthcare spending and over 1.6% of the nation's gross domestic product.

So the lobbying expense is one-tenth of one percent of the total revenue. 

Fire Season

Rowena Fire - Leslie Lamb

Iowa man has moved to Bingen, Washington. It's across the river from Hood River.

Hood River, Bingen, Rowen Fire, The Dalles

He reports:

Sitting waiting for Angie’s orthopedic consult. Both of us have bum left knees. My xray was yesterday, my consult in September after pt.

Then later today up to the mountain to haul gear for Stephen, our 72 hippy ski bum friend who is going to self build his forever cabin on 15 wilderness acres.  He has a bum knee too. Angie’s bro-in-law, 68, is soon to have both knees replaced. The year of the knee!

Being laid up dampened my plans for exploring on mc, biking, hiking…but there is nice.

Two forest fires either side of us, fortunately no smoke at house. One 50 acres, the other 2500 stage 3 evacuations. I think they are out.  

Our 72 yo ski friend Steven bought 20 acres (cheap) of eastern Oregon sparsely treed dry land, zero population nearby.  Rough road along a dry creek to the no-utility lot, passing a couple of  long disused and deteriorated camper RVs.   

His plan is to build a cabin for off-ski season use,  stay with friends near the ski slopes in the winter (not us).

To this end he has so far had a shipping container placed into a hillside.  He plans on sharing a neighbor's wood mizer (mile away) in exchange for 50% of the cut lumber, sourced from his 20 acres.

He drives a 15 yo Ford Escape, hoping to upgrade to a Ford PU soon.

Fun to visit.  Stephen seems happy but I would want something on the grid and less dry,  it was crackling tinder dry.

On the way home we detoured around the Rowena fire, 3200 acres, 40+ homes destroyed.

Container in hillside

Digging Equipment

Tales from the Fringe

Where are they now? 5!
Fire Department Chronicles

I frequently see entertaining short videos from this guy. Usually they are just short ones, but this one gives a little more information, and it's pretty entertaining.

Blood

My daughter works at the Nick-you, the neonatal intensive care unit, in a hospital. They deal with babies who are born prematurely. Whenever I see her, like I did today at lunch, she has a new horror story to tell. I imagine that most of the babies who come thru the Nick-you survive and go on home to become fully functioning babies, but the ones I hear about are abysmally sad.

In the Netflix series Kill Me Love Me, the princess marries the emperor, gets pregnant, but then miscarries, hemorrhages and bleeds to death. This is something that still happens to women. Not often, but it does still happen. Reminds me of a line from a movie where a woman is counseling her daughter that while men fight wars, a woman's battlefield is in giving birth.

If someone is hemorrhaging and you can't stop the bleeding, the best thing you can do is to supply them with new blood via transfusions. I imagine the expectation is that eventually that the blood will start to clot and the hemorrhaging will stop. It may take a lot of blood to accomplish this. What is a lot? I have no idea. A quart? A gallon? A tank truck load? In any case you have a better chance if you have a large quantity of blood on hand, a blood bank if you will.

Evidently some hospitals have blood banks and some do not. And how much blood would a prudent hospital have on hand, and how long can you keep that blood? I imagine blood has a 'best used by date' and I imagine it's not that far off, which means the blood needs to be replaced periodically.

Wikipedia page about Blood Banks.

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.

Fun with Chemistry

How an HIV Miracle Drug Vanished
Reactions

I know a tiny bit about chemistry, but it always struct me as little bit like black magic - wave your hands like this, recite this incantation, dump some of this mystery compound in the pot and presto, it changes color, blows up, or best of all, begins spewing poison gas. Seems to me like you need a ton of knowledge to do anything useful, unlike mechanics where all you need is a couple of hand tools and you can build a house.

The YouTube blurb:

In 1998, a pharmaceutical company suddenly lost the ability to make their lifesaving HIV drug at one of its production facilities. Then that failure spread to the company’s analysis labs. Then it spread to the other production facility, and within months the lifesaving drug had effectively vanished from the entire planet.  And this wasn’t the first time something like this had happened. How does a chemical just… disappear?

 

A Man on the Inside - Netflix Series

A Man on the Inside | Official Trailer | Netflix
Netflix

Comedy, not our usual fare, but funny. Ted Danson plays a widower who takes a job to go undercover in an old folk's home to find out who stole a necklace from one of the inmates. It's a very posh old folks' home, full of crusty old characters.Very lightweight. It's mostly Ted bouncing from one awkward situation to another with hilarious results.

The show takes a look at Alzheimer's disease, and it's not pretty. When a person's mind deteriorates to the point that they no longer recognize you, are they even there anymore?

Dry Eyes

Eye Drops for Dry Eyes

A friend of mine suffers from dry eyes. I had never heard of this problem before, at least not as a chronic condition. Then I saw these shelves full of eye drops for dry eyes at the local grocery store. Evidently it's a fairly common problem.

Medical Knowledge

It just occurred to me that if you are going to prepare for a disaster, one of the things you should probably include would be a book of general medicine. If you have a disaster that is bad enough to knock out electronic communications, there are liable to be people who are injured. If the Internet is down, there's no Google. A real, honest to gawd, printed on paper, book of medical knowledge might be a good thing to have. I need to take a look and see if I can find one.

Healthcare in the Early 1900s

Healthcare in the Early 1900s
Doc Schmidt  

I was just going to email this to my family and the lunch bunch on account of we're all up to our ears in the medical-industrial complex, but then I figured that's probably half the country, which means you might appreciate it.