Happy Halloween!

I've been busy lately but do need to find time to get a haircut when possible.

My staff is saying I look like Weird Al lately-I don't understand why?

A devastating 1

Hurricane Charley occurred in August 2004 (shown below).



By the time it crossed central Florida (and my town) it had luckily weakened somewhat to a category 1 storm with winds at just over 90 MPH.

I witnessed the destruction that a category 1 could cause (winds of 74-95 MPH).

Before experiencing this I probably would have said "only" a category 1. After all, the rating system goes all the way up to a 5 (winds of greater than 155 MPH).

I haven't said "only" a category 1 since 2004.

My thoughts are with a lot of family and friends who live in the path of Hurricane Sandy tonight (currently a category 1).

I'm hoping for the best possible outcome.

Wanting to give Zoots the boot

Mr. G.'s history lesson continued.

"I was sort of black-balled in the business industry for a number of years because I wore a Zoot Suit (a men's suit, that became popular in the 1940's, with high-waisted, wide-legged, tight cuffed, pegged trousers, and a long coat with wide lapels and wide padded shoulders) and so did my friends."

For some reason, I just nodded and in doing so, pretended I knew what he was talking about.

Some quick research revealed that due to the amount of material required to make Zoot Suits, the U.S. War Production Board said that they wasted materials that should be devoted to the World War II effort. It was considered unpatriotic in wartime and was a factor in the Zoot Suit Riots.

The U.S War Production Board was in operation from 1/16/1942 until it was dissolved in 1945 (just after the surrender of Japan).

It was given the task of regulating the production of materials and fuel during WWII.

It would seem that their concern regarding the Zoot Suits arose during a time when, for whatever reason, they had a lot of free time on their hands.

If not, and if they were still operating today, think how busy they would be given today's style of clothing.

Good advice

"Harboring resentment and bitterness is like drinking poison and expecting somebody else to die. Forgive."

Author unknown-have seen it attributed to more than one person

Grandi sapori (tastes great)!

Mr. G. is in his late 80's.

He grew up in Rochester, NY.

He reported an Aunt and Uncle started the Ragu company many years ago in Rochester.

"Ragu," by the way, means meat sauce in Italian.

He reported taking bottles to different shops around town on the back of his bicycle and leaving them there on consignment.

When their stock increased, which was mainly dependent on the number of bottles they could obtain, he reported often helping his Uncle sell them from the trunk of his car.

It was quite a story with remarkable details because, obviously, he was there.

He does have some cognitive impairments, however, so I decided to do some fact checking on my return home.

Sure enough, information available on the internet reports "in 1937, on the streets of Rochester, Giovanni and Assunta Cantisano, their son Ralph and relatives started selling their homemade Ragu brand door-to door."

Mr. G. was 11 years old in 1937 and was a relative.

Unlike President Obama and Governor Romney during the Presidential debates, all his facts checked out.

I'm also sure he has had his fair share of amazing Italian food over the years!

Feeling kicked in the groin

I saw the big billboard again today on the interstate that advertises "Vasectomy: No-Scalpel and No-Needle."

I was finally able to see the website address so I checked it out this evening.

Under the technique section are the following lines:

"An anesthetic solution is injected with a tiny needle to numb the scrotal skin and the vas tubes if the topical spray-on anesthetic is not adequate."

"The Dr. uses the No-Scalpel technique, exposing each vas in turn through tiny openings in the frontal scrotal walls. The tiny openings are made with a pointy hemostat."

"Once each vas tube is lifted through the small skin opening, it is divided under direct vision with fine surgical scissors. The ends of the divided vas are then placed out of alignment by applying a tiny clip to the sheath surrounding the vas."

I think the ad needs to be changed to the following:

"Vasectomy: No Scalpel (Pointy hemostat, Surgical scissors & Tiny clips only)and No-Needle (unless a tiny needle is needed for better anesthesia)."

I had a Vasectomy back in the Scalpel and Needle days.

The surgery, for me, wasn't the painful part.

The post-op feeling of being kicked in the groin for a few days was the most memorable part for me.

Oh yeah, I forgot!

The daily calender, inside an elevator, at an assisted living facility lists "Vespers: 7 PM."

This will sound pretty lame but I asked my wife, on my return home that night, what she thought vespers meant.

"For Pete's sake," said my wife, "you grew up Catholic!"

"It's evening worship Dad, evening prayers," said my 18 year-old son.

"Oh yeah, now I remember."

I grew up Catholic and also took three years of Latin in junior high school.

It derives from the Latin word vesper which means evening.

Honestly, however, I was never a Catholic Latin scholar, so I told my wife and son to only start worrying about my memory if/when I can't remember what evening worship or evening prayers means!

Impressive stacks

Mr. B. loves stacks.

At least that's just my initial observation.

I only spent a very brief time in his apartment the other day.

He preferred to talk in a common area of the senior complex where he lives.

The stacks were impressive-most were one and a half to two feet in height.

Stacks of unopened or previously opened cigarette packs; also VHS tapes, CD's, cassette tapes, and records were all neatly stacked throughout his apartment.

It was definitely a "you need to see it to believe it" type of thing.

I couldn't help but wonder the time involved to retrieve, for example, a tape at the bottom of a stack.

I'm sure he has a very orderly way of taking down and then rebuilding the stack effected.

I suspect he recognizes it's odd and that's probably why he doesn't want folks to spend a lot of time in his apartment.

Most of us have some minor OCD issues that we deal with on a daily basis.

He's a stack man.

Time efficient Rosary

Mr. G. has been saying the Rosary everyday for, he estimates, the last seventy years.

"How long does it take you to get through it?" I asked (I grew up Catholic but couldn't remember).

"I've got to where I can do it in 26 minutes," he replied.

"Wow," I said, "you sure talk fast."

"I need to, I'm not sure how much time I have left (he laughed)."

Here's some quick math:

26 minutes/day OR 9490 minutes/year OR 664,300 minutes over the course of 70 years

There are 525,600 minutes in a year so he has spent 1.26 years of his life saying the Rosary.

He's 86 years old, cognitively intact and, obviously, still has a great sense of humor.

It appears to be time well spent.

http://www.theholyrosary.org/

Paper endorsement

The Orlando Sentinel recently announced their pick for president:

http://articles.orlandosentinel.com/2012-10-19/opinion/os-ed-endorsement-president-mitt-romney-101912-20121018_1_trillion-deficit-reduction-plan-mitt-romney-obama-s-republican

A classic with a nonfunctional convertible top

Mr. G. is an amazing 86 y/o man.

One of his concerns is that he has a phimosis-a condition, in uncircumcised men, where the foreskin cannot be fully retracted over the glans (head) of the penis.

He had seen a urologist who recommended a circumcision.

Mr. G. wasn't so sure.

He had not been sexually active for over 7 years since his wife died.

"What's your understanding of a phimosis?" I asked.

"The way I look at it, my convertible has become a hard-top. I've just got to decide if I want to have the roof permanently removed (he laughed)."

"It's got to be a tough decision for you since you've been riding the same car for the last 86 years (we both laughed). It's not an emergency. We can discuss it again the next time I see you but let me know if you have any problems before then as well."

He agreed.

His classic remains intact for the time being.

Your blessings are appreciated!

It's an odd tradition in English-speaking countries to say "God bless you" whenever someone sneezes. There are various theories as to the origin. The reason I was given, when growing up, was because your heart stopped beating when you sneezed-this is false by the way! "Gesundheit," the German word for health makes more sense. It just doesn't roll off your tongue as easily as "God bless you" and to be perfectly honest, I never knew how to spell it until a few minutes ago. I think I'll stop here and just continue to rack up as many blessings as possible. I sneeze pretty darn often. I'm a blessed man.

Up in smoke

This is a picture of Winnie Langley using the candles on her 100th year birthday cake to light yet another cigarette:



It's been estimated that she smoked more than 170,000 cigarettes in her lifetime and outlived her husband, son and 10 step-children. She died one month shy of her 103rd birthday.

I suspect she also outlived most of the healthcare professionals who advised her to quit over the years as well.

The picture makes me smile.

Quality time

Yesterday was a beautiful day-perfect, weather-wise.

It was the last game for my son's fall club soccer season.

It may be his last, ever.

High School try-outs start tomorrow and he's not sure if he will play for his club team in the spring.

He likes being a goalie but few would ever consider it to be a fun position.

Next year, he's off to college.

My wife and I have spent many a weekend traveling to and from games for him.

It's potentially another last for us as well.

It's something all involved parents are faced with and need to accept.

Folks without children often have a hard time understanding the amount of time invested into children.

It's sometimes even harder to explain to them why you would possibly miss spending most of your free time taking your kids to and from his/her chosen sports/hobbies.

Down and out

One of the Nurse Practitioners I work with let me know that an 81 year old patient of ours ended up in the Emergency Room last night.

One of his two malleable Penile Prosthesis Rods had fully dislodged (come out).

I don't have any further details yet.

No clue to as if it became dislodged before, during or after being called into action or if it just worked it's way out while hanging around.

It doesn't really matter.

Regardless, it's a very bad day for this poor fellow and he's sure to be down and out for at least awhile, if not permanently.

Shown below is an example of the Penile Prosthesis Rods that are placed when a male selects this form of intervention for Erectile Dysfunction-it's not something I could ever accept but many do. If and when the time comes that I would need to ponder such a device, I think I'll just consider this one part of my body to be retired.

TV Krispies

"What seems to be the problem," asked the cable repair man.

"I'm not sure what you call it but the picture on the TV periodically gets scrambled and snaps, crackles and pops (and I immediately felt even stupider basically describing my poor TV reception as Rice Krispies).

"OK, let me check some things out."

"I found the problem," he said a short time later, "things look fine now. The signal was getting lost in an amplifier in the attic and I replaced it. You shouldn't have problems with pixelization anymore."

Pixelization.

Cool word.

It's actually a technique used primarily for censorship.

Makes sense...it just that we weren't watching anything that should have been censored.

The Golden rule

Al (Mr. V.) has advanced Parkinson's disease.

Many family members, neighbors, health care professionals and even church friends have advised Mrs V. to place him in a Nursing Home.

She politely declines.

"I may not have all the certificates and degrees of a nurse but nobody can take care of Al like I can take care of Al. I've seen a lot of Nursing Homes. They do the best job they can under difficult circumstances but I would never want to live in one, would you? If they're not good enough for me, they're not good enough for Al."

I nodded in agreement.

I could have said "Amen!"

What...something to cut health care costs?

Some drugs remain effective well beyond expiration date:

"Twelve of 14 compounds analyzed met government requirements for potency up to 40 years after the drugs' expiration dates, according to a study published in the Archives of Internal Medicine. Requiring drug makers to base expiration dates on long-term stability tests could save consumers money and help alleviate drug shortages, said researcher Lee Cantrell. However, the findings do not mean that ALL drugs are safe or effective past their expiration dates." 

Saving money, alleviating drug shortages-I suspect the above information is not music to ears of many Pharmaceutical companies!

http://www.reuters.com/assets/print?aid=USBRE89712R20121008

Priceless!

Usually when other adults find out that my daughter is an Equestrian I get asked the same question, "Isn't that expensive?"

The simple and honest answer is "yes (but then again so are a lot of other things)."

But when I catch a glimpse of her posting these pictures on her Facebook page from the National Finals show from three weeks ago...

... with the words "the greatest experience of my life so far," it's, as the commercial says, Priceless!

Where everybody knows your name

Mr. K. lives at an assisted living facility (ALF) "out in the country," in Tavares.

It's a beautiful part of Florida and only about 30 miles outside of Orlando.

There's a noticeable difference in all business. It makes me want to go inside and start looking at name tags to figure out who the owner is. I can honestly say I never have the same urge at the big chains. Here's a quick sampling of the area around where Mr. K. lives, compared to Orlando.

Orlando: 7-11, Publix, Chilli's, Outback, Friday's, Denny's, Terminex, Re-Max, Century 21, U-Haul Storage Center

Tavares: Jimmy's General Store, Scott's Country Market, Charlie's Grille, Billy's Cafe, Mary's Kountry Kitchen (spelled exactly that way), Shelley's Exterminator and Septic Service, Lou's Realty, Bob's Self Storage         

She walked the talk to the very end

"You matter to the last moment of your life, and we will do all we can, not only to help you die peacefully, but live until you die," said Dame Cicely Mary Saunders, widely acclaimed as the founder of the modern day hospice movement.

Well stated!

Dame Cicely died of cancer at the age of 87 (in 2005), at St. Christopher's Hospice, the hospice she founded.

Tap, tap, tap

I saw an 82 y/o patient today who had a positive Myerson's sign.

The inability to resist blinking when tapped repetitively on the area above the nose and between the eyebrows constitutes a positive sign.

A positive Myerson's sign can be seen with Parkinson's disease as well as early dementia and other progressive neurological illnesses.

I'm sitting here chuckling over the thought of some who are going to try and find a mirror to test themselves after reading this.

Stop blinking!

WAW

The Orlando Sentinel reports: police arrested four suspects in Sunday's fatal shooting of three members of the Warlocks motorcycle club. The shooting occurred at the VFW post in Winter Springs.

Officers quickly detained 12 people, including four men identified as members of the "Philly" Warlocks, who were later charged with the multiple counts of murder.

A search of the dozen detainees and the parking lot recovered 13 firearms, 23 knives and other weapons.

The Florida Warlocks insignia is a symbol of a Phoenix rising from the ashes as their national symbol. Their mottos (according to Wikipedia) include: "our business is none of your fuc-ing business," "To find us, you must be good; to catch us, you must be fast; to beat us, you must be kidding,"and "Warlocks forever, forever Warlocks." Their colors are Black, Red and Yellow.

The "Philly" Warlocks insignia is a Harpy, a legendary winged creature in Greek mythology best known for constantly stealing all food from Phineus. I won't record their motto here. Their colors are Red and White.

The paper reports that men representing a Warlocks chapter in Philadelphia arrived in Central Florida several months ago and planned to start their own chapter.

Obviously a turf battle was looming,

All involved appear to have been well armed Warlocks (WAW).

All the men ranged in age from their late 30's to early 50's.

Unfortunately, I suspect similarly aged members from both clubs will be getting newspaper reports, and obituaries, in the weeks to months ahead.

Merci!

I had a patient recently who had extreme flexion of the thoracolumbar spine that was partially relieved by support  and completely relieved by lying down. The pictures below are not of my patient but he looked very similar.

The term for this clinical finding was on the tip of my tongue but I couldn't remember it until I got back to the office to look up.

Camptocormia, how could I possibly have forgotten?

We can all thank Alexandre-Achille, a French neurologist for the term.

To be honest, however, I'm not sure how long I'll remember this time.At least I'll have a quick reference for the next time I forget by looking here.

The pictures below are from the article "Parkinson's disease: clinical features and diagnosis," by Professor J. Jankovic.