Wednesday, December 10, 2008

Free Lunch

It's supposed to be a fundamental principle of economics that there's no such thing as a free lunch.

I beg to differ. While I'm changing employers, folks from my old company are taking me out to lunch to say good-bye, and folks from my new company are taking me out to lunch on my first day to say hello.

So, I've already figured out this scam. All I have to do is change employers every other day, and I'll never have to pay for lunch again!

Monday, December 1, 2008

Working & Running = Happy!

Wow. 6 weeks without a post. I hereby nominate myself for Worst Blogger Ever. My sporadic writing is why my blog has sporadic readers. Although you can always use a "reader" to "subscribe" (for free) and then the reader will notify you when I've posted something new.

Anyway, I've been back at work full-time for awhile, and doing pretty well. Pretty well means I've started running again! The biggest source of pain I have right now is a frozen shoulder. I never heard of a frozen shoulder before, but it's apparently fairly common, though they don't know what causes it. It's painful, but not too much to keep me from working. Or running!

Wednesday, October 15, 2008


Got out of the hospital to finish recuperating at home. Clindamycin burned an ulcer into my esophagus and messed up my entire GI track. I seem to have a lot of trouble with side-effects, starting with Tetracycline (an antibiotic) that stained my teeth yellow when I was a kid.

Well, they got me stable, taking 2 mg of Dilaudid every 4 hours for pain, plus lots of other junk to restore my digestive system. Another week or two to fully recover, they project.

So, I get home and my left arm starts swelling up around the elbow, turning red, getting itchy and hot. An infection from an IV that was plugged in there. That happens less than 2 tenths of 1% of the time. How do I keep hitting the rare things??

Friday, October 10, 2008

Another Medical Problem

I've been in the hospital the last couple of days, was mostly irrational a few days before that. I'll probably be here at least a couple more days. The side effects from taking the antibiotic Clindamycin started bad and got to the point where I was in constant severe pain in my gastro-intestial track. One small swallow of anything would amp the pain to writhing in bed for 30-60 minutes. I'll explain more later.

Monday, October 6, 2008

FMD Update 5

What a nightmare. I developed a bad toothache a few days before going to see the specialist in New York. I had put off going to the dentist for a couple of years because I was so disappointed with my last experience... my dentist had put in 2 crowns in the back on the same side and they were too short, ruining my bite. Well, this toothache was bad enough that I couldn't procrastinate any longer, but I found a new dentist. He gave me several options, and I chose to have him remove this tooth in preparation for a snap-on-smile. I could always get an implant later, if I want to.

Well, the root of a tooth is normally inside the jawbone, but in this case the jawbone had an indentation and the root was outside the jawbone. So, when the doc pulled the tooth, he mixed some of my blood with some bone graft material and spackled it in the gum and sutured it up. It was supposed to hurt for a day or two after the Novocaine wore off. It didn't. So the doc put me on penicillin in case there was an infection. It felt a little better for a day, then got worse and worse. I was hurting a lot when it was time to leave for NY, but I didn't want to postpone that trip. The trip was very unpleasant due to my gum.

FMD-like right renal artery
Well, on the trip, Dr. Olin, the FMD specialist, had trouble reading my angiogram. The software on the CD for showing the images does a poor job of cacheing, so it was very slow. He said he'd review them later on a faster computer. Based on the images he did see during our visit, he said that the stretch of right renal artery looks very much like FMD. However, he didn't see any other arteries that looked like they had FMD, so that's a puzzle since FMD normally affects more than one short section. There is, however, a test available that I had not heard of, one that combines an angiogram and ultrasound, and gives the most accurate picture possible of an artery. Since my case is still a mystery, a friend of Dr. Olin's down here in DC may do that test.

So, I get home from the trip, and my mouth is killing me. I call the dentist in the middle of the night and leave a voice mail. He didn't call back right away, so I went to the emergency room. All they could do was put me on a stronger pain medication (hydromorphone) and tell me to go back to my dentist. Actually, the ER doc, who did not examine my mouth at all, said that I needed a root canal on the jaw where the tooth had been. I asked if there could be an infection that might be resistant to penicillin, and he said no, there was definitely no infection. I get home and talk to the dentist (cells phone signals are suppressed in the ER). The dentist walks me through some steps while I look in the mirror, and I push on my gum and some whitish-yellowish liquid comes up out of a hole in the gum. He says it's definitely infected and obviously resistant to penicillin, so he tells me to stop the penicillin and calls in a scrip for clindamycin.

My blood pressure was highly erratic all this time, but my temperature had always been normal. After starting the clindamycin, my temperature started going up and down and the pain got worse. Finally, last night, my fever came down to stay, and the mouth pain has diminished significantly. Just in time for the onset of severe heartburn, a side-effect, apparently, of the clindamycin. Another call to the dentist, who called a pharmacist, and he called and told me to use Mylanta to deal with the heartburn. It doesn't get rid of it, but it makes it a little more tolerable.

Oh, I almost forgot one thing. One afternoon after a trip to the dentist, with my mouth full of Novocaine, I felt no pain anywhere, my blood pressure was great, my mind was clear (well, you know, as clear as my mind gets...), and I was full of energy. That was extremely delightful. Perhaps my mouth has been part of my blood pressure problem. If so, that should be remedied soon.

I see my dentist tomorrow morning, and my general practitioner tomorrow afternoon.

Thursday, October 2, 2008


FMD update delayed due to dental emergency...
Pain and blood pressure out of control. Don't feel like writing...

Sunday, September 28, 2008

Mortgage Meltdown, Addendum

Here's another idea that seems obvious I forgot to put in the previous article.

It's normal, when a homeowner defaults on a mortgage, that the lender evicts the homeowner and sells the house. Normally, however, there's not a tremendous glut of houses for sale at very high prices, so houses are sitting on the market for very long periods of time. For example, the house at 100 Main Street, the owner gets evicted, and the house sits empty for a year before the bank can get it sold. Say the original mortgage amount was $2400 a month, so the total revenue to the mortgage company was $28,800 for one year. Instead the bank's revenue for that period of time is $0.

Mortgage companies, and especially mortgages backed by FHA, Fanny Mae, and Freddie Mac, instead of evicting homeowners, ought to try to work out a deal that lets the homeowner stay in the house and pay some amount of rent. Suppose the homeowner can pay half the amount they were paying in mortgage payments. If they can pay half, then the lenders' revenue will be $14,400 for the year, instead of $0. They can still try to sell it while it's occupied, but they also have the option of selling it as a rental unit that is already rented.

:typed and edited by Promise Lambert

Wednesday, September 24, 2008

Mortgage Meltdown

I don't feel like writing a lengthy treatise, but I have to say something about the mortgage crisis, since our political leadership doesn't seem to see what I think is an obvious technique to improve the situation. None of them will see this, probably, but at least I'll get it off my chest.

The Federal Government should pay off 2nd and 3rd mortgages up to 20% of the value of primary residence and take a 25% ownership of the property, if the 1st mortgage is a stable fixed-rate loan and this restructuring will enable the family to keep up with payments after the change. The valuation should be based on the valuation at the time of the last mortgage, not the current valuation.

The Fed is going to pump many billions of dollars into the mortgage crisis somehow. This method allows families to stay in their homes if they can afford it after the deal. They are lightly punished by losing slightly more home value than the percentage of financial assistance they receive. This punishment is appropriate because they bear responsibility for knowing what they could afford long term, and a deal that does not punish them is unfair to those who were more responsible with their finances. Yes, the homeowners were probably deceived by lenders pushing them into houses with payments larger than they could afford in the long term. Criminal charges should be pursued against lenders who misrepresented affordability to home buyers or misrepresented the quality of the loans to mortgage bundlers (for the mortgage resell market). This would minimize foreclosures, which will keep the maximum number of families in their homes and stabilize national home values as much as possible, contributing to a more rapid recovery of housing values than we'll otherwise have.

Tuesday, September 23, 2008

Thanks to all...

I haven't been keeping up with email, which makes me feel guilty, but I'm probably not going to do better unless and until I can get my pain significantly reduced.  I'm takng a lot less Vicodin than I could in order to avoid getting addicted and to avoid my body becoming so used to it that it doesn't work as well. Unfortunately, that means I hurt more and feel like doing very little, and it makes it hard to sleep until I'm exhausted. That means I've been costing Carla a lot of sleep also.

I've been surprised at how many people have emailed encouragements, even strangers from around the world. Wow. So if I haven't replied to an email from you, please know that I read them all, eventually, and I really do appreciate them.  -- John

Saturday, September 20, 2008

FMD Update 4

Well, it was a long, but interesting two weeks, with lots of pain, lots of high blood pressure (measured as high as 195/110) and several new developments.

First, I met with a local interventional radiologist who recommended that he go in and angioplasty my right renal (kidney) artery and look around at all the other arteries in the area, but he wanted to discuss it with my kidney specialist (nephrologist) first. So, I got a call later from an assistant of the radiologist who told me the radiologist talked to the kidney guy, and that the kidney guy wants to see me before the radiology guy does the plasty thing, so I should call the kidney guy right away to get an appointment. So, I call the kidney doctor's office, and they tell me I already have an appointment in 6 weeks. Yes, I explained, but now there's a more urgent matter so I need an appointment right away. Okay, they put me through to the doctor's assistant and I left a voice mail. The next day the assistant called me back and I explained everything, and the assistant said she would talk to the doctor and call me back. That was over a week ago, and they have not called me back. Grrr.

Okay, so the first instance of a major symptom immediately prior to the eventual discovery of FMD was on Sunday, July 13, with lots of abdominal pain, which later localized around my right kidney. I tried to tough it out and went to work as usual on Monday, but the became intolerable and I left after working 7 hours, feeling pretty lame that I couldn't hack just one more lousy hour. Monday night was horrible, and I didn't sleep much, and went to my general practitioner (GP) first thing Tuesday morning, and it didn't take long before she called an ambulance to take me to the hospital. They checked me for kidney stones and gall stones and junk like that, which were all negative. They found a suspicious wedge shaped thing in my right kidney that would need further investigation, and gave me pain meds and sent me home. It wasn't until July 30th that I finally ended up getting an angiogram that revealed FMD in my main right renal artery for sure, and showed a complete blockage in a smaller renal artery that had resulted in the death of 5% of my right kidney, and another partial blockage right next to it. However, no one mentioned the FMD to me, with the possible exception of the radiologist right after the angiogram while I was still stupid from the drugs. Stupider than usual, that is.

Well, this last paragraph is to give you dates, so you can fit this in: In the first week of August, I started noticing a pain in my right shoulder, and it kept getting worse and worse. So I went to my GP about, and was referred to an orthopaedist for a possible tear in my right rotator cuff muscle. Except how could I have torn a muscle? I hadn't been doing anything! Well that led to some big news this week. The ortho doc said all the symptoms fit a tear in the right rotator cuff muscle, gave me a shot in the shoulder and told me to come back in 3 weeks. Did that, and my shoulder was hurting worse, and that wasn't all. The shoulder had only hurt when I moved certain ways. It hurt really bad when I moved it those ways, but when I was a good boy and didn't move it those ways, it didn't hurt. ["Doctor, when I do this, it hurts." "Okay, don't do that."] But in the meantime, my right bicep had started hurting, all the time. So ortho doc sends me for an MRI of my shoulder and I have to wait until yesterday to see her and get the results. And... there's no tear. That's good, right? There's clearly some tendinitis in my shoulder, and some fluid around the joint, and the MRI doesn't show down my arm. The problem is that the tendinitis doesn't explain the severity of the pain.

Now, there's this version of FMD called intimal fibrosis that occurs in less than 10% of FMD cases, but it can cause problems in any artery anywhere, like in a shoulder. I had thought of this a few times, but the odds were really, really tiny. Until I find out I've got no tear. Now those very tiny odds only seemed like tiny odds. The odds my have been tiny, but they were, like, moving in the wrong direction, you know what I mean? So I start thinking too much about it, pondering life without my favorite right arm, and so on. Then I woke up in the middle of the night with a better theory. A much more likely theory. A highly probably theory, that lets me keep my arm solidly attached to the rest of me. Very Tense Muscles. Just hold on, it'll make more sense in a minute.

I went to my GP early this week for a comprehensive review of The State of John, with all the test results, trips to the emergency room with high blood pressure, etc. And as part of the catalog of complaints, the doc noticed my muscles were very tense. I said they had been that way a long while, and I knew it, I just hadn't been able to successfully convince my muscles to relax. It's apparently a reaction to the pain. Or possibly space aliens, but I'm going with pain as the primary culprit. So doc suggests some muscle relaxing drugs. Hey, I'm a basket case, what's one more drug to test? Well, I started taking methocarbamol (generic for Robaxin) "as needed" and pow -- it knocked my blood pressure way down, and reduced my average pain significantly. I hadn't realized just how tense my muscles were!

Now back to the shoulder theory. Tendinitis and tense muscles -- muscles acting like they were constantly doing isometric exercises. What's the treatment for tendinitis? Rest. Don't use the muscles, dummy! Except my muscles were using themselves without permission from the rest of me. So instead of taking the muscle relaxer only when my blood pressure goes high, I'm going to take it regularly for while and wear a sling to remind me not to do anything with my right arm (other than blogging), and I fully expect my right arm to thank me in a week or two. One less source of pain would be a very good thing.

By the way, I had been down to a thyroid medication and pain patches for my feet as my only medications when my kidney blew up. Now I'm on the those, plus 2 blood pressure medications, pain pills, blood thinner, and muscle relaxers. Phooey. By the way, at home, I take the generic version of Vidodin for the pain. They gave a script for Percacet, which is supposed to be stronger, but it does nothing for me. Not only does it not help the pain, it doesn't even give me the intoxicating effect that most people get. Tried it 2 weeks apart, just in case the first time was an anomaly. This, I have no explanation for. Yes, I still have an almost full bottle of Peracet. No, I won't sell it to you. You'll have to get your own malady for that.

For now, it's 11 days and counting until I see Dr. Olin.

Monday, September 8, 2008

FMD Update 3

I haven't mentioned it before, but the reason I'm posting my story of learning about FMD is in the hope that it might help someone else learn about it. Since it's rarely covered on the evening news. And even if it were, people rarely watch the evening news these days.

So, on with the story. I had a duplex Doppler ultrasound of my carotid arteries Friday morning, then Carla dropped me off at the train station and I worked about 4 hours, but on the way home I started hurting a lot worse. On Sunday, my left kidney started hurting, but not as much as on the right side. My blood pressure was bouncing around, going as high as 145/105, even though I'm on a blood pressure medication.

I had an echo cardiogram this morning (Monday), then went to the office, but it didn't turn out well. The train ride increased the pain a bit, and that apparently triggered my blood pressure to go up again. It kept going up despite a double dose of blood pressure medicine. The building I work in has a health clinic, and a nurse there put me in a dark, quiet room and called my doctor. After awhile, my BP stabilized, then went down to about 135/85, which is still too high. Then my family picked me up, and my BP went up again on the way home. After a few hours in bed, it's finally back down to the safe range: 120/80. Unfortunately, I didn't get much work done.

Thursday, September 4, 2008

FMD Update 2

Worked all day today for the first time in almost 2 months. I was tired and hurting a bit, but I worked the whole day. Even walked to the train and back home. And I got an appointment with Dr. Jeffrey Olin on October 1st. He's the director of vascular medicine at Mount Sinai School of Medicine at Mount Sinai Medical Center, and has written more about FMD than anyone else. So, I should have a lot of news after that.

Wednesday, September 3, 2008

FMD Update

Talked to my kidney doctor yesterday and saw my general practitioner today, and they both concur that it's a good idea for me to check with a doc who deals with FMD a lot. I spoke to an assistant for the doc who's written more on the subject than anyone else, and have emailed him my medical history. He's supposed to look it over and his assistant will get back to me regarding one or more appointments. In the meantime, I'm waiting for results of more blood tests, and I have duplex ultrasonography scheduled for my carotid artery and an echo cardiogram just to make sure those things are in good shape. And I now have written permission from my general practitioner that will allow me to go back to work, since my company wouldn't accept a note from my kidney doctor. I still have moderate abdominal pain, but work isn't supposed to make my condition worse, so I'm hoping to last the whole day. Work is good!

Saturday, August 30, 2008

Fibromuscular Dysplasia

Well, it turns out I may not have had a kidney infarction after all. There had been continuous confusion amongst the many doctors involved as to whether I had an infarction (from a clot) or an infection (from unknown cause) in my right kidney. The key thing I understood at the beginning was that I had one small kidney artery that was completely blocked, killing 5% of that kidney, and another small artery right next to it that was partially blocked. The blockages were either from a clot of blood or cholesterol or from an infection. An angiogram showed no sign of an existing clot, so if that was the cause, it had dissolved by then. I was put on an antibiotic in case I had an infection, but that didn't change anything. The early prognosis was that I would be fine with such a small loss of kidney tissue, that I would take an anti-coagulant the rest of my life to ward off any more potential blood clots, continue to watch my cholesterol levels, and the pain should be gone in a few weeks.

Except the pain never left. It subsided for awhile, then got worse a while, then better, and so on, but never left. I was out of work that whole time, as the pain was generally more than enough to require medication that interfered with my ability to think, which is what I get paid for. Had I not taken the pain medication, the pain would have been too much to think, so either way, I wasn't much good for working. Last week the pain improved to the point that I thought was ready to resume working and I got a note from my kidney doctor allowing me to return. At that visit, my kidney doctor reviewed with me everything he knew from all the tests. That included something I hadn't been told about before: there were some partial blockages in the main artery feeding my right kidney, and it was determined (by their size, shape, location, etc.) that they were caused by Fibromuscular Dysplasia (FMD). The kidney doctor still didn't know what caused the full and partial blockages in the smaller arteries, as things didn't quite fit the normal characteristics of either infarction or infection.

Then I found out my company and the insurance company require a note from my general practitioner, so I had to wait until next week. Then a couple of nights ago, the pain got really bad again, and my blood pressure went high (around 160/110) and stayed there. Although the pain backed off a little, the BP stayed up, and my kidney doctor called in a prescription for Diovan to bring my BP down. After a day or so of that, my BP is back down. In the meantime, I've been studying FMD.

FMD is a rare disease. Really. There's actually a list of rare diseases, and FMD is one of them. And there's a support site on the Internet run by doctors and patients, and information from FMD doctors indicates that FMD is not well recognized or understood by doctors. Patient stories support the idea that most doctors are not familiar with it.

Basically FMD results in some cells in the walls of arteries growing larger than they should, constricting the flow of blood through the artery, eventually blocking it off altogether. No one knows what causes FMD, though genes and hormones both seems to be factors. There's no cure, but the symptoms can be treated with anti-coagulates and angioplasty. Most people who are familiar with angioplasty have heard of it because they know someone who had it to open up an artery around their heart. That common usage means someone gets an angioplasty once every few years or less often. Some people with FMD get angioplasty several times a year. FMD can effect any artery in the body, with the kidneys being the most common, and the carotid arteries being the second most common.

So, I've come up with a theory, which I wrote up and faxed to my kidney specialist yesterday. He called me late last night to tell me he had been in hospitals all day and had not had time to read the letter yet, so I'm hoping to hear from him next Tuesday. I have an appointment with my general practitioner on Wednesday, and I'll discuss this with her then. My theory is that I had neither an infarction nor an infection, but that both are the results of FMD. There is a form of FMD called intimal fibroplasia that comprises less than 10% of FMD cases, but it appears to me it fits perfectly with the full and partial blockages I have in my smaller kidney arteries. It seems to me to explain everything, including my continuing and fluctuating pain, and I really like understanding things. If I'm right, however, it's bad news, because this form of FMD is the most aggressive.

Well, as Bill Gates famously said, it's good when bad news travels fast. That's because the sooner you learn of something bad, the sooner you can do something about it. So, I have FMD. I may have the most aggressive kind. Since I know, my doctors and I can more aggressively monitor my arteries and intervene with angioplasty as often as necessary. And that could give me months or years more than I might have left if we hadn't figured it out.

Whenever I have more news, and feel like posting, without being to unintelligent due to pain medication, I'll post followups here.

Sunday, August 24, 2008

Big Setback

I was sure my next training run of 5k was going to be the first time in over 20 years I'd be able to run that distance without having to stop and walk part of the way. I was just a day or two away.

Then I had a kidney infarction and lost 5% of my right kidney. That was weeks ago, and I haven't stopped hurting yet. Quit doing everything, including eating, and have lost 20 pounds, so I'm down to just over 130 pounds. Haven't weighed that little since high school.

Well, two weeks ago I start walking again, very slow, very short distances. I got to where I can walk to the Metro station again, and took a short test ride. Subway trains are way bumpier than cars, if you didn't know, and the shaking is really tough. Since then I've ridden all the way downtown twice. It made me hurt worse for awhile, but within a day it got back to the same level of hurting it was at before the train ride. I sure am looking forward to running again. And working again. And doing other things again. Especially running.

Sunday, June 15, 2008

Running Update

Well, the official results are online for the Race for the Cure, and there were only 7,637 finishers, far fewer than I had been told on race day. I was 517th, with a time of 26 minutes and 23 seconds. I was 23rd out of 222 in my gender/age group.

I ran today, to/from my front door, about 3.1 miles, based on a path I traced with Google Earth. It was 88 degrees, 18% humidity, and rolling hills. I couldn't even run a full 2 miles without stopping to walk this time. It took me 31 minutes & 31 seconds, about a pint of sweat, no known blood loss, and my weak link was breathing (again). For my next race, I may downgrade from a run/walk to a run/walk/stagger.

Tuesday, June 10, 2008

Rationing Health Care

Heresy! No one in their right mind would support rationing health care. Would they?

Well, since there is a finite amount of health care, and that amount is less than everyone would use if they could, the fact is that health care is rationed now. The current rationing mechanisms are complex, and involve many intertwined interactions between the free-market, public and private health insurance plans, health provider management organizations, volunteers, and other components. It's complex now, it's not going to become simple, and there are ways to improve it and ways to make it worse. In fact, most changes that would make one aspect of health care better will make other aspects of health care worse. So it would be prudent to make changes very carefully, understanding as much of the trade-offs as possible.

But not now. Now, it's national-electioneering time, and most candidates are going to be talking about health care. Lots of them are going to use the phrase universal health care, but what they'll actually talk about will be universal health insurance. It pains me to observe that there are so many people running for office that use "health care" and "health insurance" as synonyms.

The Politics of Health
Most politicians are not morons, so the reason they talk like this is likely that they are simply pandering for votes with sound-bites instead of carefully reasoned positions. I can't help but wonder, though, how many even realize that health care and health insurance are not the same thing. People don't need health insurance, they need health care -- health insurance is just one of several mechanisms to ration health care.

Universal Health Care. Sounds great! But people will never get what many politicians are promising... extending health care to everyone, without compromising quality. Politicians will never fulfill those promises because it's not economically possible for any society to accomplish that. Some of them make know that, but all of them will yammer about it and pass legislation that deals with health care, and they'll claim victory based on such legislation, regardless of the actual results of the legislation.

Ain't Gonna Happen
I'll use two extremes to illustrate why universal health care is not possible. The concepts are the same whether applied to a single nation or the globe, but since we're using the term "universal", I'll use global terms for this example. So let's assume a world population of 6 billion and total global wealth of 1.1 quadrillion dollars. Let's set aside an extremely meager 10% of wealth for food, housing, transportation, and all those other things people seem to like, leaving us with an even 1 quadrillion dollars for health care.

Great Health Care
For the first extreme, suppose researchers develop a vaccine that will make a person immune to all disease, but that the process to manufacture it results in a cost of one billion dollars per dose. (The pill requires a superconducting super-collider to spawn reactions that result in a molecular accrual rate wherein the energy and maintenance costs equal the billion per dose.) While were at it, let's pretend that there are no safety/side-effect concerns.

If we were to spend our 1 quadrillion dollars for health care on this super pill, we could create doses for exactly one million people, or less than two-tenths of one percent of the world's population. Um, that's noticeably less than universal. But, we run the machine because the researchers hope to discover a way to substantially lower the cost, and while they're researching, they create a few hundred of the pills. Who gets them? Who decides who gets them?

Good news! The researchers have discovered how to significantly lower the costs! Unfortunately, it still isn't enough for everyone. So, you chose... do you want the pills to go to the oldest people, the children, or random chance selection? Okay, say we chose the children for the noblest of reasons. Now, at maximum production, we can provide one pill to 80% of all children born. Sorry, there's just not enough wealth to get to 100%. Maybe if we took some of our health care money and used it to improve the economy we could get there, but that would mean we have to create fewer pills now. How could you possibly chose to reduce pill production to cover only 70% of the children now in order to get to 100% some day in the future? Those are hundreds of millions of children you're leaving exposed to deathly disease. Okay, 80% it is. Which 80%?

Great Health Care Equality
Here's the other extreme. All world governments agree to a global health care plan that will be absolutely equal. In order to ensure that it is equal, everyone reluctantly agrees not to allow any health care other than the what is provided by the global health care plan, so the rich people can't have anything better than the poorest person. Yeah! Now that's truly fair to all! Okay, we know we can't afford to give everyone the best of everything, so we have to start from the other direction. We'll come up with a list of health care benefits that can be provided to every person on the planet, adding one item at a time until we reach our 1 quadrillion dollar limit. Now let's see how much we have to spend. One quadrillion divided by 6 billion people equals... $166,666.67!

Wow, jackpot! That's a whole lot of health care for every man, woman, and child on the planet! So, we can allocate for each person for their entire life. Oh, let's say, two boxes of band-aids, two emergency-room visits for broken bones, and we don't have those super-pills under this scenario, so we'll dedicate some funds for vaccines, one-heart attack emergency room visit, a few drugs such as cholesterol and blood-pressure control, and we'll allocate the rest to cancer chemotherapy and radiation. Unfortunately for you, you need a heart transplant, and that didn't make it onto the list.

Well, that's no good, so we'll make the universal health care plan so that everyone gets up to $166,666.67 worth of whatever they need. All right! Oops, it seems that your heart transplant would cost $200,000. Sure, if you sell your house, you can come up with the extra $33,333.33 to throw into the pot, but you're not allowed to. That would be unfair to all the people who don't have any extra money, and a fundamental principle of the universal health care plan is that we absolutely must be fair. No one can get anything extra just because they can afford the extra costs. Besides, we forgot about the time you broke your arm on the playground and had a doctor put a cast on it. Now you're an additional $500 short.

But then you realize that there are a lot of people who are healthy their whole lives and never need any health care at all. The health care money those folks don't use should be made available, equally of course, to all the folks who do need it. And joyously, it turns out to be $33,833.33, so it will cover your heart transplant!

Unfortunately, it took quite a bit of effort to get the world to agree to the universal health care plan, and now its managed by a United Nations bureaucracy, so it may take a little longer to get them to change things than you have left on your old ticker.

Promises, Promises
Okay, so what's my point? The point is that universal health care is what people need, but that universal health care without compromising the maximum quality of health care is not possible, and any political candidate who says otherwise is either woefully ignorant or is lying. So, please don't vote for morons or liars.

Sunday, June 8, 2008

2 Months, 2 Minutes

My son David & I completed another 5K yesterday, the Susan Komen Race for the Cure, which raised over $3,000,000 to fight breast cancer. The temperature was about 72 degrees and humidity was about 80 percent at 6:30 AM, but the temperature climbed fast and the humidity went down a bit by the time the race was over.

The race was to start at 8:00 AM, and David and I got to the starting area at 7:20. There were so many thousands of people scheduled to run, I figured it'd be crowded at the starting line by 6:00, and I didn't want to wait there that long even if it meant having to spend as much time running side-to-side to avoid other runners as I spent running forward, so 7:20 is when I planned for us to get there. Much to my surprise, there was only one other person standing at the starting line, though there were at least a hundred on the shoulders of the road nearby.

We took places front-and-center, and I laid down to rest and wait. Normally, I don't recommend that anyone lay down in the middle of the street on Constitution Avenue. Immediately after the starting barriers were removed, about two minutes before the race started, a couple of dozen people pushed their way to the front. You could tell these were the serious runners who wanted to win or place, so I didn't mind giving way to them.

As the race began, I ran my pace, and instead of having to pass other people, other people were passing me. A lot of these folks were those who don't know their pace, so they go real fast to start, then have to walk. I wasn't able to run the whole way, but I ran my pace as long as I could, and I made the first mile in 8 minutes flat, and the second in 8 minutes and 4 seconds. It wasn't long after that, though, that I had to walk a bit, and alternated between walking and running until the last quarter mile or so, when I was actually able to put in a little kick to the finish line. It was so warm, around 2.5 miles, I had started if I would have to walk the rest of the way, but I was able to mush through it.

This race didn't use the sensors attached to shoes, so they had lanes at the finish line. You enter a lane and someone manually writes down your time, in order. Someone else tears off your bar-coded ID from your race bib and puts in on a spindle, in order, so that if it works right, they get a fairly accurate time. Unfortunately, by the time David came through, there were so many people jammed up at the finish line, he had to wait to get counted. That was the case for most of the runners, and there were tens of thousands, so I was told. David still finished in under 40 minutes, though.

I haven't found an estimate by the organizers as to when official times and places will be posted. By my stopwatch, I finished in 26 minutes and 29 seconds, so I shaved a little over 2 minutes off my time from my race in April. This time, I didn't push myself quite as hard, and wasn't completely exhausted afterward. My average speed was 7.02 miles per hour, and my pace was 8 minutes and 33 seconds per mile. Not bad considering this time last year my muscles hurt so badly without knowing the cause that I wasn't sure if I'd be alive this year. My next goal is to be able to run an 8 minute pace without stopping for a full 5 kilometers. Once I can do that again, I haven't decided if my next goal will be speeding up or increasing distance. Isn't that a wonderful dilema?!

After the finish line, I turned right and walked over to the path around the
Smithsonian Museum of Native Americans and scooped up some water to splash on myself while I waited to meet up with David there. Almost everyone else turned left to go onto the National Mall, where the organizers had lots of tents set up. Despite the enormous crowd, only a dozen or so people came over to the museum, so it was a great choice for a meet-up. That museum is such a peaceful place.

Thursday, May 22, 2008

RE: Skyrocketing Oil Prices Stump Experts

"Skyrocketing Oil Prices Stump Experts" is the headline of a Washington Post article today. Perhaps the experts... aren't.

From the article: "People don't get it," said Sen. Herb Kohl (D-Wis.) at a Judiciary Committee hearing yesterday at which senior oil company executives were grilled about prices. Kohl said: "Demand is not crazy. Why are prices going crazy?" The article quotes from a wide variety of people that are allegedly experts, and they basically say they don't have a clue.

The answer is simple, really. The prices are high because a number of events occurred that tend to create pressure for prices to rise (e.g. increasing global demand), and people who choose to invest in oil futures have gotten auction fever. That drives the prices of future oil deliveries up, and the higher the prices go, the more "feverish" the investors get.

Joe's Story
As the price of oil futures are bid up, it has a carry-over effect on current prices. Over-simplifying, and exaggerating to make the point clearer, suppose Joe has 1000 gallons he wants to sell today to a gas station, he paid $1.50/gallon, he plans to sell it for $2/gallon, and oil futures that are about to "close" are selling at $1.50/gallon. Before lunch, the price for the futures that are about to "close" are driven up to $1.75/gallon, an increase of almost 17% in a few hours. Now Joe's gotta figure after he sells his gas, he's got to buy more at $1.75.

Joe could sell the gas for what he already planned to, make the amount of profit he already expected, buy his next shipment of gas for whatever the market cost is at that time, and mark up his price accordingly. That's the way most of us want Joe to see it. But Joe doesn't see it that way. Joe figures, the gas I have is worth a lot more this afternoon than it was this morning. I'm going to charge the gas station $1.75/gallon this afternoon. And he'll make a lot more profit at the expense of the person who pumps it into his car later. Or maybe he's worried that he'll be accused of price-gouging, so he decides to sell it for only $1.70/gallon.

Good ol' Joe. It's not his fault, it's "just basic supply and demand". Except that the faster he raises his prices, the more it feeds the auction-fever frenzy of the oil future speculators.

If you haven't figured it out, Joe represents the people at the big oil refineries and distributors that decide how much and when to increase their prices.

Who's fault is it?
Well, the market pressures are what they are, and they've been creeping up. The oil future investors have been over-reacting to market pressures because their exchange medium is auction-based. The big oil companies' price setting policies have been exacerbating the problem.

What can be done?
There are several options: change nothing, lower demand, increase supplies, or regulate distribution.

1. Change nothing and the prices may soar to wild heights. I've heard people talking about the "extreme" possibility that gas could go over $5/gallon at the pump. That's nothing, over $20/gallon is possible. Why? Because when auction fever runs amok, prices have no top-end in the short-run. Have you ever been in an auction, started bidding, gotten caught up in it, and bid way more than you really thought the item was worth? It happens every day in every auction-based market. Remember the incredibly high prices of tech-stocks before the tech-bust? Same thing. Dangerous? You bet. Bad enough that nations can go to war to "protect their national interests". For example, oil was a major factor in Japan's expansionist policies leading into World War II -- they wanted to secure the oil resources their economy was becoming dependent on.

2. Lowering demand is not likely at all, and if a major effort were made, it would accomplish too little to cool off the auction-fever.

3. Increasing supplies is technically more plausible, but you'd have to get a majority of oil-producing nations to glut the market to stop the auction speculation frenzy. Those nations only have so much oil, however, and the faster they pump it out, the faster they run out, and they don't have anything to replace that income with, so they want to try to stretch it out. Plus they're getting much higher prices, so they're not as worried about the consequences as others are.

4. Which leaves regulation. There are many ways to regulate, each with their own strengths and weaknesses, from both practical and economic perspectives. Unfortunately, anything that will seriously cool off the oil futures speculators will cause a separate set of negative effects.

What will be done?
Things will keep going just like they have been, and one of two things will happen. The oil market will stabilize enough to cool the investment speculators enough for the last ones in to lose a lot of money, and then prices may start adjusting more slowly. Or, the price increases will continue to rise rapidly and cause repercussions that are so painful, governments will begin increasing regulations, and they'll implement them haphazardly and with increasing severity until there's a global crash.

What should be done?
For many decades, industrial nations have periodically had banking crises characterized by panics that are similar to run-away auction fever, and they've created more and more mechanisms to avoid panic and to intervene when panic does occur. Some of these mechanisms are always-present regulations, and some are regulatory powers that only kick-in under specific circumstances, and only until circumstances improve. It hasn't been perfected, but the overall effect has worked very well for a long time now in the banking industry.

Similar efforts should be made to regulate commodity markets, such as oil. For instance, if retail prices increase by more than a specified percentage in a specified period of time, oil companies could be prevented from increasing their profit-margins. This particular interference in the marketplace would not cause the long lines that rationing causes, but it would effectively cap the oil companies profits until markets stabilized.

Okay, so I used the topic of experts being puzzled to rattle on about some ramifications of high gas prices and espouse what I think would be an improvement. Getting back to the starting line, I don't know why anyone is puzzled. The market for oil prices is an auction, and the investors playing in it have gotten auction-fever. The question shouldn't be what's driving the high prices, it should be what we're going to do about it, if anything.

Monday, April 7, 2008

I'm Back!

I finished the 2008 Cherry Blossom 5k Sunday morning, the first timed race I've ever competed in, and the first time I've been able to seriously run in many years. And the first timed-race in my life was also the first for my two sons! They didn't take preparations very seriously, and I beat them handily. I don't want to tease them too much, however, so I don't give any extra incentive for next time. It won't take them much effort to trounce me, I suspect.

But for now, my thyroid is under control, I'm not taking any medications with wacko side-effects, and I've getting stronger every week. I'm back! Back to when I used to run just because I love to. Although at the end of the race, it was more like staggering. I left nothing on the course.

I finished in 28 minutes and 47 seconds, averaging 9 minutes and 16 seconds per mile! I placed 63rd out of 267 men (well, males, some as young as 9). I was 6th out of 19 in my age group of 45-49. Not bad, considering I'm twenty-something years out-of-shape, it was cold, it was raining, and I started at the back of the pack, so I spent a lot of effort moving side-to-side to get around people.

Some folks might think I have a tiny little competitive streak, but that's not true. The fact that I've already been examining the results to see how many more people I could have finished in front of if I had shaved off another minute, or two more minutes, is just a form of mental exercise. While I plot my next race. One scheduled for a warmer day.

Wednesday, April 2, 2008

The Myth of the Ongoing War in Iraq

It's the year 2008 and people are saying "the war in Iraq" to refer to the activities of our U.S. combat troops in Iraq. Republicans are saying it. Democrats are saying it. Independents are saying it. News reporters are saying it. Political commentators are saying it. There's only one problem with it. There is no war in Iraq.

We were at war in Iraq, but that ended when the U.S. and its footnote-allies crushed the Iraqi Army. It began on 20 March 2003, and it ended on 15 April 2003. The war is over.

Ask a thousand people what "war" means and 99% will tell you some variation of: the military of one nation or group of nations fighting the military of another nation or group of nations. On 15 April 2003, Iraq had no military. That's a noteworthy point. Here's another: Iraq has a military now, and the U.S. military is training and equipping them.

Yeah, I've read or heard people whining: "But we still have soldiers there", "But we're still spending billions of dollars on military operations over there", and "But we still have soldiers being killed in combat operations over there".

Okay, here's my specific rebuttals to those issues. We have soldiers in many nations all over the world and we are not at war with those nations. Japan, for example. The amount of money spent doesn't define whether or not we are at war. We spend a lot of money to support our troops in Japan. Altogether we spend hundreds of billions every year on military expenses even in peace-time. Yes, we have soldiers dying in Iraq, but it's not from war, it's from occupying-actions.

Since 15 April 2003, U.S. military forces in Iraq have been attacked, and killed, not by the Iraqi military, but by armed Iraqi citizens who object to our continued presence there and by non-Iraqi instigators generally promoting Iraqi civil war for a variety of reasons. When our combat troops make a raid today, it's not to defeat an opposing army, it's to enforce civil order on those rebellious citizens and to capture or kill anti-Iraqi and anti-U.S. terrorists.

So what? At the end of World War II, there wasn't much armed resistance in Germany because Germany's infrastructure was in ruins, there were relatively few men of fighting age still alive, and it was occupied by multiple very large armies. There wasn't much armed resistance to the occupying forces in Italy, because the citizens were content to start rebuilding for the most part. There wasn't much armed resistance in Japan because their Emperor had surrendered and was still nominally in charge of society. In addition, none of these conquered nations had religiously motivated murderers trying to stir insurrection.

The U.S. had more than enough troops to crush the Iraqi military in 2003. We never had enough troops to enforce civil order afterward. The "surge" helped, and a larger surge would have helped more. An earlier increase in occupying forces would have helped sooner. But it's not us against the Iraqis.

We're for the Iraqis. We want all Iraqis to share the benefits of a peaceful representative democracy. We want them to prosper. We want them to enjoy freedom. We want them to live. Regardless of whether we should have overthrown Saddam Hussein or not, the price we're paying now in lives and money is to promote freedom in an infant democracy. Not to wage war.

Friday, March 28, 2008

Running again!

I used to love running. A long time ago. Over twenty years ago. Then my medical mysteries became debilitating, and I was unable to run. For over 20 years. Then a couple of years ago, my general practitioner finally figured out what all the specialists missed. My thyroid was busted. So I started taking a thyroid hormone replacement, and I got a lot better. But I had other problems. Most of the remaining problems went away when I quit taking a medicine that was supposed to help with the painful burning sensation in my feet (peripheral neuropathy, probably due to the thyroid deal).

I started exercising again. I included walking. Faster... and faster. Then I tried jogging. Boy, did that feel great! After rebuilding a little leg strength, one day I broke into a real run. The first time in over twenty years. Wow! I loved it! I didn't run long, I didn't run fast, and didn't run far, but I ran! I increased all my exercising and ran more and more. Still not a lot, but getting better and better. I had more energy for other things, too, and started doing more things in my spare time.

Then my muscles started freaking out. Muscle relaxers didn't work. Massage made it worse. It got to the point that just touching muscles could hurt a lot. More doctors. More tests. Lots more. An unfortunately familiar pattern. On high-pain days when I couldn't work a full 8 hours, and not knowing what the cause was, I wondered how long I had left to live.

Then I had an annual physical, at my general practitioner's office. They were more worried than usual because I looked so bad. But, a few days later they called and said my cholesterol levels were finally in the good range, and I could quit taking Lipitor. Within a few days, my painful, debilitating muscle problems starting going away! Why didn't the doc's figure that out? Well, severe muscle problems are known side effects of Lipitor, but apparently most people who have those particular side effects have them very soon after they start taking it, and I had been taking it for a couple of years without any problems.

But, once again, I started getting better, exercising more, and finally started running again. Just a few paces at first, then fifty feet, then a hundred. When I got up to where I could do a slow run half-way home from the train station, I signed up for the Cherry Blossom 5K run-walk on April 6th, to give myself an external goal. It's only a 5K run-walk, but it's a real race. My first goal was just to finish, no matter how long it took. Unlike the 10 mile Cherry Blossom, there's no bus to scoop you up if you go too slow.

Well, I joined the fitness club in the building where I work, I've kept exercising, and a couple of weeks ago, I ran the whole way home, about a half-mile. And today... today I ran 3.1 miles on the treadmill... that's 5 kilometers, folks. My top speed was only 9 mph for a few paces, but I did 6 and 7 mph for sustained periods. Of course, the rest of the time I was walking. Total time? 32 minutes, 23 seconds, for an average pace of about 5.7 mph.

The race is a week and two days away, on an early Sunday morning. I'll let you know how it goes. If I live to tell...

Tuesday, February 12, 2008

Protest of Electronic Voting Machines

This morning, February 12, 2008, I appeared at my polling place in Mosby Elementary School to cast my vote in the Democratic presidential primary, but refused to use the electronic voting machines, due to their inherent unreliability. The chief and assistant chief of the poll determined that this circumstance (my claim that the machines are unreliable) was not clearly covered by their rule books, so they phoned the Fairfax County Electoral Board. After they spoke to officials there, a County official also spoke to me by phone. After a lengthy discussion, the official on the phone spoke to the assistant chief of the poll and authorized me to submit a provisional paper ballot, although they were unable to assure me that my vote would be counted. They further explained that I have the right to appear before the County Electoral Board at Noon tomorrow at the Fairfax County Government Center, Room 315-C, to defend my ballot.

I will appear before the board and base my case on Virginia Code 24.2-642, which begins, “When any voting or counting device becomes inoperative in whole or in part while the polls are open…”, and the fact that it is impossible to know if the voting computer is recording all votes accurately.

My position is that there are only two ways for a person to know that an electronic voting machine is accurately recording votes and thereby fully operational. 1. Have the voting machine produce a paper record that allows each voter to confirm that their vote is accurately recorded on the paper record and use those paper records to validate the records and tabulations of the voting machine, or 2. Have a person who understands every line of code in the software and both the original and current condition of every physical circuit in the computer hardware verify that no errors can occur. In the first case, the use of a voting machine is rendered moot except that unvalidated election results can be produced very quickly. The second case is not humanly possible, and even if it were, we should not trust our election results to any single person.

Official reasons I have heard for the use of electronic voting machines are: 1. They save money, 2. They provide rapid results, and 3. They count more accurately than people counting paper ballots. Unofficial reasons, I suspect, include overly optimistic marketing presentations of the companies who manufacture voting machines, which gloss over the systemic flaws in the voting machine concept.

The fundamental purpose of an election is to provide citizens with the ability to elect representatives by popular, anonymous votes, and there must be a method by which ordinary citizens can validate all votes, otherwise our elections are vulnerable to errors serious enough to effect the outcomes of elections, whether those errors are intentional or unintentional. The purpose of an election is not to save money nor to provide rapid results.

Saving money and providing rapid results should only be considered for methods that improve voting systems that meet the fundamental purposes of elections, which must include the possibility of comprehensive verification. A claim that voting machines count more accurately than people is not true in the case of machines without voter-validated paper trails, because without voter-validated paper trails, it is impossible to know the accuracy of the voting machines' records. The executives and technicians at the voting machine companies say, "Trust us." I, for one, will not.

For these reasons, I will never again use a voting machine that does not include a paper record that allows me to verify that my vote was correctly recorded, so that the rapid-tabulation systems can be verified. I will continue to appear at my polling place in every election and request either a fully auditable system or a paper ballot.

John Lambert
Fairfax, VA

For further reading:

  • What's More Important: Accurate Elections Or Fast Results?
  • You Can't Patch An Election
  • Black Box Voting
  • E-Voting Undermines Public Confidence In Elections Even Without Evidence of Wrongdoing
  • Judge Voids Election Results Over E-Voting Results That Couldn't Be Audited
  • Article index of voting machine issues

  • UPDATE: 2/13/2008

    Well, I got to defend my ballot with the Fairfax County Electoral Board, and it was a fun experience. They had 3 voting members for this process and 2 advisors, and they were all intelligent, reasonable people who were focused on following the rules to ensure the integrity of the election. Excellent! It was determined that the person who authorized me to complete a provisional ballot should not have done so, as the rules provided those only for people who were not in the polling book, but contended that they should have been in the book, not for people who wanted a paper ballot because of any other reason. Well, the rules for the Board are different from the rules at the poll, so the issue was now different. One voting member took the position that I was eligble to vote, and they had my sealed vote, so they should count it. Another took the position that I shouldn't have received the provisional ballot in the first place, so it should not be counted. The third's position was that I was trying to "strong-arm" a way to use a paper ballot, when the rules did not provide for that (which was correct), so he was opposed to counting my vote. Then they asked the advisors about precedents and were told that this issue has arisen in the past, and the votes were counted. Based on that insight, they all agreed to count my vote.

    The best thing, though, is that when I inquired about how I could pursue moving Virginia away from non-voter validated voting systems, they told me that it had already been done. Last year (I probably missed this in my research because it was so recent), the Virginia Legislature passed a law that all new voting equipment must include the option to process paper ballots. And there will be at least four in use in Fairfax County this November. (And they said that they would make sure that one of those machines was in my precinct!)

    Tuesday, January 8, 2008

    Everything Has An Upside

    Personally, I don't recommend you try to develop peripheral neuropathy for any reason, but if you're stuck with it, there can be advantages...

    When I was in the neighborhood of ten years old, I accidentally raked the index and middle fingers of my left hand across the rotating blade of a table saw. It sliced into each finger tip parallel to my fingernails and took out chunks of meat. I was surprised at how much blood could come out of fingers, since there aren't any arteries that far from the heart. But those little veins and capillaries carried an awful lot of blood. Yuk. I hate seeing blood. Especially mine.

    Of course, the wound healed over within a week or two, but those fingertips were still sensitive to touch for a long time after that. Eventually, though, they got to where I didn't notice them any more.

    That is, until the first time I tried to play a guitar. Trying to fret the strings was too painful to endure. Yeah, I know, it hurts every new guitar player until calluses form. Except my index and middle fingers hurt far worse than the other two fingers, especially when I pressed right on the scars in certain directions, so I'm pretty sure that was worse than usual. At any rate, it was bad enough to keep me from trying for more than a few minutes once every few years.

    Now, take that scenario, add a couple of decades of nerve deterioration in my hands, and viola, those two troublesome fingertips no longer hurt too much to fret a guitar! They still hurt a little bit, but I figure they're about the level that most people would normally feel. That's where my neuropathy really pays off! :) And as an added bonus, my ring and little fingers on my left hand don't hurt at all... they're too numb!

    My best neuro-doc has also told me that my peripheral neuropathy may improve eventually, since it was caused by deficient levels of thyroid hormones that is now being controlled. So, I may lose numb-finger "advantage", but if I do, you can be sure I'll have well-developed calluses long before then. Make hay while the sun shines, as they say, or in this case, make calluses while the pain is numbed!

    Why guitar? I couldn't stand the poor sounds I was getting out of my violin long enough to get to the point where it wasn't too annoying. I don't really care much for the sound my autoharp makes. My trumpet is a little too LOUD to practice whenever I want. The guitar is easy to get good sounds out of if you can hold the strings down, I like the sound I get with thumb picking/strumming (don't care much for the sound I get from picks), and its quiet enough that I can practice any time I want!

    Oh, and why are my hands and arms numb, but the nerve damage in my feet causes a nasty burning sensation? I dunno. It's relatively common for peripheral neuropathy, but no one seems to know why some people get burning sensations vs. numbness in various places. That's one of the 23,917,603 reasons I say that medical science, like all other sciences, is still in its infancy.