Monday, December 17, 2018
As per usual, I didn't finish this post in one go. The following paragraphs we're written yesterday. Looks like it's going to be another beautiful day here.
Just a smashingly beautiful day here in the southwest Panhandle of Nebraska. Fifty-six degrees and sunny as I write this at 1227L. Just a light southerly breeze. Right before I sat down I had a lovely romp including a dozen ascents of smokebong hill and I'm feeling pleasantly well used.
As you might expect from the title up there, it's been a bit busy around these parts.
We installed a permanent drain tube in my Dad's abdomen on Thursday. The idea is to allow him to drain the accumulating ascites fluid at home rather than journey into tow to visit the hospital for a weekly paracentesis.
Of course the world isn't as simple as all that. At least not so simple that putting in a permanent drain is like snapping a hose onto a fitting.
I'm not sure if I've explained the while abdominal fluid thing before...
The liver is a major player in just about everything your body does. It's a big part of the digestive system where it serves both as a filter and as a factory for production of a great many proteins and enzymes and hormones and stuff. When you eat food the food goes through the gut -- stomach and intestines. The gut breaks food down into molecules that the body can use for cellular metabolism, but those molecules have to go through the liver to be "tweaked" and sorted and refined. At the same time the liver filters the detritis of it's metabolic and catabolic efforts. To get from the gut to the liver, nutrients travel via the circulatory system. Oxygen and nutrient rich blood enters the gut via the aorta, the big central abdominal artery. As the blood flows through the intestines it picks up nutrients, then flows to and through the liver via the portal venous system.
When the liver is sick this blood flow is slowed and restricted by scar tissue. It backs up in the liver, increasing in volume and pressure. Eventually protein rich plasma begins to weep out of the liver and collect in the abdominal space. That's where the fluid comes from, and once in the abdominal space it has nowhere else to go, so it builds up there. If you don't do anything to remove fluid and reduce pressure, eventually the non-compressible fluid will make it impossible for the diaphragm to work. When the diaphragm can't work you can't breathe and that's the end of the tune.
Fortunately, the fluid can be removed relatively easily. Dad's been getting weekly paracentesis For about 10 months now and he's never had any problem. Other than having to have it done of course. I suppose some folks might see having a needle jabbed into your belly every week as somewhat of a problem. Butt I digress.
Placing the permanent tube went well but it was rather an ordeal for Dad. They wanted his abdomen to be very full of fluid to improve both ultrasound visualization and overall safety. Once the tube was in place they drained about 15 liters of fluid. That's about 33 pounds of mass, and for various reasons removing that much fluid at once -- even though it's taken from the belly and not the circulating volume -- induces a certain amount physiological shock from the change in overall fluid balance/dynamic. So he felt pretty small and weak for a good 24 hours.
The next day there was a great deal of fluid leaking from around the tube. This is to be expected. Dad's liver is weeping about a liter of fluid into the abdomen every day, and since water doesn't compress (the fluid is mostly water) his intra-abdominal pressure goes up. Having just placed a tube in there, there's an unhealed pathway from inside to outside and rising pressure forces fluid to flow through that pathway. As it heals in the flow will first slow, then hopefully stop. In the meantime we're doing a lot of dressing changes.
Things are looking up today, with very little leaking, so it looks like we're headed in the proper direction.
All the rest of life keeps going on of course, and Friday I had to gather cattle for shipping yesterday. The weather cooperated, as did the cattle, so the whole thing was quite enjoyable and satisfying.
If the weather guessers are correct, or even fairly close, we could even have a couple more days of lovely weather before the next front arrives with more seasonal conditions. This time of the year you kinda have squeeze all the lovely out of nice weather while it's here. It's ephemeral, which makes it a treasure.
By the time Friday morning rolls around we'll be starting the annual shortest day-longest night as winter solstice arrives. Thereafter the days will be getting longer and spring will be on the way. Rebirth is upon us. Time to enjoy a pagan sammich!
Monday, December 10, 2018
What have you done for me today, legs?
Prettiest day of the week. It was 14 degrees when I got up but the weather guessers had forecast a sunny, warm and mostly wind-free day, so I had high hopes. I wanted to take advantage of the forecast 50 degree temps and get in a good workout.
As I pushed off it was still pretty cold -- 20 degrees -- but the sun was already feeling warm and the wind was nowhere to be found. It was very pretty and a morning filled with promise.
I wasn't feeling it though. I didn't have a lot of energy and I wasn't filled with my favorite sense of zest. I was therefore more than a little pissed. Why can't I have the zest and energy all the time? Yesterday I felt great.
But that was yesterday. It was lovely but today is not yesterday. Today I have to deal with today.
The first mile was creaky and hard. I couldn't catch a rhythm. My legs felt weak and tired and my joints felt creaky and rusty. I ran like a special olympian, not that there's anything wrong with that. But where was the easy grace, the fluid motion, the boundless energy?
That was yesterday. I pressed on.
Smokebong hill was torture. I pressed on. I had some business at the hospital and I pulled up there at roughly the 2.5 mile mark. That gave me a five-minute breather. Business concluded, I lurched back into an imitation of a running man.
I went the long way and came to the underpass steps from the west. I was feeling better in the sense that I was moving better. I still felt tired and weak but I persevered. As I ran steps I kept planning on quitting, then kept recycling the ongoing lie of "just one more." I hit a good stride between flights 50 and 100. The last 50 went much better than I could have hoped, really, given that my legs felt like spaghetti.
It was a good way to wind up the workout, pushing and proving that tiredness and spaghettification notwithstanding, I can still dig deep and find more juice in the tank. It might seem stupid or even counterproductive, but I don't think it is. Suck it up and drive on is easy to say, but harder to do. The doing is the important bit.
I know for a fact that pressing on is important and that it's on hard, shitty, gutchecking days like today that I make substantial and lasting progress.
I did a couple of blocks of cool-down and called it good. I was rather surprised to find that I'd done six miles altogether.
For all my whining and complaining, I realize that there are countless folks who might give anything to be able to run like the crippled wind just one more time.
I am blessed.
And here's a psychotic stream-of-semiconsciousness post-workout ramble. I do not know why.
Thursday, December 6, 2018
Why Estonian? Well, it seems we Evertsons came from Estonia. If we didn't spring originally from Estonia, it seems we at least paused there for a good long time some 15-20 generations ago. More or less. Probably. Maybe. Who knows? I wasn't there. But the evidence I've scraped up seems to have overturned the Norway/Sweden lore I heard so often in my youth. Butt I digress.
Why happy? Well, the overnight snow was very light and fluffy and -- most importantly -- easy and even fun to scoop this morning.
Nona sure enjoyed it.
Curiously, the geese were flying east.
It was coldish -- about 19 degrees -- but there was very little wind this morning. When it's cold and still and the snow is light and fluffy the dreaded chore of scooping is transformed into a joyous, heart-lifting lark.
So yeah, happy snow. Õnnelik lumi!
Wednesday, December 5, 2018
I had a girlfriend back in high school who was way into Bread. She ditched me for someone who could really, really pretend that they loved the group's music. Smart girl.
But that is not what this is about.
One of the constants of my early life was Grandma Helen baking bread. I think she baked bread every other day for most of her life. It was a constant and I took (as you do) the fruits of her labor for granted. When she passed a couple of decades (!) ago fresh baked bread was no longer a constant. While I missed it I didn't obsess about it. Things come and go, things change. It's a feature of life.
I did finally decide to see if I could figure out how to bake bread. It had always looked like both a lot of work and a lot of magic, and I wasn't sure I could pull it off. I messed around with different basic recipes, and while I always got a baked wheat flour product, it wasn't always bread. And it was never the bread of my memory.
At some point I dug into a shoe box filled with Grandma's recipes. I didn't have much hope that her bread recipe would be there, because she'd often remarked that she didn't have or need a recipe to make bread. Surprisingly though, I found a yellowing slip of paper which appeared to be a recipe (of sorts) for bread. It was really just a list of ingredients and some cryptic words that might be interpreted as instructions.
The ingredients seemed right. "3C water, 2env yeast, 1/4C sugar, 2tsp salt, 3T butter, 9C flour." The instructions were sparse. "Mix water yeast sugar, set aside. Whisk flour/salt in bowl. Add butter. Add liquid. Mix, turn out -- knead. Rise 3x, last in pans. Bake 350 45 min."
I did some reading up on bread baking technique and was able to get a sense of how the sparse instructions might have represented what Grandma actually did. Shockingly, it worked! The bread I baked was pretty much a dead ringer for the bread Grandma baked. It wasn't exactly the same, because it wasn't Grandma baking it. But it was close enough. Same smell, same flavor, same texture. I use a microwave to melt the butter and I don't think Grandma ever did. I also let the stand mixer do the kneading, and Grandma always used the Armstrong method. I can do it that way, and I have done it that way, but all in all I prefer the mixer.
For those who'd like to play along at home...
3C (680g) lukewarm water (circa 110 deg. F)
¼ C (60g) sugar
2 envelopes dry active yeast (4 ½ t or 18g)
3T melted butter
1 ½ t (16g) salt
9C bread flour, 2.75 lbs or 44 oz or 1250g)
Weigh water, yeast and sugar and mix in bowl, set aside until yeast begins to foam on surface. Melt butter in microwave. Weigh flour in mixer bowl, add salt. Add melted butter, then water/yeast/sugar mix. Mix/knead with dough hook for 10 minutes. Raise in oiled, covered bowl for 30 minutes in warm dark place. When doubled punch down and raise again until doubled, 20-30 minutes. Punch down and divide into thirds with scale. Form into loaves and place in oiled loaf pans. Cover and let rise 20-30 minutes.
Bake at 350 F for 45-50 minutes, until well browned and done. Turn out on cooling rack and brush tops with melted butter (optional). Let cool completely before slicing.
All in all, and interesting experiment. These days I bake bread every week, and only seldom do I buy "store bought." I can't say why I do this. It's a combination of things, really, but at the end of the day I enjoy baking bread and I enjoy consuming the product. Reason enough I suppose.
Monday, December 3, 2018
What's better than a freezing fog?
To go all partially sciency, fog is simply a big load of liquid phase water droplets suspended in the atmosphere at or about ground level. For various reasons having to do with the properties of molecular water, a great many of those droplets remain in their liquid phase even when the ambient temperature falls below the freezing point of water. By definition, these droplets are supercooled.
When the supercooled water droplets contact ground level stuff, like grass or trees or your windshield, the kinetic energy of the collision between liquid water droplet and stuff is enough to cause the water to instantly shift phase from liquid to solid. Well, not really instantly, it takes time for the shift to happen. But not very much time. Those droplets become ice much faster than you can blink your eye.
For all the hassle of freezing fog -- low viability, slippery roads, the misery of damp cold -- it's also a very beautiful thing. For some reason it feels good to me to recognize and appreciate the beauty. I didn't ask for it, but nature served it up anyway. How's that for a gift?
The Siberian tiger flu I've been battling is turning out to be a tricky one. I get a little better, then a little worse, then a little better, then a little worse. While it's rather a pain in the nether regions, it's also sharply tilted toward being a fascinating example of the body's ability to fight off foreign -- especially Eurasian foreign -- invaders. (Had to inject some racism there in keeping with my membership in the Great Caucasian Male Patriarchal Ownership Of The Universe Society).
See what I did there? Siberian? Eurasian? Caucasian? I keel myself.
Being a comedic ailing racist, it turns out, is another of nature's priceless gifts.
And from the "it's good to live in deplorable-irredeemable land" file...
We're blessed to have a very good hospital here. We've got everything the big city hospitals have except for the enormous crowds.
This morning I wanted to see if I could arrange for my Dad to have his weekly paracentesis tomorrow instead of Thursday. Tomorrow he's scheduled to have his picc line replaced, he's got some extra fluid build up going on this week, and it'll be a bit easier on him to make one, rather than two, trips to the hospital this week.
So I just walked into the hospital and back to the nurses station and asked. Doctor Broomfield heard me asking and stuck his head around the corner. "Sure," he said. "I'll look at him when he comes in tomorrow and we'll take fluid off if we need to."
Where else can you just pop in unannounced and make medical arrangements?
Seems like I'm surrounded by gifts of wonder. Which is cool.
Sunday, December 2, 2018
It's been a week since the arctic turtle flu hit me. Last Monday I started to feel sick, and by Wednesday-Thursday I felt awful. Coughing, sneezing, headache, muscle and joint aches, drained of energy, sleepless, etc. You all know the drill.
It's a process. The body has to go into immune mode and fight the viral invaders. If you've got a reasonably sound immune system and if you're in reasonably good health you'll feel better in about a week. If you take medicine to ease the symptoms, you'll feel better in about seven days.
Today is day seven. I feel a lot better, though I'm not completely well yet.
Yesterday was a yucky day weather wise. It was overcast and misty with temperatures hovering just above the freezing mark and a strong northerly wind. The forecast called for snow, and lots of it. Three-to-six inches during the day, 8-14 inches overnight. So we got zero snow during the day, and about a scant inch overnight. Not that I'm complaining, mind you.
The wind died down about 10 p.m. last night and that's when the snow started. The air temperature stayed fairly warm and only fell to 28 degrees. This morning the winds remained mild and the sun began to break out of the dissipating clouds.
It was lovely out and I was feeling better, so I decided to scoop snow, and if that went well, to go for a gallop to blow the cobs out. I scooped and noticed that the sun was melting snow faster than I could scoop it, which was a nice surprise. I didn't croak from the effort; in fact I felt invigorated. Not quite back to normal and still with some coughing, not to mention a sinus headache which I feared might portend a bout of sinusitis.
I don't like the sinusitis. I suffered a barotrauma (sinus squeeze) flying with a head cold many years ago. That trauma turned into a massive sinus infection which led to a remarkably pretty and petite ENT doc bashing a hole in my sinus with a hammer and chisel. Ever since I've been somewhat prone to sinusitis and very gun-shy about the condition. Butt I digress.
Nona and I set out on a running, ball-playing adventure. I dressed in sweatpants and sweatshirt, nice warm workout gloves, full-calf compression socks, and UA HOVR winter running shoes.
The shoes have a tough ankle cuff to keep the snow and mud out. They allegedly contain some kind of high-tech warming/cooling material to keep your foots at just the right temperature. Surprisingly, it seems to work. Also surprisingly, the rather low profile tread is decidedly grippy on snow and ice. So winner-winner, two-bill dinner.
Long story short, we had a nice three-mile run and did 50 flights of underpass steps. It was somewhat hard going as I've got a good bit of lingering fatigue from the flu, but hard going is just a nice challenge. It was a super workout and felt really good.
Also, whilst running steps I developed a spectacular nosebleed and my sinus pain immediately went away. Just what the doctor ordered!
Meanwhile back at the ranch, Mom is still recovering from her bout of the flu, and Dad is starting to feel like he's getting it. We'll have to watch that closely, for he is neither in good health nor equipped with a robust immune system these days.
And that's the report from this neck of the not-so-snowy woods.