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Hawaiian Shirt Day 2009

Whoo Hooo! Today is Hawaiian Shirt Day!

“Say what?” you ask.

Each year I look forward to the day when I can commute wearing sandals, bike shorts and a Hawaiian shirt. That means, for me, it’s close to 60° (15°C) and not pouring rain. I can ride comfortably, heck even build up a big sweat, when that happens. Today was the day.

I was so enthused I forgot about the weather forecast. Ah, yes, Thunderstorms in the afternoon. At work I thought “well you’ll just get wet, no biggie.” As it turned out the storms included 30mph sustained winds with gusts to 50.

Good thing I made it home before those hit!

June 4th, 2009 | Category: Bicycling | Print This | Leave a comment

Letter to Danny Hauser

With all the media attention the Hauser family has appointed a contact person, Jim Navarro, and established a website. The home page on the website has a side bar Being in Touch which says “If you have an inspirational story, information about your experience … please consider sharing that story with us.”

I wrote a letter to them:

Hello Everyone,

In November 1977 my doctor said “there hasn’t been a sign of cancer in your body since June.” I went weak in the knees and almost fainted. Why hadn’t they told me that great news in June? Perhaps because they understood the risk of my refusing to continue the course of treatment that had been planned out in the fall of 1976 when I was diagnosed with stage 3B Hodgkins. I was 19 at the time of diagnosis. My treatment, both chemotherapy and radiation, lasted a full year. I somewhat stoically endured that treatment.

Boy oh boy, do I know what you are going through. They used the MOPP protocol on me. I believe they quit using it in favor of chemos with less violent side effects. However it sounds like there really isn’t a difference in your case Danny. For me retching and thowing up would start half an hour after the injection and last for a day or two. How about you?

Sticking with it is really key. Check that date in my first sentence again. In 1977 they barely knew what they were doing. Successful treatment had been discovered just six years earlier. Only 60% of the patients would go on to survive long term. I’m sure your doctors have told you about the chances today.

What they haven’t told you about is life after chemo. It’s great – and not just because you don’t have to go through chemo any more.

Danny, I’m sure you’ve been asked “What do you want to do when you grow up?” Why do grownups ask about work, which most of them don’t like?

I want to know what fun you are going to have after chemo. Will you think about that as much as possible? Maybe even do some of it now?

Here are some of things I’ve done since I finished up with chemo. By the way I live in Portland, Oregon. When I was being treated I lived in Boise, Idaho. Between then and now I’ve also lived in San Francisco and Albuquerque, New Mexico.

Raised a german shorthair pointer, who I named Woof. These dogs have short fur and spots, love to run and have lots of energy. Woof was a friendly dog – even to cats.

Go swimming. I was on swim team in high school, so I have always felt comfortable in the water. Think about what it’s like to swim with a snorkel in the Florida keys, Hawaii, or the reefs of Bali (in Indonesia, west of Australia) looking a bright tropical fish – some of them bigger than your head. Think about rafting down a wild river and flipping out of the raft in a quiet section between rapids and swimming along side the raft. Imagine being at the side of a lake on a hot afternoon and diving in just to feel the chill of the water.

When I got fat (when I was being treated for Hodgkins I was really, really skinny and stayed that way for years) but finally I got fat I started to ride a bicycle. At first five miles was “enough”. Then I rode more and more and more. I’ve ridden alongside ducks taking off from a pond and flying so close to me I could hear their wings beating. I’ve ridden across mountain passes in the Cascades – OK climbing up was not the most fun – but the 20 miles of zoooming downhill quickly made up for it. I like to smell things while I ride. The pancakes cooking at a little cafe, the flowers in a lady’s garden, the fresh cut smell of wood at a sawmill, hay and freshly cut grass. Or rain – when the first few drops hit the ground the world smells wonderful. Somehow being on a bike makes all the smells better.

Those are just three things I happily remember from my life. There are hundreds, maybe thousands, more – when you live a long time you get to collect all sorts of memories while you have all sorts of fun, interesting, weird, inspirational and other kinds of experience.

At the same time I still remember being in chemo. Each year that memory, the one you are getting now, gets softer and softer. Most times now when I remember being in chemo it is like remembering when I tied my shoes yesterday. Imagine what that must be like: the sickness you are having now becomes as stirring as the memory of tying your shoes.

The good memories are much stronger than the bad ones. I hope you stay with treatment so that on some day over 30 years from now you Danny, like me, will have a lifetime of good experiences and memories and a love for the years of life your treatment provided.

Good luck with the endurance race you’re in now.

Write if you’d like to. I’ll answer any question I can.

Michael
who had stage 3B Hodgkins in 1976.

I hope to hear from Danny and find out about his hopes for life after chemo.

May 31st, 2009 | Category: Life | Print This | Leave a comment

Cookie for Your Thoughts

The practice of torturing suspected terrorists received fresh blows Friday after a magazine reported that a key al Qaeda suspect offered useful intelligence after receiving sugar-free cookies.

That is from a Raw Story story on a Time Magazine story detailing revelations from former FBI interrogator Ali Soufan. Prisoner Abu Jandal had been held in Yemeni for over a year yielding no information before skilled FBI investigators arrived.

Time interviewed several interrogators who have worked with the U.S. military and retired intelligence service employees asking “[what works?] How does an interrogator break down a hardened terrorist without using violence?” Time reports “All agreed with Soufan: the best way to get intelligence from even the most recalcitrant subject is to apply the subtle arts of interrogation rather than the blunt instruments of torture.”

The Time article (3 pages) lists several examples of how smart interviewing succeeded. One example shows how these techniques work in a situation where time is of the essence.

May 30th, 2009 | Category: Ethics, Politics | Print This | Leave a comment

Hacked PC Value

It’s not your bank information or credit card numbers hackers that take over your PC are interested. Those items are bonuses. The real use of a hacked, or zombie, PC is in the computing power the hacker can use. Things like:

Illicit Web Hosting – You too can serve up porn
Zombie Grunt Work – Help spread the virus love
E-Mail/Webmail Attacks – Share the load of sending spam
Account Credentials – Your MySpace, Facebook, Gmail …
Virtual Goods – If the gamer has gold in them there games, well, make that had gold

Brian Krebs explains all of these in his excellent security article.

May 30th, 2009 | Category: Computing, security | Print This | Leave a comment

Health Care Costs

The New Yorker has an excellent article on health care costs. It focuses on the Hildago county Texas area and it’s main city McAllen. This area has the second highest health care costs, as measured by health care spending, in the USA. It is second only to Miami. This is in stark contrast to El Paso county, about 800 miles up the Rio Grande, a place with very similar demographics. The spending in Hildago county is roughly twice that of El Paso county. Are the citizens of Hildago county getting better care for all the extra spending?

Nor does the care given in McAllen stand out for its quality. Medicare ranks hospitals on twenty-five metrics of care. On all but two of these, McAllen’s five largest hospitals performed worse, on average, than El Paso’s. McAllen costs Medicare seven thousand dollars more per person each year than does the average city in America. But not, so far as one can tell, because it’s delivering better health care.

Where is the money going?

Read the article. The root cause is revealed in the first page or so.

But don’t stop there, near the beginning where, the high cost culprit is revealed. Author Atul Gawande goes on to speak to his own experience as a doctor, when he bullied an admitting physician to keep his son overnight for observation. This hospital stay, he realized after doing further research, was unnecessary. Dr. Gawande also examines the practices of the Mayo Clinic and practitioners in Grand Junction Colorado. Both of these have costs among the lowest in the nation while providing care that is close to the top available. Those cases, where high quality care is provided at low cost, are the truly instructive ones.

Nor are these two cases special instances that cannot be repeated elsewhere:

Grand Junction’s medical community was not following anyone else’s recipe. But, like Mayo, it created what Elliott Fisher, of Dartmouth, calls an accountable-care organization. The leading doctors and the hospital system adopted measures to blunt harmful financial incentives, and they took collective responsibility for improving the sum total of patient care.

This approach has been adopted in other places, too: the Geisinger Health System, in Danville, Pennsylvania; the Marshfield Clinic, in Marshfield, Wisconsin; Intermountain Healthcare, in Salt Lake City; Kaiser Permanente, in Northern California. All of them function on similar principles. All are not-for-profit institutions. And all have produced enviably higher quality and lower costs than the average American town enjoys.

The money quote: “[Lester Dyke, cardiac surgeon], is among the few vocal critics of what’s happened in McAllen. “We took a wrong turn when doctors stopped being doctors and became businessmen,” he said.

May 29th, 2009 | Category: Financial, Health | Print This | Leave a comment

Can You See?

Ya like Bizarro? The cartoonist, Dan Piraro, keeps a blog that provides background to the daily comics, links to other versions, and links, lots ‘o links. All the links go to images. They’re as fun as the cartoons. And this is, to me, the fun part. No links to pages, no links to ads, just links to lots of amazing photos.

It must be really great to be a cartoonist. And a great way to get rich, just like it says here.

How to Become a Millionaire

May 28th, 2009 | Category: Web Curiosity | Print This | Leave a comment

Daniel the Chemo Kid

(two updates below)
Are you aware of Daniel Hauser? At this time he’s 13, has Hodgkin Lymphoma, and is on the lam with his mom. They are running to prevent a court order that would force Daniel to resume chemotherapy for his Hodgkins.

There is a lot of controversy over this case. People argue over patient’s rights, parent’s rights, the pain/benefit balance for cancer treatment. Dr. Rahul K. Parikh wrote a sensitive article for Salon.com exploring the complications.

This is a gripping story for me. At 19 I was diagnosed with stage 3B Hodgkins. Good timing on my part – an initial cure for Hodgkins was just being recognized. As my oncologist put it at the time “we know it works because people we treated five years ago are still alive.”

Treatments have improved since 1976. Side effects are “less” severe. Yet the central truth of Hodgkins chemotherapy is selective poisoning. Subjecting your entire body to poisons that will, 19 times out of 20, kill the cancer before it kills you. Living through that is not a good time.

At 13 Daniel feels the pain way more than he can foresee the decades of life that lie beyond treatment. I wish his parents could see the life that lies beyond treatment.

What follows is the contents of my letter to the editor on this matter.

In November 1977 my doctor said “there hasn’t been a sign of cancer in your body since June.” I went weak in the knees and a lmost fainted. Why hadn’t they told me that great news in June?

Perhaps because they understood the risk of my refusing to continue the course of treatment that had been planned out in the fall of 1976 when I was diagnosed with stage 3B Hodgkins.

I was 19 at the time of diagnosis. Medical treatment, both chemotherapy and radiation, lasted a full year. I somewhat stoically endured that treatment and then spent years, mostly on my own, working on mental recovery.

Daniel at the very young 13 cannot be expected to have the foresight to see beyond the daily pain of treatment. He is behaving quite rationally.

However his parents are failing him. They need to make the life saving decision to keep him in chemo. They need to follow up by being there for him and getting him the now widely available help to live through treatment – on a psychic basis.

I hope they find Daniel and his mother and get him into treatment. I trust that if that happens on some day over 30 years from now Daniel, like me, will have memories of treatment and a love for the years of life it provided.

Update: Daniel and his mom have returned from their time away from Minnesota. Daniel will be getting the treatment with a 95% success rate. It is with great relief I withdraw the statement “his parents are failing him.” May their journey through treatment go as well as possible.

Update: Kent Petersen is participating in the annual Livestrong Challenge to raise funds for the foundation. Donate Now! Why? The Livestrong Foundation does more than raise money for research. Their mission: We can help you face the challenges and changes that come with cancer. 30 years ago that element was missing in treatment. The Livestrong Foundation is supporting a vital aspect of helping people get back to total health. It is strongly worth supporting.

May 22nd, 2009 | Category: Health, Life | Print This | Leave a comment

Like 2002 – Riding at 242

I’m starting over.

In November 2002 I started bike commuting to address my health issues, most of them tied to obesity. In August 2007 I faltered. Through early 2008 I rode in bits and pieces, perhaps once a week. Then in September I quit. Maybe I rode once in December 2008. But, effectively, I quit.

What was the effect? Between August 2007 and this morning I’ve gained 35 pounds or about 1.6 pounds a month. I’m back so close to where I was in 2002 that, effectively, I’m there again.

Not quite there there, but close enough. There are many changes since then. I can ride faster and further carrying the same set of a dozen cans of Crisco in fat on my body. (What a mental image! 12 Cans of Crisco! That’s why the pants don’t fit.) So my muscles, heart and lungs are stronger. Certainly not as strong as they were in 2007. But much stronger than in 2002 – a time when I cursed speed bumps on moderate climbs. In 2002 I’d be in a 20 inch granny gear climbing a 3% (if even that “steep”) grade and come to a speed bump that would almost stop me from continuing. Now I ride those same grades in something much higher than the granny and the bump is a bump. I’m doing an 11.8 mile commute instead of a 4.7 mile one.

Some similarities are present. I’m now working on working up to riding a metric century. 62 miles have gone from “wow? can I do that?” to “nice start for a day” to “oh gosh, can I do it again?” The first one is going to be tough.

And then it will get easier and easier as I do more and more. The only trick is to keep doing the more.

May 22nd, 2009 | Category: Bicycling | Print This | Comments (1)