Cankles

The Ancient Greeks Certainly Didn’t Like Them

Semonides of Amorgos (floruit 7th Century BC) is by no means the most famous ancient Greek poet. In Richmond Lattimore’s Greek Lyrics, which I read at Dartmouth in a class on ancient Greek literature in translation, there is a brief quote (the rest of the poem has been lost) to the effect that:

A woman thick around the ankles is no good.

There isn’t much literary quality there. In fact, there isn’t much of anything. But there is something about that line from 2,700-2,800 years ago that has somehow survived whereas many plays by Sophocles and Euripides haven’t.

And are men with thick ankles any good? I know that whenever I visit the doctor, she checks my ankles to see whether the blood is pooling there, indicating poor circulation. (I used to have thicker ankles, but over the last several years it’s been OK.)

There is a word in popular parlance describing the phenomenon. The word is cankles, combining the words calf and ankles. My Mom had cankles, but then she did have problems with blood circulation that eventually precipitated fatal heart failure in her 79th year. Based on my Mom and what I have picked up from my own doctors, cankles go with all kinds of bad things relating to the heart.

Now it is possible for cankles to not be related to heart or kidney failure. I just don’t know what else they could signify, other than obesity.

 

 

Plague Diary 24: Zoom, Babies, and Barkies

Boredom Times Infinity

There are a number of stereotypes emerging from our months’ long quarantine: Zoom images of not altogether with it participants, small children, and pets—just to name a few. Being retired and not involved in alcoholism or recreational drugs, I am not into Zoom. There are zero circumstances which would call for a number of my friends and acquaintances being dragooned into meeting with me. Besides, I don’t have a camera on my PC at present. If I decide to get Skype or some other video telephony application, I might change my mind. Otherwise, nyet.

Pets and Babies Do Nothing for Me

It seems that most quarantiners have an irresistible urge to feature their pets and small children. That would have meant something to me decades ago, when I wanted to join that particular club. But having my pituitary gland and the chromophobe adenoma that devoured it removed at the age of twenty-one, I became ineligible to have a baby that looked anything like me. Nowadays, when I think of babies, I think of overfilled diapers. And I become comically allergic when I spend more than a couple hours with a dog or cat.

I would very much like to see my friends, but fortunately I am not going crazy from isolation. It seems that I am well-prepared for quarantining:

  • I have a library of several thousand books
  • I own hundreds of DVDs of classic movies, foreign and domestic
  • My cable TV gives me access to hundreds of free movies each week
  • I like to cook
  • I have a telephone

So I don’t have to shove pets and poopy diapers in your face, and I don’t need to appear on Zoom wearing nothing below my navel. You might call it the joys of sublimation.

Plague Diary 23: An Etymological Curiosity

A Look Back to the 1918 Influenza Pandemic

I was scanning the channels early this evening when I made a surprising discovery. There seems to be a term from the 1918 Influenza Pandemic that has become part of our language. The “crawl” on one of the news stations casually mentioned that the term “slacker” derived from scofflaws during the pandemic that refused to wear face masks.

According to the Saturday Evening Post website, then, as now, there was an organized resistance to wearing masks:

[T]he Influenza pandemic of 1918, triggered a comparable patchwork of ordinances and ensuing economic fallout. Some Americans’ reactions a century ago took similar form, particularly a group of fed up San Franciscans who called themselves the “Anti-Mask League.” Although San Francisco saw one of the worst U.S. outbreaks of the pandemic, these dissidents opposed orders from the city’s Board of Health not because of the economic implications, but because they saw it as their right to walk the city maskless. Besides, they didn’t think the things were working anyway.

The more things change, the more hey remain the same. The members of the Anti-Mask League were referred to as slackers.

From the Enid Daily Eagle of September 25, 1918

There are, of course, some differences between the coronavirus and the outbreak following the First World War. All I can do is re-iterate the warning from the newspaper clip above:

Don’t get “scared.”

 

 

Rights vs “Rats”

End Quarantine Protest in Huntington Beach

They are both the same word, but “rats” (R1) is the Southern Confederate drawl version of “rights” (R2). They do not, however, refer to the same thing. R1 people are likely to insist that this is a free country, meaning they are free to do anything they want, even if it causes harm, like shouting “Fire!” precipitating a riot in a crowded theater. They are free to think that whatever they believe is true, such as that Covid-19 is a lie.

Myself, I consider myself to be an R2 person. I have certain inalienable rights, but these stop short when they cause harm. If I fire an AR-15 automatic rifle into a crowd, the possibility of killing multiple people puts a limit on my “rats.” Likewise, going to a crowded bar, getting coronavirus, and passing the disease on to my friends and relatives, possibly killing several of them, is to my mind a criminal act.

Confederate Prisoners Fighting for Their “Rats”

I first stumbled onto the difference in a scene from the 1993 Ted Turner film Gettysburg, when C. Thomas Howell, playing the part of Lieutenant Thomas Chamberlain, comes across a group of Confederate prisoners and asks them what they were fighting for. He doesn’t quite understand their answer, that it wasn’t for slavery that they were fighting, but for their “rats,” making him wonder why they were talking about vermin. It’s interesting to me that one person’s rights could be seen as another person’s crimes.

I see Trump in a difficult position. The disease is a serious one, and at the same time the economy is in dire straits. On one hand, his return-to-work policy could result in tens of thousands of deaths, especially of those misguided people who believe in him. On the other, it could lose him his presidency if his followers get so an inkling of what is really happening.

 

Plague Diary 21: Open With Restrictions

The Los Angeles Arboretum in 2017

Little by little, selected trip destinations are opening up s-l-o-w-l-y and with multiple restrictions. I can now visit the beach, but only if I am actively swimming, walking, or running. If I lie down and try to get a tan, or picnic, or even bring a cooler with me, the police would roust me. And of course, the water fountains are closed, together with the snack bars. Also the parking lots along the beach will be closed.

At the Los Angeles Arboretum, one can only walk on the paved paths in a park where half the paths are unpaved. And, of course, the benches are off limits, water and food are not available. I assume that if you sit down on one of the capacious lawns, you will be asked to move on.

Descanso Gardens is not closing down any of their unpaved paths, but again no benches or food, though water will be available.

The next time we get a heat wave, I will probably take a bus down to the beach and take a walk. I would like to lie on the beach, but I suppose a walk would be good for me.

I have this funny feeling that it will be many months before anything resembling normalcy will be restored to us.

 

 

Plague Diary 20: The Virus Mutates

As the Virus Mutates, the Symptoms Change

In a way, I hate writing about Covid-19. It seems that over 80% of the news on any given day is about the virus. One result is that most of us stay-at-homes are itching to get on with our lives. The pressure to do away with social distancing is growing from the top down, thanks to the current occupant of the White House. Suddenly, reasonable measures to contain the virus are being treated by protestors as violations of the constitution of of our God-given rights. (That last word, given a Southern drawl should come out pronounced as “rats”)

According to a CNN article released today, it seems the virus is mutating before our eyes and exhibiting a different array of symptoms, including:

  1. Aortic occlusions causing blood clots in the body’s main artery.
  2. Multi-system organ failure, when all the patient’s organs shut down at once.
  3. Pediatric multi-system inflammatory syndrome in which a child suffers “persistent fever, inflammation, poor function in one or more organs, and other symptoms that resemble shock.”
  4. “Covid toes,” in which red or purple lesions appear on the bottom side of the toes.

Based on conversations I have had with people, most think a vaccine is on the point of being developed that will allow all of us to return to work shortly. Please note, however, that the fastest a vaccine has ever been developed to fight a particular disease is four years, I suspect that if the coronavirus is mutating, it will probably take longer.

My prediction: As a result of social distancing, coronavirus will die down and then return in sudden outbreaks when the controls have been lifted. The people who are supporters of the President will, upon relaxing social constraints, be particularly likely to catch the disease in one of its new, more troubling configurations.

 

Zoonotic Spillover

So This Pandemic Comes to Us from Bats?

My one experience with bats comes from the 1980s while I was visiting Carlsbad Caverns in New Mexico. Every day from June to October, almost precisely at sunset, tens of thousands of Brazilian free-tailed bats emerge from the cave, gliding inches from the ears of spectators seated in an amphitheater near the entrance.

While I admire the creatures for devouring untold billions of insects, I have never been tempted to eat bat meat in any way, shape, or form. But the current coronavirus pandemic could be due to Chinese in Wuhan attempting to do just that with meat obtained at a highly unsanitary institution referred to as the “Wuhan Wet Market.” According to CNN, a bat-infected pangolin could have been eaten by Patient Zero of the coronavirus.

Bats Emerging from Carlsbad Caverns at Sunset

Others say that the virus emerged as a result of a lab accident in Wuhan in which a study of bats was involved. In either case, it was an instance of zoonotic spillover, in which a disease crosses from an animal to a human.

Whatever the source, there are numerous conspiracy theories in China, the United States, and around the world fomented by the usual guilty parties. These state that the virus was deliberately spread by China or the U.S. or by God, who is dissatisfied by the laxity and sinfulness of His worshipers.

Pangolin

I am not in a position to rule on how COVID-19 started on its quest to infect the world. Many comparisons have been made to the Black Death (Bubonic Plague) of the Middle Ages, of which one website provided the following description:

The Black Death was a devastating global epidemic of bubonic plague that struck Europe and Asia in the mid-1300s. The plague arrived in Europe in October 1347, when 12 ships from the Black Sea docked at the Sicilian port of Messina. People gathered on the docks were met with a horrifying surprise: Most sailors aboard the ships were dead, and those still alive were gravely ill and covered in black boils that oozed blood and pus. Sicilian authorities hastily ordered the fleet of “death ships” out of the harbor, but it was too late: Over the next five years, the Black Death would kill more than 20 million people in Europe—almost one-third of the continent’s population.

Thankfully, COVID-19 has nowhere near that mortality rate.

Still, be careful and stay safe!

 

 

Bad Toenail Karma

Toenail Edges Growing Into the Skin

I think it all started with my father. He had thick toenails that tended to curl inward as they grew. The end result: a tendency toward ingrown toenails. I remember once going with him to my podiatrist in Los Angeles. He was in such pain from the cleaning out of the ingrown toenails that he resolved never again to visit a podiatrist.

It was my misfortune to inherit my father’s toenails. Mine, in fact, are so thick that I could probably slice through heavy sheet metal with my bare feet. The difference is that I go to a podiatrist regularly to clip my nails and dig out the ingrown ones. And I tend to have at least one or two a month. Yes, it is painful; but catching them early is less painful than neglect.

Is it my shoes? I don’t believe so, if only because my toes never hurt when I walk. The only time I feel I have an ingrown toenail is from the weight of my bedsheets brushing against my toenails.

What can I do about my ingrown toenails? Since I can’t control how my toenails curcl as they grow, I just have to grin and bear it.

 

Things We Take for Granted

We Can’t Make Assumptions That Health Care Will Be There for Us

We walk into the kitchen, pick up a glass, and turn the tap on. What if nothing comes out? Or, worse, what if what comes out is polluted like the water in Flint, Michigan? What if we flush the toilet, and it just won’t go down because the sewer line is all backed up? What if the traffic signals just stop working? Or the telephone lines? Or the electricity?

Every day of our lives, we make casual assumptions that what has worked in the past will continue to work. I have this odd inkling that perhaps we are living at the start of a period in which things we assume will work, just won’t work.

I recently read an article on Salon.Com about how some 20% of rural hospitals are on the point of collapse. Given the money-grubbing nature of our healthcare system—especially on the part of pharmaceutical corporations and health insurers—I can see why there aren’t enough dollars in rural areas to motivate hospitals to remain in business.

This comes at a bad time, when the political divide between the urban areas on the coasts and what has come to be called “flyover country” has led to hard feelings. Much of Trump’s support is, I feel, based more on this urban/rural divide than any particular love for the orange-headed horror. Things can only get worse if Aunt Tillie dies trying to get to a distant hospital, but doesn’t make it.

Government can rectify this situation, but only if voters are willing to let government do the things that government does best. The nihilistic conservatism and Tea Party anarchy of the times makes this difficult.

 

(Don’t) Ask Your Doctor

So You Think You Can Second-Guess Your Physician?

You don’t have to watch a whole lot of television before you start running into a barrage of commercials attempting to influence you in “asking your physician” about the various nostrums that are being advertised. And you wonder why prescriptions cost so much?

Here is a brief survey of three such drugs I have seen lately together with a list of things that can happen to you if you were dumb enough to urge your doctor to prescribe them. Please note that while a sotto voce voice in the background warns you of impending disease and death, you are watching attractive actors indulging in an active, trouble-free lifestyle.

Humira (Adalimumab) – Abbvie Inc. – For Psoriatic Arthritis

Serious infections have happened in people taking HUMIRA. These serious infections include tuberculosis (TB) and infections caused by viruses, fungi, or bacteria that have spread throughout the body. Some people have died from these infections. Your doctor should test you for TB before starting HUMIRA, and check you closely for signs and symptoms of TB during treatment with HUMIRA, even if your TB test was negative. If your doctor feels you are at risk, you may be treated with medicine for TB.

Cancer. For children and adults taking TNF blockers, including HUMIRA, the chance of getting lymphoma or other cancers may increase. There have been cases of unusual cancers in children, teenagers, and young adults using TNF blockers. Some people have developed a rare type of cancer called hepatosplenic T-cell lymphoma. This type of cancer often results in death. If using TNF blockers including HUMIRA, your chance of getting two types of skin cancer (basal cell and squamous cell) may increase. These types are generally not life-threatening if treated; tell your doctor if you have a bump or open sore that doesn’t heal.

Taltz (Ixekizumab) – Eli Lilly – Also for Psoriatic Arthritis

Taltz affects the immune system. It may increase your risk of infections, which can be serious. Do not use Taltz if you have any symptoms of infection, unless your doctor tells you to. If you have a symptom after starting Taltz, call your doctor right away.

Your doctor should check you for tuberculosis (TB) before you start Taltz, and watch you closely for signs of TB during and after treatment with Taltz.

If you have TB, or had it in the past, your doctor may treat you for it before you start Taltz.

Do not use Taltz if you have had a serious allergic reaction to ixekizumab or any other ingredient in Taltz , such as: swelling of your eyelids, lips, mouth, tongue or throat, trouble breathing, feeling faint, throat or chest tightness, or skin rash. Get emergency help right away if you have any of these reactions. See the Medication Guide that comes with Taltz for a list of ingredients.

Crohn’s disease or ulcerative colitis (inflammatory bowel disease) can start or get worse with Taltz use. Tell your doctor if you have any of these symptoms or if they get worse: stomach pain, diarrhea, and weight loss.

You should not get live vaccines while taking Taltz. You should get the vaccines you need before you start Taltz.

Chantix (Varenicline) – Pfizer – To Stop Smoking (This ad uses a pixillated turkey rather than live actors)

Some people have had new or worse mental health problems, such as changes in behavior or thinking, aggression, hostility, agitation, depressed mood, or suicidal thoughts or actions while taking or after stopping CHANTIX. These symptoms happened more often in people who had a history of mental health problems. Stop taking CHANTIX and call your healthcare provider right away if you, your family, or caregiver notice any of these symptoms. Before starting CHANTIX, tell your healthcare provider if you ever had depression or other mental health problems.

Some people have had seizures during treatment with CHANTIX. Tell your healthcare provider if you have a history of seizures. If you have a seizure, stop taking CHANTIX and contact your healthcare provider right away.

New or worse heart or blood vessel problems can happen with CHANTIX. Tell your healthcare provider if you have heart or blood vessel problems or experience any symptoms during treatment. Get emergency medical help right away if you have symptoms of a heart attack or stroke.

Sleepwalking can happen with CHANTIX, and can sometimes lead to harmful behavior. Stop taking CHANTIX and tell your healthcare provider if you start sleepwalking.

Do not take CHANTIX if you have had a serious allergic or skin reaction to it. These can happen with CHANTIX and can be life-threatening. Stop taking CHANTIX and get medical help right away if you develop swelling of the face, mouth, throat or neck; trouble breathing; rash with peeling skin, or blisters in your mouth.

Use caution when driving or operating machinery until you know how CHANTIX affects you. Decrease the amount of alcohol you drink while taking CHANTIX until you know if CHANTIX affects your ability to tolerate alcohol.

The most common side effects of CHANTIX include nausea (30%), sleep problems (trouble sleeping, vivid, unusual, or strange dreams), constipation, gas and/or vomiting. If you have side effects that bother you or don’t go away, tell your healthcare provider.

Now if you still want to tell your doctor what to prescribe for you, you’d be letting him off the hook. After all, he doesn’t have to research and find the best drug for your condition. And it’ll make you look smart, at the possible cost of discomfort, disease, or even death.

My advice? Mute all prescription commercials. The risks far outweigh the advantages.