Gleanings of the Week Ending November 25, 2023

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The items below were ‘the cream’ of the articles and websites I found this past week. Click on the light green text to look at the article.

20 Incredible Winners From the 2023 European Wildlife Photographer of the Year Contest – Lots of natural beauty…captured in photographs.

A known environmental hazard can change the epigenetics of cells – Formaldehyde. It is a widespread pollutant - formaldehyde enters our body mainly during our breathing and, because it dissolves well in an aqueous medium, it ends up reaching all the cells of our body. It is associated with an increased risk of developing cancer (nasopharyngeal tumors and leukemia), hepatic degeneration due to fatty liver (steatosis) and asthma.

How forest schools boost children's immune systems – It seems the benefits go well beyond immune systems.  Hopefully this type of school for 3 to 5 year old will increase in availability/popularity.

Circular Maya Structure Uncovered in Southern Mexico - Similar round structures have been found at the Maya sites of Edzná, Becán, Uxmal, and Chichen Itzá.

Health Care Workers Are Burning Out, CDC Says - The CDC researchers analyzed self-reported symptoms of more than 1,400 adults in 2018 and 2022 who were working in three areas: health care, other essential services and all other professions. Workers’ self-reported poor mental health days in the past 30 days was similar across all three groups in 2022, but health professionals saw the most significant jump, from 3.3 in 2018 to 4.5 in 2022. Reports of harassment at work also spiked among health care workers over the five-year period, going from 6.4 percent to 13.4 percent.

How To Bring Back the Prairie, a Tiny Bit at a Time – The use of “prairie strips” on farms in an effort to restore a portion of the Minnesota’s remnant prairie and to soak up polluted water.

These Ten Stunning Images Prove That Small Is Beautiful – From Nikon’s Small World Photomicrography Contest. My favorite was the cuckoo wasp.

Deforestation in Colombia Down 70 Percent So Far This Year - Since taking power last year, leftist President Gustavo Petro has enacted a slate of new policies aimed at protecting Colombian forests, including paying locals to conserve woodland. The recent gains in Colombia mirror similar advances in the Brazilian Amazon, where leftist President Luiz Inacio Lula da Silva has cracked down on forest clearing; deforestation is down 50 percent through the first nine months of this year. In 2021, more than 100 countries, from Brazil to Russia to Indonesia, set a goal to end deforestation by the end of this decade, but so far forest loss has declined too slowly to stay on pace for this target.

European wildcats avoided introduced domestic cats for 2,000 years – About 50 years ago in Scotland, however, that all changed. Perhaps as a result of dwindling wildcat populations and a lack of opportunity to mate with other wildcats, rates of interbreeding between wild and domestic cats rose rapidly.

Why grazing bison could be good for the planet - The shortgrass prairie makes up 27,413 sqare miles of remote land straddling the US/Canadian border to the east of the Rocky Mountains. This rare habitat is in ecological decline. Plains bison co-evolved with the short-grass prairie. In the 12,000 years since the end of the Pleistocene, they have proven themselves to be potent ecosystem engineers. An adult bison eats about 25lb (11kg) of grass a day. The grasses adapted to their foraging. Vegetation across the plains uses the nutrients in their dung. Birds pluck their fur from bushes to insulate their nests. Bison also shape the land literally. They roll in the dust and create indentations known as "wallows" that hold water after rainstorms. After the bison move on, insects flourish in these pools and become a feast for birds and small mammals. Pronghorn antelope survive by following their tracks through deep winter snows. Replacing cattle with bison greens floodplains…setting the stage for beavers.

Ramping up Elder Care – November 2023 (update)

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My sisters and I thought we had time to learn about various options at a comfortable pace and then ramp up support for our parents in a targeted way over the next few months. We ordered two cameras to install in their home and made appointments to meet with two service providers for the next time I was in Carrollton – but that plan changed quickly when one of my parents entered the hospital.

I went to Carrollton early - entering 24-hour rotations with one of my sisters to support my parent in the hospital. My other two sisters and my daughter handled things at my parents’ house (it is traumatic for two elderly people married over 70 years to be separated for even short periods).

We learned a lot during the hospitalization about changes we need to make to avoid aspiration of liquid into the lungs (i.e. thickening of ALL liquids to honey consistency is now required). Previously some liquids had been thickened to a lesser amount (nectar) but water was unthickened….and now even that will have to be thickened. But – the reward is no coughing while (and after) eating or drinking!!!!

Small anomalies can make big impacts…low potassium and dehydration were two that our parent experienced. And the associated weakness/dizziness curtailed almost all physical activity for a little over 24 hours which required some slow increase of activity on the following days to get back to ‘normal’…and maybe that was a ‘new normal’ that was a little reduced from the prior normal.

Two cameras were installed and we used them along with virtual meetings to help our parents talk to each between physical visits. We decided a third camera would be worthwhile, so it was ordered.

We quickly established a contingency sleeping arrangement in case the hospitalized parent required more support at night immediately after coming home from the hospital.  The room includes a twin bed with plenty of room for a caregiver to move around….and for extra equipment. We are anticipating that ambulation will need to be monitored/supported (i.e. a belt around our parent … a caregiver with a hand on it) during their recuperation until we are sure the fall risk is minimal.

As I write this, our parent is still in the hospital but due to go home within 24 hours. We hope we have ramped up our support plan sufficiently.

Stay tuned for the next installment of Ramping up Elder Care!

Previous posts: November 2023

Gleanings of the Week Ending July 22, 2023

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The items below were ‘the cream’ of the articles and websites I found this past week. Click on the light green text to look at the article.

The ground is deforming, and buildings aren’t ready – Underground climate change in urban areas where heat islands underground cause enough expansions and contractions to damage building foundations…particularly in older buildings.

How noise pollution impacts nature – A study out of Vail, Colorado, showed that increased trail use by hikers and mountain bikers disturbed elk so much the cows birthed fewer calves. Another out of Grand Teton National Park showed that backcountry skiers scared bighorn sheep during winter when food was scarce, with potentially lethal consequences.

Hospital understaffing and poor work conditions associated with physician and nurse burnout and intent to leave - The study from the University of Pennsylvania School of Nursing found that physicians and nurses, even at hospitals known to be good places to work, experienced adverse outcomes during the pandemic and want hospital management to make significant improvements in their work environments and in patient safety. The solutions to high hospital clinician burnout and turnover, they say, are organizational improvements that provide safe workloads and better work-life balance NOT resilience training for clinicians to better cope with adverse working conditions.

The simple ways cities can adapt to heatwaves – Heat monitoring and planning is become more important for cities…the climate emergency in cities is a health emergency.

New biodegradable plastics are compostable in your backyard – New plastic made from blue-green cyanobacteria that isstronger and stiffer than previous plastics from the same raw ingredient. They can be recycled…but also degrade rapidly in the environment.

Giant Hand Axes Discovered in England Point to Prehistoric Humans’ ‘Strength and Skill’ – More than 300,000 years old perhaps from an interglacial period. Early Neanderthal people inhabited Britain then…and maybe other archaic human species too.

Germs, genes and soil: tales of pathogens past – DNA sequencers and powerful computational tools…applied to ancient microbes…probing their role in human history. This article describes how the work is done, ethical considerations…using examples of what has been accomplished so far. The field of archaeogenetics is just beginning.

Back from the Dead: New Hope for Resurrecting Extinct Plants – There is a global effort to digitize herbaria specimens which had helped identify holdings of extinct plants…sometimes finding seeds. And then the challenge is how to best attempt to grow old seeds.

Pain risk varies significantly across states – Pain due to arthritis varies geographically in the US – with the moderate to severe pain being 23% in West Virginia vs 7% in Minnesota.  There is also a difference between people that did not complete high school…and those who obtained at least a bachelor’s degree – with the delta being greatest in West Virginia, Arkansas, and Alabama. There is a need to focus on the macro-level policies (i.e. generally at the state level) while continuing current individual interventions.

The Acropolis Adopts Crowd Control Measures for the First Time – The post-pandemic travel surge is overwhelming at some places – including the Acropolis!

Gleanings of the Week Ending July 1, 2023

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The items below were ‘the cream’ of the articles and websites I found this past week. Click on the light green text to look at the article.

How technology helped archaeologists dig deeper – Tools that tell us a lot more than excavation can: chemical and genetic analysis, lidar. This article uses new archaeological data from several cities (New York, Cahokia, Rome, Pompei, Angkor Wat)…pointing out that new analyses reveal that they were often full of immigrants that built the city and there were places those people lived nearby that often were not noticed by excavators! Archaeology is now able to tell us more about how ordinary people lived – not just the elite.

The white roofs cooling women's homes in Indian slums – Maybe white roofs will become a trend in lots of places…reduce the heat island effect that cities must struggle to overcome as the planet gets warmer.

Vienna is the most livable city in the world – It has stability, robust health care and education systems and strong infrastructure, among other factors. There are no cities in the US in the top 10; Honolulu, Hawaii is 25th on the list and the top city located in the US. There are 3 in the top 10 located in Canada: Vancouver, Calgary, and Toronto. 

That's no pizza: A wall painting found in Pompeii doesn't depict Italy's iconic dish – Tomatoes and mozzarella were not available 2,000 years ago when the fresco was created! Tomatoes came from the Americas a few centuries ago and mozzarella was invented in Naples in the 1700s.

This Ancient Maya City Was Hidden in the Jungle for More Than 1,000 Years – Found during a survey with light detection and ranging (lidar) scans in the Balamku ecological reserve on the Yucatan Peninsula. The site is on high ground surrounded by extensive wetlands. The ruins have been named Ocotun (‘stone column’ in Yucatec Mayan) in honor of the many columns found at the site.

Is fast fashion making us sick? – Fashion can be rife with toxic chemicals such as formaldehyde and chromium…and the US has done little to protect consumers from these toxins in clothes. Researchers are correlating declining fertility rate and the rise in autoimmune diagnoses in the US with chemicals found in our clothes.

Winners of the 2023 Audubon Photography Awards Celebrate the Beauty of Birds – Eye candy images of the natural world.

Surgeons must tackle three global health challenges to save lives – Assuming that a new device or approach is always better - not a good assumption but a common one that surgeon make!

The perilous life of the solitary pangolin – Learn about this African animal…their situation in the wild…and how things have changed over the past decade.

Winners of the 2023 BigPicture Natural World Photography Competition embrace our world’s biodiversity – Images telling stories.

Gleanings of the Week Ending February 11, 2023

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The items below were ‘the cream’ of the articles and websites I found this past week. Click on the light green text to look at the article.

Why the world feels so unstable right now – Intermittent instability of nonlinear systems of nature and global society –weather and climate, the economy, a pandemic, a war. We attempt to model nonlinear systems to predict these intermittent instabilities…but it is hard. Right now there seem to be significant nonlinear systems interacting: weather/climate + diseases (COVID-19 and bird flu (US)) + inflation + Russia’s invasion of Ukraine.

Completing The Electrical Circuit at Kilauea in Hawai'i Volcanoes National Park – The technique to get a detailed ‘CAT scan’ of the volcano…..mapping locations of subsurface magma in 3D.

Ex-cell-ent Clouds off Chile’s Coast – Open and closed-cell marine stratocumulus clouds photographed by Moderate Resolution Imaging Spectroradiometer (MODIS) on NASA’s Terra and Aqua satellites. Learning more about these clouds….contributing to better weather prediction and improving the accuracy of climate models.

The Surprising Substances Ancient Egyptians Used to Mummify the Dead – Evidently some of the substances the embalmers were using came from Southeast Asia. Perhaps embalming instigated early global trade.

Algae robots transport antibiotics to infected tissues (infographic) – Researchers inserted the modified algae into mouse windpipes…they spread into the lung tissue and killed pathogenic bacteria!

Hundreds of Frank Lloyd Wright’s Designs were never built. Here’s what they might have looked like. – Computer generated models from David Romero.

5 expert tips to protect yourself from online misinformation – We all need tools to help us distinguish information from misinformation.

Montessori: The world’s most influential school? – I sought out a Montessori pre-K and K for my daughter about 30 years ago…and it fit her needs. I have no way of analyzing how closely the school adhered to classical Montessori ideals.

An action plan to prevent Alzheimer’s disease – Defining what 2nd generation memory clinics should include.

Gallup: Fewer than half of Americans believe US healthcare is good enough – Not surprising really – it’s expensive and we are all getting more skeptical that the system is as effective as it should be for what it costs. Evidently the people in my age group (over 55) were generally more satisfied with their health care than other age groups; people old enough to qualify for Medicare may not be as anxious about costs but I was surprised that I am in the minority in thinking US healthcare is ‘subpar’ rather than ‘excellent’ or ‘good’ based on the effectiveness issue and the structure of the system overall.

A Patient Perspective of Medical Care in the US

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Part of the aftermath of making a long distance move is establishing new doctors. I’ve completed the process at this point – 8 months after the move. It’s been a learning experience. I started out with the intention to find a primary care physician and specialists in the same system so that I would only have one portal for all my medical information – unlike my legacy situation that involved at least 4 different portals. The portal for my new doctors is well organized and has become the primary way I get results and send questions/messages to my doctors. In general, the lab work is done very quickly and posted on the portal; I see it about the same time that the doctor sees it. The system of doctors – specialists – labs – hospital also includes several urgent care facilities that I appreciate; their availability can help avoid a busy ER; I’ve already used an Urgent Care facility prior to my first appointment with my new primary care doctor when I got a very painful bite that looked infected. On the downside -

  • Vision and dental care are not general part of ‘medical care’ from an insurance perspective or systems with MDs; vision and dental are still separate. The initial dental practice I selected wanted to do very different (and expensive) kinds of cleaning for my teeth and I’ve opted to go to a new one that is more like the dental practices I’ve used in the past. It’s hard to know how to evaluate dental recommendations since they are outside of the primary medical system. I like the vision care practice I chose but may have similar misgivings as I get closer to needing cataract surgery.

  • The various specialist doctors and non-blood labs/radiology are in separate buildings; they are relatively close together, but I am careful to record the building address  in my appointment calendar; it’s a high traffic area and it could be challenging to get to the appointment on time if I went to the wrong building first.

Thinking about the big picture of medical care in the US - It is not achieving ‘best in world’ results based on healthy lifespan stats. Why is that?

  • Insurance is expensive and confusing. I’ve had health insurance since the late 1970s and the trend has been increasing cost and complexity over the duration. Checking that doctors are in-network and drugs are ones that are on the formulary is a required skill to get insurance to cover costs….and even then, sometimes surprise charges occur. What happens when your doctor prescribes a drug that is not on the insurance company’s formulary? I am very aware that I have been fortunate to always be insured….understand that the cost of good medical insurance is prohibitive to many and that often means not getting medical care until there is a health crisis…and going to an emergency room.

  • Cultural reluctance/aversion to embrace public health measures. Over the past decade, there has been increased resistance to public health measures (for example, not getting vaccinations for children, older adults declining vaccines, flying when sick (coughing, sneezing),  and aggressively against mask wearing at any time) and demands on health professionals for treatment that is not appropriate for their condition (for example, demanding an antibiotic for a viral infection or are an ineffective drug for COVID or a drug advertised on television that is for a condition the patient does not have). I am mentioning the demands for inappropriate treatment under public health because it impacts the costs for medical care overall, increases resistance of microbes to antibiotics making them less effective when they are needed, and makes the workplace for doctors/nurses more stressful (and some decide to leave the profession resulting in shortages of skilled personnel).

  • Dominate lifestyle. We live in a world of fast food and ultra-processed foods…people are more sedentary because of their jobs or the type of entertainment they choose. It is harder to “eat healthy” now that when I was growing up and as a young adult. Many people in the country are obese and/or in poor physical condition. However – there are a lot healthier foods available now if we educate ourselves. For example – kale was not something I ate as child, now it is my ‘super green’; other foods that I’ve only know in the past 20 or so years include: pomegranates, edamame, beet greens, red cabbage, butternut squash, ground turkey. There are also a lot of ways to measure physical activity…and some have leveraged those metrics to become more physically fit. Still – healthy lifestyles are not as prevalent now. The bump in life expectancy that was achieved after many people managed to stop (or not start) smoking is being eroded.

  • Aggressive intervention with drugs. The medical system tends to treat with drugs rather than recommending lifestyle changes. Part of this skew is the way doctors are trained (often nutrition is not included in their education) and part is probably based on their experience that most patients will not follow through and make a change. If a drug can change the measure the doctor is seeing (like blood pressure or cholesterol levels), then the doctor tends to immediately medicate. Any unwanted side effects from the drugs are resolved through changing to a different drug or adding a drug to reduce the side effect or telling the patient that the benefit of the drug is greater than the impact of the side effect. But – if people can change their lifestyle, they are probably addressing the root cause of the problem rather than artificially doing something that changes the measure but leaves what is causing the problem the same. Long term maybe we’ll know if the drugs really do very much for increasing healthy lifespan.

  • Specialists with blinders to anything outside their specialty. The notion that a primary care physician can integrate care is overly optimistic.

    • Many times, the specialists are proceeding with their focus; if treatment is meeting the measures they want, side effects or over medication are not a priority for them.  For example – an endocrinologist adjusting medication to get the levels of hormones to a precise level is often unconcerned or dismissive of a patient reporting heart palpitations, hot flashes, and eyebrows falling out.

    • Emergency room doctors are focused on resolving the primary cause of the emergency visit and sending the patient home as soon as possible; this leads to quick fixes that often do not prevent the same issue occurring repeatedly. A good example is cellulitis in older patients; the ER gives them antibiotics and they go home…often returning with cellulitis again in a month or so. If the ER is not overwhelmed and there is an alert attending in the ER or in the hospital, more proactive measures can be taken…perhaps re-evaluating the dosage levels and complexity of existing medications, adding a prophylactic antibiotic, etc. that can prevent rapidly recurring ER visits for cellulitis.

  • Lack of trust. Patients believe doctors may have alternative incentives than patient health when recommending treatment/drugs and doctors believing patients may not be doing as they say and/or taking meds as prescribed. Not sure how this can be bridged other than encouraging more transparency on both sides.

The bottom line – I want to believe that I am proactively maintaining my health and being a knowledgeable patient that asks relevant questions to understand my doctors’ logic….thus making the best of the medical care available…but there are certainly times that I have some doubts. So far, I have been able to resolve those doubts and am satisfied that I am on a healthy path. However - I am increasingly concerned about individuals with fewer financial resources, less healthy or not as knowledgeable. The trend is toward more challenges within the US healthcare system!

Cancer Diary – Entry 13

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It’s been a year since my cancer surgery. All the diagnostics at the one-year mark show that I am cancer free….so the surgery was a success.

My last post was 4 weeks after the surgery but now I realize I should have done a post at 8 weeks since that is when the hematoma was finally gone. And two weeks later, in the area where the last hematoma color had been, cellulitis developed. The cellulitis might have been unrelated to the surgery, but it was a first instance of cellulitis for me…disconcerting; it was quickly resolved by antibiotics (unfortunately, I develop a reaction to the first type prescribed right after the second dose).

My fingernails became very brittle in the spring. They have returned to normal now. I suspect that the surgery and associated medication change might have been an issue but that my body had recovered/acclimated at this point.

The scar and puckering around it are not fading as quickly as I expected – perhaps because of skin sensitivity to the recommended topical vitamin E and/or cocoa butter and sunscreen, developing hives in the scar area (reaction to an antibiotic), and the silicon patches not being as effective as advertised. My current strategy is to cover the scar when I am out in the sun (rather than using sunscreen) and to use the mildest of moisturizers.

My cancer was detected early before it impacted my perception of health, and the surgery happened expeditiously. A year later, I am feeling healthy (almost like I felt before the surgery) but 2022 had the most health related ups and downs of my life!

Previous cancer diary posts:

Gleanings of the Week Ending October 22, 2022

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The items below were ‘the cream’ of the articles and websites I found this past week. Click on the light green text to look at the article.

US National Integrated Drought Information System – 68.4% of the US is abnormally dry…46% is in moderate drought…27% in severe drought. Use the location tab of this page to select state or county level maps color coded for their drought status. Where I live, we are in moderate drought.

Autumn in the Adirondacks – Leaf color has not been impacted by the drought in the Adirondacks. The pictures are from the Landsat 9 satellite. I’m enjoying the color from the ground – even with the drought here in Missouri making it not as colorful as it probably was in prior years.

Why cork is making a comeback – The main product mentioned in the article was cork stoppers….but I thought of the calm I felt when I walked into the University of Michigan’s Law Library with a tour group and realized how much the cork floor muffled our footsteps. It was the highpoint of the trip with my daughter when she was considering the school for her undergraduate studies.

Blue fibers found in dental calculus of Maya sacrifice victims – Analysis of more than 100 sacrifice victims found blue fibers in the mouths of 2 of them. Are the fibers from blue gags left in the mouths of victims over and extended time? Similar pigment called Maya blue has been found in other sites where it may have been used to paint the bodies of sacrificial victims. Another archeological mystery…

See the buzzworthy winners of the Wildlife Photographer of the Year competition – Eye candy for the week.

Millions of Americans are losing access to maternal care. Here’s what can be done – 36% of the counties nationwide – largely in the Midwest and South – constitute “maternity care deserts,” meaning they have no obstetric hospitals or birth centers and no obstetric providers. That does not bode well for the health of mothers and the next generation.

These stunning satellite images look like abstract art – and they reveal much about our planet – 8 images selected from US Geological Survey satellite images of the Earth’s surface.

Engineers weave advanced fabric that can cool a wearer down and warm them up – Maybe the ‘cool down’ of this technology (if it can be developed) will help us deal with climate change more effectively. There are already beginning to be more heat related deaths and there will be some occupations that will become impossible without technology to cool the body in outdoor environments.

Rainfall is becoming more intense in most of the US – East of the Rockies…there is increasing precipitation intensity. Water resource management is more challenging. Flooding risk is going up too.

USGS Public Lecture Series – A wide range of topics including volcanoes in Alaska, earthquake early warning for all, migratory big game, droughts and groundwater quality, modernizing the national water information system….and many more. I am beginning to work my way down this YouTube playlist.

Medical Transition

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The process to transition medical care after a long-distance move is a little complicated. I’ve made the address switch (and sometimes policy) for my insurance, identified new doctors, requested medical history be sent, and had a first appointment with one of the doctors…now hoping I haven’t forgotten anything.

First appointments are always a little challenging with paperwork and meeting a new doctor. I am trying to establish doctors that are all in the same system so that I’ll only have one portal (unlike the situation in Maryland where every doctor seemed to have their own!).

I realized that even finding my way to the building and the office was part of the ‘first appointment’ challenge. I tried to notice things about the building that were a little different: the young trees in the parking lot islands (not sure why they were wrapped as they were) and the glass atrium light fixture/loft railings. Maybe I’ll remember the place when I am due to return in 3 months!

Gleanings of the Week Ending May 14, 2022

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The items below were ‘the cream’ of the articles and websites I found this past week. Click on the light green text to look at the article.

Why human brains were bigger 3,000 years ago – Some possible explanation: human populations reached a large enough size to share/divide labor and knowledge with others, writing….however, brain size/IQ relationship is not deterministic.

Operating rooms are the climate change contributor no one’s talking about – The health care industry accounts for 8.5% of all greenhouse gas emissions in the US. Operating rooms represent 70% of waste in hospitals and 3 to 6 times as much carbon as the rest of health systems.

Where tornadoes strike most frequently is changing – More erratic tornado activity and the broad impacts of climate change.

Do you have a lost twin? - The rate of twins among live births is only about 1.3%. But as many as 12% of all naturally conceived pregnancies may begin as twin pregnancies.

Wild fox kills 25 flamingos and a duck at National Zoo – We see foxes in our neighborhood. They seem to have adapted to the suburban environment. This one was very efficient to kill 25 birds, though.

A 10,000-year history of geo-ecological change in Yellowstone’s lower geyser basin – A study using a 26.5-foot core from Goose Lake.

US could cut transport emissions by 34% b 2030 – The current trend will reduce emissions by 19% but a bit more focus would provide a bigger reduction.

Garbology: How to spot patterns in people's waste – We’ve been getting rid of a lot as we prepare to move. I try to do as much as possible via donations and recycling…but there is still a lot going in the trash. Some of it came from Texas with us back in 1983…and was still in the same box!

6,000-Year-Old Slate Rings May Have Symbolized Relationships – Friendship rings? Careful analysis revealed the rings had been intentionally broken…and shared (i.e. pieces of a ring were found in two separate burial sites).

How Taipei discovered an active volcano on its doorstep – Disconcerting. Even of there is some ability to provide early warning of an eruption…could the city be abandoned quickly enough?

25 months in COVID-19 Pandemic

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The positivity rates and hospitalizations continued downward but in Maryland they are not down to the lows we go in the summer of 2021 before the Delta variant came along…and then the Omicron spike. Still – most of the mask mandates have been allowed to expire. My daughter reported that at her university there seemed to be a lot of strep and flu infections after the mask mandate was lifted; masks were protective for more than COVID-19! I have continued to wear my mask when I am indoors (at the grocery store and when I waited to get my car serviced, for example). All the doctor’s offices where we’ve had appointments are still requiring masks.

When I made my road trip from Maryland to Texas (via Missouri), I put on my mask at rest stops and when I registered at the hotel…when I went grocery shopping while I was in Texas. I took my air purifier with me too. I was traveling through areas that had higher positivity/hospitalization rates than Maryland and noticed that there were very few people wearing masks. There are some analyses of sewage around the country that have indicated the presence of the omicron sub-variant that is problematic in Europe in the US but, so far, there does not appear to be an uptick in COIVD-19 cases here.

I am masking when I look at houses – both to protect myself and to be considerate of owners of the houses I am viewing. I do as much as I can online before I see the house in person.

The one place I did not wear I mask indoors this past month was at a baby shower while I was in Texas; I’m far enough past the event to know that no one there was infectious!

I still feel vulnerable because of my surgery earlier this year and my recent illness while I was traveling; I am not as confident that my immune system is as robust as it was a year ago; I am continuing my strategy of masking. My husband and I got our second COVID-19 booster soon after the recommendation came out. As we both continue our search for a new house, the vaccine and indoor masking are our risk reduction strategy…at least for now.

Another observation - my husband had an outpatient procedure this past month, and the COVID-19 process was still in effect: they required that I wait in the car for 1.5 hours rather than a waiting room. I was fortunate that I could park in a sunny place since the temperature was in the 30s!

Overall – the pandemic appears to be waning. People are making individual decisions about masking and the amount of masking varies a lot from place to place. This is the new normal?

Being Sick While Traveling

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There was one time I had a terrible cold while traveling during my career – but I was never sick enough to seek medical attention until my time in Texas last month. It was quite an experience.

I was tweaking the dose of a medication per my doctor’s instruction and, at first, I thought my high heart rate and feeling hot was caused by that change…but it continued to get worse over the next 24 hours. I finally noticed a pink area of skin on my abdomen and went to an Urgent Care…where I was diagnosed with cellulitis by the doctor (after the first place I called would not accept Medicare…aargh!). At first the antibiotic seemed to work very well. My heart rate declined back to normal with a few hours of the first dose. The pink area was reduced in size and fading after the second.

Trouble started about the time I took the 4th dose. I haven’t taken much medication so didn’t know any antibiotic I was allergic too…it happened that the one prescribed caused me to itch…I scratched…welts formed ---- HIVES! It was scary since it was described as an indication of an allergic reaction to the antibiotic. I managed to take some Benadryl and reach a doctor to switch me to another antibiotic.

I thought everything was going well – finally. Then I somehow attached something that bit me multiple times (maybe it was multiples of the same insect?)…so I had the remnants of hives (that were no longer itching as much) and bug bites that were new and itching. I covered all of it with calamine lotion to keep from scratching.

Fortunately - I was recovering by the time I started the two-day drive between Texas and Maryland. That trek is the topic of tomorrow’s post.

Cancer Diary – Entry 12

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4 weeks after surgery:

  • The surgical glue has flaked off the incision. I collected the bigger pieces and did a round of macro photography – commemorating the milestone – before throwing them away. The texture of the glue varied…crinkled, fibrous, crystalline. Blood that became embedded in it provided some color.

  • I’ve started putting Vitamin E and cocoa butter on the scar to help it fade over time (and am keeping it protected from exposure to sunlight).

  • The hematoma is mostly gone. The speed of the ‘clean up’ increased over the last week.  

  • On a not-so-positive note – I’ve been celebrating too much with food and my weight has started to creep upward…starting work to reverse that and continue on my plan to reduce 5+ pounds from my weight at the beginning of the year.

This with be the last Cancer Diary post unless something else happens. Right now -  the prognosis is good with continued monitoring tests to confirm. All the baseline tests indicate that the cancer was caught early and that my ongoing risk is low.

My experience has prompted me to think about what ‘good medical care’ means….what led to the early diagnosis and treatment. Looking back…it was a 12-year progression from a blood test revealing a risk factor prompting annual monitoring blood tests and ultrasounds. There was a biopsy with a benign result 6 years ago….and lastly a biopsy that revealed the cancer last fall. My primary care doctor coordinated all the monitoring until 2 years ago; I opted to go to a specialist thereafter. The specialist recommended the surgeon. Of the three, the specialist is the best at sharing his rationale of monitoring and treatment….and that is something I have come to appreciate more over the past few months.

Previous cancer diary posts:

Cancer Diary – Entry 11

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The doctor that referred me for cancer surgery scheduled a follow up appointment for about 2.5 weeks after the surgery - assuming the surgeon would complete his role at about 2 weeks after the surgery (which I posted about in the 10th Cancer Diary post). The appointment with the doctor that will continue my care is the most recent milestone in my journey with cancer and getting treatment. He confirmed that I would not need radiation/chemo and ordered blood lab tests immediately and developed a plan for the next year: periodic blood tests and an ultrasound in a year. I am pleased that my cancer was caught early enough that I am on track to be ‘cured’ rather than living with cancer for the rest of my life.

It was bitterly cold the day of the appointment…but I was buoyed by the results I already knew from the surgeon and the continued fading of the hematoma/healing of the incision. The doctor provided excellent feedback and answered questions…the tech that did the blood draw did a great job getting the needle in smoothly then filling the multiple vials of blood required. On the way out of the building, I stopped for a few seconds to photograph the garden that looked so inviting when the weather was warmer; the fountain is turned off now and it’s too cold to linger but I still like the look of the place. I hurried to my car, thoroughly chilled, but appreciating the time out in the world, away from home. I celebrated that the appointment had been early enough that I got a close parking space!

I am so buoyed by the results that I am feeling more optimistic than I have all during the pandemic; I realize that, even though I was consciously reminding myself that the cancer had been detected early, I experienced a deep anxiety about it that became part of everything I was thinking and doing for the past few months.  Now I’ve started wearing earrings again (when I am not going to be taking a mask off and on), buying flowers every week at the grocery story and making multiple arrangements to place everywhere in the house. This is a time of celebration…a time to be happy that I am healthy and enjoying winter 2022.

Previous cancer diary posts:

Gleanings of the Week Ending January 29, 2022

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The items below were ‘the cream’ of the articles and websites I found this past week. Click on the light green text to look at the article.

Photography In the National Parks: My 10 Favorite Shots From 2021 – I only went to one national park in 2021: New River Gorge (in West Virginia). There are so many beautiful National Parks to see…and they’re worth seeing again and again.

Big Gulp: Blue Catfish Eat Wood Duck – We’ve seen fishermen catch blue catfish at the base of Conowingo Dam (we’re there for the bald eagles). They are huge…sorry to learn that they eat ducks.

Top 25 birds of the week: Raptors! – How many of these live in your area of the world?

Air Pollution Makes It Harder for Bees to Sniff Out Flowers – Not just a problem for bees…also moths, hoverflies and butterflies are having a harder time. This results in a 14-31% reduction in pollination among plants exposed to polluted air.

Ocean microplastic pollution may be greater than estimated – Not a good trend…and this form of pollution that is new enough that the full impact is still being discovered.

With Fewer Animals to Move Their Seeds, Plants Are Stuck in Threatened Habitats – Another way the world is becoming less resilient at a time when climate change is pushing all life to use all the resilience available.

Large Permian Basin Methane Leaks Are Causing As Much Climate Pollution as 500,000 Cars – It’s frustrating that the oil industry has not been a better steward of resources they are extracting for energy. The methane leaks are a waste of the effort put into extraction….and bad for the planet too.

Dinosaur food and Hiroshima bomb survivors: maidenhair trees are ‘living fossils’ and your new favorite plant – Learn more about the ginkgo tree! There is one along my walking route in my neighborhood and others I find in local gardens and parks near where I live. They are so different from other trees…worth noticing.

North Sea Fossil Fuel Companies Plan to Invest More in Wind than Oil Drilling – Hurray! Maybe other companies around the world begin to do this too….a strategic move for Shell, Total and BP.

Antimicrobial resistance now a leading cause of death worldwide, study finds – This challenge will increase over time…if we don’t take action to slow the development of resistance and develop new antimicrobial techniques (maybe we need more strategies than simply trying to develop new antibiotics).

Cancer Diary – Entry 8

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The surgery day finally came. I showered with antibacterial soap as instructed and minimized what I was taking to the hospital in the pockets of a freshly laundered fleece jacket: new mask, eye glasses case, ID and insurance cards and phone. My clothes were comfortable pull-on pants and a button front top…wool socks with clog shoes. We left early enough that the sun came up while we were enroute into the city. The temperature was in the 20s but the place where my husband dropped me off was only a few steps to the door of the building. With the Omicron surge in our area, he was instructed to go home and come back later to get me.

Everything went as expected at first – easy check in because the pre-registration had been complete…the nurse came out to get me and got me into hospital gowns…IV ports were put in….the anesthesiologist came…the surgeon was about 20 minutes late. And then there was a time I don’t remember at all…and I’m in a recovery room…woozy at first and with a headache…drinking a Sprite and realizing that the dehydration headache from the early morning is gone.

Toward the end of the time in the recovery room, things were not as expected. There was more swelling than there should have been. Rather than going home, I would be admitted for overnight. I began to realize I should have paid more attention to the non-optimal outcomes to the surgery and that my phone was running out of power. I was taken in a wheelchair from the outpatient recovery room, through a labyrinth of corridors to a hospital room; on the way there, I noticed every bump in the route and that the swelling seemed to be increasing. The nurse immediately checked the swelling when I arrived ….and realized a hematoma had formed. There was a flurry of activity in the room where the hematoma was drained; they were able to slow the bleeding but not stop it….so back to an operating room where there was another time that I don’t remember at all.

Afterward I learned that while it is not common – it happens occasionally because so many blood vessels into a cancer have to be stopped…one of mine was not seen bleeding during the 1st surgery so the incision was reopened and it was stopped. Then the area was searched further to make sure there was no other bleeding.

Another time in recovery and then back to the hospital room. A nurse had found a charging cable for my phone while I was in the second surgery, but I was too exhausted to turn on the phone until the next morning.

So – not a ‘smooth sailing’ experience. I found myself being very thankful for the doctor recognizing that something might not be quite right…the nurse realizing that the problem had become critical… the professional team that slowed the bleeding and got me back into an operating room to fix the problem.

Cancer is scary and having a ‘bleed’ right after surgery could have been a ramp up of anxiety…but my emotions were almost on pause…in a surreal experience of passively observing highly trained people focused on me…doing what needed to be done. I’ll always remember someone reassuring me, as pressure was applied to slow the bleeding as they moved me from the hospital room to the operating room, that they would get me a clean gown.

22 Months in COVID-19 Pandemic

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22 months in COVID-19 pandemic is a long time to be in heightened awareness mode…long enough for new habits to become well established. I would feel very odd going into a store without a mask….or going shopping at a time where there are lots of people in the store…or shopping slowly…or going out to eat rather than getting takeout. These new habits are just part of the way I am out in the world right now; they are not difficult to sustain.

My concern about COVID-19 has increased over the past month as the Omicron variant has become more widespread and the infections/hospitalizations in Maryland (where I live) have increased dramatically. My husband and I have backed off the plans we had for beginning to get out more. We are enjoying our house and yard…doing outdoor activities on our own in areas without a lot of other people rather than meeting a group.

I take advantage of every opportunity to enjoy whatever I am doing:

…a sunrise before going into the grocery store

… the unfurling of yellow roses over several days as I do my normal activities in my home office (I had the vase on the window sill)

…the snow caught in the pinecones/greenery on our front door (I had opened the door to take it down to dismantle/take to the compost pile but decided to leave it)

Making the conscious effort to appreciate my surroundings is my best strategy for sustaining a positive attitude. I have also started setting 30 minute timers all during the day and doing 3 minutes of walking. It is a great way to move throughout the day and stay focused on whatever I need to do during the other 27 minutes!

My husband and I have planned what we will do after my cancer surgery since there will be a higher than usual chance we will be exposed to COVID-19. For him, being in the waiting room for hours is the challenge; even if he goes outside to eat/drink and everyone is masked when indoors…it will be a lot longer indoors away from home since the initial lockdowns of the pandemic. For me, the exposure could take place during the surgery itself…from the time I take off my mask to the time I wake up from anesthesia; presumably everyone will be masked and the air filtration will be good….but still more chance of exposure than my normal routine. Our plan for 5 days post-surgery is to be on separate floors of our house when we have our mask off (sleeping, eating/drinking, showering) ….and test if we have any symptoms. I’ll post more about it as we implement the pan.

By the time I am recovered from surgery and ready for another road trip to Texas, the Omicron variant may be waning and hopefully another variant is not burning bright and hot….but maybe that is wishful thinking.

Cancer Diary – Entry 7

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A flurry of pre-op activity….the discipline of getting to appointments on time and filling the waiting time between.

The uptick in activity pre-surgery increased two weeks before the surgery date with an appointment with my primary care physician for bloodwork, EKG, and chest x-ray. Everything came back good for the surgery; however, there was a ‘nodule’ that showed up on the chest x-ray. There was a follow-up CT Chest that indicated that the issue seen in the x-ray was not there (i.e. the ‘nodule’ seen in the x-ray was a shadow or other artifact rather than something real). I was very discombobulated by the x-ray and was glad I could get an appointment for the follow-up the next day. The data from the tests done by my primary care physician were posted on the surgeon’s portal 9 days afterward….I was glad to know they had gotten to their destination.

Three days before surgery, I had a PCR test for COVID-19 at a drive through testing site for surgery patients (i.e. not a site for the general public/symptomatic people). It was my first experience with a PCR test and was easier than I expected:

  • We had gotten 3 inches of snow overnight and my appointment was at 9 AM, but the streets were relatively clear, and I drove up to the parking lot testing location a few minutes early; there was no line; the guard checked me in, and I drove into the tent where a nurse with full head gear respirator checked my ID and did the test.

  • The nurse did not need to swab deep in my nose!

  • Supposedly the results will be available and posted to the portal within 48 hours…the day before the surgery.

A person from the outpatient surgery center called with some final instructions:

  • No food after midnight, no liquid after 6:30 AM….and stopping certain supplements. I already knew those things from previous instructions, but it was good to be reminded.

  • I need to shower with antibacterial soap (like Dial) and not apply anything post shower; I made a special early morning trip to the grocery store to get the appropriate soap.

  • They are on heightened COVID protocols now and have closed waiting rooms - recommended that my husband drop me off and return at the time the nurse specifies during a call to him when my surgery is complete; he will never go into the building. I will be at the surgery center for at least 5 hours.

  • When the nurse calls my husband after my surgery concludes, she will also provide details for at-home/follow-up care and then I will get the same thing in writing before I leave the facility. One question we’ll ask is whether we should proactively assume I might have been exposed to COVID and should implement our strategy of masking/separation-when-unmasked at home.

  • The time I need to arrive for surgery was 15 minutes earlier than I was told previously.

  • I needed to provide insurance and billing information to the pharmacy at the facility so the nurse could pick up any prescription I needed to send home with me.  

  • The exact location in the building where I need to go when I arrive was also indicated; all I had before was the address of the building.

  • The list of things I should bring with me is short enough to fit in my coat pocket: insurance card, glasses case, phone, photo id. They already have my medication list in their files.

I am set to stay near the bedroom on the second floor of our house for at least the 1st 24 hours after surgery. Snacks and flowers and supplements are on top of my dresser. There is a small folding table and chair set up in case I want to eat a meal or two up there.

I am relieved that the surgery is going to happen as scheduled (not cancelled or delayed because of increased hospitalization due to COVID-19) and reassured after the conversation with the person from the surgery center; it was good to talk to a real person!

Next Cancer Diary post will be about my perception of the surgery day…

Previous cancer diary posts:

Cancer Diary – Entry 6

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A month of waiting for surgery and almost another month to go….assuming that the hospital does not become overwhelmed with treatment of COVID-19 patients and the surgery is cancelled/postponed. I am not anxious about the possibility….yet; my concern has been ramping up over the past few days with the hospitalizations in Maryland increasing and the indicators that the Omicron variant’s being more contagious than the Delta variant….and knowing that a lot of people are gathering for the holidays (more than last year….with vaccinations available, a lot of people made big plans for this year prior to Omicron emergence). By early January – the medical system could be very stressed. There is little I can do to improve the situation aside from staying healthy myself; I am trying to keep myself busy and focused on other things.

There was little in my activities this month on the critical path toward my surgery other than continuing to take the medication. The surgery date was moved forward by a couple of days and an appointment made for a pre-surgery COVID-19 test. I was glad there was a lull; I thoroughly enjoyed my daughter’s whirlwind visit (road trip for her) for Thanksgiving and then had time to focus on supporting my sisters’ from afar as my mother was hospitalized. Fortunately, the hospitalization was short, and the follow-up seems to be improving her condition rapidly; her quality of life is improving beyond what it was a month ago! And I am relieved that I didn’t need to make an unplanned road trip to Texas.

We ventured out for a walk around Druid Hill Park and through the Christmas lights at Brookside Gardens. Both were enjoyable outdoor experiences…good for our mental health. There are other outdoor activities we’ve planned…but on our own in uncrowded settings rather than organized events. The more we learn about Omicron, the more cautious we are becoming.

It’s cold enough that I have ramped up indoor activities… another effort to avoid thinking too much about my cancer. I am spending considerable time on a Coursera course: Anatomy of the Upper and Lower Extremities (from Yale University). During the holidays, I spend more time cooking…making more complicated recipes and trying new things. And there are the regular things like Zentangle tiles and book browsing that I can ‘do more’ too. I’ve started buying flowers every time I got to the grocery store since the view from my window now is bare trees; on the plus side, the birds are easier to see.

Overall – this month of waiting has not been hard at all. At this point, my mental perspective is about the same as it was a month ago although I find myself bracing for the possibility of the increases in hospitalizations from the pandemic causing a postponement of my surgery…an event that would be a major setback from my perspective.

Gleanings of the Week Ending December 18, 2021

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The items below were ‘the cream’ of the articles and websites I found this past week. Click on the light green text to look at the article.

Monkeying Around with Venom – Hadn’t heard about ‘Snake Detection Theory’ before; it is the idea that snakes have exerted a selection pressure on the origin of primates’ visual systems, a trait that sets primates apart from other mammals. This paper is some recent research that supports the theory.  A condensed description of the research paper is found here.

Why climate lawsuits are surging - Lawsuits are becoming tool to force change…in conjunction with activism, policy and science. There have been some successful lawsuits…and more in the pipeline. Sometimes the suit is about better enforcement of environmental laws…and sometimes it is about climate protection for future generations becoming a constitutional issue.

Florida to Feed Starving Manatees, as Pollution Shrinks Food Supplies – Florida farm runoff caused alga blooms that cut the penetration of sunlight into the water so much that it killed the seagrass that manatees eat…and there have already been more than 1,000 that have starved. It is estimated that there are about 8,000 manatees remaining in Florida waters. It is unclear that the seagrass can be restored.

Top 25 birds of the week: December 2021 – Enjoying bird photographs!

How volcanic eruptions helped the ancestral Puebloan culture flourish – Response of people to the stresses of abrupt climate change evidently resulted in larger population centers…universal pottery making and turkey cultivation…more sedentary living…increasing social inequity.

Major Contract Awarded To Rehabilitate Section Of George Washington Memorial Parkway – The parkway is along the Potomac River between Great Falls and Mount Vernon. It was one of the first beautiful and history things we discovered when we moved to the area in 1983…and long overdo for renovation. Parts of it carry a lot of daily commuter traffic in Northern Virginia.

The impact of drugs on gut microbes is greater than we thought – Most people are aware of the impact of antibiotics, but other drugs impact the gut microbes too…and some of those drugs are treating chronic conditions so are taken for years. It appears this study was mostly about methodology to tease out the impact of drugs vs the underlying disease….much more work still to be done before concrete recommendations can be made.

The race to make vaccines for a dangerous respiratory virus – RSV (Respiratory Syncytial Virus). There are currently 4 candidate vaccines and one monoclonal antibody treatment that are in last-stage trials. It appears we are at the cusp of much faster vaccine development times because of what happened to develop the COVID-19 vaccines.

The tomatoes at the forefront of a food revolution – The idea is to use Crispr modification to sustain the productivity of the tomato crop as the climate changes.

Chronic exposure to air pollution may increase risks for ICU admission or death among COVID-19 patients, study finds – Sometimes it is hard to separate the role of the environment on health disparities. This study analyzed 6,500 COVID-19 patients admitted to 7 New York City hospitals.