T -13

I have an arrive at the hospital time of 6 a.m. tomorrow, and a surgery scheduled start time of 8 a.m. If they keep to their schedule estimate, that means I'll be out of surgery by about 1030, out of anesthesia by about 11. So roughly speaking by about noon I should be done at least with the tough part.

And there's a tiny possibility that I may not have to stay overnight. No guarantee, but the check-in nurse pointed out that this is being booked as a 23 hour observation, which I gather is an insurance stratagem because insurance people only want to pay for a maximum of 23 hours of me being there. 23 hours from six in the morning means checking out at 5 a.m. and 23 hours from the surgery start would mean checking out at 7 a.m. Neither one is impossible, of course, just as there is no guarantee that I won't stay longer than 23 hours. For one thing, the surgery might run long -- though I devoutly hope not. In, out, and profoundly boring -- that's what I want.

Let the cutting (sigh) begin.

Preparing

This evening, while I lolled about web surfing, my wife looked through the paperwork from the hospital. I had already gone through it, although with a certain amount of denial as I did so. She didn't find any surprises, but there were a couple of things that we didn't really expect, or that I had not understood, or that I was nervous about.

For example, just general anxiety about the process of getting put on the gurney, getting to wait around as people bustled back and forth and all of that fun. I think the waiting is going to be tedious and possibly not very much fun. I'm going to worry, I know. One person who comments on this blog had suggested getting knocked out early. I'm not sure that's going to be possible, but she reminded me that the last time I had any kind of operation, I wasn't even aware when they had given me the sedative. That's a good thing -- it means, that I won't really care what's going on. For another, the literature had said that there would be a nurse assigned to me upon arriving from the operating area. I was a little spooked by that -- were they expecting something bad to happen, that I would need specific attention? My wife informed me that although a nurse might be assigned to me , it didn't mean I would be the only person she would be watching. I'm a little shaky about the whole post- operative procedure, actually -- being in a hospital room overnight, which I haven't done since I was 21, not being able to get out of bed by myself, things like that. And though I want to get started with therapy, it scares me a little too. It's the unknown. I don't like it.

But this is how I psych myself up for it.

guns, bullets, and bombs

This is a quick thought because I'm not a deep thinker.

One article in today's New York Times Magazine talks about a person who has opened up a market for the trading of the ability to create greenhouse emissions. The concept is that while we wish nobody did this, perhaps the market can be used to make it profitable for company not to do it. Companies like profits.

Another article talks about what it's like to live in an environment where you routinely have to go into bomb shelters because otherwise your family is routinely in the risk of being killed (hideously). I can't believe that anyone wants that to happen, although both sides are apparently willing to let it happen and to cause it to happen.

So here's my thought.

We've seen how well peacekeeping efforts have worked over the years. One idiot or group of idiots with a gun or a group of guns, blammo, fighting starts again.

What if there was a market to allow this to occur which would have the effect of limiting how much it occurred? Not the total abolition of it (which is desirable in the abstract, but apparently not in the concrete) but the reduction of it?

Is that possible? Is that practical? Is that a ghoulish concept?

Hookers

To my knowledge, I've never known or met a hooker.

This is a little bit of an accomplishment, I suppose, because I grew up in New York City, and while I don't think the hookers run rampant in the streets there, like the running of the bulls in Pamplona (what an interesting image that would be), I do think that they're fairly common. There was the time I was waiting to cross the street to go over to the port authority bus terminal and a girl came up to me and said, would you like to go to a party? That ended pretty innocuously though -- I said no, I'm on my way to the airport. She said, where are you going? I replied, South Dakota; she said, too bad. And I agreed. It wasn't until much later that it occurred to me what she was actually offering. I guess I'm oblivious that way. For that matter, I went through a year in Southeast Asia, courtesy of the US military, and never met a hooker there either. Okay, I did get the impression that certain services could be acquired at the massage parlor in downtown Korat, Thailand, but I never did. I was too chicken.

What brings us to mind is some surfing that I've been doing using the Stumble-Upon package. They categorize sites based on classifications -- keywords -- that other people have assigned to them. As it happens, the keyword that I've been looking at is Adult. What amazes me is how often the sites that turn up promote the idea that the girl next door is actually a hooker -- sweet, innocent, possibly virginal, yet experienced, sexy, and knowledgeable about all sorts of interesting sexual variations.

I like fantasies as much as anyone, but I've been around awhile. I know this is untrue. It still catches my attention. The thing is, while part of my brain is saying, hot darn, look at that, another part is saying "that's somebody's daughter".

It's a very weird feeling.

NNIGN

After 9/11, I came up with a concept that I called NNIGN, or no news is good news. What that meant was that for awhile, I wasn't going to read the newspaper, I wasn't going to listen to the television, and I wasn't going to listen to the radio -- at least not to the news on the radio. The reason was that it wasn't making my life any better. What it was doing was scaring the hell out of me. This shouldn't have come as too much of a surprise of course, because that's what newspapers do. They don't publish things that make you feel better (the occasional feel-good article notwithstanding); they publish things that startle and dismay you.

Gradually over time, I started reading again. Depending on how I feel, I may skip some of the articles on the first page, but usually I'll read the first section. However this morning, I decided that the no news is good news policy is still valid. Because this morning, the lead article in the Washington Post -- the one in the center, above the fold -- was about the secret war on bioterrorism.

Here's the deal. I don't want to know. I'm that there are evil, hateful, vicious people in the world. I don't want to know what they're doing. Knowing what they're doing does me no good at all. It scares me, it alarms me, and it does not help me. What I want from my paper -- in this case, the Washington Post -- is intelligent, thoughtful, and insightful commentary that will help me deal with my world. What I'm getting, in this case, is fear journalism. I suppose as an adult, I have to know that there is a serious and scary problem. Fine. I know. Just tell me that intelligent, capable people are handling it. And let's stop right there. What I almost want is a headline that says that bad things are happening, but it's okay: we're taking care of it.

Comics, anyone?

Humid

Friday morning, and the living is humid . When we woke up this morning, most of the windows were covered in condensation. Part of that, I think is due to the fact that I like to sleep in a cold house. When we go to bed at night, I tend to set the temperature fairly low. I won't say how low but on occasion we wake up shivering. This might be why I liked the temperature in South Dakota. But this morning, it really was a humidity thing. Last night ,the temperature and general sense of wetness was oppressive -- kind of like the classic wet blanket.

I was in a fairly melancholy mood this morning. I'm not sure why. After all, I've been thinking about the surgery for about a week.Something about it this morning though, just scared me.I was in an actively wimpy mood. I blush to say how I manifested this; let's just say that it took some serious hugging before I felt better. Of course, like the classic American male, I then thought, what about people who have more serious injuries and illnesses? Don't you think they have much more right to feel wimpy and dejected and melancholy? And I had to admit that of course they do. Yet they dpn't. There is a woman, who writes a blog called Haiku of the Id-- I just added it to the blog roll the other day. She certainly qualifies.She's an oncology nurse, and in a supremely ironic condition, she has cancer. How do you live with that?I don't mean that in the physiological sense, but in this sense of just getting on with your life. People with cancer get hang nails. People with cancer have car problems. People with cancer run out of cereal. So if they have to deal with the routine crap of life every day, why should I feel in my life is any different? Why should I get to mope around when they don't?

A little Friday morning philosophy.

Rainy day

It's about 10 minutes to six now on a rainy Thursday afternoon. We were on our way home from work when the skies abruptly opened. It wasn't actually much of a thunderstorm, but it was pretty impressive nonetheless. There was a question of where to pick up our daughter --when the weather is bad, they tend to move the kids out of the park and parked them someplace strong, like one of the schools. This rain had just started. We weren't really sure, so we guessed and fortunately we guessed right. Our daughter wasn't very happy with the rain, because it's loud and noisy, and she doesn't like that kind of thing. However we talked a little bit about what she done that day in weather camp, and that sufficiently distracted her so that by the time the storm passed, she didn't even notice.

It's about five days until my surgery. I'm still a little apprehensive, but I am comforted by the thought that the odds are very good that my arm won't be any worse than it is right now. Most of the fun of showing it to people has worn off by now. It gets old pretty quickly when people grimace and say you must really have hurt yourself badly. I knew that! Have to admit, I get a little scared, and I find myself wondering, do these people know something that I should know. But the bottom-line is that I don't really have much choice. I really do think it's going to be better -- maybe not soon, but in the foreseeable future. I guess in a way I have to believe that, but intellectually I really do. And as I've been telling people, next week I'm going to get to spend a day in a drugged haze -- and as stressed out as I've felt lately, that's not a bad thing.

Had something a little unusual happen to me the other day. In addition to all the other physical fun that I'm having lately, including some gastrointestinal upset about which I won't give you details, my blood pressure has been lower than normal. This has unfortunately manifested itself by me being dizzy on occasion -- no, even more than normal. We went out and bought a blood pressure cuff from the local drugstore and found that yes, it was in fact low -- diastolic, not the systolic. We called up the local family practice, and the nurse that I normally see said that I had looked a little dry when I last came in. I said that I hadn't had much appetite lately (wonder why?) and had in fact lost about 6 pounds. She suggested that I might be dehydrated, and said that I should try to eat and drink a little more. I have never had anyone say that to me before.

Time for dinner!

More Practicing

We just got back from taking my daughter to a swimming lesson. She swims pretty well actually, mostly because I've been paranoid over the last half-dozen years. As a result, I was not too terribly concerned to see that the deepest part of the pool where my daughter would be swimming was 10 feet deep, or to put it another way, roughly twice her height. I know, I know -- it's possible to drown in 3 inches of water, but still, I don't think she will.

I think that my personal fear of water generally came from when I was a kid and I was in a lake at a camp messing around with some of the old rowboats that they had there. I found out pretty quickly that it isn't a good idea to be leaning over the front of one rowboat hanging on when the next one decides to make a sharp turn. I found myself in about 15 feet of water, and it was only after much splashing around that I managed to get back into the boat. In fact, it wasn't until about eight years ago that I got to the point where I felt comfortable in the water -- although not in the ocean, where I find to my surprise that some people really do swim.

Of course, with my current impairment, any swimming is out of the question. Though I did see where swimming is good exercise for rehabilitation. Wonder if I can get my insurance company to pay for a pool?

Talkin'

OK here we go. I'm trying out the Dragon NaturallySpeaking tool. It's something I bought the other day to see if I could make it type for me and what you're seeing now is the result of about 15 minutes practicing through their tutorial. Everything that you see so far has been done using the tool. I'm sure that I'll have a lot of mistakes, and a lot of very strange punctuation's but this is a good start. The temptation is to try and use lots and lots of words that it couldn't possibly know. But of course flummoxing the system is hardly in my own best interest. So this is not bad.

Checked Out

I had my 'medical clearance' this morning for surgery -- they did an EKG and took some blood, then proclaimed me fit to be cut. Isn't that special?

Reading

I normally enjoy reading about medical procedures, but I find that as I read about hemiarthroplasty surgery, I'm skipping the ones that list what can go wrong. Instead I gravitate to those saying 90% restored function in a year, things like that.

Wonder why?

Thinking

I was thinking about my friend who died, and about the power of good thoughts.

When I found that she was sick, I asked a friend who was very religious if she would pray for her. I didn’t really think that it would help -- stage four stomach cancer is about as bad as it could be -- but I didn’’t want to miss even the faintest possibility. She did, but it didn’t help. My friend died a week later. I still think about her fairly often. Usually, its just fantasy about being able to go back and help her nip that cancer. Sometimes I remember standing next to her hospital bed, feeling the texture of her hair as I stroked it while she slept. (I just wanted to do something.) And once in a while, I remember being in a low visitor's chair next to her bed a couple of the times when she had to get out of the bed. Those hospital gowns aren’t made for modesty, and when it rode up her legs I saw much more of her than I’d ever seen before, certainly much more than she might have willingly shown me. It was more than a touch erotic, but I wish that those good thoughts had worked, even so. I've have given up those thrilling sights in a heartbeat, for that.

My situation isn’t nearly as bad. But next Tuesday, as the result of something that I wish I could go back and change, I undergo the" ten percent likely" arm surgery (the buzzword is hemiarthroplasty), to be followed by months of rehab. So much for my good thoughts.

Regrets are pretty enduring things.

Talking to the Cutter

Today I get to talk to the orthopedic surgeon, and - presumably - find out if surgery is in my future, and, if so, what kind. I am guessing 20% chance none (not counting the rotator cuff tear, which might not get repaired)), 65% chance pins for the fragments, 10% upper humerus replacement, and 5% more than that. The first is so high because I've started to get a very limited amount of mobility back (almost no lifting strength, though), and the second is highest because it makes sense. Plus these are surgeons, and you know what surgeons like to do.

I'm a little apprehensive.

Saturday Morn

Its about 8 on a humid Saturday morning. Must say, I slept very well. I think I’m getting used to this harness thing at night – though there still is nothing quite as surprising as feeling industrial strength Velcro as you move. And its a bit of a bother to have the various pieces of it catch on every other piece. Wonder if it’d be practical to have Velcro that just attached to its own kind? Then if you were making something that needed four connectors, you’d use four different types, and that wouldn’t interlock. Guess that’s too much effort. After all, most Velcro users aren’t using the massive pieces this thing does. Takes a fair amount of effort to open. I did suggest to my wife that I get someone to help me on occasion with getting it on and off , but when I mentioned the specs - tall, slender, blonde, Swedish Womens Gymnastic Team - she cooled to the idea.

I am in bed at the mo, typing with one hand. That voice software will show up this week. I have high hopes for it. You can use it for a number of non-text functions too, apparently, but I have to admit that the one I like the best is macros—you say a key phrase and it types a whole paragraph. The guy demoing says that he uses it to respond to critical emails. The product types something like sorry that we can’t agree, but I am glad that we’ve had the opportunity to exchange views; thanks for writing. The key phrase (for him) in that case was ‘piss off’.

Today we are going to a family reunion, aka an opportunity for my wife to spaz out. Tomorrow my wife and daughter are going to a bridal shower, aka an opportunity for my wife and daughter to spaz out. Me, I am trying to hide.

Changes

Some years ago, I heard somebody say that the only person who appreciates change is a wet baby. I believed it then, and even more now. Both the large software company that I work for and the one my wife works for are making changes, and as Jim Croce might have said, they’re not of the pleasant kind. From what I’m given to understand, in both cases the changes are driven by lack of profit.

Hers are worse; they’re firing people again. We'd say there was no rational reason to be concerned about the safety of her job, but these guys fire without apparent logic. Still, her sanity is important. I've told her -- and I mean it -- that she can quit whenever she wants. Whenever.

Mine are more benign; they’re moving people around. Not an improvement, from my perspective; I still am not getting the opportunity to do what I want to do, but I will likely be doing more of what I don’t want to do.

I am very glad to be within a couple of years of retirement. I wish she was, too.

Not Naked

As I write this, I am not naked. Not that I'd tell you if I were, but I wanted to point out that right this minute I am not. I have on a T shirt and shorts, and over the T shirt I have the shoulder immobilizer.

Why is this worth mentioning?

Because I got it on without help. All of it. Even the harness.

Took me ten minutes, cost me an aching arm, but I did it.

You Never Talk To Me

Since becoming effectively unimano (c'mon, parse the Latin) I've been frustrated by the pace of typing. If I am fortunate, I can lean back, rest the laptop on my legs, and key mostly with my right hand and a little with my left, moving the keyboard up and down with my legs. Not great but better than one finger poking. But that style doesn't work with my heavier, hotter work laptop in bed, let alone at the office.

This afternoon I finally got to watching the entire TED presentation that I mention on the sidebar. Its not bad, and the concepts presented at TED are interesting. Toward the end he demos a piece of voice recognition software -- not sure, but I think it was this one -- which got me to wondering if that would work for me.

So I'm going to look into it.

Book

I've not read French Women Don't Get Fat, but it sounds believable to me as I think of how we eat. Any thoughts?

Reading Lists

Even since high school, where I first saw one, I've liked the concept of reading lists. (OK, at the time, I despised it, but in retrospect...)

This one, from UCLA-Berkeley, has a predictable bias, but I think even conservatives might find it of interest.

Weirdness

This may be a weird post because I'm in a weird mood. Sorry.

I didn't sleep well last night - arm kept twinging, which is abnormal. Its actually been doing well, by my standards -- I even got a tad more flexibility -- like, a half inch more lateral motion. So now I am lying down, which tends to help, and my eyes were closed, dozing. What a sluffer.

My work group had a mtg and they talked about a problem I'd had. Wasn't pleasant, but it could have been worse. I'm still irritated by the prob -- the cause was me forgetting to do something, and there was no backup system to remind me. I appear to be the only one who thinks that having a support system would be a good idea, as a memory backstop. They must all have nailed this or have great memories. Then again, this a computer company that heavily relies on manual data gathering.

I'm just ticked, maybe. I hate failing, especially publicly.

I love the concept of systems -- even the word sounds cool to me. It implies interlocking, feedback, complementarity, learning, adaptive. Too bad the implementation is so poor so often. Like the snarky way blogger spell checker says HEY you're not using one of our words...Do you REALLY want to do this? Yuck.

Amazing

This is an informal clip of George talking with Tony, and I actuallylike what I hear him saying-- mostly because he uses plain language instead of what I've heard called 'the greasy language of diplomacy'.

Control

As I accommodate myself to this new style of living, some things annoy me, and some scare me.

I have taken two t shirts and torn out the left seam so that I can wear them as a sort of poncho/shirt. It works, but when I walk, the whole left side flaps open unless I've tucked it in. Not easy to do! We bought a couple more that were cheap and way bigger so that even cut open they'd drape better. Haven't tried them yet. The thing is, I'm pretty casual in how I dress - but this is TOO casual. It irritates me that I can't do better. (And why is a device aimed at immobilizing one arm not made to be put on one-handed????)

The hideous black and blue on my toes is mostly gone, though a couple are still swollen and shiny. That scares me, as I have a med condition which could manifest itself as toe damage (or even loss). I ignored the condition for a long time. Its been under control for about 18 months now, but I still worry -- what if I screwed myself with callous disregard?

Things like this makes me feel out of control - or like something thats been left out in the rain.

====
b4 I forget -- check out Geeky Mom. She's saying some interesting things. (Course, she usually does!)

Storm Warnings

A stormy mawnin in the household. The offspring was the eye of the storm. She was in an okay mood initially, but that rapidly went downhill -- I think she felt that her constitutional right to sloth in front of the TV had been abridged by everyone getting up late. She bolted breakfast and went downstairs -- just as well, as we discussed possibilities for arm surgery; I think she would have been grossed out -- but then she was offended when we reminded her that she had to go next door to feed the cat in the neighbor's absence, and then even more when we were obviously irate upon learning that she'd lost the neighbor's key. Which she insisted was not in her cluttered room, and, as it turned out, she was right.

Sigh.

Politics

I read a lengthy description today of why both Israel and Hamas believe in what they are doing.

Bottom line was, Israel says that it is defending itself against a hostile proto-nation that is resident, for the most part, in Lebanon. Bad news for Lebanon. Hamas says it is defending itself against a nation that wants to eliminate it, which nation it would like to eliminate.

The more of this I hear, the more I want to be an isolationist. And if that isn't possible, I want to pick sides based on benefit to us. Do I really mean that? Hell,I don't know. I'm just tired of wars going on based on emnities that have existed for decades and centuries - and I'm tired of us always, somehow, being involved.

Post Walk

My wife and I (wonder if I should adopt the style of some bloggers and refer to her as, say, Mrs. Stuff?) just got back from a walk. Its hot out but I was glad to go. A couple of days ago we did it and I was hyper lethargic. She thinks I was in shock from the fall, which isn't medically accurate but I know what she was going for -- a sense of having no energy. This was much better. Sleeping well last night, and then another two hours today, especially after a wonderful breakfast, does a lot for my mood.

As does coming back to find three interesting comments to my post about a scullery. The best accompaniment to having a scullery would be to have a scullery maid (or man; I' ?m not picky) but as most people south of Bill and Melinda Gates don't think in those terms, I guess I'll pass on that (though not the upstairs maid; she's key to many male fantasies.) The ideas mentioned are interesting. I''d not thought of the holding drawer to run water through -- I like that -- but I did think of, and even hear of, people with multiple dishwashers. Eventually, I think, your daily dishes would come from there, the non-routine ones being in the cabinet, and there would undoubtedly be times when you wonder - are these the clean ones? Course, for guys, the question would be 'the clean enough ones?'

I thought about the sink thing, too. I kind of like the two sink idea but I bet it depends on how often you actually wash in the kitchen sink. I would guess, for us, less than a quarter of the time. Would the separate sink be overkill? Its like the design I saw of a cold water spigot close to the stove so you don't have to carry pot of water across the kitchen. And I assume a drain right there, too?

Fun to think about.

Kitchen Design

I don't have great thoughts about this. When we had our kitchen remodeled, I liked to say that we went from a kitchen with storage, places to prep food, and places to cook food to a kitchen with some more storage, some more places to prep food, and places to cook food. Oh, and its prettier. I do like it, but alone I'd likely never have done it. Since I've been keeping a spreadsheet of house thoughts, though, a couple have come up more than just a few times. They just make sense to me, and, like much of the list, I hope we can do it with the Next House. One of those is a scullery.

I have never liked storing dirty dishes in the sink. If the dishwasher is empty, thats where they should go (a philosophy not shared by my daughter). But when its not -- well, okay. But sometimes they stay there a long time (by my standards), and fairly often they sit on the counter, too. Nothing gets your day started better than having to push aside the spaghetti sauce pot so that you can find space to make the morning coffee. And it looks so appealing the next day, too.

So, the scullery (area): someplace to get dirty dishes out of sight and out of the way. Of course, not too far, or one day we'll be saying "Hey, where did all the glasses go?"

Somber

Well, I'm in a somber mood.

Part of it is seeing the news and feeling as if the world is going to hell in a handbasket. Middle East, Far East -- the inmates are in charge. Here, too, of course.

Part is the prospect of the next year and my arm. Driving in snow with an arm strapped up sounds unpleasant.

Part is work -- I lost six hours today to a problem that should have taken half as long, but that our much-vaunted process doc neglected a key point., and could have been handled by the on-call but that the customer wants only one person to have that authority.

And part is that I slept very badly last night.

I told my wife I need something really nice to happen to me.

Shameless Theft

No, not the Republicans. At least, not this time.

This is a recent post from The Class Factotum Speaks. It's a classy blog that I really should read more often.

Flying the privileged skies

posted 07/14/06

We are here and let me tell you, business class is the way to go. You get to enter the plane through a special door. Wait! No! First, you get to wait in a special lounge where strapping young cabana lads wave palm fronds over you and drop peeled grapes in your mouth.

OK. I’m exaggerating about that part.

Youthful Tendency Disorder

Our nation's secret shame, revealed.

Readin' Med

This might be good news. Might.

Computed tomography of the left shoulder shows a comminuted, impacted and infra-articular fracture of the proximal end of the left humerus. The anatomic neck is impacted into the humeral head cleaving the humeral head into several fragments which are in close apposition to each other. The shaft is displaced slightly laterally and superiorly with the humeral head fragments rotated medially and inferiorly on the humeral shaft. There is mild upward subluxation of the humeral head on the glenoid. There is no significant joint space widening and there are no free fragments of bone identified within the glenohumeral joint.

There is no-fracture of the bony glenoid. There is no fracture of the scapula. There is no fracture or separation about the acromioclavicular joint.

The soft tissue windows show mild edema of the deltoid and pectoralis muscles and there is a mild degree of supraclavicular edema and subcutaneous edema over the anterior aspect of the shoulder. There is no hematoma identified in the soft tissues.

And here's what I get from that.

Remember that the humerus looks like a golf club, with the head of the club being the offset head of the bone. When I fell, the shaft pushed into the anatomic neck (more or less the base of the club head), splitting the head into multiple fragments which are still close to each other. The shaft has shifted slightly, and it moved in and possibly up out of the groove where it meets the shoulder to form the joint, but no bone fragments are apparent in that area. The part of the shoulder where the humerus joins to form the shoulder joint meets looks intact. There is evidence that there was bleeding. The muscles areas are slightly swollen.

When the humerus head breaks into chunks, mobility goes way down; hence my problem. I'm wearing the shoulder immobilizer to keep those chunks from shifting and doing damage to themselves or the socket. (Like forming chips; not good because they cause abrasion and wear on the socket.) If they're close enough, they can actually remerge on their own by forming connections via calcium buildup. In that case, surgery isn't needed. If they aren't close enough, or malform, it is. Even if I do need surgery, the shoulder appears intact. There's a chance only relatively minor surgery would be needed -- screws and such to contain the fragments rather than bone replacement and possibly partial shoulder replacement.

Here's an example of what I'd like to have happen, found here:

This is the radiograph of a 50 year old, otherwise normal woman who presented with a comminuted fracture of her proximal humerus sustained in a fall (see figure 1). She had a normal neurovascular examination.

Our concerns include :

1. Could this fracture be successfully managed non-operatively?
2. If operative intervention were necessary, what would be the best method of internal fixation?

Management

The fracture was managed nonoperatively. At 6 weeks the radiographs (see figure 2) showed early callous and the position remained acceptable so gentle motion was commenced. Twelve months later the fracture was solidly united. She had full use of her arm and a full range of movement both of her shoulder and elbow.

Let's hope, shall we?

What, me worry?

Ooooooh yeah.

I was worried, a little, about the dental implants, and now I'm worried a lot about the arm. From what I've read, we're talking almost definite replacement of the head of the bone, possible replacement of the part of the shoulder that cups the head, probable loss of function, and probable loss of strength. Plus definite long term rehab.

Being home all week, I've had time to read a lot about it (did you know that fractures of the anatomical neck rarely occur? Guess where mine is) and dwell on it. This is not good.

So tonight we're driving up to my job, and I'm going to see if I can sit comfortably in my chair. If so, office tomorrow. I need the distraction.

There's just one catch. If I go in, while I'm there, I can't use the john. Oh, I can, but afterwards, umm....

I won't be able reach back to pull my pants all the way up.

Talk about reason to worry!

You've Got MAIL

I am continually surprised by the volume of mail that I get at work. I should note that my tolerance for and acceptance of corporate BS is fairly low. I never learned to go with the flow, and especially not to venerate it, mull it over, and discuss it at length as my coworkers seem able and delighted to do. So I'm not a good baseline.

But lately it seems to have sprouted. Looking at the current crop, I have:
- one from a customer asking me to come to a recurring meeting.
- one from a team leader asking me to look at errors on a given system
- one from a security person telling me the systems that a user has access to
- three from a coworker, one listing a report that I have nothing to do with, one responding to someone else on a problem and copying me because I told her about it, and one responding to a customer and copying me for no apparent reason.
- one from our change manager telling me I have to fill out a form to get something done
- one from an automated system telling me I have to do a yearly review of something
- one from a coworker asking questions about response to an audit -

Whew. And thats about a tenth of whats in there.

This is uncool!

DeBoxtered

Funny....unless it was yours!

MTYWTN

Here is more than you likely wanted to know about my accident. I won't mind if you ignore it, since its primarily of interest to me.

I actually fell twice. I came into the hall, heard the timer beeping, stepped quickly -- and the next thing I knew I was on my hands and knees, dazed. I don't know this but I think I fell forward and hit my shoulder on the door into the kitchen. I was seriously out of it. I rolled onto my back for a minute. I knew my wife was out but I found myself calling for her anyway. Then I climbed to my feet, staggered into the kitchen, turned off the timer, pulled the cooking stuff from the oven. Actually I may have just turned it off and opened the oven door. Next thing I remember, I was on my hands and knees again, facing out of the kitchen and into the hall. I looked behind me and felt my toes bent under. I lifted each foot and they flipped back. I crawled down the hall, climbed slowly into bed, and hoped I wasn't going to die.

If I used illegal drugs that would be my explanation for those sensations.

Old Thoughts

This is six years old, but it rings fresh to me.

Some of Bill's stuff

This silly movie reminds me that sometimes stupid stuff just -- happens. And so, temporarily, I feel better.

Scanning

Last night, I searched for info on shattered humerus. I found two sites where the writers said essentially that while it was a major inconvenience, it was not the end of the world. Both of them said they got through it. (For obvious reasons I did not read any entries that looked grim.) One of those blogs said a positive attitude helped. I'm gonna try.

I was surprised and pleased to get notes of condolence from two people I don't know. One, I had commented at her site, but the other, from India, I had never met. That people do read what I write, even if only that once, is - gratifying. I won't make too much of it, but I like it. I really appreciate the thoughts.

I have on an elastic thing that goes around my chest, to which two soft cuffs are attached; one for my wrist, one for my upper arm, to immobilize my shoulder. I tugged a tshirt over it. I look like I am doing a Napoleon impression.

Getting some amazing typos. Fah on one handed typing.

ortho

I did not, in fact, sprain a muscle in my arm.

I shattered the ball in the ball and socket that lets th arm move.

Tomorrow I get an MRI to see which option they will choose.

a) bind it tightly and let the bones re-fuse.
b) replace the upper bone and the ball.
c) replace the upper bone, the ball, and part of my shoulder.

I am devastated.

Health Tip

Don't fall on your shoulder. Man, that hurts.

Being Jane

This site, called Be-Jane, is aimed at women who want to be able to do simple home repairs. I think it's a marvelous idea -- and not just for women, either.

Thoughts

For some time, I've wanted to be an adult.

Thats not to say that I think I'm not, but in a way, I don't. I never truly feel that I'm in control of my life, doing things intelligently and with foresight. I do things occasionally that I later regret, thinking 'jeez, why the hell did I do that'? Stupid things -- not taking care of myself, getting incredibly mad at things that I knew were not worth it, but I got mad anyway. I've felt for some time that when I do grow up, things would be different. After all, when I see others -- who clearly are adults -- they never seem to have these doubts, or make these errors. So me, too -- eventually. I've even found myself on occasion thinking that once I die, then things will calm down and be ordered and reasonable. Which, depending on your belief structure, might actually be the case, but as it relates to living... well, no, that seems to be a non-starter as a concept.

This afternoon, I thought again about that, and - not for the first time - I wondered: At what point are you grown up? Really grown up?

And I think -- I think-- it's when you no longer routinely wonder about it. I'm hoping to get to that point.
=================

Its the day after I wrote the above, and a stray thought just drifted into my mind: am I looking for permission? And, if so, to do what? Or is it absolution, for things that I regret having done? If so, why can't I just do it myself?

This is an interesting insight. I'm going to have to think about this.
=================
Later that day. I just went for a walk with the person I trust most in the world. In a rambling dialogue, and frequently monologue, I told her what I think my problem is -- a problem, to an extent, that we both have, but once which I think I've milked. I told her that I think that I need to get in the mode of forgetting about the past, forgetting about what I did or didn't do to get me where I am now (thinking specifically about the things that I don't like now), and get instead into the mode of thinking critically and rationally about these things. Focusing on what I can do to fix them, and if not fix them, then keep them from getting worse. Focusing on what I can and will do -- because focusing on wonderful things that I just won't do is useless and worse than useless.

It was -- very interesting.

Talent Show

I am not a fan of talented kids, as I think they're either absurdly polished, with a legion of trainers and voice coaches, and a whole bag of cute mannerisms calculated to appeal to the audience, or they're lovable only by their parents and friends - talented, but not Talented. Good enough for the locals, but not more.

And then there's this kid .

Here, Fishy...

Though I don't like to eat fish, I do like to watch them. So from time to time I think about getting an aquarium tank for the living room -- something, say, about two feet long, a foot and a half deep, and an foot and a half to two feet high. That's big but not massive. I've seen massive tanks, and they scare me. Incredibly heavy, for one thing. I wouldn't want to have to get a Special Stand for the tank.

Which is actually all the 'planning' that I've done as regards getting one. But I like the thought. Even the web sites that are dedicated to 'aquaculture', and informing me sternly of all of the hazards, plans, requirements, conditions, considerations and whatnot haven't -- entirely-- dissuaded me from it.

Images

This,,.from the MarkTucker.Com site, says more eloquently than words what I wish to be able to do, photographically. He is a gifted photographer with an elegant and eloquent style.

Being Manly

I've come across a couple of sites lately on the general theme of 'men's issues'. They seem to be predominantly oriented to people who want to complain about their life -- kind of the web equivalent of 'my wife doesn't understand me'. Thats a gross simplification, but I just don't respond to that. Not that I'm adverse to complaining; my wife can tell you how much and how often I will complain when I am not happy with how things are going at work. But whimpering about not being understood seems gratuitously self-indulgent to me. Hard as it is for me to make friends, I still feel that if the friends you have don't understand you, you have the choice to either work harder at the relationship, or just give it up.

Other sites are more focused in 'how to be a man' or 'how to be a father', and those are marginally more interesting to me. By the former, I'm not talking about the 'iron john' style of manliness, or the GQ don't I look good style, but rather sites talking about how to express yourself, how to understand others (by which I mean: women), and that sort of thing. They're helpful, though again, most of the time I'd think you can figure this out for yourself. I was amazed when I realized how much time one gender spends trying to understand the other -- you'd think they lived on different planets. Years ago, I summarized my knowledge of the relationship: Guys like to solve problems, and then empathize; women like to empathize, and then solve problems. Either can stop anywhere in that path. Whiles thats pretty simplistic, its usually held true for me. For more detailed knowledge, I read books by Deborah Tannen; she’s a linguistics professor who speaks with insight and without condescension about communication – how it works, how it doesn’t. For the other things -- like, what the hell is a prostate, and why should you know about prostate cancer; how do you handle money in your family -- those are interesting sites, and sometimes I do learn things.

As for how to be a father -- I'm lucky. I have a wife and daughter who make that very, very easy.

Dancin'

This is a video of an amateur dance team that I thought was pretty nifty.

Fiddling with Firefox

One of the few things that I don't like about Firefox is that awful sound that it makes when you say to search for something on the page, and it can't. The author of this page refers to it as the 'Firefox fart sound', and thats as good as any. Fortunately, he provides two ways to get around it. I chose to change the sound -- I pointed to file:///c:/i386/windows xp balloon.wav -- and it works just fine.

Destroy the Page

I've seen this piece of humour done in a kid's magazine as a 'Destroy the Page' activity (the child cuts up the page) and I couldn't figure it out there, either.

Tagline Wisdom

I'm a kleptomanic, but I'm taking something for it.

It turns out that taxation with representation isn't all that much fun, either.

Don't get even. Get odd.

I'm not tense. I'm just very, very... alert.

Doctors and Medicare

A page at the American Medical association web site says that they need help. They want the people to contact their congressfilk to ensure that the Medicare payment levels stay where they are -- else the doctors will, regretfully, have to slice the number of people they can see per day, which translates into having to wait longer to see a doctor. Unless, of course, you're one of those people paying for caviar medicine, but the site doesn't mention that.

I guess I don't understand that. I suspect they mean 'well, we can't afford to see you for free, or for the amount that you can personally pay, so without Medicare paying part or all of the freight, we're not going to see you at all'. If so, thats a fair financial decision. I doubt anyone expects them to do it for free, and I suspect that some number of doctors do a portion of what they do on a pro-bono basis. They have the same right to a living as anyone else, and except for the docs pulling in the major bucks, I don't begrudge them. (Isn't that nice of me?)

But to imply that Medicare payment cuts will force them to make a change to the number of people they see -- sorry, I don't buy that. It'd be their choice, not the government. Now, that aside -- should the government reduce spending on Medicare? The older I get, the clearer (and more selfish) that answer becomes. But I'll make an offer: cut it for my routine things that I can afford to pay, which are probably going to be more than others can pay. But keep it around as a stopgap, if I need it.

Would that work? Heck, I don't know. Hope so, though.

Point...Counterpoint.

Found this while wandering aimlessly through the net:

I have made it clear in my columns that Bush supporters are not true conservatives. They are brownshirts with the same low intelligence and morals as Hitler's enthusiastic supporters. And they are just as resistant to facts.

Ah, civilized public discourse.

Talking

This evening, my daughter's mood was a little on the morose side.

We talked for a while, and it came out that one of the sources of the mood was that she could hear our neighbors splashing in their pool. She hadn't been invited. She thinks that we ought to get one. While we're at it, she'd like a bigger bedroom, and she thinks we should have one, too. One, say, like her friends, which is large enough for two beds, a sink, a separate bathroom, a flat screen television, a computer, and a stereo. (Her parents are not rich. But they have more money than we do. Oh, and their bedroom? 'Gi-normous.')

Didn't help that she tried to light a couple of sparklers, and the fuel in the propane match ran out after the first. The pack of matches all blew out. And by the time we found another pack, she wasn't really in the mood any more.

I cheered her up, but not all that much.

Creativity

I was just thinking about creativity. Okay, no I wasn't, I was at a site called Phylotaxis, playing with the cute little #something# that they have in the center of their page -- its a cluster of balls that you can rearrange, zooming through it with your cursor, watching them reform. After a bit I zoomed a bit too hard, triggering a jump to a page where a larger version of the cluster appeared, each ball being a news item that you could select. I was fascinated by that when first I saw it, and I still am. It is a wonderful technical achievement, and its delightful. It reminds me, conceptually, of a 'lollipop tree' that is outside a tall building in Boston where I used to work. The wind would come whipping in there, and the trees -- bright yellow circles on poles -- were put there to cause turbulence and smooth out the air. At least, I think thats what they were for. Whatever, they were a delightful design and a clever solution -- like Phylotaxis.

One of the people who occasionally comments here is a life coach for gifted people (a category I barely inhabit these days, but on a good day, yes). I admire that kind of skill, and I love and cherish creativity. Its awesome. I try to encourage when I can (usually, thats limited to my daughter), manifest it when possible (amazing how often that means 'get up, walk away from the problem, and think about something else), and delight in it when I see it.

Iraq

I think that the continued presence of the US in Iraq is leading to a general coarsening of attitudes regarding whats permissible by US forces stationed in a war zone. No one will say that its okay for our forces to kill and rob, because its not -- but when that does happen, I think the feeling is tending towards 'well, hell, this is a country where the kids carry lethal weapons, and blowing up your opponents is normal ; regular rules are off.' I don't think its that far a step from that attitude to saying that murder is, if not acceptable, understandable.

That's not civilized, but I'm beginning to wonder if 'civilized' behavior is a luxury that we cannot always afford. At the same time, I wonder: does it have to be a black or white question? Is there such a thing as situational ethic, where what would be intolerable here is condoned there? Is there a level that is civilized here, and a different one that is civilized there? If so, what does that make us? Some would say pragmatic; others, hypocritical. Can both be right?

This is the kind of thing that sometimes triggers the phrase 'national debate'. These questions need emotion and intelligence. We need to speak forcefully yet respectfully. We need to be adults, and we need to state what we want our country to be, what we want it to stand for, what we're willing to do to achieve that, what we're not. We're not currently capable of that level of discourse, so the discussion goes to the demagogues.

Good things to think about on a day dedicated to freedom.

July 3.75

It's almost the fourth -- excuse me, The Fourth! -- which means that all over the country, people are making preparations. Some of them are delightful, some are lugubrious. I won't be watching television, so I won't have to lunge for the remote if Dubya shows up pretending to be the leader of my country (I'm not sure who is, but I know for sure he isn't), and I probably won't be going to any picnics, much as I'd like to -- I don't know of anyone having one, and what with the timing of the fourth in the middle of a work week, I'm just not going to be in the mood to celebrate. Reading this got me pretty down, too.

But I think this is a great country, with a lot to like and a lot to love. Even with all of the organized insanity and the chaos, I'm glad it's mine.

SOTA

This is just a guess, but I think that when a web site says that something it does is 'state of the art'....it probably isn't.

Legal Stuff

Even wiley ones need it, it seems.......

Give Me Some Skin !

Here's an article I just came across that's pretty interesting --

Scaffolds for skin reconstruction by ZDNet's Roland Piquepaille -- Researchers at the University of Sheffield have developed a dissolvable scaffold for growing new areas of skin when it's severely damaged. These microscopic scaffolds, made from specially developed polymers, look similar to tissue paper. The researchers think that this technology will move out of the lab in a few years.

Rhetorical Question

I don't know if its so much rhetorical as anguished; I really would like an answer, but I really don't expect one. But here goes:

Big company. Lots of people know lots of things. Every so often one of them knows something you would like to know, and they'd tell you if you asked.

How do you find them?

Many companies adopt the approach of 'oh, we'll have people self-identify themselves as experts', and then when you need one, hey presto'. Others say 'oh, we'll use programmatic methods -- scanning emails for keywords, establishing data repositories that can be keyword-indexed'. Still others establish company or division wide instant messaging systems and say 'see, you can use this to flash-message everyone who MIGHT know and someone will pop up and answer.'

All of these do work, but not without effort. And planning. And insight. You have to have a tight community with a strong desire to help others (and a willingness to be helped in return); plus, you have to have a limited number of questions, or a way of filtering them so that you only get the questions you can and would answer. It would help if there was a method of tracking and indexing the questions that were asked, so that only the new ones actually got out to the audience, or the ones that were sufficiently different. Librarians - experienced librarians - to perform this function would be ever so much better than trying to do it programatically. And it would be good if you got brownie points for answering questions, suitable for trading in some currency of your choice, just to encourage use.

All of this is Quite Difficult. All have been done, in bits and pieces. Some are abysmal failures, delightful only to their creators. Some work -- occasionally. Few are scaleable. None are what you really want, which is to ask the HAL9000, and have it just tell you. For that, you need people. Smart, willing, knowledgeable, communicative people. Friendly would help, too.

So -- how do you find them?

=================

Afterthought:
Part of the reason that I like thinking about things like that is because they're intellectually interesting, unlike what I do from day to day. I'd gladly give up half my pay, just for that opportunity. Twice in my working life I had the opportunity to work with someone who was creative, not bureaucratic; who just wanted to solve problems in an inventive manner. Man, do I miss that. The creative impulse is a wonderful thing.

Microsoft Ipod

I've probably mentioned this video before, about 'what would happen if Microsoft owned the Ipod, and improved its packaging', but what the heck -- the video is so incredibly well done, and it makes me smile each time I see it, that I'll mention it again.

Buying Houses

Every so often I will go into a spasm of frenetic eagerness and insist that we HAVE to buy another house, or at least land upon which to PUT such a house, right now, so that we will have it DONE by the time we are ready to have a retirement home built. (I put in the caps because that's how it feels to me when I am spazzing out in this manner.) Usually, I calm back down, and start thinking realistic thoughts about gee, that means your money is locked up, so you assume that the increase in the cost of real estate will be greater than the money you could have earned keeping it in the bank, and that desirable land won't be available then, plus now you have to maintain that land, and if you don't build within X years you might have to get another perc test, and if it fails, then now you have property no one's going to want to buy, and you can't put a septic system in, WAH, now you're screwed. I really do think that planning for retirement housing and acting in advance when you can is a good thing and key to success; I just can't seem to get past the YeahButs when I try. But I keep at it.

Speaking of buying houses, a Finnish company called IGGLO (Here's their site, but be warned; it seems to be in Finnish) has an interesting spin on the basic concept.

Road Trip

We're back from a road trip to the town where my wife attended college. The town has a 'folk festival' every year, and if we are free, we go -- not so much because it's a captivating presentation, but just because it can be interesting at times, and its a relatively cheap family activity. I have a low tolerance for kitsch, of which there is a surfeit there, so I spent most of this morning simply sitting in the shade and watching people go by == boy, we're fat around here == and then strolling once around the rectangle formed by the booths and whatnots, returning to my seat. After about two hours, my daughter joined me, and we returned to the van, where we sat reading while my wife continued to tour the festivities with her mother and an aunt.

I like road trips.