Monday, January 15, 2018

Perfect for Today

I saw this on the book face earlier today, and I've been thinking about how appropriate it is all day.
Sad that in my life time, this 'democracy' has empowered the worst among us.

Maybe something good will come out of this misappropriation of hopeful-but-misinformed-quasi-populist protest vote... like #MeToo, or equal pay for women, or awareness of how Oprah is actually a billionaire while Drumpf is a charlatan thrice bankrupt, thrice divorced, who preys upon his rivals' wives and the worst fears of easily manipulated Umerikuns.

Zobaczymy

Sunday, December 24, 2017

Please, Let This Be The LAST Jedi

We went as a family this afternoon to see "Episode VIII The Last Jedi" at the San Marcos Regal Theater.  I'd hoped it would be better than Episodes I, II, and III... and it was, for the most part.  The Original Star Wars (Episode IV) still remains the best, most impactful, memorable Lucas Film of the series, in my humble opinion.  This Last Jedi could probably have been much shorter, included fewer meaningless plot dead-ends, and flowed better than it actually did in the film we just saw... but that's probably the grumpy old man in me commenting openly ("back in my day, you cut people in half with light sabers; you didn't stab them!").

Sure, it was a western / space opera with multiple themes introduced, but it was not the tour de force that the lonnnnng intro & ramp up led the movie-goer to believe.  Hamil goes out far better than Ford went out, in Episode VII, and some of Fisher's appearances look almost computer generated, in the varied lighting she is depicted compared to those with whom she is speaking to or interacting with.  Admiral Ackbar, sadly, is no more.

Several issues I had with the film that still stick in my craw are:
- in space, you don't need bombers (there's only microgravity, or no gravity)
- furry penguins should be delicious, or comical, but not both
- tasting white crystals form the ground, is stupid & potentially deadly (could have been anything more toxic than just salt)
- since when are dueling weapons strong enough to withstand a light saber blade? (in IV-VI there was nothing stronger than a light saber blade)
- if the evil emperor is so knowing and omniscient, why would he be so careless to leave Luke's lightsaber on an oversized arm rest next to him?
- if a ship can be piloted into light speed directly in the path of enemy ships to obliterate through them, why wait until 80% of your fleet is blasted into nothing before making that last spectacular jump?
- if a casino full of the top 1% of the 1% of war profiteers is so opulent, why do they have only 5 cloaked foot guards and 2 little flying police cars?  (ever been to Monaco? I have...)
- if a rebel fleet is trying to run away on regular engines, and are running out of fuel, why doesn't the Imperial fleet just just into hyperspace ahead of the fleeing ship, surround it, tractor beam it, and obliterate it (or force it to surrender)?

Much of the film, depressingly, appears to be made to introduce more toys, more marketing, more character "bling" and accessories that I, as an adult man, could not give a care about.  ALL the previews leading up to the film (we got there 25 minutes early to get good seats) were for inane movies and products that I could not care less about seeing, buying, or mentioning here... but obviously idiocracy seems to be crazy about them.  There were no less than 3 major motion pictures previewed that are coming out that were video game extensions of concepts or movies that I consider irrelevant.  Just because making a CGI model is possible, doesn't mean it Should Be Made, every time.

If you're a HUGE Star Wars fan...  enjoy.  It's not that bad.  I just hope it's the Last Star Wars film I see now that all of the original characters, expect the droid and Chewbacca are gone (and Carrie Fisher is gone in the real world).

Three Billboards

Last night, Nathan Jr, Dr Desert Flower and I went to the old La Paloma theater in Encinitas where they were showing Three Billboards Outside of Ebbing, Missouri.  We'd heard it was good.  Mistakenly thought it was a Coen Brothers movie, as Francis McDormand is it in the lead role,  and the 90 year old La Paloma was somewhere we'd never been, so we bought our tickets in cash at the old time box office (they don't take credit cards), sat in the dilapidated non-reclining seats (circa 1928), and breathed the chilly air of the theater, waiting for the show to being.

It is a somber, moving film.  It is a Very Violent film.  It is a sad film.  It's a well acted and well directed film.  And, as someone who lived in semi-rural the South for 16 years of his adult life, I'd say it is a fairly accurate depiction of life, prejudices, and culture in rural American "fly-over" country.   Beautiful country-side combined with a deep, thick, undercoat of lawlessness and a loose-sense of imposed community that often times runs no deeper than superficial pleasantries.

Francis McDormand should win an Oscar or Golden Globe for her role.  Woody Harrelson is great in it, throughout.  Sam Rockwell - who admittedly is NOT one of my favorite actors as he often plays a goof (Hitchhiker's Guide), clown, a fool, a cocky & flawed playboy (F is for Family) - makes you Hate him, viscerally in the first 2/3rds of the film.  Clarke Peters (Lester, from The Wire) is under-stated in the movie.  I don't want to spoil it, but it was both a great movie and very disturbing at the same time.

After the movie, we were all somewhat down, silent, depressed, retrospective... pondering life & existence... akin to how my buddy Ryan and I were after seeing Schindler's List in Atlanta back in 1993, but without the genocide.  So we got a good meal and some strong drinks at the Encinitas Bier Garden, before driving back up to the homestead.


Friday, December 15, 2017

полезные идиоты, Useful Idiots

Vladimir Lenin coined a term while he was alive, called the "Useful Idiot" (полезные идиот).  To Lenin, a "Useful Idiot" was a Westerner who agreed with the Soviet view on the world, who idealized the Socialist system, and who willfully over-looked the downfalls of collectivization - downfalls like disincentive to work, disincentive to become an expert on anything, disincentive to be productive (since whether you work or not, you're not going to get ahead... sit back, and let others do the hard work).  A "Useful Idiot" could be manipulated by the Soviet Union to spy, gather information, be counted on as a sleeper cell that the Kremlin could activate when needed... to be useful.
полезные идиоты (Useful idiots)
Now, I don't speak Russian as Roy Moore of Alabama does, to be able to pronounce the phrase correctly.  Roy is apparently very good at speaking to teenage girls, at the mall, at their high school, at the movies, and in his car parked in the darkness behind the restaurant where the girl worked as a waitress.  Roy was also romanticizing about how AWESOME the United States was before the Civil War, when slavery was still legal in the South, families were stronger, and homosexuality "did not exist"... sure Roy, keep convincing yourself of that, in English, or Russian, whichever you prefer.  Had you won your recent Senate race, you'd have been a very полезные идиот.

I've not travelled to Russia, met with their operatives, or colluded with any foreign power to influence the course of a national or local election in the United States as many in the White House staff have done in 2015, 2016, and 2017.  For a very small investment, Vladimir Putin's dictatorship has gleaned a remarkable windfall of apologists, sycophants, Manchurian candidates, "but what abouts...", and shrill voices on Faux News, at all levels.  Impressive R.O.I. for Russia - they probably never thought that So Many Americans would willingly become полезные идиоты for them to leverage.

If you voted for Drumpf, and now you feel remorse or regret for doing so, after the childish buffoon in chief has shown repeatedly how easily baited he is, how his attention span is shorter than most 2 year olds' (even the best behaved ones), how he's going to trash the US economy the say way he ran his own businesses into the ground 4 times, shorting his contractors and declaring bankruptcy 4 times, how know-nothing he is about everything that is not Drumpf-centric, how truth-challenged he is on 99% of everything he says, tweets, expresses and rants about.... if you regret casting your vote for this remarkably unqualified puppet, I can unstained how you're feeling.  I once threw my vote away on Ross Perot, and helped to enable the governor of a rural chicken producing state to become Commander in Chief where he indulged his libido, cozied up to the despicable Newt Gingrich and his "Contract on America", and presided over the dot com bubble that grew the world economy strongly despite Congress's and the Federal Reserve's best efforts to spoil that success.

But if you voted for Drumpf, and you're doubling down on your support, embracing all the lies and vitriol that Faux News spouts out on a daily basis... if you have no regrets whatsoever, and still cling to the unjustified belief that Drumpf will make everything better, then I have only pity for you, and I encourage you to learn Russian as many of the other полезные идиоты have done.  This way, you can better understand what your Russian masters have in store for you, AND, if you learn all the colloquialisms, you'll understand when they are mocking you, snickering, and laughing about how easily manipulated you are as their полезные идиот.

Thursday, December 14, 2017

Welcome Back Dial Up Speeds!

Hey, all you Trump voters who voted for a disruptor who would shake up the system...  well, congratulations!  You just got dial up speeds back from your ISP!  Yes, you too can try and download and stream movies, live sports, youtube and other internet content at 14.4kps, or 9.8kps, or some other nauseatingly slow download and upload speed, akin to when Windows 95 was the dominant operating system!  Trump's FCC just voted today, in a 3-2 vote, to annul the Obama era Net Neutrality regulations!!!  Isn't that great!!


Now, when I flew through Atlanta last week, I was TSA Pre, because I wasted a day of my life and $100 of my personal money, down in Otay Mesa, signing up for Global Entry, in an effort to make getting through border (airport) immigration checks faster than the majority of the other 400 people on an international 747 flight.  When I got to the front of the TSA-pre line, I saw "Clear", which had 5 people in line, and dumped Immediately to the TSA ID checker station.  With "Clear", if you PAY MORE, you get to skip the normal lines AND the TSA-pre lines.  For ANOTHER $180 a year, on top of TSA-Pre, I could get "Clear", and use it infrequently.

Why did I mention Clear here, on post about the end of Net Neutrality?  Well, Trump admin spokes-persons have quoted Clear as their model as to why having more money, and more access, is always a good thing.  Disney world fast pass, airport Clear, and now... if you have Koch Brothers levels of money, you can stream Amazon Prime, Netflix, or anything else you want while the meager peasants who make 1/10th or 1/100th or 1/1000th what you do wait, endlessly, for their data to download, so they can enjoy their internet content as well!  It's not a dump truck, it's a series of tubes!!!!

Congratulations Trump voters!  Even though 98% of you can't afford it, you've helped the richest 1 or 2 percent of your comrades.  While I read my book (on paper, not electronically), work in my yard (no electronic connections needed), or enjoy time at the beach, you can curse your slowwwwwww internet connection.  Obama pushed for net neutrality, and the FCC maintained it.  Trump's corporate friends and monopoly alliances reversed that ruling so that 98% of Umerika can suffer!  Fantastic!

Tuesday, December 12, 2017

Stay Human, What's In A Name

Dr Desert Flower and I are big fans of Stephen Colbert.  We DVR his show each night, and enjoy watching it the next evening after dinner.  National ratings have shown that DDF and I are not alone, and Late Night with Stephen Colbert is now the highest rated late night show. Not all of Stephen's guests are interesting to us, but the monologue is always great.

Stephen was smart enough to ally himself with the musical genius and genuinely nice person Jon Batiste as his band leader, at the head of Stay Human.  From the very first time I saw the band name Stay Human, I started thinking about its origins, etymology and implications.  The First thing that came to mind, is the obvious concept "remain a human, a nice person, don't become a mean jerk".  And that Might have been what Jon Batiste had meant to imply.

But a single interpretation is kinda boring... so I thought of several other meanings:

Stay, human!  - as spoken by an alien, who has a human as a pet, who is trying to train the human to behave when the alien goes to work.  Stay, sit, fetch, shake... all commands that an obedient human pet could obey, as long as they are smarter than the average alt-right voter.  The Porno For Pyros song Pets made me think of this concept.  (imperative)

Stay, human... Stay, human.... - the heart-felt wish of a werewolf during a full moon who may be visiting his fiancee's parent's home, and who doesn't want to change into a werewolf and kill his new family. (futile)

Stay human - a strategy move, proposed by a D&D player, to move one of his other pieces and leave his human character alone; the human stays still while the halfling or the elf moves forward.  (strategic)

Stay human - when Han Solo and Chewbacca show up at a cantina where they are not welcome, and the owner discriminates against Wookies whom he refuses to serve.  (discriminatory)

Stay Human - an intergalactic B&B where various species from different worlds who are traveling through want to rest.  At Stay Human, they cater to the needs of homo sapiens, and they've earned a 3 nebula rating.  = )  (recreational rental)

Stay, Human - a decision by a Federation of Planets Appellate Court Judge to prevent the Humans from doing something really stupid (again)... similar to how the 9th Federal Circuit Court here on Earth keeps stopping Drumpf's bigoted, misguided, xenophobic and illegal executive orders, declaring a stay on implementation of such idiotic and mean-spirited policies. (legal)

Stay, human? - an incredulous and disappointed trans-species cyborg response who was trying to become more machine like, when his friends and relatives implore him to stop the transformation and remain as a human... even though he was very determined to go through the full transformation to 100% machine.  (incredulous)

Stay human - as nations and political parties become increasingly tribal, isolationist, and hateful towards one another, unable to communicate or find common ground... perhaps through music, Jon Batiste believes he can bring such opposite polarized parties together, keeping everyone as "human" as possible  (aspirational)

Stay Human - the decision of the galactic leader of the sea otters from South Park, to prevent the humans from expanding and propagating throughout the galaxy, and containing them to a smaller sphere of influence.   (societal)

Dougie v Woody - Today


Today, Alabama voters go to the polls to choose between Dougie Jones (from Twin Peaks, but better...  since the Alabama Dougie Jones can complete full sentences, prosecuted hateful racists and segregations who bombed churches and schools in an effort to terrorize black Alabamians) and Woody (from Toy Story, only worse... since Woody would never try to seduce or molest a mall worker, a 16 year old, or a 14 year old girl; Woody never got banned from the Gadsden AL mall for hitting on high school girls in the food court).

When I look back at Bob Packwood, Gary Hart, and William Jefferson Clinton's inappropriate sexual misconduct and behavior while in office, it makes my mind spin and leaves me in disbelief that miscreants like Drumpf and Roy Moore can appeal to more than 10 or 20% of the voting population who think just like them, or who idolize them.  How can CINOs (Christians in name only) line up in support of Drumpf and Moore?  I understand how neanderthals who think just like Moore and Drumpf can align themselves, rally, and support such creepy adolescents who never learned how to be a civilized adult man in modern society.  I get that, I know - and have worked with people - who think a lot like Drumpf and Moore in many ways... I've met them, and I know they exist.  I know they are not a majority (though they are delusional enough to THINK they are the vast majority).

When I hear people on television refer to the "Great State of Alabama" I ask myself "how can a state's voters elect anyone who has a recidivist history of sexually preying upon teenage girls, calling them at high school while they're in trig class, approaching them at the mall, trying to make out with them and grope them in his car parked behind restaurants in Alabama, when he was More Than Twice As Old as they were?"  This was not 18 or 19 year olds with someone in their 20s.  This was 14 and 16 year olds with an adult man who was TWICE as old as the teens at the time.  District attorney, State Judge, then State Supreme Court Judge... twice, after he refused to up-hold the Constitution of Alabama and the Constitution of the United States, and had to be removed from office, twice.  In ANY OTHER State, Roy Moore would be toxic, polling no higher than 20% of the other troglodytes in the electorate who make the worst people in society feel better about themselves.

Steve Bannon - (approximation)

I used to live in South Carolina, for 16 years, and in South Carolina, Governor Mark Sanford was run out of office for Far Less. Roy Moore could not be elected to any office in South Carolina, despite what Steve Bannon might try to spin.

Thursday, December 7, 2017

North San Diego County is on Fire

North San Diego County is on Fire this evening.  Fallbrook (the Lilac fire) went from 10 acres to 2000 acres in 2 hours, and is now approaching 3000 acres, with 0% containment.

The photo above I took from the hill over our neighborhood looking north.  We are about 15 miles South of the current wild fires.  About 20 buildings have been destroyed, with more on the way.  As I drove home from the elbow doctor this evening (my final visit!  hooray!) I took the picture below on the I-5 North that as moving at < < less than 5 mph.   The smoke is being blown by Santa Anna winds from East to West, out over the ocean, where it is joining with a Tijuana wild fire that has burnt 200 acres of rural vegetation.
I'll be preparing an evacuation kit this evening that contains
- clothing
- laundry detergent & fabric softener sheets
- bottled water
- snacks
- freeze dried camping food
- medical kit
- self protection, for security, against miscreants
- two 5 gallon gas cans (which I'll fill at Costco tomorrow morning)
- cat food, litter, litter box, cat food & water dishes, cat carrier
- wine
- nuts
- dried fruit
- in-house fresh fruit
- microwave pop corn
- basic cooking utensils, frying pans, slow cooker
- cell phone chargers & Mac chargers
- whiskey & whisky
- Rxs & Rx refills
- warm clothing, jackets, sweaters, hiking boots
- emergency crank radio
- batteries
- dish soap
- flash lights
- garbage bags
- tarps
- camping knives
- axe & saw
- basic hand tools
- extension cords
- rope
- family documents
- credit cards

Now it is time to eat...  and then pack.  Hopefully, it'll all just be proactive and un-necessary; il faut voir.

Thursday, November 30, 2017

November's Last Wine Review

As I spent the afternoon cleaning up my office, I have a pile of bottles that I need to toss out.  Before doing so, I wanted to briefly mention them here.  All of these were drinkable, enjoyable, affordable, and bought at my local Bressi Ranch Trader Joe's grocery store.  None of them were more than $10 a bottle with the exception of the Pinot Noir, which was about $16 a bottle if my recollection is accurate.

The Monique Cellars 2016 Sauvignon Blanc Central Coast white wine was pretty good.  Screw top, not corked, it was fine quality.


The Castle Rock Winery 2015 Sauvignon Blanc Mendocino County has a straight-forward label, was less than $6 a bottle, and is shelved right next to the Trader Joe's branded wine bottles I mentioned earlier.  Screw-top also, this wine did not suffer from a poor quality cork, oxidized shelf life, or any skinny or undrinkable aspects.  Recommended as an affordable go-to wine, if you're not near a Trader Joe's.


Kidia Sauvignon Blanc, estate bottled 2016, D.O. Loncomilla Valley Chile.  It had some citrus notes but was not over-powering like a New Zealand Sauvignon Blanc.  I tried it, liked it, and thought I'd mention it to you here.

Reserva Orquídea Rosario Estate Sauvignon Blanc, D.O. Valle Central Chile.  Like the Kidia Sauvignon Blanc, this was an enjoyable white wine. Also a screw top, shelved beside the Kidia, it was a delicious dual bottle purchase.


Lastly, Trader Joe's Platinum Reserve Pinot Noir Carneros 2015, 1430 cases produced.  Dr Desert Flower really enjoyed this wine, stating it had notes of currant and a smooth follow-through on tasting (as of February 2016 I can't drink red without getting itchy).  I had a sip, and it was yummy.  More pricey near $16 a bottle (or two to three times as much as the other bottles mentioned above in this post) it's not for every-day drinking chez nous, but it is a good recommendation and something we'll enjoy from time to time (while supplies last).



For tasting notes and nuances, it's been too long since I enjoyed these to be very descriptive here.  However, if any of these were bad, I would have either dumped them down the drain, or not mentioned them here... rest assured.

Thursday, November 23, 2017

What To Expect After Elbow Surgery

So back in July, I posted here (link here) that I'd screwed up my olecranon bursa on my left elbow by jamming it tween the arm rest and the fuselage of a 4 hour Delta flight to Cincinnati at Just the Wrong angle.  The bursa ruptured, made my arm swell, heat up (infection), and was painful.  If I tried to load it working out with free weights, working in my yard with hedge clippers, or doing yoga (like plank pose) the elbow was painful, wobbly, and no fun.

Bryce Canyon (not how it is not "smooth")
I took methyl prednisone (at the advice and Rx of an Urgent Care doc here in Carlsbad) to make the swelling go do and relieve the pain.  The steroids worked, But, the insidious damage had already begun on the bone itself, following the bursa rupture.  The bursa fluid provided food for naturally occurring bacteria (like staph) to feast upon, and the bones where it spilled (the ulna, for example) provided an Excellent network of a narrow lattice-like maze where the staph could eat, breed, and hide from white blood cells (lymphocytes) whose job it was to envelope and kill the invading bacteria.  Problem is, the white blood cells are larger than the bacteria, and can't get into all the nooks and crannies of the bone lattice work.

The end of each of the arm bones are supposed top be nice, smooth, elliptical shapes, where bursa and synovial fluid sacs keep the hard bone from rubbing against the other hard bone.  The fluid sacs act as cushions, to prevent bone-on-bone damage.  While working out and going to physical therapy with a damaged bursa, the bones were grinding on each other, the bacteria were multiplying and building infected lairs in the bone, and throughout July and August, it kept getting worse.  Bone erosion, bone infection, bursa inflammation... it was a vicious cycle.

So I go to an orthopedist who does an x-ray.  Being versed in radiography, I know how poor the resolution can be on an x-ray, especially when dealing with 3D shapes, since the x-ray is a 2D picture.  X-rays are also notorious for not being able to see much of anything on low density soft tissue and fluids, aka the inflamed bursa and progressing bone infection.  They prescribe more steroids, and tell me to ice my elbow - with a freezing cold ice bath for 15 minutes being the most effective - and continue physical therapy.

As a good patient, I go to PT three times a week, I ice my elbow at least once a day.  It hurts less, but it is still wobbly, and when I try to do heavy lifting (like 180 lbs bench pressing) or heavy curls (like a 65 lbs curl bar) it screams at me in pain, so I stop.  I can do light hedge clipping, but anything requiring significant effort and strength, the left elbow rejects the notion, completely, sends extreme pain signals to the brain, and I halt the activity.

Throughout August I struggle with this troublesome elbow.  It's not getting better, and it seems to progressively becoming slightly worse.  Yoga poses that use my arms become increasingly painful.  Playing drum set is fine for about 5 minutes, but after that, Ouch, Yikes, Stop!  Dancing (with ethanol enhancement) to silly songs like YMCA or Vogue, where hand movements are necessary Truly Aggravate the left elbow and result in pain, swelling, throbbing... driving the infection (that I did not yet know I had) DEEPER into the bone.
Just before Dr Desert Flower and I went to Montpellier France for a work conference at Labor Day that she needed to attend, the elbow started to get red, swollen, and exude puss (yes, very gross).  I go back to my primary care doctor who looks at it, and categorically says "you need dissection, you need packing, you need drainage and vacuum and antibiotics... you Must see an orthopedic surgeon immediately!"  I told her that all orthopedists were booked for at least the next 6 weeks and I had no way of seeing anyone, especially not 2 days before heading to France.  She leapt into action, and made an appointment with Scripps best elbow surgeon that afternoon.  The surgeon re-arranged his schedule, and saw me late that afternoon in his office down in La Jolla.  He took a culture from the oozing elbow, hoping to grow in a lab whatever the infectious agent that was troubling me.  Nothing grew, of course. He also placed me on a massive dose of broad spectrum oral antibiotics (4x a day), to try and kill (or at least subdue / slow the progress) the infection.

He gave me a huge bag of betadine swabs, sterile gauze, ace bandages with velcro, and medical tape to clean and dress the festering elbow while in France.  I dutifully cleaned my elbow with the betadine swabs each day after I showered, and carefully wrapped it in the sterile gauze for the week we were in France.  On the plane ride home, I sat with my arms crossed over my chest, protecting my sensitive elbow from being bumped by other passengers, the passing drink cart, and anything else in the crammed, lemming-like environment that is the coach economy section of international commercial travel, unless you're on Aeroflot.

When I got back to California, I was supposed to have an MRI of my elbow pre-surgery so that the surgeon would know what to expect.  Due to the arcane and byzantine American health care system, the MRI was Still Not approved by United Health care, and I had to waste a day of my life getting an ultrasound of my elbow, instead.  The Scripps elbow ultrasound radiologist took one look at the high resolution image, and said "this is not classical, you'll be getting an MRI".  He pointed to the screen where the contours of Bryce Canyon were showing up on the end of my ulna, instead of the nice smooth egg-shape that was supposed to be there.  Change the angle of the UT probe, and yep, the canyons and valleys and out-cropping were still there, in graphic 3D.  The MRI should confirm it, the radiologist said.  An hour later, United Health Care approved the MRI, and it was schedule for 2 days later, on a Saturday.

The next day (Friday) the Hospital with the MRI machine called, and said they had a last minute opening, am I available?  Unemployed and unable to use my left arm... sure... I was available.  So I got fast-tracked into the MRI the Friday before my surgery on the next Wednesday.  The elbow continued to "weep" out puss over the weekend and right up to the day of surgery.

Holding the vancomycin "hand grenade"

The morning of the surgery, the surgeon's PA (physician's assistant) comes into the pre-op room where I am wearing just a open-backed gown, and asks me "do you know what to expect, what is coming?"  I told her my abbreviated understanding, of surgery, followed by 2 or 3 weeks to let it heal, followed by weeks or months of physical therapy.  "Not quite" was her reply.  She then laid out the whole treatment plan that I had no clue would be so onerous.

It went as follows:
- Wednesday morning surgery to remove the bursa, and pack in antibiotic "beads"
- the infected bone would be removed (picture a medical dremel tool) to 'clean it up'
- stay in the hospital for 2 days, with my arm immobilized in a cast
- go back into surgery on Friday night, and have the beads removed, check on progress of the wound, clean up anything that needs internal clean up
- Saturday, after surgery, if I am stabilized, go home with a fancy portable vacuum pump, that will keep suction on the elbow wound - which they won't stitch closed - to drain fluid and to aid in the healing and closure of the wound over time
- keep the vacuum pump on me for at least 3 weeks, changing the dressing on the elbow with a visiting home health care nurse 3X a week
- install a PICC line (peripherally inserted central catheter) into my right arm, that runs up to my heart's ventricle vestibule, where it will dump out liquid antibiotics that I will infuse at home, twice a day, for 2 hours each dose, for the next 6 weeks
- come back to the doctor's office once a week through this whole process, to check on progress of the wound healing, to take vital signs, and make sure there's no relapse back into infection.

First look at home, after surgery (disgusting, yes)
Ugh!  I had no idea that it would be such a life-halting inconvenience.  If I had been employed at this time, I would have had to take 1/2 days basically EVERY DAY for a month, to deal with this health issue.  Why could they not just stitch up the elbow, like a "normal surgery"?  Then the bursa would not grow back clean and healthy and the bone infection would continue to destroy the ends of my bones.  It needed to heal "from the inside out", and closing the wound before the bursa had fully rebuilt itself from scratch would have a negative prognosis, with re-infection likely.  According to the surgeon, who volunteers much of his time at the local San Diego VA, Afghan and Iraq vets with bone infections from shrapnel fight the infection for months at a time, on and off antibiotics, and the only way to seriously correct the problem is to surgically dissect (dremel tool / bone saw / etc) the infected bone, and then let the body grow it back.

The surgery went fine.  Two hours under general anesthetic.  The final wound was 50 mm long by 20 mm wide by 10 mm deep (or 2" x 1" x 3/8ths of an inch, roughly).  Bursa removed, and 4 mm of ulna dremel tooled off.  Lots of Percocet in the Hospital to deal with the pain.  The re-check 2 days later also went well, beads removed, I was set to leave the hospital on Saturday with my portal vacuum pump... but.. bureaucracy stepped in the way.  Apparently, no one filed the final paper work to get me a pump to take home, send the vancomycin antibiotic to my house, or arrange the home health care nurse visits.  "We're sorry, but you'll need to stay until Monday, or maybe Tuesday, once the paper work is done."  Unacceptable.

The hospital bed was a VERY uncomfortable "smart bed" made by Hill-Rom Versa Care.  It was supposed to "auto adjust" to the patient laying on it.  Instead, all it did, was inflate and deflate, Every Two Minutes, to tilt my pelvis forward and back, legs up slightly, legs down slightly.  It was uncomfortable, disconcerting, disruptive, and impossible to sleep soundly on it.  Whoever the morons at Hill-Rom were who designed this monstrosity obviously never asked for customer feedback.  The nurses Could Not turn off the auto-adjust, or the bed alarmed at the central nurses' station.  Sleeping on this continually moving, hot-and-sweaty, poorly designed, poorly conceived contraption meant that Saturday night in the hospital was a very unhappy & unpleasant & restless experience for me.

Sunday came, and the bureaucrats in "Program Management" continued to drag their feet.  Apparently walking and chewing gum at the same time was a challenge for them.  "We might have a pump delivered after 7pm tonight, but we can't guarantee it... we don't normally discharge patients on weekends".  UGGGHHHH!  And then "Even if you get the pump, we have not gotten any confirmation that you'll get the antibiotics or wound nurse... so it's best to just wait until Monday or Tuesday."  This was not the Riyadh Saudi Arabia Ritz, and I was not enjoying my house arrest.  But my heroic floor nurse "Jose" leapt into action.  Working 7am to 7pm, he forced the system to accept all the discharge paper work, prepped me for going home, and KNEW that if he didn't get me out before the end of his shift, I'd be stuck in the hospital for Sunday night unnecessarily.  Jose's efforts were successful; the pump arrived at 7pm, we left at 730pm, and the antibiotics showed up on our door step via courier at 1030pm.


Then, everyday, from October 16th through November 22nd, twice a day, I had to sit and infuse my IV antibiotics through my right arm, into my heart.  Each infusion took roughly 2 hours.  I watched all of Stranger Things, Luther, F is For Family, the Twin Peaks Fire Walk With Me debacle, Dr Whos that I had not seen, and re-read Zelazny's Chronicles of Amber, finished JRR Tolkien's Silmarillion, and started Iain M Bank's "Use of Weapons".  I could not sweat during this time, as perspiration caused the adhesives on the PICC line to loosen and come off my skin.  The PICC line ran straight to my heart, and getting a blood or heart infection was not something I wanted to entertain.  So a month of being sedentary was required.  I tried learning basic Spanish in this time too... but without someone to practice and converse with, I made little progress on this front.

Every week I returned to Scripps in La Jolla to have the nurses, PAs, and doctors tell me how "beautiful" my wound looked, and how well it was healing.  Every 2 or 3 or 4 days, I showered with a large plastic sleeve sealed around my left arm, and baggies that looked like a shower cap over the PICC line dressing.  Today (Thanksgiving) was the very first day I could shower and use Two Hands!  Hooray!

First wet to dry dressing, jammed in
During this time, the first 3 weeks, I had to wear the $22,000 portal vacuum pump around my neck (even sleeping with it, and recharging it as I slept).  Every Monday, a nurse came to change out the vacuum sealed dressing.  Every Thursday, I went to doctor's office in La Jolla to have them change it again.  After 3 weeks, the vacuum pump was discontinued, and I had to do a "wet to dry dressing".

What's a "wet to dry dressing" you might ask?  (I had no idea what it was).  Well, using sterile technique with nitrile gloves and sterile gauze and sterile saline, the patient PACKS in sterile gauze that has been wetted in saline, jammed up into the wound, using sterile cotton swabs as well as nitrile gloved fingers.  Yes, this is unpleasant and mildly painful.  Then, the jammed in gauze is covered by a 2x2 gauze pad, which is then covered by a 4x4, which then gets and ace bandage wrapped around it, to hold it all into place.  All of this is done using just one hand, since the left hand is too far away from the let elbow to be of any assistance.  The Next Day, using sterile gloves, all the jammed in gauze is yanked out, and the process started again - approximately every 24 hours.  Each time the nasty used gauze came out, it looked like a little piece of lemon peel.




At my Nov 22nd visit, I was told the "wet to dry dressings" could be discontinued, and "put a bandaid on it" .. a large 2x2 inch bandaid...  but no more dressing changes.  And the PICC line was removed, leaving an irritated upper right arm where all the dressing adhesives were aggravating my fair skin.  Once again, the nurses and doctors admired how "beautiful" the wound was, and how well it was healing, which was a very strange things to experience from the patient's perspective.  I am glad that the whole wound process is NEARLY over.  I go back in 2 weeks for a followup, and THEN likely, physical therapy will begin, and last through MLK day or Valentines day 2018.  I will be happy to begin working out again, able to sweat, and re-building lost muscle mass... as soon as the bursa is re-built.  I Do Not want to re-infect the ulna or any other bones, so I have to take it easy on my arms and lift nothing more than 5 lbs with my left arm until after my next doctor visit in 2 weeks.

My friend Joe M texted me several Spanish curse words, to help me learn the slang of the language (similar to how I first learned French).  If you want to call me up, or text me in Spanish during the next two weeks, I'd appreciate the practice.  In the mean time, I'll be working on legs and core and aerobic exercise, until I get clearance from my doctor to begin rebuilding strength in my left arm.

Yes, this Thanksgiving I am very thankful that my wife has a good job with good health insurance coverage that paid for this 6 digit surgical experience, and I am very thankful I don't have to get my left arm amputated.  One armed drummers are not very good.