Game Review

Well, it turns out that I have become something of a board game and card game buff. And so, I thought I would share and review my latest acquisition. The game is called Frog Juice and, like many of the games I enjoy, it is produced by Gamewright.

Frog Juice is a card game of witches, spells, black cats, and "all-purpose witch wash." The art on the cards is fantastic and in some cases appropriately reminiscent of a tarot deck. The gameplay is unique and fun but gets repetitive after a couple of games. The object is collecting ingredients and power cards with the goal of having the most points at the end of the game. There is a little strategy involved, but for the most part it is the luck of the draw. I suspect that with more people the game would be more interesting. Overall, Frog Juice is a fun game with great art that makes you think, a little.

For a game that is somewhat more challenging and great for groups of 3-5 players try Loot by gamewright.

CNN.com - Mike Mikula cartoons - September 9, 2005

Check out this Cartoon on CNN.com:

CNN.com - Mike Mikula cartoons - September 9, 2005:

"Mike Mikula has been drawing political cartoons long enough to recognize that regardless of which party he's from, the emperor has no clothes. He's honed his skills on his comic strip, 'Rotundarama,' which appears in Roll Call, and as the editorial cartoonist for the Atlanta Business Chronicle."

SHINEDOWN - Save Me

I heard this song on the radio tonight and I thought the lyrics were worth sharing.
(click the title link to hear the song)

I got a candle
And I’ve got a spoon
I live in a hallway with no doors
And no rooms

Under a windowsill
They all were found
A touch of concrete within the doorway
Without a sound

Someone save me if you will
And take away all these pills
And please just save me if you can
From the blasphemy in my wasteland

How did I get here
And what went wrong
Couldn’t handle forgiveness
Now I’m far beyond gone

I can hardly remember
The look of my own eyes
How can I love this a life so dishonest
It made me compromise

Someone save me if you will
And take away all these pills
And please just save me if you can
From the blasphemy in my wasteland

Jump in the water
Jump in with me
Jump on the alter
Lay down with me

The hardest question to answer
Is why

Why

Someone save me if you will
And take away all these pills
And please just save me if you can
From the blasphemy in my wasteland

Someone save me
Someone save me
Somebody save me
Somebody save me
Please don’t erase me"

I am not sure what struck me about this song. I think I was struck by the honesty of the lyrics. The song is both a cry for help and a statement of faith. I think too often we think of faith as the simple answer to any problem. Faith isn't simple. It is raw truth.
- The hardest question to answer is why.
Faith calls us to seek the answer despite the struggle.

Juan-ana Coffee

Check out this website for fair trade coffee from San Lucas Toliman in Guatemala. I visited the Catholic parish in San Lucas and was amazed at the effect that the parish ministry has had on the community. In other areas of Guatemala ( a country recovering from 36 years of civil war incited by a CIA supported military coup) the health of the indigent mayan people is very poor. The water is not clean. There are no schools for children. Many children are forced to work breaking rocks for pennies a day because their fathers have left for the U.S.. In S.L. all children go to schools that are run by the parish. There is also a hospital that provides basic health care and emergency care to the community. One of the many other ministries initiated by the church is the coffee farms.
Visit the website to learn more: http://www.juananacoffee.com/

Land for the land-less is one of the most important efforts made in the integral human development program in San Lucas Toliman. It makes available to a farming people what is vital to their lives - land on which to produce their own basic food. It also gives them an opportunity to raise a cash crop of high quality to meet other human needs.

post-hurricane infections - another reason to stay out of the floodwater

Dangerous infections are on the rise in the gulf coast area. There has been an outbreak of infections caused by bacteria in the genus vibrio. The significance of this finding is that cholera is caused by a species of vibrio. Cholera is an epidemic-causing bacteria which causes severe diarrhea and resulting dehydration. Fortunately the epidemic serotypes of v. cholera have not been isolated. Here is an excerpt from the CDC report (click on title for link):

Hurricane Katrina made landfall on August 29, 2005, with major impact on the U.S. Gulf Coast. During August 29–September 11, surveillance identified 22 new cases of Vibrio illness with five deaths in persons who had resided in two states (Figure 1). These illnesses were caused by V. vulnificus, V. parahaemolyticus, and nontoxigenic V. cholerae. These organisms are acquired from the environment and are unlikely to cause outbreaks from person-to-person transmission. No cases of toxigenic V. cholerae serogroups O1 or O139, the causative agents of cholera, were identified. . . .

Although precise exposure histories are not yet available for all patients, the infections caused by V. vulnificus likely resulted from wounds exposed to flood waters among persons with medical conditions that predisposed them to Vibrio infections. No evidence has been found of increased Vibrio gastrointestinal illness.

The effects of this disaster are clearly far reaching.

new pertussis vaccine approved in June

I had the strong urge to change the subject. So I did some research on the most recent pediatric medical advancement - the pertussis booster. Recently, there has been an increase in the number of pertussis diagnoses in both children and adults. While pertussis does cause significant illness in adults (ever had a lingering cough that lasts 6-8 weeks or longer?), it is of most concern for the infants exposed to it who are incompletely vaccinated. Here are some stats from Up-To-Date online (http://www.uptodate.com, subscription required):

According to the World Health Organization (WHO), there are currently 20 to 40 million cases of pertussis each year with 90 percent occurring in developing countries. In 1999, the disease was responsible for 295,000 reported deaths, most of which occurred in Africa and Southeast Asia [19]. The case fatality rate during the years 1990 to 1996 was 0.2 percent in the United States, with 84 percent of deaths occurring in children less than six months of age [20].
The introduction of widespread vaccination in the developed world in the 1940s resulted in a marked decline in the number of cases and deaths due to pertussis (show figure 1). The number of reported cases in the United States fell from approximately 200,000 per year prior to 1940 (approximately 155 cases per 100,000 population) to a historic low of 1,010 cases per year (approximately 0.5 cases per 100,000 population) in 1976 [17,21,22].
However, the incidence of pertussis has been increasing worldwide over the past 15 to 20 years, including in the United States (show figure 1) [17,19-22]. The Centers for Disease Control and Prevention (CDC) reported 7,867 cases in the United States in 2000, the highest rate since 1967 [20]. The increase in pertussis cases is supported by a surveillance study using a single serum anti-pertussis antibody assay in Massachusetts where the incidence of pertussis was 75 to 100 cases per 100,000 adolescents and at least 5 cases per 100,000 adults [23]. As pertussis is significantly underreported, the true incidence is probably much higher.

The Facts:
1. pertussis is on the rise
2. pertussis is dangerous to the smallest children
3. immunity to pertussis wanes over time so that immunity in adults is very low
4. infants and children get pertussis from adults with waning immunity

Now we can do something about it. Though it has not been commercially released yet the booster vaccine will be released soon. I realize that it seems far-fetched, but vaccinating adults will save babies lives. So, if you are a health care worker, or someone who cares for children, especially infants, ask your doctor about the booster pertussis vaccine. VACCINES SAVE LIVES!

P.S. In the near future it will be part of the vaccination schedule for adolescents.

Elizabeth McNeill Byrd, MDChristopher A Ohl, MD, Pathogenesis and epidemiology of Bordetella pertussis infection. Up-To-Date Online. February 2005.

JC sings

My amazing friend JC wrote this song:

When the sun came out and there was nothing there
the nightmare that just was
the breeze in your hair
you feel like life was floating away
you don't know if you'll make it another day

dont it feel sometimes like everything's against you
it makes you just want to run and hide
turn around and you'll see that all of us are with you
'cause we are your country and were on your side

Some loves were lost
some not yet found
and you try to hold on to your little piece of ground
you dream of a hand reaching out like a searchlight
and your hope won't let you give up the fight

well, dont it feel sometimes like everything's against you
it makes you just want to run and hide
turn around and you'll see that all of us are with you
'cause we are your country and were on your side

The storm always passes and the rain comes and goes
just what tomorow brings well nobody knows
but i stand with my brothers and my sisters hand in hand
'cause together we will face this life
together we will stand

dont it feel sometimes like everything's against you
it makes you just want to run and hide
turn around and you'll see that all of us are with you
'cause we are your country and were on your side

turn around and you'll see that we are with you
cause we are your country and were on your side.

We all have to respond to this tragedy with our own talents, in our own way. Then, we have to share that response with our community. Thank you JC for a moving song. I hope that more people get to hear it.

When September Ends in New Orleans

These Green Day lyrics are powerful in the Katrina context.

GREEN DAY LYRICS

"Wake Me Up When September Ends"

Summer has come and passed
The innocent can never last
wake me up when september ends

like my fathers come to pass
seven years has gone so fast
wake me up when september ends

here comes the rain again
falling from the stars
drenched in my pain again
becoming who we are

as my memory rests
but never forgets what I lost
wake me up when september ends

summer has come and passed
the innocent can never last
wake me up when september ends

ring out the bells again
like we did when spring began
wake me up when september ends

here comes the rain again
falling from the stars
drenched in my pain again
becoming who we are

as my memory rests
but never forgets what I lost
wake me up when september ends

Summer has come and passed
The innocent can never last
wake me up when september ends

like my father's come to pass
twenty years has gone so fast
wake me up when september ends
wake me up when september ends
wake me up when september ends

Kanye Speaks/Raps, Wal Mart Acts

An excerpt from a song I had not heard before the benefit concert tonight:
Kanye West "Jesus Walks"

To the hustlas, killas, murderas, drug dealas even tha strippers jesus walks with them
To the victims of Welfare for we living in hell here, hell yeah, jesus walks with them
Now hear ye hear ye want to see Thee more clearly
I know He hear me when my feet get weary
Cuz we're the almost nearly extinct
We rappers is role models,
we rap we don't think
I ain't here to argue about his facial features
Or here to convert atheists into believers
I'm just trying to say the way school need teachers
The way Kathy Lee needed Regis, that's the way I need Jesus
So here go my single dawg radio needs this
They say you can rap-about-anything except for Jesus
That means guns, sex, lies, video tapes
But if I talk about God my record won't get played, Huh?
Well if this take away from my spins
Which will probably take away from my ends
and i hope it take away from my sins
and bring the day that I dream aboutNext time I'm in the club everybody screamin out(Jesus Walks)
God show me the way because the devil's tryna break me down(Jesus Walks)
The only thing that I pray is that my feet don't fail me now

Last week Kanye was censored for criticizing President Bush on national TV saying,
I hate the way they portray us in the media. You see a black family, it says, "They're looting." You see a white family, it says, "They're looking for food." And, you know, it's been five days [waiting for federal help] because most of the people are black. And even for me to complain about it, I would be a hypocrite because I've tried to turn away from the TV because it's too hard to watch. I've even been shopping before even giving a donation, so now I'm calling my business manager right now to see what is the biggest amount I can give, and just to imagine if I was down there, and those are my people down there. So anybody out there that wants to do anything that we can help -- with the way America is set up to help the poor, the black people, the less well-off, as slow as possible. I mean, the Red Cross is doing everything they can. We already realize a lot of people that could help are at war right now, fighting another way -- and they've given them permission to go down and shoot us! . . .
George Bush doesn't care about black people!

Kanye speaks and sings with righteous anger. He was censored for his statements. I think his voice should be heard. Now is the time for what may seem irrational. Now is the time to empty our closets filled with piles of stored emotion. Let it out so we can all take a good look at it and move on. If we continue to censor the voices that speak for the victims the suffering will not cease. The systems will not change.

On a completely different note:
NPR ran a story today on All things considered about the efficiency of Wal Mart's response to the storm. This was a statement made by Phil Capitano mayor of Kenner, La.

"FEMA couldn't get here. Red Cross couldn't get here. Homeland security couldn't get here. The only ones who could get here were the Wal Mart corporation. We were, we are extremely appreciateive and extremely grateful."

The story goes on to describe the efficiency of Wal Mart's response. Apparently Wal Mart prepares yearly for the hurricane season by stocking trailers with bottled water throughout many of their distribution centers inthe gulf and east coast regions. So the company was ready and moblized before the storm hit so that their trucks could arrive as soon as safely possible. During the interview, mayor Capitano goes on to suggest that our government organizations and relief organizations ought to meet with officials from Wal Mart to learn about distribution and logistics.

During what has been called the most anticipated natural disaster in American history it was not the myriad of local, state, and federal agencies that responded efficiently and quickly to the storm. It was Wal Mart. The multi-national corporation that is often criticized (by me and many others) for its poor treatment of employees and its devastating effects on local economies and small businesses. Well done.

Patient and Doctor?

This is something I wrote in 1/2004:

Low Back Pain
Act I

As I was sitting on the examination table with my legs hanging over the edge swinging slightly I reflected on what it was like to be in the patient’s role for once. I realized the patient part was one that I dreaded playing. My attire was indecent; a simple paper gown which chaffed at my mid-thigh just barely hiding my penguin patterned boxer shorts from view. I pondered how I would describe my ailment to my physician as I sat waiting, legs swinging, brushing my cotton sweat-sock covered toes on the berber carpeted floor. My family physician, Dr. Su, entered the room, greeted me, and quickly began asking questions. I immediately developed stage fright; I had learned the wrong lines. Fortunately, knowing what Dr. Su would ask, I was able to improvise most of my answers.
“What brings you in today?”
“I have low back pain.”
“How long has that been going on?”
“For 5 years now.”
“What have you done to treat it before?.”
“Muscle relaxants and NSAIDS. But it always comes back.”
“Tell me about the pain.”
I froze. I knew from experience that this question was important. What I said now would determine whether my doctor thought I had a kidney stone, a muscle sprain, a herniated disc, an aortic aneurysm or any of a myriad of other possibilities which I had not studied hard enough to even consider. The consequences were dire. If I misrepresented my situation I could end up in the operating room, or so it seemed. After a significant pause, I realized I had missed my cue.
I stammered, “It is a stabbing pain, but not really. Sometimes it burns, but not always. It is definitely achey. Achey and intermittent and episodic too.”
I proceeded to use all the words that I knew to describe pain and some that I had made up, but I could not really make the words match the experience. Fortunately, she interrupted me.
“Where is the pain located?”
Knowing the proper way to indicate the location of my pain I confidently extended my right index finger and proceeded to place it over my posterior superior iliac spine. I paused for a moment, enjoying the spotlight.
I told her “it hurts the most right over my P.S.I.S.” So much for the spotlight, I had blown it. I had slipped into the language of the physician forgetting my role as the patient. Dr. Su gracefully saved me from awkwardness by reciting her next line,
”Does the pain move anywhere?”
“Well, I sometimes have pain in my leg, but I don’t think it radiates.” At least not how I thought radiating pain radiated. Radiating pain is like lightning traveling from the root of the involved nerve out to its tiniest branches. “No, my pain does not radiate.” My pain starts in my low back and like a wick ignited by flame, travels slowly inciting the nerves to potentiate the perception of pain. Eventually the fire smolders down my antero-lateral thigh to my fibular head just below the knee where it flares up for an instant before extinguishing. The journey takes so long that I have always thought of the pains as separate in etiology, one originating in my leg and the other in my back.
“Where is the pain in your leg?”
With my finger still extended I pointed to my fibular head, remaining silent this time so as to avoid the embarrassment of my previous role reversal.
Dr. Su continued to ask me all of the required questions and I continued to answer them in the appropriate manner, trying not to stray from the facts that I had deemed medically important. Finally, it was time for the physical examination. The rest of the script was up to her.
After the obligatory auscultation of the chest Dr. Su proceeded to examine my back and legs. I lay on my back while she lifted each of my legs in turn.
“Do you have any pain when I lift your leg?”
“It hurts in my back but it doesn’t hurt at all in my leg.” No radiation, I thought. Little did I know that she had merely ignited the slow-burning wick that would ultimately set my lower extremity ablaze.
She finished the exam by demonstrating equal reflexes in both of my knees.
“Well, it looks like you have a muscle sprain. There is no radiation of pain, and the straight leg raise is negative. So a disc herniation is unlikely. You are pretty inflexible though. I think your inflexibility has resulted in poor resolution of the muscle injury. Let’s try some physical therapy for flexibility and strength training.”
I was relieved. The diagnosis I had hoped for. Muscle sprain. There was no herniated disc impinging on a nerve sending lightning bolts of pain along an anatomically determined tract that would eventually require a surgical procedure that was classically unsuccessful at relieving pain. No. Muscle sprain. This is the diagnosis I wanted. Knowing the nuances of the script, I performed so well that I received the benign diagnosis for which I had hoped. And so the identification of the herniated disc which was sandwiched between my fourth and fifth lumbar vertebrae bulging out into my spinal column was delayed, at least until the next act.

Getting Started

First blog ever.
I was inspired by my brother to begin a blog. Who knows what will come of it.

Here is a brief comment I posted on my brother's blog (http://inyourhearing.blogspot.com). I think it is a good place to start.

More fuel for the fire:
"The government's disaster chief waited until hours after Hurricane Katrina had already struck the Gulf Coast before asking his boss to dispatch 1,000 Homeland Security workers to support rescuers in the region - and gave them two days to arrive, according to internal documents. Michael Brown, director of the Federal Emergency Management Agency, sought the approval from Homeland Security Secretary Mike Chertoff roughly five hours after Katrina made landfall on Aug. 29."AP

A quick story of my own personal shock:
On Monday 8/29 I was listening to Morning edition on my way into work.

Morning Edition, August 29, 2005 · The great fear of many experts is that Hurricane Katrina may drive the waters of Lake Pontchartrain over levees and into the city, overwhelming an elaborate pumping system. The potential exists for the worst flood damage in U.S. history.

I was shocked 2 days later when I heard a recording of G. W. Bush saying "I don't think anyone anticipated the breach of the levees."
Unbelievable.