(from www.motmplus.com)

It’s time for a change. Clearly, writing on Saturdays (my only day off from studying) isn’t working. It’s time to transition to daily writing. It’ll take less time, give me my Saturdays completely off, allow for more reflection and up the number of posts on the blog. Everyone wins!

***

It’s the day after Thanksgiving break. It’s hard to get up. Thankfully, I spent part of yesterday studying, and so I feel a desire to get back and learn more.

I get to UVM around 7:30 and spend some time reviewing the Red Book (our anatomy book) and our Dissector before class at 9.

***

9 AM begins Block 3 of HSF. As I walk in, I find the customary packet of printed lecture outlines for each lecture in these next few weeks. I grab it and take a seat.

Betsy (i.e. Dr. Ezerman) welcomes us back and reminds us to do evaluations so we can see our grades. She reminds us that Block 1 was “Motors, wires and chassis”, i.e. lots of muscles and what innervates them, while Block 2 was ”Plumbing and climate control”, i.e. respiration, cardiology, the endocrine system and homeostasis.

Block 3, she informs us, is about the gastrointestinal system, i.e. “Eat, drink and be merry!”

She then introduces Dr. Haeberle and his “barf cart” to simulate the digestive system. For some reason, it looks to me like the bottom part of a concession stand cart with a bunch of scientific apparati on it.

He’s a bit of a character. To demonstrate that chewing produces a cohesive bolus (a ball of food that won’t stick to your esophagus), he ground up some food, rolled a bit of it into a ball and threw it into the audience. It did stick together after landing.

He also utters this phrase during the lecture: “Au contraire, my gastrointestinal neophyte.”

Dr. Mawe then comes to give two lectures about the impact of a meal on the gastrointestinal system. Pretty straightforward. But you gotta love a guy who shows us pictures from his colonoscopy as part of his lecture. (Not to mention an image from when his son swallowed a quarter.)

***

Lunchtime comes. This time, I take it with the Reproductive Rights interest group, who are having a seminar with free pizza. Cate Nicholas, who heads the Doctoring Skills part of HSF along with Dr. Rubin, talks with us about how she worked as an abortion care provider for several years and discusses her experience and thoughts.

Even though it was somewhat lighthearted in discussion, it still is sober to discuss. It has to be. What I walk away with is the fact that the abortion issue is much more complicated than most people on either political side realize.

***

From 1-4, I have Histology. Thankfully, most of this is redundant with what we talked about in the lecture today.

The two course TAs come in to lead this session. We love it when TAs lead because they’re concise, they hit everything we need to know for the exam and they’re super-helpful with helping us identify structures.

Watch this name: Isabella Martin. My understanding is that she’s going into pathology. If so, she will not only be an excellent pathologist, but she will also be an effective and enthusiastic teacher.

***

Afterward, I go to a classroom and spend some time teaching myself information from the RedBook. Then I go home, have dinner with my housemates, and prepare for lab tomorrow, do some Imaging and review Histology / today’s lecture notes.

 As I review the lecture outlines, I find this paraphrased phrase: “I was going to put an exclamation point here, but didn’t upon remembering the Seinfeld episode that mentioned that topic.”

I rethink whether Dr. Mawe is antic-free.

Josh Pothen (UVM’s Meager Med Student)

Donate $1 to The Meager Med Student!

It was Monday morning and the start of another long week. I hadn’t been feeling well the night before and I thought I was coming down with flu. I had a huge headache, was nauseas and had incredible pain in the right lower side of my stomach. I decided that I wasn’t going to take chances with this new H1N1 flu and asked my co-teacher to take me to hospital. The doctor did his poking and prodding and suspected Appendicitis. He wanted to take blood and some x-rays. After having done that, he told me they couldn’t find my appendix. Well, so much for the Appendicitis. He said that I should monitor the symptoms and if they continued, I should come back again.

The following morning, the headache, nausea and pain had increased beyond bearable limits. We rushed off to hospital and went to the ER. A doctor examined me and the next thing I knew I was hooked up to a drip and been given an injection. I was told further x-rays and other tests were needed. About three hours later after all the tests were done, I had another session with the doctor. I was told that I had a 6,25mm kidney stone in my right kidney. Apparently, any stone over 5mm requires medical intervention. The thought of an operation and having to spend time in a Korean hospital scared the hell out of me.

Let me put things in context here. A Korean hospital is run a little differently to a traditional Western hospital. There are nurses, but the majority of them work an eight to five day. Obviously they have a skeleton staff that takes care of emergencies. However, if you are recovering in a Korean hospital, your family takes care of you – no nurses! Furthermore, there are no meals that are brought to you; you need to provide your own. In other words, all after care is the responsibility of your family. So if your like me, a foreigner in a foreign country, chances are your family are back in your home country. The other noticeable thing is that Korean hospitals are not as spacious as Western hospitals, with very little privacy. The space between the hospital beds is probably less than 0,5m. Two people standing back to back in the space between two beds would find it a tight squeeze. The other thing that I noticed while lying on one of the beds in my pain drugged filled haze was the amount of beds that had dried blood stains running down the sides of them. I assumed this was from where peoples’ drips had come unstuck.

As terrible as all of this sounds, I would rather spend time in a Korean hospital just to get rid of the pain. One person had this to say about the pain of having a kidney stone, “Imagine someone punching you in the stomach, kicking you in the groin and then stabbing you numerous times with an ice pick. When you can imagine this type of pain, and then multiply it by ten!”

As ‘luck’ would have it, I would not require any surgery. I was to undergo Extracorpeal Shock Wave Lithotripsy (ESWL). It costs around $450 (R3500-00) and uses microwave shock waves to shatter the kidney stone into smaller pieces, so that it may pass easily through the system. If you lucky, it will work first time around, otherwise you have to have repeated sessions at $450 a pop.

Extracorporeal Shock Wave Lithotripsy

I was given two more injections for the pain and then sent to the room where I would receive my ESWL treatment. I lay down on the table while the doctor was pulling me this way and that way to try and position me over the ‘sensor’. He started the machine up and it started making this gentle whirring sound. I thought this was nice and soothing. The doctor walked around the machine a few times and then left the room. I could have sworn he locked the door…although the drugs could have made me imagine it. The initial pain that I experienced was excruciating. Imagine that your kidney is a piñata and the excited kid with the baseball bat is the machine and the kid is repeatedly bashing the piñata to try and get the candy. This is what was happening to me. The machine was repeatedly ‘shooting’ these microwave shock waves directly at the kidney, trying to smash the kidney stone. At one point that son-of-a-bitch doctor sent in my co-teacher to tell me to breathe normally and stop holding my breath as the treatment wouldn’t work. He knew if he came in and told me, I would have probably given him a quick sharp ninja kick to his groin. The pain was so intense that I was holding my breath trying to brace myself for the next wave of attack! The whole process lasted about forty minutes, although it seemed like forty years. At the end of the session I felt like a million bucks. No headache, nausea or pain…the drugs had definitely kicked in!

It has been almost a week now and I still have not passed the kidney stone. The pain comes and goes and one just has to try and manage it the best way you can. I’m due back at the doctors in a day or two to check whether the stone has passed through my system or not. If not, they want to do another ESWL treatment. There is an English expression, once bitten twice shy. They’ve made my right kidney a piñata once before, I think I will give it a miss this time around and try some natural home remedies instead…if the pain will let me that is!

Aahh, I sprained my ankle!

See, it was my brother’s birthday today, (Happy b-day, Andrew!) so he and three of his buddies and I and our parents and my mom’s dad all went to a place called Sky High Sports. Basically it’s a bunch of trampolines connected to each other, with a separate foam pit and dodgeball area. you jump on the trampolines and play for an hour or so.

I took my shoes off and jumped on the trampoline arena for a good three minutes (:D) before I fell and hurt my ankle. I’m not exactly sure what happened, but i think it had something to do with the yellow pads in between the trampolines. I might have tripped over one, or jumped on one accidentally, or something like that.

So I went down, and my ankle hurt really bad, and my dad and this staff person came over to help me up and get off onto a bench. My ankle swelled a lot, and I cried, and I got an ice pack, and I sat out for the rest of the hour.

Yah, it looks like my knee. But that round oval thing on the side of my foot is actually a swollen ankle…and the white thing is my sock…

So I was asking my parents all kinds of questions. “How am I going to sing on Sunday with my choir?” “How am I going to go to school on Monday?” And the most pressing, “How will I get to the car?” Mom answered, “You have a big daddy. He’ll help you.”

And I thought, ‘I’ve got an even bigger Daddy too, and I know he’s gonna help me.’ Why does it take hardship for us to recognize and appreciate things we often take for granted? Thank you, God, that it wasn’t broken or anything worse.

So I got a piggyback ride out of Sky High, and afterwards we went to a restaurant, and my ankle was better but I couldn’t put weight on it, and it  hurt if I turned it too much. Then Dad made a doctor’s appointment, and at 7:30ish we headed over there.

I hobbled out of the car and a security person asked if I wanted a wheelchair, and Dad said yes. He wheeled me into the waiting room and told the lady @ the desk, “We’re here for the 7:30 showing of ‘Fix My Ankle.’ She laughed, and i did too. Dad’s so funny. He always tries to make me smile.

After five minutes we were shown into the doctor’s office where a nurse got some basic info from us. Then we waited for a while and I read my book. oh-by the way, this sign was on the garbage–

oops, didn’t mean to make it that big.

so then the doctor came in and looked at my ankle, and she said I needed x-rays. Then Dad and I waited some more, and Jeff the X-ray Guy came in. He wheeled me into the x-ray room and told jokes. I asked if I would feel anything, and he said ‘Only as much pain as you feel when you’re talking on the phone. Or standing by the microwave.’

‘Should I take my glasses off?’ I wondered. ‘No, only if your ankle goes up into your head. Then we’d have to take your braces off, too. That would be kinda painful, cuz all I have are some pliers.’

He took 3 x-rays and Dad wheeled me back. Then the doctor came back in and gave us some papers and looked at the pics with us and said I sprained my ankle. Then the nurse came and gave me crutches and a boot/splint/thing.

Now, i’m in good humor and my ankle only hurts a teeny bit.

Night, everybody! Happy Belated Thanksgiving.

ibby out.

via cyanide and happiness

ich brech dir die finger!

übrigens habe ich immer schwierigkeiten mir das wort “röntgen strahlen” oder “röntgen” zu merken, WTF? letztens in einer konversation aufgetaucht und ich suchte das wort und alle haben mich angeschaut als wäre ich ins koma-lala land zurückgekehrt…WOW, ja, ich finde “X-RAY” hört sich einfach geil an, viel geiler als “Röntgen”, wen kümmerts?

The daily weird

The lips remind me of an old rubberband that disintegrates and dies when being stretched after years of idleness.

From the site:

“X-RAY ANALYSES OF SPEECH

PROJECT PARTICIPANTS
Peter Branderud, Hassan Djamshidpey, Christine Ericsdotter Bresin, Diana Krull, Catharina Kylander, Jaroslava Lander, Björn Lindblom, Hans-Jerker Lundberg, Johan Stark, Johan Sundberg, Ivar Wäneland

ABSTRACT
The goal of this project is to investigate 12 speakers with the x-ray equipment at Danderyd Hospital, that is especially calibrated for synchronous registration of articulatory movements and sound [1]. Each subject is recorded for 20 seconds at 50 images per second. The x-ray films are of high quality, which facilitates the phonetic interpretation. The analysis is made frame by frame by tracing the speaker’s vocal tract profile and by feeding the information from the different parts of the vocal tract profile (jaw, mandible, pharynx, tongue contour and lips) into the APEX model. At present, we are investigating how the movement of the tongue is modified when the tongue blade gestures for dental and retroflex stops interact with the tongue body motion for various VCV contexts [2, 3].“

More images and info found here

I came across an article in the New York Times in which Dr. Dennis C. Turk mentions:

“The exact cause of back pain is never found in 85 percent of patients.”

“REALLY?!” I immediately thought.

Dr. Russell K. Portenoy said:

“It’s good for the public to know how little we know.”

Is it?! You might just scare the you-know-what out of every patient out there! Think about being the patient with chronic back pain who is coming to the doctor looking for answers and the doctor says, “Well, we have no idea what’s causing your pain but…” Not what the patient is hoping to hear!

The article asks:

“So what’s a sufferer to do?”

Good question. The article starts talking about drugs and surgery and the side effects and unreliable results of them. But I think, before we start talking what to do, we should figure out why the cause of back pain isn’t found. THAT is the BIG question.

Why is the cause of back pain never found in 85% of patients?

It all comes down to WHAT we are looking for. If we believe the cause, or underlying source, of someone’s back pain is a disc injury, facet joint damage or arthritis, then we will look for damage using X-rays, MRI’s and CAT scans. When or if damage is found, treatment that will attempt to address that damage will be recommended. And then we see the painful statistics that large numbers of people who have surgery still have the pain afterwards and many people will have to have repeat surgeries. If drugs are recommended, well we all know that’s not fixing the problem, it’s just trying to cover it up – not good!

Here’s what’s important: doctors are trained to look at the condition of the body – disc injury, facet joints, arthritis – but what causes the condition of the body? Doctors have gotten this wrong – it’s not age, activity, or genetics – it’s position.

“Position?” You ask. Yes.

The position or posture of the body causes the condition of the body.

It’s that simple. The determining factor in your health is not your age or genetics as many people will try to convince you. Your pain is not caused by the activities you do as you have been told. Those are cultural lies. Stop believing them…or you will never get better. Better to me means 100% better. No pain. No limitation. No excuses. Freedom.

You’ve experienced this state before. We all did. When we were 5, 6, 7 years old. We could do anything with no pain or limitations and we loved it! We lived free. When we are free of physical pain and limitations something else very powerful happens: we start living the rest of our life without limitation and anxiety. We have piece of mind.

So, now, what do you do? Where do you go from here? Start by convincing yourself that your pain is caused by your posture. Here are some resources to help you:

• Reading the synopsis of Egoscue will help you understand how your posture causes pain (and damage).

• Great interview with Pete Egoscue about pain, traditional treatments and how Egoscue is different.

• Read Pain Free by Pete Egoscue.

• Attend a Pain Free Workshop where we will explain to you exactly what is causing your pain and how to fix it. It’s FREE.

36 2 Go

• OMG…Overslept this morning…hate doing that…it throws my entire day out of synch. It was Jourdies fault…she slept at Emmas last night, so when my alarm went off..I though…Ohhhhh…I can have an extra hour because there is no school run…instead of resetting the alarm I just got back into bed….and back into a deep deep sleep…AGhhhhhhhhhhhhhhhhh
• I am so so glad its Friday…after last weeks attack of the pigs im still exhausted and this week has been very long indeed…chilling tonight with a glass of red…out with the gang tomorrow for some much needed Vodka/Sambucca therapy.

Peter Andre’s Phone Bill Must Be Huge..He Just Keeps Voting

I’m Katie Price… Get Me Out Of Here! Jordan threatens to quit I’m A Celeb over trial torment

Katie Price has revealed she is on the verge of walking away from I’m a Celebrity… Get Me Out of Here! as the public backlash over her return to the jungle becomes too much to bear. The glamour model has only been in the jungle for five days, but the public have already voted for her to do a string of ghastly ‘Bushtucker Trials’ on the ITV reality show. And it may be they are enacting their revenge after being forced to wade through endless headlines about her split from her ex-husband, singer Peter Andre. In the live section of tonight’s show, Miss Price looked dismayed when she learned she would have to take part in her fourth bushtucker trial on Friday night.

Relatives of the star have now said they believe viewers are punishing her because of her outrageous antics during a high-profile divorce from Andre. Miss Price has now endured three trials and is set to attempt a fourth one in Friday’s episode. On last night’s show, she said: ‘I’m absolutely ready to leave camp.’ She said she was pining for her children, severely-disabled son Harvey, seven, her son with footballer Dwight Yorke, alongside son Junior, four, and daughter Princess Tiaamii, her children with Andre. The brunette, who had been covered in cockroaches and bugs, forced underwater in a pond full of larvae and through dark tunnels infested with rats for her challenges, insisted: ‘I’ve had enough. ‘I miss my children. I’m hungry. I want a nice bed and I don’t want to have to put myself through these horrible challenges. I don’t like it.’

Who’s it gonna be? Katie insisted she knew it would be her when she was put up against Gino Di Campo Earlier this week she suffered a panic attack after crawling through the tunnels. Yet she was also picked for another task which involved her swimming through a pool of baby crocodiles as well as a live trial on Wednesday night. Giving her thoughts on being picked again, she said: ‘I think the public want to give me a bad time. ‘You can’t take it personally even though it’s hard not to. They’ve seen me battered for the last 3 or 4 days.  Let someone else have a go.’ Katie’s mother, Amy, and brother Danny yesterday likened her treatment to someone being stoned to death in ancient Rome.

Speaking on ITV1’s This Morning, Danny said: ‘She has this façade of being very strong, controlling, not showing any emotion, but there is a side to her that’s very vulnerable and insecure.’ Asked about Katie constantly being chosen to take part in the Bushtucker Trials, her mother said: ‘It’s very painful but we told her ‘you know you’re going to get every trial. ‘It’s like let’s stone them, it’s like the gladiators. They’re taking out their spite on her.’ Wednesday’s trial saw Miss Price trying to retrieve a number of stars with her teeth, the first from a pool of gunk and the second from a tangle of mealworms. She then had to retrieve objects hidden in a sphere of snakes, dive into a pool of baby crocodiles, drink a glass of ‘beetlejuice’, put her hands in gloves filled with ants and then pick up live eels.

Earlier in the week she had to be lifted out of a dark tunnel after a gruelling bushtucker trial in which she had to crawl through a series of rat and cockroach infested tunnels in the dark and collect stars to win food for the rest of the camp. But when the small space was flooded with water, the model – who suffered a swimming accident as a child – panicked, and shouted to be pulled free. She was close to tears and shaking when she came out and hyperventilated as medical staff tried to calm her down. Meanwhile, the star also talked about ex-husband Peter Andre on the show.

Fellow contestant Justin Ryan said: ‘One of the hardest things about splitting up with Peter and it must be so much more difficult for you is the division. Camp Katie and Camp Peter.’ Katie replied: ‘I don’t know who started all that. It’s pathetic. We’re both human beings. So many people get divorced.  So many people every day, you know.’ When Justin suggested that it would be good if the two could remain friends she replied: ‘I’d love that. I’d absolutely love that. If I had it my way. It’s nice for the kids to have both their parents and both get on.’ Sam Fox said that she hoped that the couple would end up talking for the children’s’ sake. ‘It will happen,’ added Price. ‘It’ll probably take a few years.’

Also in Thursday’s episode, the camp were split into two groups in a battle for Base Camp. The winning team would be excluded from the first vote off and live in the relative luxury of base camp, while the others would be forced live in Exile and over the next few days will have to compete in Bush Battles. The winner of each day’s Bush Battle would have immunity from the first vote off and will return to live in Base Camp.With the two teams  chosen, they all stood on wooden platforms underneath buckets holding poles pressed against a button on the bottom of the bucket.

Queen of clean: Kim Woodburn is horrified to be staying in Exile Camp after losing the bush battle One false move and the contents would be released and that celebrity eliminated. One by one, each celebrity was eliminated before Sabrina Washington was declared the winner. With team leader Colin, Sabrina and her teammates Justin, Katie, Jimmy and Joe returned to Base Camp which had been transformed into a relative jungle paradise. Katie enthused: ‘I’m so relieved.  It’s like returning home.’ The camp had been transformed, furnished with camp chairs, pillows for the beds, dressing gowns, firewood and purified water.

Samantha Fox is disgusted to see a rat in exile camp

The group were thrilled to learn they would have additional food delivered that night and found chocolate and cold beers in the caravan. Meanwhile, Lucy led her losing teammates Gino, Stuart, George, Sam and Kim to the Exile camp, which was nothing but a simple clearing with one log and one bed. The camp contained only the bare essentials and the camp mates were horrified to see rats running around. Ex-Hollyoaks actor Stuart even managed to catch one and place it outside of their clearing. Queen of Clean Kim was disgusted and declared ‘I couldn’t take much more of this filth.’

Funny Story…Poor Guy

I went to the Home Depot recently while not being altogether sure that course of action was a wise one. You see, the previous evening I had
prepared and consumed a massive quantity of my patented ‘you’re definitely going to s**t yourself’ road kill chili. Tasty stuff, albeit hot to the point of being painful, which comes with a written guarantee from me that if you eat it, the next day both of your butt cheeks WILL fall off.
Here’s the thing. I had awakened that morning, and even after two cups of coffee (and all of you know what I mean) nothing happened. No ‘Watson’s Movement 2′. Despite habanera peppers swimming their way through my intestinal tract, I was unable to create the usual morning
symphony referred to by my dear wife as ‘thunder and lightning’. Knowing that a time of reckoning HAD to come, yet not sure of just when,
I bravely set off for the Depot, my quest being paint and supplies to refinish the den..
Upon entering the store at first all seemed normal. I selected a cart and began pushing it about dropping items in for purchase. It wasn’t until I was at the opposite end of the store from the restrooms that the pain hit me.
Oh, don’t look at me like you don’t know what I’m talking about. I’m referring to that ‘Uh, Oh, S**t, gotta go’ pain that always seems to hit us at the wrong time. The thing is, this pain was different. The habaneros in the chili from the night before were staging a revolt. In a mad rush for freedom they bullied their way through the small intestines, forcing their way into the large intestines, and before I could take one step in the direction of the restrooms which would bring sweet relief, it happened. The peppers fired a warning shot. There I stood, alone in the paint and stain section, suddenly enveloped in a noxious cloud the likes of which has never before been recorded. I was afraid to move for fear that more of this vile odor might escape me. Slowly, oh so slowly, the pressure seemed to leave the lower part of my body, and I began to move up the aisle and out of it, just as an red aproned clerk turned the corner and asked if I needed any help. I don’t know what made me do it, but I stopped to see what his reaction would be to the malodorous effluvium that refused to dissipate. Have you ever been torn in two different directions emotionally? Here’s what I mean, and I’m sure some of you at least will be able to relate. I could’ve warned that poor clerk, but didn’t. I simply watched as he walked into an invisible, and apparently indestructible, wall of odor so terrible that all he could do before gathering his senses and running, was to stand there blinking and waving his arms about his head as though trying to ward off angry bees. This, of course, made me feel terrible, but then made me laugh.. ……..BIG mistake!!!!!
Here’s the thing. When you laugh, it’s hard to keep things ‘clamped down’, if you know what I mean. With each new guffaw an explosive issue burst forth from my nether region. Some were so loud and echoing that I was later told a few folks in other aisles had ducked, fearing that
someone was robbing the store and firing off a shotgun. Suddenly things were no longer funny. ‘It’ was coming, and I raced off through the store towards the restrooms, laying down a cloud the whole way, praying that I’d make it before the grand mal assplosion took place.
Luck was on my side. Just in the nick of time I got to the john, began the inevitable ‘Oh my God’, floating above the toilet seat because my ass is burning SO BAD, purging. One poor fellow walked in while I was in the middle of what is the true meaning of ‘Shock and Awe’ . He made a gagging sound, and disgustedly said, ‘Sono@##!, did it smell that bad when you ate it?’, then quickly left. Once finished and I left the restroom, reaquired my partially filled cart intending to carry on with my shopping when a store employee approached me and said, ‘Sir, you might want to step outside for a few minutes. It appears some prankster set off a stink bomb in the store. The manager is going to run the vent fans on high for a minute or two which ought to take care of the problem.’ My smirking of course set me off again, causing residual gases to escape me. The employee took one sniff, jumped back pulling his shirt up to cover his nose and, pointing at me in an accusing manner shouted, ‘IT’S YOU!’, then ran off returning moments later with the manager. I was unceremoniously escorted from the premises and asked none too kindly not
to return. Home again without my supplies, I realized that there was nothing to eat but leftover chilli, so I consumed two more bowls. The next day I went to shop at Lowe’s. I can’t say anymore about that because we are in court over the whole matter.
Jerks claim they’re going to have to repaint the store..

Mystery of Death Valley’s gliding rocks

These extraordinary pictures reveal a bizarre event that is puzzling the science world – rocks that glide across the desert.Amid the eerie silence and the 50C heat of California’s Death Valley these giant boulders appear to move smoothly – and unaided – across the desert.The rocks, some as heavy as 17 stone, edge along in bizarre, straight-line patterns across the ultra-flat surface of the valley. They can travel more than 350 yards a year.

Er… how did that get there? One of the extraordinary moving rocks leaves a track through Death Valley Scientists believe the phenomenon is caused by a coming together of specific weather conditions.Studies suggest a combination of 90mph winds, ice formations at night and thin layers of wet clay on the surface of the desert all help to push them along. Photographer Mike Byrne, 40, has spent years documenting the stones’ mysterious movements. As his amazing pictures show these real-life rolling stones leave trails across the sand in places almost untouched by man. He said: ‘Some of these rocks are as heavy as a person, it is really is strange to imagine them gliding across the desert like this. ‘They must be the original real-life rolling stones, they just keep moving through the sand and I don’t believe anyone has really 100 per cent worked it out yet.

More of the boulders and the eerie paths they leave across the Valley

‘Most of the stones are found on an old lake bed, known as the Racetrack Playa, where the ground is particularly flat.’It has been documented over the years and it is something very special to witness, although I know climatologists believe the phenomenon could disappear in a few years as the temps continue to rise.’One of the strongest theories about what the rocks move is that water rising from beneath the surface of the sand is pushed by the wind creating a surface the rocks can move along.’Death Valley is the lowest point in the U.S., at 282ft below sea level.It is almost completely flat and holds the record for the second highest temperature ever recorded on earth, a blistering 58C.In the 1990s a study by a team of scientists lead by Professor John Reid, from Hampshire College, Massachusetts, attempted to explain the rocks’ movement.His study concluded that the rocks may be moved when they become embedded in sheets of ice forming at night on the surface of the sand.As the sand melts Prof Reid said that the rocks were moved along by the ice and wind, thus forming the patterns.

Sorry …But This Guy Is A Prick

Revealed: The Newcastle footballer who couldn’t get by on £75,000 a week

The star also had lucrative sponsorship deals with various companies including Pepsi and Nike but had not been paid for these until NVA stepped in to get the contracts honoured, bringing in thousands of pounds.Before they managed his affairs Martins had not been paid a penny for his image rights on Newcastle United shirts and mugs. He had received nothing from his sponsorship deals and could not even find the contracts he had originally signed.NVA said it also organised travel visas, a passport, his mortgage and property valuations, and was constantly going up to Newcastle from its London offices for him.Mr Tennink told Judge Richard Seymour, QC: ‘Day to day life with superstars is demanding and superstars are demanding.’Martins, who owned several fast cars including a top-of-the-range £85,000 Porsche Cayenne 4×4, spent the money on a lifestyle of luxurious penthouse homes and fine dining.He owned a large multimillion pound home in the exclusive footballers’ enclave of Darras Hall, near Ponteland, Northumbria, and rented an opulent flat overlooking Newcastle upon Tyne’s trendy Quayside.The striker, who was sold for £9million to German side Wolfsburg after Newcastle were relegated from the Premier League earlier this year, paid NVA £67,500 in January last year and another £25,000 in April last year but NVA claims it is still owed over £300,000.Martins, who was not in court yesterday, is fighting the claim and the hearing is scheduled to last for three days.

Everything you never knew you wanted to know about Jedward

They are, without doubt, the sensation of the moment: two quiff-haired innocents, who can neither sing nor dance but have taken the country by storm. Everyone’s talking about Jedward.

The twins’ outfit last week consisted of silver suits from Topshop. X Factor stylists were still sticking tiny mirrors on the collars minutes before they went on stage to perform

WHICH WAS BORN FIRST? John and Edward Grimes were born on October 16, 1991, at the Rotunda Hospital in Dublin. John is the elder, by ten minutes. The twins were delivered three months early, at 28 weeks, and weighed just 2lb each. They were given only a 50 per cent chance of survival. Both spent weeks in an incubator before being allowed home. Their father John said: ‘They were so small and fragile, but thankfully they pulled through. They have always had a bond and I think it goes right back to that.’

BOYS TO MEN The boys grew up in a large home in the village of Rathangan, Co Kildare, with their brother Kevin, who is a year older. Their father John is a computer expert and their mother Susanna a secondary school teacher.

X Factor experts have refined the look of the twins who don’t mind trying out garish outfits

Their parents wanted them to have a bedroom each, but they stayed together because they missed each other so much. They boarded at The King’s Hospital, a private £6,000-a-year school, in Dublin, until they were 12. John says they were bullied, physically and verbally. ‘I think it was because we stuck out a lot,’ he said. A local describes them as ‘eternal oddballs’. Their parents split up and they now live with Mum in Lucan, a suburb of Dublin. They attend the posh private Institute of Education. Their mother says they have always been ‘music mad’ and love Robbie Williams and the Backstreet Boys. Last summer they scaled the four highest mountains in England, Ireland, Scotland and Wales for charity. Asked where they see themselves in ten years, they said: ‘We see ourselves as being a bit older.’ They came 7th and 13th in an Irish schools’ mountain run this year and John won a bronze in the 1500m at an under-19 indoor championships last March – Edward was fifth and six seconds slower.

ACTING UP Simon Cowell detested their arrogance on sight, calling them ‘vile little creatures who would step on their mother’s head to have a hit’. Their athletics teacher Ann McGee says she thinks the apparent cockiness is just an act. ‘They’re lovely lads and I think they are probably playing up to the camera.’

Their head teacher Jim D’Arcy agrees: ‘Their persona on the show must be a bit staged because they’re not arrogant. I’ve never had a second of trouble from them and the teachers love them.’ Described by an X Factor spokesman as ‘truly very sweet boys’, they have made a pact to sign their autograph for every fan who asks. Edward says: ‘We sign crazy stuff, from iPods to arms, to everything in the dictionary!’

WHICH IS WHICH? Pay attention: there are several key differences. Edward has more orangey hair, bushier eyebrows and better skin. His teeth are a fraction snagglier. The clearest giveaway is that John has a pointy right ear. He also has pierced ears, a scar on his forehead and never stops talking. John at 5ft 11in is about an inch taller than Edward, though they wear the same size clothes. On the advice of producers, the twins have started to do the Ant and Dec trick of always standing in the same order to help people differentiate. As you look at them, John is always on the left and Edward on the right.

ONE STEP BEHIND Edward always seems to be a little more off-key and out of step. However, X Factor singing coach Yvie Burnett says they do have potential. As well as spending two hours a week with each of the contestants teaching them their songs, Yvie says: ‘I do mother them. Singing can be psychological and if they are down or not feeling confident my job is to bring them back up.’ Their full names are John Paul Henry Daniel Richard Grimes and Edward Peter Anthony Kevin Patrick Grimes

HAIR RAISING The pair claim it takes only ‘five seconds’ and a dollop of gel to get their 3in quiffs ready in the morning. When they perform, though, their quiffs are backcombed, gelled and sprayed into submission by the studio hair and make-up team. According to chief stylist Faye Sawyer, when she first met them their hair was all sticking up ‘like Rhydian on acid. We tried to tone it down and make it look more soft and more quiffy’. One friend from Ireland says: ‘They have always had the big hair.’ Not surprisingly, they are expected to land a big money deal to plug a haircare brand the minute they leave the show.

The boys came into X Factor with a big love of high-top trainers

THE TRAIL BLAZERS When the twins turned up to the X Factor auditions they already had their own style – blazers and high-top trainers they call ‘runners’. Stylists then set about tweaking it all into the image we now know and love. ‘Their look is based on the Eighties, which were in turn inspired by the Fifties, so there’s the quiff, the jackets and drainpipes,’ says Faye Sawyer. The red shiny jackets the twins wore in Britney Spears week were made especially from patent leather, in homage to Britney’s famous red catsuit. The jackets are likely to be auctioned in aid of the show’s support for Great Ormond Street Hospital. Last week’s silver suits were from Topshop and stylists were still sticking tiny mirrors on the collars with hot glue guns ten minutes before John and Edward were due on stage. ‘They are like male models. They can wear anything,’ says Faye.

CEREALGATE Jedward are very noisy in the X Factor house – getting up at 7am and playing music loudly enough to annoy the rest of the contestants. They also have bubblegum blowing contests – John apparently blows bigger bubbles. The twins like to wear odd socks. They split two pairs between them, so they have one of each colour The twins eat vast amounts of cereal – with water, because they think dairy products give them spots. Sometimes they ‘borrow’ food from housemates – leading to Jamie Archer, Olly Murs and Danyl Johnson marking their cereal boxes with ‘Keep Off!’ signs. Meanwhile, Danyl also spends time sulking. He can’t understand how Jedward are becoming ever more popular.

GROUNDED! It has been mayhem outside the X Factor house in London’s Golders Green for the past few weeks, with hundreds of teenage girls camped outside. Neighbours have complained about some of Jedward’s fans who try to flash their underwear at the twins. A guard at the house said: ‘John and Edward are not allowed out – it’s studio’s orders. They cause too much chaos.’

Which is which? John and Edward may look identical but there are subtle differences to tell them apart

THE HATE MAIL John says: ‘We get hate mail and vicious letters. Some is so bad X Factor haven’t let us see it. It’s hard when we have to go out and perform and be happy and confident and smiley because we know if we slip up they’ll come after us. We know a lot of people hate us. I get so upset by it I can’t sleep. It goes round and round in my head. ‘We’ve had a gang come up to us in the street, saying ‘There’s those twins’ and they came after us. We had to run away. Edward was shaken and upset. I had to calm him down and tell him not to think about it.’ A fortnight ago, their mentor Louis Walsh became so rattled by the booing from the studio audience he was caught on camera flashing a two-fingered gesture at the offenders. He said: ‘They were calling them awful things. It’s not a football match. John and Edward’s family are there.’ He added: ‘It’s just a small handful of people in the audience shouting obscenities. I wasn’t letting them get away with it. It’s not right. The boys are only just 18.’ There are at least 40 Facebook pages devoted to getting Jedward off the show. The boys have five dogs and an eight-year-old budgie called Joey at their home near Dublin

OMERTA! Simon Cowell is rather alarmed by the public outcry which followed the controversial result in which the twins were saved while the talented Lucie Jones was sent home. Both Olly Murs and Lloyd Daniels have said that they are ‘not allowed’ to talk about the row in public, on Cowell’s orders. Meanwhile, the twins have personally apologised to Lucie.The truth is that Cowell didn’t want to be seen as the meanie who ended their run on the show. There were more than 4,000 complaints to ITV and 150 to regulator Ofcom.

GHOSTBUSTERS The twins are banned from all tanning products. The make-up artists emphasise their pale Irish complexion. In common with the other finalists, Jedward had £450 of free teeth whitening at the London Centre for Cosmetic Dentistry with top dentist Dr Mervyn Druian, whose clients include Amanda Holden and Carol Vorderman.

The twins look a lot shorter without their high quiffs

WHAM! BAM Wham’s I’m Your Man appears to be the favourite for Jedward to perform tomorrow night, but the contest is notorious for last-minute changes. If ever a theme was geared towards the twins’ strengths, it must be this one. Blond highlights, a tendency to bounce around on stage, and the obvious fact they are a pop duo should all help John and Edward. The stylists have not yet settled on a look, though we are assured it won’t involve a bouffant blow wave, shorts and shoulder pads. Whatever – it sounds as if we are in for another haphazard and wildly entertaining display.

DANCE ENVY? As everyone has noticed, Jedward have benefited from a big production number every week – with pyrotechnics, dancers and elaborate costumes. Naturally, other contestants are jealous. A show spokesman admitted: ‘They’ve had quite a lot of choreography and rehearsal time because there was a need for it.’

CELEB FANS Peaches Geldof (who wants to marry Edward) was spotted wearing a ‘Jed we can!’ T-shirt at a live show. Westlife think they’re hilarious. Ronan Keating, Bono, Colin Farrell are supporters – as, quite frankly, is everyone Irish. And they’ve charmed Robbie Williams and Brian May. David Cameron, Kelly Osbourne, Peter Andre and Michael Buble are also fans. As is Harriet Harman, apparently.

The twins have embraced their nickname

COWELL THE CONVERTED After they beat Lucie, Cowell was dismayed by the backlash from the public and told John and Edward to lie low. He had, of course, been their chief detractor in the first few weeks, but has started to be more encouraging. ‘If you allow – which I think is right – the public to determine who wins, you’ve got to go with it. You don’t have to agree with it, but you have to go with it,’ he said. Any embarrassment Cowell may feel over the success of the tone-deaf twins has been undoubtedly sweetened by the fact that Jedward have already signed a contract (as have all contestants) which means he gets a cut of any commercial deals they do until at least March 2010. They have already received television offers from networks including Disney, Nickelodeon and the BBC. Cowell’s adviser and ex, Sinitta, said: ‘Simon would actually create a show especially for them. Anything but see them win The X Factor.’ The final word on Cowell’s love/hate relationship with them should go to Louis Walsh: ‘I don’t like normal people and Simon’s the same. We hate it when normal people come in to sing. We love them slightly bonkers.’

The other X Factor contestants Olly Murs, Stacey Solomon and Lloyd Daniels take a break from rehearsals

The 11th Husband  !!!

A young man married a beautiful woman who had previously divorced 10 husbands. On their wedding night, she told her new husband to “Please be gentle; I’m still a virgin.”
“What ?” said the puzzled groom.
“How can that be if you’ve been married ten times?”
“Well……..
Husband  #1 was a Sales Representative; he kept telling me how great it was going to be.
Husband #2 was in Software Services; he was never really sure how it was supposed  to function; but he said he’d look into it and get back with me.
Husband #3 was from Field Services; he said that everything checked out diagnostically but he just couldn’t get the system up.
Husband #4 was in Telemarketing;  even though he knew he had the order, he didn’t know when he would be able to deliver..
Husband #5 was an Engineer;  he understood the basic process but he wanted three years to research, implement, and design a new state-of-the-art method.
Husband #6 was from Administration;  he thought he knew how but he wasn’t sure whether it was his job or not.
Husband #7 was in Marketing; although he had a product, he was never sure how to position it.
Husband #8 was a Psychiatrist; all he did was talk about it.
Husband #9 was a Gynecologist; all he did was look at it.
Husband #10 was a  Stamp Collector; all he ever did was…………  God I miss him !!.
But now that I’ve married you, I’m so excited”.
Wonderful”, said the husband, but why ?
You’re with the  ” GOVERNMENT “.  .
This time I KNOW I’M gonna get SCREWED.

Funny X Ray

Jumping Your Bones

]]> http://semanticscience.wordpress.com/2009/11/20/swat4ls2009-sonja-zillner-towards-the-ontology-based-classification-of-lymphoma-patients-using-semantic-image-annotation/ Fri, 20 Nov 2009 10:59:38 +0000 na303 http://semanticscience.wordpress.com/2009/11/20/swat4ls2009-sonja-zillner-towards-the-ontology-based-classification-of-lymphoma-patients-using-semantic-image-annotation/

(Again, these are notes as the talk happens)

This has to do with the Siemens Project Theseus Medico – Semantic Medical Image Understanding (towards flexible and scalable access to medical images)

Different images from many different sources: e.g. X-ray, MRI etc…use this and combine with treatment plans, patient data etc and integrate with external knowledge sources.

Example Clinical Query:” Show me theCT scans and records of patiens with a Lymph Node enlargement in the neck area” – at the moment query over several disjoint systems is required

Current Motivation: generic and flexible understanding of images is missing
Final Goal: Enhance medical image annotations by integrating clinical data with images
This talk: introduce a formal classification system for patients (ontological model)

Used Knowledge Sources:

• Ann-Arbor Staging System – particularly suitable for lymphoma patients
• RadLex
• Foundational Model of Anatomy
• Semantic Image Annotation

Requirements of the Ontological Model

• Capture the rationale of the Ann Arbor Staging system
• Integrate external ontologies
• Ontology must describe the patient record

Now showing an example axiomatisation for the counting and location of lymphatic occurences and discussses problems relating to extending existing ontologies….

Now talking about annotating patient records: typical problems are abbreviations, clinical codes, fragments of sentences etc…difficult for NLP people to deal with….

Now showing detailed patient example where application of their classification system led to reclassification of patient in terms of staging system.

Earlier this year I wrote a (hopefully) humourous piece about having asthma. Oh, that was easy then, when I was on top form, lungs working at 90% of their capacity, a peak flow of 540.

Now my peak flow is down to 200, a day or two ago 100.

So this leads to insane drug abuse. Mainly of steroids. I double my inhaler usage and I get the multi-purpose Amoxicillin 500 mg and then some dinky elliptical maroon pills called Prednisolone that I take six at at time and can lead to such side effects as Moon-Face and insomnia.

If it’s a clear night and you wake in the middle of it, open your curtains and see me smile down at you.

Yesterday I went for an X-Ray at Lewisham Hospital. The results were fine (I think- they don’t tell you anything, but they did let me leave, and my doctor had said they wouldn’t if there was “anything gross”).

So I head to the Radiology Department (next to the Nuclear Medicine Department… I don’t know, and I was too afraid to ask).

There’s a smallish queue at the reception and two or three ahead of me is the King of Coughs. This man’s cough is relentless. It’s not a barking or hacking cough. It does, sadly, have a hint of the death rattle about it. His cough sounds like a cough trying to cough.

He’s seen to and he coughs to a seat.

A few minutes later I hand in my form and I’m given a green ticket. A39. Tickets like you pull out of a machine when waiting at the delicatessen counter in a supermarket.

I sit near the Rothko print, and a few rows away from the King. He looks like me only twenty years older. And really what I mean by that is that we both need haircuts, a shave and a good bath. We’re like Catweazle and Catweazler.

We both get called at the same time to go to our next waiting post. His name is Edward. We’re given shopping baskets (it is like being at the supermarket!) and asked to go into cubicles, strip to our waists, put our clothes in the baskets and to put on thin green cotton robes.

Then we sit next to each other and wait a few moments, smiling at each other.

Edward goes off for his X-Ray and I go off for mine. Then we both come out and wait again. This time we sit opposite each other and say hello.

Edward has chronic bronchitis. Although Edward has a truly awful and worrying cough, he is smiling and he is happy to talk. He rushes things out, in a seemingly random order; he has chronic bronchitis, his wife died a year ago, he worked and rushed, and ate, and drank, and met, family, a brother, all work, all rush, all coughing… random thoughts that made me think he is leading to an understanding of what condition his condition is in. But it isn’t coming and so I try to prompt him.

But Edward, who is me twenty years on, is quite a little deaf. Through the coughs, and the coughs of the coughs, I try to make myself clear, to be heard. And regular readers of my blog will know that this is not something I normally have difficulty with. But I’m in a hospital, and I’m doing my best to be sensitive, already making enough noise with my own heavy breathing and gasping.

I felt the secret to Edward’s condition was his work. He seemed to be driving at that. Perhaps he’d been a baker, spending a lifetime breathing in flour. Or perhaps he’d worked with asbestos.

I ask him what he did, and he hears. “Worked for the council”.

And then the radiologist approaches us both. We can both get dressed. We can both go. Our doctors will get the results soon. Nothing “gross”.

I’m glad. For both of us. Take care Edward.

Originally Written by: Mendelsohn, Robert, M.D.

In 1980, as he lay dying of cancer, an eminent 71 year-old internist, Dr. Frederick Stenn, made his final assessment of “Modern Medicine” in a letter to the New England Medical Journal published under the title: “Thoughts of a Dying Physician”. This is what he said: “Most physicians have lost the pearl that was once an intimate part of medicine – humanism. Machinery, efficiency, precision, have driven from the heart warmth, compassion, sympathy and concern for the individual. Medicine is now an icy science. Its charm belongs to another age. The dying man can get little comfort from the mechanical doctor.”

In view of the above statement, Dr. Mendelsohn, in his new book, Male Practice, has systematically, listed and exposed, many of the medical practices of today, which he feels are directly opposed to the welfare of the patient.

HOSPITAL TESTING:

In 1980, the American Medical Association did finally abandon its support for the routine annual physical, and the American Cancer Society for routine annual mammography, pap smears, and chest X-rays. It took too long, but they had to cave in because of the overwhelming evidence that these procedures are actually dangerous, not just no good. In the case of the pap smear, many of the tests are inaccurate and unproven to begin with, and these deficiencies are compounded by false interpretation and inefficient, careless work in the labs. Medical testing laboratories are scandalously inaccurate. In 1975, the federal Center for Disease Control surveyed labs across the country and found that 10 to 40% of their work in bacteriologic testing was unsatisfactory, 12 to 18 % erred in blood grouping and typing, and 20 to 30% botched hemoglobin and serum electrolyte tests. In another nationwide survey, 50% of the high standard labs licensed for Medicare work failed to pass. In the labs studied by the CDC, 10 to 12% of the healthy specimens were reported to be diseased, causing patients to receive hazardous treatments when they were not really sick’.

X- RAYS:

One of the most dangerous weapons in Modern Medicine’s arsenal is the X-ray machine. Most doctors order X-rays carelessly and needlessly and either don’t know or don’t care about the damaging cumulative effects. Most doctors won’t warn you that X-rays can produce cancer in your breasts or leukemia in your unborn child. They’ll tell you that radiation is at such a low level that it can’t do any harm, just as I was told by my professors in medical school more than 30 years ago. Any doctor should know that there is no minimum level of radiation below which a woman is safe from harm. He should know that the radiation effects are cumulative – you can be damaged or destroyed by the combined effects of all the X-ray doses you have ever received. Many dentists insist that the radiation dosage is so minimal that even the cumulative effects couldn’t do any harm. This attitude is so common throughout the profession, and it defies the policy of the American Dental Association. Acknowledging that the cumulative effects of X-rays are dangerous, the ADA cautions dentists against the routine use of diagnostic X-rays.

Pregnant women need to be particularly cautious where X-rays are concerned. It is known that a single abdominal X-ray of a pregnant woman can predispose her child to leukemia. Women of childbearing age have a special need to be concerned about the cumulative effects of the X-rays they receive during the course of their lives. It is the accumulative radiation, not age in and of itself that influences the birth of a child with Down’s Syndrome.

SURGERY:

Surgeons in America operate twice as often as those in England. I’m convinced that women have needless surgery because we have more surgeons than we need. Studies have repeatedly shown that the amount of surgery performed varies greatly from one locality to another and that this difference is not determined by medical need. When prepaid plans, in which surgeons are salaried, are compared with fee-for-service plans, the results are startling. Doctors whose income depends on the number of operations they perform, do 50 to 100% more surgery than those who receive the same salary no matter how many patients they put under the knife!

Preventive surgery does trouble me, and it should trouble you. Most surgeons regard the appendix, which they remove with impunity with little or no indication of infection, as another of God’s mistakes. In 1975, 784,000 appendectomies were performed in the U.S. and about 3,000 of the patients died. Most of them were described as “emergency” operations, yet one out of four of the appendixes that were removed were found to be perfectly healthy when they reached the pathology lab. Beyond the immediate risks of surgery, how will losing your “useless” appendix affect you for the rest of your life? Very little effort has been made to find out, but studies done by one eminent researcher showed that persons whose appendixes had been removed were twice as likely to develop cancer of the bowel. He concluded that the appendix may be important to the body’s resistance to all forms of disease. Sixty percent of all directors of approved residencies in general surgery and obstetrics-gynecology in the U.S. recommend removal of the appendix when uncomplicated hysterectomies are performed.

If Modern Medicine continues on its present course, one of every two women in the country will part with her uterus before she reaches the age of 65. Many doctors routinely remove the ovaries and tubes when they perform a hysterectomy, apparently caring little that their patient will then suffer the rigors of premature menopause. Even without removal of the ovaries and tubes, the removal of the uterus itself appears to have an acute effect on ovarian hormone production in some women, and headache, dizziness, hot flashes, depression, and insomnia can be produced, as well as suppression of libido. Studies have found reduced sexual drive in 60% of the women who have had their uterus and both ovaries removed.

DRUGS:

Your morning newspaper often features headlines lauding a new “miracle drug” that has just appeared. You may find this reassuring, but you shouldn’t. An incredible percentage of the medicines doctors prescribe – possibly 3 out of 5 – simply don’t work. Many are prescribed in place of safer and more effective alternatives. Remind yourself that medicine hasn’t changed since two centuries ago when Voltaire wrote: “Physicians have been pouring drugs, about which they know little, for diseases, about which they know less, into human beings about whom they know nothing.”

DRUGS DURING PREGNANCY:

I sometimes hear from pregnant women whose doctors are giving them tranquilizers and other dangerous drugs. They not only damage the mothers, but also risk inflicting deformities on the unborn child. There are few situations in which the administration of a drug during pregnancy can be justified. It is currently estimated that the typical pregnant woman receives an average of four drugs during her pregnancy, most of which entail a known or unknown potential risk to the fetus. Obstetricians are more inclined to seek the approval of the mother by displaying concern for her comfort than to protect the welfare of her unborn child. It is vital, therefore, that pregnant women educate themselves about drugs and try to avoid taking them throughout their pregnancy, because even after the first trimester there is still a great unknown risk. Danger lurks in every medication, whether intended for coughs and colds, constipation, relief of pain, insomnia, stomach distress, or symptoms of anxiety or depression. Evidence that aspirin can dramatically arrest the growth of human embryo cells was demonstrated a decade ago in a study done in England. The effects of aspirin include fetal deaths, birth defects, and bleeding in the newborn. High doses of vitamin C can produce jaundice. Bendectin is another case in point. This toxic drug is prescribed for the relief of nausea and vomiting during pregnancy, although there is no solid scientific basis to believe that it works. Since nausea and vomiting are two of its side effects, it would be a miracle if it did work.

THE BIRTH CONTROL PILL:

Over the last two decades I have read scores of scientific studies revealing the diseases and mortality rates suffered by users of the Pill. These women have been shown to have a higher incidence of cancer of the cervix, uterus, breast, and liver. The Pill has also been linked to heart attacks, strokes, diabetes, gall bladder disease, pulmonary embolism, hypertension, and mental depression. Permanent sterility can also result. To these major effects can be added a score or more of lesser symptoms, ranging from vaginal infections to growth of hair on the face. The Pill wouldn’t have many takers if women were told that it alters hormonal balance to create a physiological dysfunction. The desired result is to interfere with a natural process – ovulation – by causing the body to malfunction. Thus, the Pill literally makes every woman who takes it sick. For some women, the immediate symptoms are mild and scarcely noticeable; for others, they are severe. But all of those who take it are exposed to potentially deadly risks. After all, the damage may not appear for 20 or more years.

THE IUD:

Since the late 1960s, millions of American women have been supplied with these dangerous devices by their physicians. Few of them realized that the IUD could make them permanently sterile, perforate the uterus and migrate into the abdominal cavity, or cause pelvic inflammatory disease (PID). In 1974, the FDA released figures that linked 39 deaths to IUDs. Since 1970 more than a million women have suffered acute pelvic infections attributable to the devices. It is estimated that 20% of them – as many as 250,000 women – have been or will be rendered sterile by IUD-induced PID.

Doctors failed to consider a new hazard that the seven most widely used IUDs had in common. Each of them had a string attached that descended from the uterus into the vagina. This innovation was designed to enable women to determine whether their IUD was in place and to make the device easier to remove. At the outset doctors overlooked the fact that the strings provided an inviting path for bacteria to travel from the vagina into the uterus – and when this became known, they chose to ignore it. Because the lining of the uterus was irritated by the IUD, the bacteria found a hospitable environment in which to produce pelvic inflammatory disease. The infection could then spread to the ovaries and the fallopian tubes.

The insertion of foreign objects into the uterus as a means of birth control dates back at least two thousand years. Until the early 1960s, when they were co-opted by the population control proponents, American doctors refused to use them because they caused infections, peritonitis, and death. Only twenty years ago the use of IUDs was considered a form of malpractice, and warnings against their use were given to students in medical schools.

HOSPITAL VS. HOME BIRTH:

Your doctor won’t tell you, so I will: your own bedroom is safer than the hospital delivery room, and the hospital nursery is infinitely more threatening to your baby than a crib next to your bed. After working in hospitals for most of my life, I can assure you that they are the dirtiest and most deadly places in town. They are actually so germ-laden that 5% of all hospital patients contract new infections that they didn’t have when they arrived. All of these germs are hazards to the mother, of course. They are even more threatening to the newborn babies, whose immune systems are not yet fully developed. I am also concerned that the obligatory ritual of placing silver nitrate in the eyes of the newborn – theoretically to guard against gonorrheal infection – may be responsible for the higher incidence of astigmatism and myopia in the United States than in countries that don’t perform this ridiculous rite. Unfortunately for the baby, silver nitrate can cause blocked tear ducts during the first six months of life and more important, a chemical conjunctivitis that prevents the newborn baby from seeing.

The complications that a pregnant woman is told to fear are rarely a hazard when the baby is delivered at home. Most of them are real, all right, but they occur only because of the things the obstetrician does to the mother in the hospital after she gets there. A British report on perinatal mortality released in 1964 showed an overall mortality rate in hospitals that was more than double the mortality rate of babies born at home.

The turning point in taking the process of childbirth away from the mid-wives – and from mothers, as well, was the elimination of the birthing stool, on which mothers delivered babies by allowing natural contractions and gravity to do their work. Doctors began placing mothers flat on their backs on high tables, with their knees raised. This made it virtually impossible for them to deliver their own babies and assured that they would need a doctor to help. It has made having babies infinitely more difficult, perilous, and painful. The practice of laying birthing mothers flat on their backs was initiated to satisfy a kinky erotic aberration of France’s Louis XIV! Not surprisingly, other doctors soon concluded that what was good enough for the royal household must also be good for everyone else. They adopted the lithotomy position, apparently in the belief that Newton and Kepler were wrong, and that by royal edict the law of gravity had been repealed.

Since it obviously has no legitimate medical basis, you are entitled to ask why doctors continue to force mothers to have their babies while strapped down flat on their backs. The position itself creates the pathology that makes normal births abnormal. Until she is moved to the delivery room, the mother will be confined to her bed. She will be denied the freedom of movement and exercise that would relieve her tensions, ease her fears, expedite her labor, and reduce or eliminate her pain. Her baby will be exposed to the risk of damage from lack of nutrition and oxygen that the supine position may cause and the hazards that will result from its mother’s treatment with drugs. The mother’s pain will be increased, so drugs will be administered that will retard and prolong her labor. Labor will be induced by invading the uterus and rupturing the membranes, increasing the risk of infection and fetal damage or death. The mother will be further confined by the attachment of intravenous gadgetry to keep a vein open for administration of drugs and to provide nourishment, because she will not be allowed to eat or drink. A fetal monitor will be strapped to her abdomen or inserted into her uterus and screwed into the baby’s scalp. The mother’s pain becomes so unbearable that pain-killing injections are given that paralyze the lower half of her body. She can no longer feel her contractions and must be told when to push. Finally an episiotomy is performed. (When he performs an episiotomy, the doctor cuts through muscles and nerves, producing a numbness that sometimes persists for years, whereas natural tears are likely to be superficial so only a few stitches are required most of the time.) After delivering the baby, the doctor hurriedly cuts the cord before it has stopped pulsating, so the infant’s blood backs up in the mother. It is that mixing that produces erythroblastosis (Rh disease) in a subsequent child. He tugs on the cord to expedite delivery of the placenta, increasing the mother’s risk of hemorrhage. The mother’s risk of infection, already increased over the previous hours by multiple vaginal examination, becomes even greater. Next, he must repair the damage done to the perineum by the episiotomy he performed. This may cause sexual dysfunction later on. Finally in denial of everything that prompted the mother to go through this ordeal, the baby is whisked off to the newborn nursery, and the mother to the recovery room to sleep off the drugs. This is motherhood?

Reference: Male Practice by Robert Mendelsohn, M.D.

Voice is sound production. Speech is what ultimately comes out the mouth after the sound is modified by the tight coordination among the throat muscles, palate, tongue, lips, teeth, etc. An example of a voice problem is hoarseness. A speech problem would be stuttering, or nasal-sounding words, or mumbling.

Speech researcher Christine Ericsdotter precisely captured the intricate movements of the tongue, lips, pharynx and jaw during speech using a rapid-fire X-ray.

Check out the video she created here!

This link provides a cartoon animation of how each sound in the English language is produced from an anatomical standpoint.

Well folks I had my surgery and thanks be to God for all of your prayers.  I did not have to get an ICD,  instead I got an Implantable Loop Recorder.  This little device which is about the size of a jump drive sits right between the 2 and 4th rib.  The job of the loop recorder is to record all cardiac activity which my doctor can download at any time.  I also wear what is called a Zoll Life Vest.  This vest,  is basically a portable AED.  I wear it next to my skin and it monitors my heart ,however;  unlike the loop recorder,  it actually treats an arythmia when it picks one up.  For instance,  if my heart goes into polymorphic ventricular tachycardia or Torsades de pointes,  which are the most common fatal rhythms that Long QT syndrome sufferers can go into, it will deliver a shock.  Fancy huh?  So I guess you can say I am wired!!! Soo  all in all I am doing well and I thank God for doing the healing.  Yes I went to the hospital and utilized the doctor’s and the wonders of modern technology but God is the one who directed the surgeons hand.  God granted the specialist wisdom to treat my condition and prescribe the correct dosage of medication.  God is holding back the side effects of the medications and allowing them to work as they claim they should.  In the beginning of this sickness I said, “anyway you bless me Lord I will be satisfied”,  guess what folks?  I am…

~Anointed

To find out more about the Life Vest or the Loop Recorder just click on any of the words Below…..

Implantable Loop Recorder

This is not my X-Ray but if you look on the Patients left which is your right you will see the loop recorder it looks like a small rectangular box tucked right beside the heart.  Pretty neat stuff huh or just TMI hahahaha?   Ok folks that’s the end of your Grey’s Anatomy lesson for today!

~Anointed

{X-ray art via Wikimedia}

My cellphone’s insistent jangle burst into the splendor of the pre-school parent-teacher conference. We were in the midst of hearing about our son’s many strengths: high cognitive skills, wonderful communication, exemplary vocabulary and supreme sense of humor. Embarrassed by the interruption and not wanting to disturb the string of compliments, I found the phone and abruptly turned it off.

A moment later my brain registered concern. I had seen the identity of the caller—my friend who was picking up our older son after school. As the pre-school teacher continued his praise, a fraction of my brain ran through the possible reasons for her call. Perhaps she was reporting that she had him and all was well. Or maybe she was checking if it was okay to get ice cream, since her sugar standards are more generous than mine. I trusted that she could handle whatever might be going on, and that in fifteen minutes I would be done with the younger brother who is always shorted on attention. But part of me was already gone, wondering and hoping nothing was wrong.

The moment our conference ended I called back. I listened for a clue in the tone of her “hello.” I heard no panic, only concern. The news: my child had fallen while playing basketball, moments after he arrived at her house. He was lying down with ice on his elevated foot, which might be the tiniest bit swollen. He did not want to play; he wanted his mommy. Something was wrong.

Relief sprinkled with guilt danced down my spine. This was not an ambulance emergency, but it was a real injury and I had not answered the call. Points off for me.

We hurried over. When he saw me, his red eyes closed, his mouth twisted, and he reached for a hug. He hurt. I lifted him up and carried his 60 pounds to our waiting car.

Settled at home, I phoned the pediatrician. “Didn’t I see you five minutes ago?” she said, herself the mother of a pre-schooler. “What happened since then?”

“Slam dunk contest,” I explained. “Hmm. It could be broken,” she said, “but it’s too late in the day to get an orthopedist appointment and I don’t want you within a mile of the ER. If he can’t walk on it tomorrow morning, go get it X-ray’d.” We kept it on ice, fed him Motrin, and crossed our fingers.

—

The X-ray the next morning showed three broken bones, clear as the sunny day outside. The orthopedist held the film up to the sunshine streaming through the window on the eleventh floor of the medical building. Four floors below was the obstetrician whose hands guided this child’s entrance into the world, whole and perfect. I stared at the broken bones I was entrusted to safeguard and felt a momentary dizziness, a breach of duty.

The mop-haired orthopedist explained how the foot’s growth plate would create new bone cells to heal these fractures in a matter of two weeks. I wanted to know about long term consequences: “Will this be a problem for his future in the NBA?” He gave me a smile, looked back at the X-ray, and did not spoil any dreams: “No. This won’t be a factor to keep him from professional sports.” Other things may, but not this. Good enough.

From the rainbow assortment of casts, Aaron chose light blue, for the Dodgers. The doctor cautioned us not to scratch under it, warning about cuts and infections. I carried Aaron to the elevator, and his feet almost reached the floor. But he knew how to hold on, his four-foot-four frame wrapped around me. I didn’t mind; it was something I could do for him, a penance.

Downstairs, the pharmacist equipped him with crutches, and told him he was the best 8-year-old crutch-user she had ever trained. But they were no match for the three deep steps leading to our front door. Aaron handed me the crutches when we got home, and reached up for his father’s arms to carry him in.

The rest of the day brought visitors with balloons and Sharpies to sign his cast. His girl cousins drew hearts, his grandfather wrote “break a leg.” He worried aloud about how it would feel to sleep with a cast on.

At 3:00 a.m. the itching began. “Mom!” he moaned from his bed. “It itches so bad!” I thought of the doctor’s warning of infected cuts and tried to comfort him in other ways. I scratched his back. No help. I offered him mind tricks: “Try scratching the other leg and see if it helps.” Uh-uh. I tried persuasion: “An itch is just your nerves telling your brain to scratch, but there’s nothing physical there.” No! Mom, please!

Neither of us could take it any longer. I searched the darkened house for a safe scratcher. I came back to his room with a scrubbed-clean skinny paintbrush. “Use this,” I said.

He accepted the black rounded implement and gently guided it down the top of the cast toward the middle of his shin. One second later came one of the most beautiful sounds I have ever heard, as beautiful as the cry that followed the frightening minute of silence after he was born: “Ahhhhhhhhhhhhhhhhhhhh.” His face relaxed into sheer relief as he exhaled in ecstasy. I took the implement from his hand and set it on the table next to him. He rolled over, murmured “thank you, mama” and fell asleep before I could kiss his head “you’re welcome.”

He had the weekend to learn how to walk on three legs. It was hard, unsteady work. He left the crutches in the corner most of the time, opting for crawling and hopping. His good leg tired. His armpits ached. His heart dampened from missing flag football games. His mind worried about how he would fare at school, with his classroom on the second floor.

Monday came, we arrived at his school with some trepidation. In a matter of minutes he learned some good things: There is an elevator at school. He can choose a different friend to ride with him each time. He can play on the classroom computer at lunchtime with anyone he picks. As the day went on, he and I learned ever more valuable lessons: Children can be kind, patient and compassionate. He is strong. He is resilient. At his core, he has a positive outlook. He can weather this. He can meet any challenge. Nothing can stop him.

What is it?

The term sciatica describes the symptoms of leg pain and possibly tingling, numbness or weakness that travels from the low back through the buttock and down the large sciatic nerve in the back of the leg. You may not be aware of back pain, however. The majority of people who experience sciatica get better with time (usually a few weeks or months) and find pain relief with non-surgical treatment. Sciatica occurs most frequently in people between 30 and 50 years of age. Often a particular event or injury does not cause sciatica, but rather it tends to develop as a result of general wear and tear on the structures of the lower spine, often as a result of faulty movement patterns over years.

Sciatica symptoms

For some people, the pain from sciatica can be severe and debilitating. For others, the pain might be infrequent and irritating, but has the potential to get worse. While sciatica can be very painful, it is rare that permanent nerve damage will result but it might take many months to recover on its own. It is important to undergo a thorough examination to establish how badly the nerve is damaged.
What can I do about it?
An important thing to understand is that sciatica is a symptom of a problem. It arises as a result of something compressing or irritating the nerve roots that comprise the sciatic nerve rather than a medical diagnosis or medical disorder in and of itself. This is an important distinction because it is the underlying
diagnosis that often needs to be treated in order to relieve sciatic nerve pain. If you visit a Chiropractor they will conduct a thorough examination of the back to establish what may be causing the sciatic pain. Common causes of sciatica are a lumbar herniated disc, spinal stenosis, degenerative disc disease or spondylolisthesis.

A Chiropractor will decide whether you need an x-ray or MRI scan before treating or whether you need referral to a neurosurgeon or orthopaedic surgeon. However, chiropractic treatment can be very effective in relieving the pain of sciatica.

In my search to optimize my linkedin searches I came across something interesting for recruiters/researchers that search internationaly. One of the great frustrations I personally have with Linkedin is that it only allows you to search one country simultaneously while for a lot of my jobs I really don’t care where people are coming from. It now means that I have to run a search several times in order to make sure I have the maximum amount of candidates.

I can of course try and search through the search engine of Linkedin directly and see what it gives me but the results have not been optimal. If I add say (Netherlands OR Belgium) to my keyword search I get a lot of false positives simply because of people having those words in their profile. One of my favourite ways of searching Linkedin is not using linkedin at all, it’s the all-mighty X-ray. Be prepared because I’m taking you on a bit of a journey.

X-ray explained
Now, hopefully most recruiters are comfortable with x-ray but for the less boolean-gifted recruiters a quick explanation: x-ray is a Google search string that allows you to focus on one particular site. If I put site:linkedin.com in my Google search it will give me only results from………….right, LinkedIn! There are big advantages to x-ray over a LinkedIn search and that is that you really can see all of the public profiles on linked and you can actually contact them. Reason for this is that a) your search results is limited by the size of your network and b) LinkedIn allows you to see the LinkedIn profile if you come in through this back door where if you did a normal search it wouldn’t allow you if that person was outside of your network.

Whenever you do an x-ray on Google don’t forget to add inurl:pub OR inurl:in -intitle:directory in order to eliminate pages where such a groups and events. To further narrow it down add -inurl:updates. To give you an idea of the power of this string: it gives 30.200.000 hits. I would say much of the population of Linkedin

The international X-ray
For the more advanced recruiter that wants to search internationally there are some ways to limit the search to a specific country or some specific countries. Glen Cathey wrote an article about how to do this after I had contacted him about some international search he had done. To recap his research:

You can do a search on postal codes on Linkedin:

If you take a large city as say Amsterdam, The Netherlands you see that in the city there are several postal codes

Now if we do a search on Linkedin with the postal code 1000 in the Netherlands you will see that all of them have in their profile “Amsterdam Area, Netherlands”.  And with that “area, country” we can play.

My own research completes Glen’s list and below a list of all the structures that are being used

“Area, France”
“Area, Germany”
“*, United Kingdom”
“Area, Switzerland”
Area, Belgium
Area, Netherlands
Area, Sweden
Area, Spain
*, Finland
Area, Norway
*, Russian Federation
*, Portugal
Area, Italy
*, Ireland
Area, Denmark
*, Austria

As you can see most countries in Europe follow the “area, country” setup except for the UK but what can you expect from a country where people drive on the wrong side of the road?

Now, let’s say I need a user experience expert in the Netherlands? A what? Yeah, sorry but I had this search recently so might as well take that one. A search on “user experience” in the whole of the Netherlands gives me 1239 hits. I’m not going into how I can increase it by perhaps looking at other job titles, that is not the meaning of this article.

An x-ray on google site:linkedin.com (inurl:pub OR inurl:in) -intitle:directory -inurl:updates (”Area, Netherlands”) “user experience” gives me 2.510 hits. A lot better of course, way too many results and I would need to narrow it down but I’ve just doubled the number of candidates. Now this seams to work but if I’m searching for more countries I may run into the Google limit of 32 words in the boolean search. As well I’ve found that somehow not everybody has a region mentioned in their profile which would render the “area, country” string useless. In a niche market like UX I can’t afford to lose out on a single candidate.

The Holy Grail of international x-rays
So here is what I’ve found and if I’m not mistaken nobody else has blogged about it. So here is my ticket to fame LinkedIn has recently changed all the personal links on peoples profiles. Now, US-based profiles haven’t changed and still are http://www.linkedin.com/in/NAME but as I’m based in Spain my personal link has changed to http://es.linkedin.com/in/tedmeulenkamp. A check on other profiles gives that profiles in the UK now have uk.linkedin.com, in Germany de.linkedin.com and the Netherlands nl.linkedin.com. I have not (yet) compiled a list of all the country codes but they seem to be following the standard country codes used globally.  So wow, Linkedin has actually placed a country code in the personal links of all their members! Have I found the holy grail for international linkedin x-rays?

So before we bring out the champagne (or cava in Spain) let’s test this.

site:linkedin.com (inurl:pub OR inurl:in) -intitle:directory -inurl:updates inurl:nl.linkedin.com user experience” gives me 2.990 hits. Not bad as it increases the amount of hits over the previous one because of the before mentioned fact that not everybody has a region in the profile but they surely have had to give their country when signing up. But we are still not there, what if, just imagine, what if the country code is only used in personal profiles and not on any other pages. That would mean we could get rid of inurl:pub OR inurl:in as thus save space.

site:linkedin.com -intitle:directory -inurl:updates inurl:nl.linkedin.com user experience” gives me exactly the same amount of hits as my previous search and that is just awesome! It really means that we can leave out inurl:pub OR inurl:in. But wait, wait, wait. What if we leave out -intitle:directory and -inurl:updates?

site:linkedin.com inurl:nl.linkedin.com user experience” again gives me the same amount of hits. AMAZING!!! We went from a pretty lengthy search string to this compact, easy to remember, easy to use search string! Just to be complete if you want to use this string for a multi country search you just put in inurl:nl.linkedin.com OR inurl:be.linkedin.com OR etc).

So folks, run the following and bookmark it for your international searches:

site:linkedin.com inurl:nl.linkedin.com KEYWORDS”. Change the country code and keywords and rock on!

Conclusion

There is so much more to get out of Linkedin by using an X-ray and now with this new search string you can actually very accurately search per country and profit of the larger network and accessibility of the x-ray search! And dear friends in the US, sorry but because you still have the original profile links you still need to use the full search string.

UPDATE:

I got a lot of reactions to my post and some have had some interesting suggestions:

One is to actually delete site:linkedin.com in the string but put site:COUNTRYCODE.linkedin.com. That seems a pretty good thought and I set out to do some testing on it. Here are my results:

What does this mean? I don’t know? One conclusion might be that in the original search there are a lot of duplicates or it might mean that the new search eliminates valid hits. I think you need to try for yourself and see if you get enough valid hits. I would of course be very interested in hearing about your finding!

Sacha Otten did some very good work on the string if you work on several countries in the same string. My original string had; (inurl:be.linkedin.com OR inurl:nl.linkedin.com etc). Sacha came up with (inurl:be OR inurl.nl)linkedin.com.

I did another test drive and here is what I’ve found

That actually seems to work very nicely and it saves us real estate in the search string. Thanks Sacha!

Beautiful photographs. Coloured x-rays of everyday objects. At the Oxo Gallery until 22nd November. Free.
See more at www.gustogallery.com

Taken with my iPhone:

The office is turning out to be beautiful.  For me, working in beautiful surroundings impacts how I work, think and enjoy being in the space.  I put a chandelier in my office that is spectacular.

We got the CO and will, as planned, see patients starting on Tuesday!  It will be so wonderful to work as a chiropractor instead of as a builder and contractor, technology investigator, HR department, decorator and general fix-everything-that-may-go-wrong person, before it actually does.  I logged my hours this past week and worked 16 hours on 3 days and 17 hours on the other two.  Of course it’s now Saturday night, and forgetting trip to IKEA and two other furniture stores, while hopefully everyone else is out playing, I’m working on figuring out how to get a link for this blog onto the website, that also isn’t quite completed yet.

The very fancy newest and greatest digital x-ray machine was installed and I’m ready to take pretty pictures of bones and show them to patients.  Stop in anytime Monday-Thursday between 9-1 and 3-6 and we’ll be glad to serve you.  And if you just want to stop in to say hello (and bring me a black coffee) I’ll be very glad for the visit!

But you are a cripple, Blanche...

For the first time in three weeks, I have picked up my stick (lent to me by MacGuiver from the bar next door) and walked. Out there- outside. Yesterday I had my follow-up x.ray at a medical centre and in the afternoon, another visit to my GP to be signed back on for work, all things being well.

The x ray was a fairly efficient affair. We were sitting in a small bay with plastic seating, at right angles to a corridoor with many doors leading off it into various x-ray and consulting rooms. Along the corridoor hurtled medical staff in a self-important flurry, occasionally calling out names, then barking the order ´this way, please´. By the time I followed my nurse she had disappeared, and I stood peering into open doors, thinking ´yeah, but which way?….´ until she found me. Back in the waiting room I heard ‘Maria Milagros Martinez’ called out, and a woman of about 30 years old came forward. Mary Miracle Martinez. That means she was named in the eighties sometime. I understand older Spaniards having religious names – it was a decree of Franco´s that all babies christened after a certain date must have a religious name, hence the glut of Mary Josephs, Joseph Marys, Jesus, Mary of the snows, of the pains, Pains, Consolation, Immaculate, etc etc. But what were her parents thinking? Mary Miracle Martinez? Sounds like a specialist hooker or a girl who fires herself out of a cannon for a living. Nowhere near as bad, however, as my favourite ghastly name which is Circuncision, shortened to Circun. An old lady’s name originating in Andalucia, apparently, thankfully dying out these days.

Following the x ray I was told I could go home and it would be sent to my GP electronically. I asked for it to be sent that day so as not to waste a visit to my GP that afternoon and was assured it would be done that morning. Knowing in my gut that something in the process would screw up, I hobbled home. At the doctor’s later (by this time with a sore-ish foot due to all the walking) I was told the xray had been sent but in the wrong format and I’d have to go back again the next day. Deep breath….

Today I made a visit to work to sort our paperwork. I went by metro, perfecting my authentic Dr House limp with stick.

''Make your own cup of tea.''

Reactions to the stick are interesting. At the best of times it´s hard enough to get someone to give up their metro seat for you. I was offered a seat twice, once by an older gentleman and then by a young woman. Suddenly there were other walking wounded everywhere. In the carriage with me a young man with a wheelchair, another man at Sol metro station with a zimmer frame, a girl on crutches, in Plaza Lavapies another man resting on a bench with his crutches. As the metro carriage door opened and the wheelchair guy and I tried to leave, the usual press of bodies stopped us leaving before they piled into the carriage, and one bitter old cow tutted loudly at us as we tried to push pur way through and onto the platform. I reacted in true Spanish fashion, snapping at her,

´Well, let us get off first, then!’ Sometimes being half Spanish has its advantages- you are allowed to answer back, to have a damn good whinge when you need to, to push and shove, and you can permit yourself not to apologise when someone else shoulder barges you in the street.

After calling in to work I went to the office where the Ponce pays his rent and sorted that out for him. The doorman to the building rushed out of his little booth as I was leaving- a red-faced balding midget with a huge grin, and asked me how I´d done it, then why didn’t I have a man to do these things for me, then next time I should call him and he’d lift heavy things for me, finishing our short chat with the statement ´God, but you’re gorgeous, you are.’ Thanks very much, but no thanks….

It feels good to be out and about again. It´s as though I have been away in another country, or in a chrysalis, emerging blinking into the light. Over the past few weeks it has become winter. The walk back from the x ray yesterday morning was glorious. My appointment was at 8.10, and I saw the sun rise pink over the Puerta de Toledo. The streets are quieter, the terraces are almost all brought inside by now and there are even a handful of Christmas decorations up. Winter in Madrid is bitterly cold but exhilerating. It felt good to be back. Enough of this crippled house arrest. I think I might keep the stick though, as an affectation, and as a handy way to get a seat on the metro.