Category: Uncategorized

27 July 2023

3:36 am. Newton’s third law of motion: for every action there is an equal and opposite reaction. I maintain we teach the wrong sequence of college prep science courses in high school. The most common sequence is biology first, chemistry second and physics third. In my opinion, we should reverse the order: physics first, chemistry second and then and only then teach biology.

I don’t see how anyone understands biology today without a firm foundation in physics and chemistry. So why Newton’s third law? Dr. Burgers prescribed me an antibiotic (Cephalexin, 500 mg, 2x) to head off any infection from yesterday’s aspiration of the hematoma. Stated clearly on the sheet that has “Important Information” is “May cause diarrhea. If persists or becomes severe notify dr or rph. Diarrhea may occur weeks or months after taking drug. Call dr or rph.” I’ve started taking Imodium and Lomotil again.

I was very tired last night and turned out the light at 8:30 pm. From that time until around 11 pm I was making periodic trips to the toilet with, wait for it, diarrhea. That was from one pill of Cephalexin at 6 pm. I’ll call Kathy later today and see if Dr. Burgers wants to change the prescription. Until then, I’ll take another Cephalexin at 6 am.

At 2 am I was waked by a passing rain shower. By 3 am I decided to get coffee and start my day. I may end back in bed and try to get a little more sleep but I suspect I’ll do an early morning walk in between rain showers. We are under another flood advisory today with 80% chance of rain today.

My depression is a little better today, or at least at 3:30 am. Last night I talked with my cousin in Greensboro before bed and it’s amazing how a little giggling over the phone helps. It seems to be a trait when I talk to the three sisters. I giggle with Jo and Jean. Jo and Jean giggle when they talk – sometimes for an hour. Giggling is an underestimated panacea.

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The cashew is a tree native to South America that belongs in the cashew or sumac family of plants (Anacardiaceae).

The plant produces one of the most unusual fruits in the plant kingdom. The red structure you see is referred to as the “apple” and the curved blackened structure below it is actually the real fruit of the plant, botanically called a drupe. Inside this drupe is what you know as the cashew seed. The “apple” is actually the pedicel and receptacle of the flower of the cashew. Hence, the cashew is said to be an accessory fruit, meaning that parts other than the ovary of the flower help make up the mature fruit and seed.

This tree was in the yard of one of my neighbors. Sadly she cut it down. She tried to give away the cashews but mostly the fruit fell to the sidewalk and made a mess. Given the fruits contain urishol, the dermatoxin in poison ivy, no wonder. Both parts are edible. Strangely, more people are allergic to peanuts than to cashews.

Biota of North America Program (BNAP) reports 12 genera of Anacardiaceae in the United States. Through my travels, I have photographed 3 genera and 7 species. Two of these species are toxic: Metopium toxiferum and Toxicodendron radicans.

5 am

It’s still raining so it looks like I’m not gonna walk this morning. Stay tuned!

24 July 2023

I seem to be sleeping a lot these days – both at night and at nap time. It could be due to the blood I’m expressing into that damned bulb. At last count, 224 ml or 0.4 of a pint. I’m sure I’m replacing it but probably not as quickly as it’s going out.

I seem to do better in the mornings. I walked 1.5 miles today around 9 am. It was hot but not unbearable. The person I felt sorry for was the lone guy putting shingles on the house across the street from me. He just finished up (4 pm) and I can’t imagine trying to do roofing work in this heat (feels like temp 104°F). He finished shingling the entire roof today and it’s a big roof.

I picked up John around 11:45 am this morning and we met Joel at the Peter Pan Diner on Oakland Park Blvd and Dixie. It’s been in the same location since 1979 (I moved here in 1985) and it’s been years since I’ve been. It closed for a while after a fire but otherwise, it’s been open 24/7 since 1979.

I’m not sure why but most diners down here are run by Greek families. As far as diners go, this one is a cut above most in the quality of their food. We were seated in the bar area – a first for all of us – even though there was plenty of room in the main dining area.

Joel had the fish sandwich, John had a Ruben and I had the Salisbury steak with mashed potatoes. Everyone agreed the food was good. The diner has been gay friendly as long as I can remember and they even had “rainbow” cake in their dessert display case today. It’s the type of place that the waitresses have worked there 15-20 or more years.

I’m not sure I was great company. I was tired and not very hungry although I did eat about half of my dish. Joel and John had plenty to take home for another meal. After taking John back home, I went to bed for a nap and slept at least and hour and a half.

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There’s some disagreement as to whether this plant is considered a Florida native or simply an introduction from Cuba. In any case, it’s native to the Bahamas, Cuba, Central America and Greater Antilles.

It’s a member of the borage or forget-me-not family, the Boraginaceae. Biota of North America (BONAP) lists 42 genera in that family in the U.S.

No less a personage than John James Audubon named the tree for his friend John Geiger who “salvaged” ship wrecks off the coast of Florida. Audubon stayed at Geiger’s house while in the Keys and today it is known as the Audubon House.

You may wonder about the quotes around salvaged. Key West made an industry of leading ships purposefully onto reefs and then claiming salvage rights. Geiger could have been perfectly legitimate.

The tree doesn’t get too terribly large in most ornamental plantings in South Florida but it’s readily recognized by its orange flowers. The fruit is somewhat pear-shaped and is somewhat whitish in appearance.

This plant stumped me when I first saw it and a neighbor had a row planted along her swale. She was the one to tell me the name of the plant. Since my first discovery of the plant, I’ve seen it more and more planted as an ornamental in Fort Lauderdale. It’s always nice to see “natives” planted instead of ornamentals from other country.

Over my cross country trips, I’ve photographed 17 genera and 34 species in the borage family. That bit of data surprised me! Click on the links to see photos of the plants.

17 June 2023

Well, will wonders never cease? I had my very first night of complete sleep not interrupted with diarrhea! I was, however, prepared. Melinda brought me applesauce and BJ’s brand of Depends (Berkley/Jenson).

I got out of bed at 6 am, had some Rice Crispies with bananas and started my day. Stomach pains and nausea then hit and I headed to the toilet. Miracle of miracles, I had my first semi-solid stool moment. (I should have taken a photo – ugh, maybe not.)

I immediately went back to bed and slept until noon. I think it’s critical I catch up on my sleep. I did put some witch hazel on my face with all the rash. Here’s what my face looks like.

I met with the oncology surgeon Dr. Burgers yesterday. Jim was kind enough to take me in and even stop for some shopping before taking me home. I made a decision about the chemo.

After explaining everything to Dr. Burgers, I asked about the option of surgery first and chemo later. She was open to the idea and agreed to hear me out. After some questioning of her, I realized that instead of 14 chemo treatments before surgery, there would only be 6 chemo treatments after surgery and that the treatments would probably entail only two of the four drugs: Taxotere and Perjeta. She also said that since I already had one chemo session, I may only need five chemo treatments.

I would probably have check up appointments 2 weeks after surgery, then one month after surgery, then every six months for around 5 years. After that, probably yearly visits for the foreseeable future. I’m sure I’ll also be on tamoxifen for five years.

She did an ultrasound and the tumor shrunk from 2 cm to 1.6 cm with just one chemo session. I simply told her I didn’t have it in me to do 13 more sessions. She understood and said she was working on a case with Dr. Velez that was the very same as my situation. She also said she understood I did not hit it off with Dr. Arnaout and she thought Dr. Velez was a better fit for me.

Dr. Burgers also mentioned there are more new protocols that are coming out they are looking at and I might fit into one or more of those with even more reduced chemo to only target the HER2 cells.

She likes to schedule surgery 3 weeks out from the last chemo, so that would put me the 26th of June or the 3rd of July, but it all depends on her calendar. I should know the surgery date by Monday.

Kathy also scheduled a meeting with me and Dr. Velez for July 3 at 2 pm to introduce myself and listen to his plan for after surgery chemo. She also brought up BRATT as did my cousin Jimmie: bananas, rice, apple sauce, toast and tea. That helps fight diarrhea.

My big concern was diarrhea and the effects the dehydration has on my kidneys and my heart. We discussed the possibility of Lomotil as a possibility as opposed to Imodium which doesn’t seem to be working even at double doses.

Jim took me to Publix and I got everything except applesauce. I may have some around the house but the stuff has probably expired. I’ll get some of that tomorrow.

Check the applesauce. My neighbor Chris brought over four individual servings and as I mentioned earlier, Melinda brought 3 large containers from BJ’s. Also Cathy, Nicole, Mary Kay, Barbara K, and John all volunteered to bring over some. Cathy volunteered to cook me meals but in reality, I’m sticking with the BRATT diet for now. And sleeping.

Just to show you how good a doctor Dr. Burgers is, she called me at home (not her job) yesterday and explained she had consulted with Dr. Velez (not her job) and had agreed that I could take Imodium every four hours and she wrote a prescription (again not her job) for Lomotil which I could take in conjunction with Imodium, every six hours. Then she explained Dr. Velez would work to get me in sooner than July 3 for a consultation (again, not her job). This woman cares about her patients!

I think today will be eat the BRATT diet and sleep and more sleep. We are in heat warnings and storm warnings today all day.

Stay tuned!

25 May 2023

Well, I can’t drink for 12 hour nor drive for 24. Not sure what that means that it’s OK to drink sooner than it is to drive.

Tom picked me up at the house at 8:15 am and strangely, I-95 was pretty clear sailing. The result was we had time to kill. We walked to the Holy Cross cafeteria and Tom got a coffee. Alas, I was on no food nor drink after midnight the day before. As time neared to head up to check in for the port insertion, Tom thought he had left his phone in the cafeteria. By the time he made it to the waiting room, I was already admitted and taken back to the prep room.

As an aside, Tom and I rode up together before he forgot his phone and then we shared the elevator with the nurse who eventually admitted me. He was carrying three coffees and I asked if one was for me. He laughed and said “see you later.”

When they took me back, Brandon, the nurse with the coffee, and I were constantly chirping about coffee and how I had none and he had one. Then we were off on how he didn’t seem to have time to drink his but I did have time to drink his.

Monique (now known as Monique I) inserted an IV and told me the good stuff was coming. One of the operating room nurses, Rosemary, continued prepping me and around 10:15 I was wheeled into the operating room and met Monique II. Monique II was the surgical nurse and Rosemary was the attending nurse who monitored my blood pressure, EKG, and pulse rate.

The operating table was very narrow and they had to put up guards to either side to keep me on the table and to have a place to lay my arms during the procedure. Absolutely nothing happened for quite a while with me just laying on the table and the nurses chattering. Monique II eventually wiped me down with an antiseptic and let that dry and then applied another antiseptic and let that dry. The covered my body with sterile drapes and then my face. I had to keep my face turned to the left so they could access the right internal jugular.

Eventually, Dr. Rush came in and introduced himself (he peeked in under the drape) and said he would take good care of me. I assume they had already dosed me with fentanyl and versed.

Fentanyl is an opioid used as an anesthetic and as pain relief. Versed is a benzodiazepine used as a relaxant during surgery. To be honest, I couldn’t tell the effect of either of those.

Dr. Rush then numbed the two incision areas. You can see the YouTube video on port insertion here. The worst part was the injection of the lidocaine to numb the areas. That actually hurt. The team used both an ultrasound and x-ray to follow the path of the catheter and to check on the location of the port.

I could feel the insertion of the catheter into the internal jugular but it didn’t hurt. It was pretty much the feeling of pushing something through a tube. When he inserted the port, there was the feeling of more pushing but that was it. I knew when he did the few stitches to the port incision but that was pretty much it. He probably didn’t spend more than 10 minutes on the entire procedure.

I asked Monique II and Rosemary to take a couple of photos for me.

I was wheeled back to the prep room and looked at the time and it was 11:15 am. Rosemary said I could be released by noon. They wanted to observe me to make sure there was no bleeding and the anesthesia was wearing off. That was when she told me no drinking for 12 hours and no driving for 24. When she said the bit about no drinking, she raised her eyebrows and hands and said “I have to tell you that, regardless.” Monique I removed the IV and I was taken by wheel chair to the reception room, gathered Tom, and wheeled to the entrance of the hospital where the valet brought Tom’s car.

I’m under orders of no heavy lifting with that side of my body for the first few days. I’ve been encouraged to take a day off from work – no problem there. In three days, I’ll be able to remove the bandage, take baths and swim. I cannot remove the steristrips – they have to fall off on their own.

The nursing staff were great. The doctor was so quick, I had no real impression of him other than him telling me I did great and his work looked great. Rosemary told me before being wheeled in that Dr. Rush was indeed, very, very good.

The two most painful parts of the entire process was the insertion of the IV – it hurt like hell – and the lidocaine injections – not nearly as bad as the IV. Otherwise, it was a breeze. Just lay there and do what they tell you to do.

Next up is June 5th and my first chemotherapy infusion.

Stay tuned!

Saturday 11 June 2022

Every morning, first thing, I turn the computer on and log into my msn.com site. Like Facebook, it often has lists like “Oldest Hotel in Your State” or “How Many of These Countries Have You Been.” I mentally answer the Facebook ones but don’t actually take the survey or answer – I’m on enough mailing lists. At least, the ones on msn.com will tell you if they are ad based.

Today I ran across an interesting one on msn.com that listed all 50 states highest and lowest points. I had been to the highest point in four states: Mississippi, North Carolina, Tennessee and Texas. I had been within sight of three others: Washington, Oregon, and California.

My first high point had to be Clingmans Dome in North Carolina. It’s a cheat climb because you park you car in the parking lot at the base of the visitor center, but it is still a 331 foot elevation gain from the parking lot. Clingmans Dome peaks at 6,643 feet. I have no recollection of my first time to the top but I’ve climbed it many, many times over the years.

My second high point came as a graduate student in Dr. Pullen’s Flora of Mississippi class. It was in Tishomingo County (before I started my survey of the state park there) and we climbed to an elevation of 806 feet! At the time, there was no road to the top and you had to hoof it up for an elevation gain of 150 feet. Today, you can drive to within 9 feet of the top. We collected plants on our way up. What was interesting was Dr. Pullen made it up without any heavy breathing and he had to be in his 60’s then. Several of the graduate students were panting pretty good.

My third high point was also my toughest – Guadalupe Peak in Texas at 8,749 feet. This is a 2,982 foot elevation gain in 8.4 miles. The park service recommends you allow an eight hour time span to hike up and back. It took me 10 and nearly killed me. Any time you have a 3000 foot elevation gain, it’s brutal.

My last acme was Mount Mitchell in North Carolina. It logs in at 6,684 feet. It’s 41 feet lower than Clingmans Dome. If you walk the trail (I did not) it’s a 3,694 foot elevation gain. If you park in. the parking lot, you probably gain about 27 feet in elevation.

As far as other peaks I’ve visited but not topped out, Mount Rainier in Washington is the tallest at 14, 441 feet, Mount Whitney in California is 14, 505 feet and Mount Hood in Oregon is 11, 249 feet.

I am proudest of Guadalupe Peak but I never want to climb it again.

There are a group of hikers that are members of the fourteener’s club – those that climb 14,000 feet peaks as a hobby. The highest I’ve ever been was Emerald Lake in Rocky Mountain National Park and it was an elevation of 10, 138 feet which was a 689 foot elevation gain from the parking lot at Bear Lake.

I’ve also snowshoed Bear Lake to Nymph lake in the same spot with Michel and Nancy with an elevation gain from Bear Lake to Nymph lake of 230 feet. Nymph Lake is at 9,679 feet.

I can’t say what motivates fourteener’s nor what motivates me to hike up mountains. It’s not really a lot of fun doing it until you get to the top and see the sights. Then it all seems worth it. Many times I’ve asked myself what in the hell I’m doing. Then I do it again.

Stay tuned!

Monday, 23 May 2022

Of course, I goofed. I forgot that two of the inns I stayed had already charged a deposit. The result is the lodging was $2114 vs. $1530. That brought the total of the trip to $3,400. I knew I was thinking it was a cheap stay at Beechwood Inn.

It’s taken me two days to unwind from the trip. I had scheduled another massage upon my return and got it today. The therapist is Tom Marten at 5Points Massage. He’s been in the business over 30 years and does an excellent job. What I particularly appreciate is he works my butt – literally. The Gluteus Maximus is the largest muscle in the body and yet so many massage therapists ignore it. Trust me, after you have driven over 2100 miles, you appreciate a little butt massage.

Tom also stretches you out. He takes each leg and lifts it up into your body and holds the position for 20 seconds. He always seemed pleased with how far he can go with me and never fails to compliment me on it. There’s something about how he does the massage that really gets the blood circulating in my muscles.

After I left his studio, I was limp as a noodle but headed to get my jeep washed. It is love bug season and I had a great sample on the front of my car plus all the dust from the dirt roads to which I was routed. I usually wash and wax the jeep myself but I just don’t seem to have the energy to do it and I wasn’t looking forward to the scrubbing of love bugs. The car wash charged $5 extra to “de-bug” the jeep. They do an OK job with the wash so it was worth it to me.

Next up is to see if I can reset the head rest on the driver’s side. It accidentally deployed during the trip and according to YouTube, I can pop it back in place. I suspect if I am successful, when I next take the jeep in to be serviced, they will have to reset the computer. The head rest deploys mostly in accidents to help prevent whiplash. I somehow triggered mine accidentally.

I got back into my physical routine today. I walked 1.4 miles this morning, did my yoga stretches, and swam laps in the pool. I had enough energy to rake the leaves in the side yard. After being away for 13 days, the mango tree had shed enough leaves you almost couldn’t see the sidewalk. It took me a good hour to rake and clean and wash down the patio and pool decks.

As you might also guess, Palm Beach, Broward, and Miami-Date counties have been upgraded to high rates of Covid. It seems someone failed to report compete data to CDC and we went from mild to high rate of infection after CDC discovered the failure.

Not to be outdone, the first case of Monkey Pox was reported in – get this – Fort Lauderdale. It seems the person was an international traveler. I used to tell my students that physicians these days needed to be well versed in all the diseases of the planet because with the advent of jet travel, any disease, normally isolated to a particular area, could now be spread through jet travel. You can’t just be an expert in tropical diseases when you are in Miami. Physicians in New York may see tropical diseases in their patients who flew up from the tropics.

A practical example is what happened with barnacles. Barnacles, at one time, were species restricted to particular locations. One species would be found in the waters off Japan, another species endemic to the California coast, and yet another species endemic to the waters off Brazil. You get the idea. With the advent of exploration by sail, barnacles hitched a ride on boats and have been spread worldwide. Species restricted to Japan, for example, can be found in most waters of the world with similar temperatures. We are now seeing it with diseases.

Hopefully, I will continue to add to the blog over the next few days. Stay tuned!

Sunday, 22 May 2022

It’s funny how quickly you can get back into a routine. Get up, make coffee, pour cereal, do computer work, morning walk, etc. I am certainly a creature of habit. What’s strange is any time I take a trip, my routine goes out the window and yet when I return, so does the routine.

Sunday morning is my usual grocery shopping routine and since I tried to use up everything before my trip, I had to do a lot of restocking on this grocery visit. I was out of just about everything.

The afternoon was spent entering my trip expenses into my MoneyDance software program so I can see if I really have any money left after the trip. It was cheaper than I expected.

I spent $520.94 on food and I have to admit I could have done that a lot cheaper but I figured while on vacation to go ahead and spoil myself. The sad thing is the food at all the restaurants wasn’t that great. Almost every restaurant I visited was having labor problems – not enough people.

Lodging ran to $1530.00. I stayed in some very nice places and some so-so places. Diesel fuel ran to $428.52 and miscellaneous stuff like gifts, entry fees, etc. ran to $336.56. All total I spent $2,816.11 on the 13 day trip or approximately $216 per day. When you consider the price of diesel ($5.19-5.99 per gallon) it was a fairly economical trip.

Other than the visit with Jimmie and Stephen, the highlights of my trip was my stay at the Beechwood Inn, hiking Black Rock Mountain State Park trails, and my ability to hike the Deep Creek/Juney Whank trails without stopping to gasp for air. The stay at Wakulla Springs lodge was a bucket list item and it met expectations.

Now, back to my routine.

Stay tuned!!