Thursday, March 06, 2014

Life: Episode V, SBO Strikes Back

For followers of this blog, you know I have been hospitalized for small bowel obstruction in 2004, 2005 and earlier in 2009 and later in 2009.

In 2004, there was a surgical intervention. One side-effect of a surgical intervention is the formation of scar tissue and possible adhesions. These raise the risk of future bowel obstruction episodes.

Think of the intestines as ribbons in a bowl (abdominal cavity). Normally, they slip and slide past each other without incident. But if one has scar tissue so they aren't so smooth in certain patches and they are sticky (adhesions), the ribbons will not always slip and slide past each other as smoothly and every once in a while they get stuck. At that point, the plumbing analog gives you the best picture - things get backed up!

And so it was at 2AM Thursday January 30. Sometimes, the pain goes away in an hour or so and I return to regular life. But by 8AM, the pain had not receded and I was concerned and phoned my primary care physician. He was booked for the day but slotted me in with one of the younger doctors in the office. J drove me to the office for the 10AM appointment.

The doctor had my medical history so she knew to ask about how the pain compared to previous episodes. She then listened for "bowel sounds" and then did a physical exam feeling different parts of my belly and asking where it hurt when she would press. My regular PCP swung by and they talked about my situation with me and agreed I should be sent to the ER at Santa Monica UCLA Orthopaedic Hospital.

view of north wing (photo using paper artist app)

ER's in big cities are busy places and the physical space of the ER often shows the signs of the wear and tear of lots of patients coming through. It took an hour or so before I was assigned an exam room. As I walked in, I could see patients in the hallways.

An IV line was put in, blood was drawn and I was given the "pink liquid" to drink for the CT scan. The pink liquid has bound iodine which allows the radiologist to see how well things are flowing/not flowing in my intestinal tract. One drinks the liquid a bit at a time and eventually when I drank enough of it and it had some time to work its way through my system, I was wheeled into the CT scanner for pictures. This was followed by another set of pictures with iodine introduced through the IV. The sensation of the iodine coursing throughout the body is unmistakeable hence the radiology technician always tells you in advance what you will experience so it won't be so alarming.

With the two sets of pictures completed, I was wheeled back to the ER exam room.

As I mentioned, the ER exam area is crowded with mere curtains separating the exam beds. The two patients nearest me were clearly elderly patients. I didn't actually see them but I could hear the doctors asking them questions. Since they could not hear well, the doctors and nurses were asking them questions quite loudly! And indeed, from the questions, their conditions were quite serious.

Eventually, the ER doc on my case came in and said, you got a partial small bowel obstruction and we are going to put a nasal gastric tube into you and admit you into the hospital.

The nurses came to put in the NG tube and explained what they would do. Having been through the procedure four times before, I knew the drill. Nonetheless, the sensation of having a plastic tube threaded into your nose and down your throat into your stomach is not something you ever get used to.

I was moved into a room in 4NW - fourth floor north wing. The low steady suction was turned on. I was given a shot for the nausea which would eventually recede as the NG tube took out backed up fluid in my stomach. The IV kept me hydrated, my potassium levels at the proper level, and provided calories. When evening rolled around they gave me a stomach acid blocker through the IV and a shot to stave of blot clots. The shot was into my belly fat!

Friday morning brought the morning blood draw, x-ray and visit by the surgical team. Later I was visited by the hospitalist. The hospitalist is like the primary care doctor but she/he works in the hospital. Both the surgeon and hospitalist seemed upbeat about my situation. SBO is not an uncommon reason for hospitalization and their plan was to let the NG tube work and avoid surgery if at all possible. They encouraged me to get up and walk around.

north facing window while walking the 4th floor (photo using paper artist app)

By Friday afternoon, they pulled out the NG tube and would observe me on Saturday. Saturday morning x-ray. They said it looked good so Saturday lunch, I had my first meal - the liquid diet. Saturday night I had my first regular meal. Sunday morning, I had a light breakfast and they cut me loose!

A huge thank you to the nurses and staff of 4NW! You guys/gals are terrific. And thanks to the docs - PCPs, ER, radiologists (never actual met them!), surgical consult team and hospitalists!

Friday, November 15, 2013

New template

Turned 50 this year!

This blog has been left someone underused these days. But I've decided to recognize leaving the 40-something life with a new template and color scheme.

Hope to write here occasionally!

Thursday, September 12, 2013

Politics: Syria giving up chemical weapons - practical realities

On paper the idea of Syria's Assad giving up their chemical weapons to UN inspectors sounds great but there are some possible practical problems - they can get moved and hidden (as indicated in CNN report below which may or may not turn out to be correct) and, of course, Syria is an active war zone so sending UN inspectors to go inventory them and supervise their neutralization is easier said than done. And finally, Syria is a client state of Russia. Thus, with one hand the Russians can say to Syria give up your chemical weapon stocks (seriously or with a wink) and, on the other hand, give them more conventional weapons to continue the war with the rebels.

Syria may be moving chemical weapons into Lebanon and Iraq.

Friday, May 10, 2013

Money: What would Jim Cramer think?

Am not a financial analyst but I do try pick some stocks along with leaving a good portion to the "index ETFs" so I don't have to think too hard.

Currently, have long positions in these 4 companies:

Verizon (VZ) - Wireless is huge and will keep getting bigger. Of the 4 biggies in the USA (Verizon, ATT, T-Mobile, Sprint), I went with VZ because its a big Dow30 stock with solid dividends. I've been surprised at the run up in the price since I picked it up a while back so does that make this a growth stock?
Disclaimer: I use ATT Wireless because I signed up with them eons ago and am too lazy to change. Also, since I do travel to Europe occasionally, Verizon's CDMA phones probably don't work in GSM Europe. But many of my friends like their Verizon cell phones because of good coverage in a wide range of locations.

Whole Foods (WFM) - With the increasing health consciousness of Americans, WFM is positioned for growth. Also, I like CEO John Mackey's free market perspective. And finally, by all accounts, the company treats the employees well and they provide good responsible products.
Disclaimer:  I do shop at WFM as well as Trader Joes and Sprouts and Ralphs and I'm not vegan or vegetarian but am trying to be more health conscious about what I eat and also how its produced.

Time Warner Cable (TWC) - Its a risk I admit but I think their aggressive moves to lock up LA Lakers and LA Dodgers and LA Galaxy to form Time Warner Sports Channel will boost them.
Disclaimer: I am a subscriber to TWC because they are the only service where I live. So far I have been pleased with their cable TV and broadband internet.

Union Pacific (UNP) - Sometimes, you just got to buy the big dog in the industry. Of the US rail companies (UNP, CSX, NSC, KSU), UNP has the most total revenue. Rail isn't a glamourous business but they move a lot of goods and materials around the country.

Would these pass Cramer's critical eye?

Wednesday, May 08, 2013

News: Politics of coverage

Time now Wednesday 10:04AM PDT. Just checked,,,, ...

Four of the five news sites have the Ohio kidnap story as the main story. I define main as big fonts with prominent photo at the top of the web page.

One news site has the Benghazi hearings as the main story.

The other four that have the Ohio story prominent do have "watch live" links.

What does this say about the editorial decisions at the major news sites?

Wednesday, April 10, 2013

Faith: Elder Ordination

Had the honor and duty to be ordained as an elder in the PCUSA last Sunday, April 7, 2013. I'll be serving as the clerk of our session (the governing council in our church). I was moved as it sank in that I was stepping into a stream that has been flowing for 2000+ years when Jesus inaugurated the church. As part of the ordination, the following questions are asked and answered:

a. Do you trust in Jesus Christ your Savior, acknowledge him Lord of all and Head of the Church, and through him believe in one God, Father, Son, and Holy Spirit?

b. Do you accept the Scriptures of the Old and New Testaments to be, by the Holy Spirit, the unique and authoritative witness to Jesus Christ in the Church universal, and God’s Word to you?

c. Do you sincerely receive and adopt the essential tenets of the Reformed faith as expressed in the confessions of our church as authentic and reliable expositions of what Scripture leads us to believe and do, and will you be instructed and led by those confessions as you lead the people of God?

d. Will you fulfill your office in obedience to Jesus Christ, under the authority of Scripture, and be continually guided by our confessions?

e. Will you be governed by our church’s polity, and will you abide by its discipline? Will you be a friend among your colleagues in ministry, working with them, subject to the ordering of God’s Word and Spirit?

f. Will you in your own life seek to follow the Lord Jesus Christ, love your neighbors, and work for the reconciliation of the world?

g. Do you promise to further the peace, unity, and purity of the church?

h. Will you seek to serve the people with energy, intelligence, imagination, and love?

i. Will you be a faithful elder, watching over the people, providing for their worship, nurture, and service?

j. Will you share in government and discipline, serving in governing bodies of the church, and in your ministry will you try to show the love and justice of Jesus Christ?

Faith: Rule of Benedict 5

#ruleofbenedict 5: humility begins with obedience

Faith: Rule of Benedict 4

#ruleofbenedict 4: good works come from loving God and othes above self, realizing time is short and trusting in God's mercy

Thursday, April 04, 2013

Sports: Looking back on the 3 Final Four runs of UCLA under Howland

Three Final Fours (2006-2008) and Coach Howland was viewed as having a job for life at UCLA.

Well, things went downhill rapidly and by 2013, he was fired.

Those three great runs were of course fueled by talented players who have made for themselves a place in the NBA and by Coach Howland's emphasis on strong man-to-man defense. Of course, some fans second guessed that he didn't allow the team more freedom on offense which may or may not have kept them from the NCAA Championship.

The reality, looking back, is that the difference between victory and defeat is often very slim and UCLA and Howland's fortunes could have been much less.

Turn the clock back to 2006 and what basketball fan will every forget the epic collapse (if you are a Gonzaga fan) or comeback (if you are a UCLA fan) in the regional semi-finals? That first Final Four and Championship game appearance could easily have ended as a "mere" Sweet 16 finish.

In 2008, UCLA was down for almost the whole game against Texas A& M in the 2nd round. UCLA took the lead with hardly any time left. A&M had the final possession to tie the game and their guard drove to the basket but missed in what replays would later show was lots of contact where a foul could easily have been called. Perhaps, he would have missed one or two of the free throws or UCLA would have won in overtime but the game remains one of the more controversial "no calls" in NCAA Tournament history. Thus, the 2008 Final Four run with Kevin Love and Russell Westbrook and Aaron Afflalo could have ended ignominiously in the second round.

Am pretty surch Coach Howland will find a new place to coach and get a fresh start with a new fan base. And hopefully, Coach Alford will be able to grow further as a coach and bring UCLA back to competitiveness.

Fans had hoped for a bigger name coach but I think UCLA hasn't gotten a big name coach since Larry Brown.
Coaches since Brown:
Larry Farmer - prior assistant coach experience with the UCLA job being his first head coaching position
Walt Hazzard - UCLA job first head coach position
Jim Harrick - UCLA job was second head coach position after modest success at Pepperdine
Steve Lavin - UCLA job first head coach position with prior assistant coaching jobs
Ben Howland - successful head coach at Northern Arizona and Pittsburgh prior to leading UCLA
Steve Alford - some successes as head coach of Southwest Missouri State, Iowa and New Mexico before coming to UCLA.

Saturday, March 30, 2013

Faith: Rule of Benedict 3

#ruleofbenedict 3: good decision making requires listening of and respect for all involved