Archives for May 2003

B-36 Museum in Fort Worth

I have a personal connection with this aircraft type, my father served on it during his Air Force enlistment. He has a yearbook of sorts, and I have very fond memories of listening to his active duty experiences. He’ll still tell you one, if you ask.


It’s a huge beast, and isn’t preserved in great numbers. In fact there are only four in displayable condition, and the one here in Fort Worth needs a permanent home. The City of Fort Worth is its name, and it was renovated with a ton of volunteer time (over 40,000 hours) and support form Lockheed Martin.

There are several terrific sites devoted to the B-36, and most have links to donation sites for a new home.

Update: added the top link:
B-36 Peacemaker Museum
Goleta Air & Space Museum
Convair B-36 Peacemaker and YB-60

Help vote a new name for SARS

SARS is not a really catchy name for a disease. Jim Treacher has a poll to vote for a potentially better one.

My vote went to Fu Man-achoo.

via The Greatest Jeneration

AC, part two

No, the airconditioner isn’t yet fixed. Perhaps today. “The part” can be purchased, so we’re not looking at a stupendous repair bill, just astonishing.

The computer makes noises like aircraft at the end of the runway during the day (90 plus degrees and 90% humidity will do that). Those cooling fans are earning their keep.

Funny, I’m watching “The Money Pit” just now. Wonder why that’s funny?

Tarantula Glasses

Tonight, at dinner, we began discussing tarantulas. My older daughter had one try to walk into her house through the front door a few days ago.

That’s when it happened: my 6th grade daughter lets fly with this interesting factiod:

“If you touch a tarantula and then rub your eyes, you will have to wear glasses”.

Although my drink didn’t come out my nose, I did make an appropriate choking sound. She tells me she heard it on TV.

TV. Aaah.

Federal agents trained to spot SARS

Really, I’d rather they worried about terrorism, and finding terrorists (and this says really bad things about mission creep).

So, let’s recap the symptoms of SARS from the CDC:

Clinical Criteria
Asymptomatic or mild respiratory illness
Moderate respiratory illness
Temperature of >100.4? F (>38? C), and
One or more clinical findings of respiratory illness (e.g., cough, shortness of breath, difficulty breathing, or hypoxia).
Epidemiologic Criteria
Travel (including transit in an airport) within 10 days of onset of symptoms to an area with current or recently documented or suspected community transmission of SARS?, or
Close contacts within 10 days of onset of symptoms with a person known or suspected to have SARS infection.

So, if you have a cold, be prepared to be stopped and held, involuntarily, until a Public Health officer interviews you. It doesn’t say in the article if you could just elect not to travel and leave, and thereby avoid the public health evaluation certain to follow.

Another reason to drive, not fly.

The Lemon

The Lemon is the Onion’s younger, less sophisticated cousin. And it’s pretty funny.

Added to the blogroll. As is The Onion.

Iraqi Info Minister’s Newest Gig

is giving out Error:404 info.

Iraqi Information Minister is the most popular search term leading people to my site, and I blogged about him once. Well, now twice.

via LGF

Arsenic Suspect Suicide in ED?

I have blogged recently about arsenic poisoining, and have been following the news reports about the investigation.

Four days ago a parishoner in the church where the coffee was poisoned killed himself. The artlessly worded second paragraph:

…who died of a self-inflicted gunshot wound to the chest Friday night after being rushed to a hospital. The state medical examiner’s office ruled the death a suicide Tuesday.

Does anyone think that they rushed this person to a hospital so he could shoot himself in the chest in the ED? Silly reporting, even for CNN.

Interestingly, the investigation isn’t over, and that’s a good sign; this would be an easy ending for an intellectually lazy investigation to stop.

Testosterone Replacement

First, the testosterone humor I know:
(when discussing the odd behavior that resulted in a young man’s injury):”Testosterone is a neurotoxin”.

Testosterone replacement is a valuable treatment, and isn’t anything I will ever do in my practice. It isn’t an emergency.

That having been said, I stumbled across a very good summary article about testosterone replacement therapy in the Digital Urology Journal. (I wonder if they were aware of the humor in ‘Digital Urology’).

Basically, benefits of medically indicated replacement are:

to enhance libido and the frequency of sexual acts and sleep-related erections… … positive effects on fatigue, mood, and sexual function, as well as significant increases in sexual activity… … improve positive mood parameters, such as feelings of wellness and friendliness, while reducing negative mood parameters, such as anger, nervousness, and irritability.

There are basically three different approaches to testosterone replacement: pills, shots, and patches.

Pills work, but elevate people’s liver enzymes, and need to be taken several times a day. Shots work, usually one a week, at least until a steady-state concentration is achieved.

The patch section made me laugh; one is applied directly to the scrotum (to take advantage of a particular enzyme activity of that skin). The other patches are for ‘regular’ skin.

So, you think you might benefit? See your doctor, who will either order the correct tests and perform the exam, or refer you to a urologist for the workup.

To find your own urologist, can help.

My First Anniversary

of blogging. I started blogging May 2, 2002. I had then, as now, nothing substantive to say. I have never written an amusing anecdote like Lileks (and am reasurred that nobody else has, either). I haven’t written a 10,000 word essay on anything, and have no interest in it.

What I have done is, mostly, entertain myself and indulge in my computer hobby.

Here’s to another year of blogging. It gets slowly better, and it’s still fun. I’ll stop when it isn’t fun any more.

Home Improvement

In the last week, the yard sprinkler system quit working and the airconditioner went out.  No big deal, except, of course, I was out of town.

Sprinkler repair consisted of replacing the innards of all the front yard valves, and now they work normally (problem turned out to be several valves that wouldn’t close, so there was never enough pressure to activate any one zone, basically they were all on).

The AC has proven to be a bigger problem.  The first repairman to come out said the coil needed to be removed and ‘vatted’, as the reason it didn’t work was it was too dirty to pass air.

This isn’t covered by the home warranty, as it’s "cleaning, which is routine home mainenance".  If you’ve ever had your AC coils vatted as part of your routine maintenance, please drop me a comment.  Battle with home warranty to follow.

The second repairman agreed with the first, but of course he says there’s no guarantee this will actually fix the problem, just plunge about $300 into an 18 y/o system and hope for the best.

Hmmmm.  It’s hot in here.  We’re vatting on Monday.

Prehospital Amputation

Prehospital amputations are performed rarely; usually, enough tools / hands can be assembled to lift whatever obsturction is pinning the extremity and free the victim. That having been said, I recall reading about some prehospital amputations being lifesaving (I cannot find any links).

In some cases people have done it themselves to save their own lives (life over limb). According to CNN:

MOAB, Utah (AP) — A Colorado climber amputated his own arm Thursday, five days after becoming pinned by a boulder, and he was hiking to safety when he was spotted by searchers, authorities said.

Aron Ralston, 27, of Aspen, was in serious condition late Thursday at a hospital in Grand Junction, Colorado.

Ralston was climbing Saturday in Blue John Canyon, adjacent to Canyonlands National Park in far southeastern Utah, when a 200-pound boulder fell on him, pinning his right arm, authorities said.

He ran out of water on Tuesday and on Thursday morning, he decided that his survival required drastic action.

Using his pocketknife, he amputated his arm below the elbow and applied a tourniquet and administered first aid.

He then rigged anchors, fixed a rope and rappelled to the canyon floor.

Wow. This fellow is exceptional, and is to be congratulated.

From what I have read, prejhospital amputations aren’t really all that difficult: the hard part is in making the decision, which isn’t taken lightly, but if it’s to be done it should be done in time to save the life of the patient.

Disclaimer: this is not medical advice. Don’t do this. The technique involves cutting through basically two different tissue densities: skin/fascia/muscle/nerve/artery/vein are going to be no match for a good strong pocket knife. The bone is an entirely different matter; the most practical device I’ve seen recommended is a flexible saw (like is used on tree limbs), which they still use in the OR, I hear. If there’s no way to cut through bone, plan to go through a joint. All of this tissue is well enervated (meaning everything hurts), so be prepared. Place a tourniquet prior to starting; when free, move like the wind to help!

In the case of our climber, I have to wonder if he didn’t have bones broken in his forearm, or already had a partial amputation he completed. Time will tell. And he did the right thing: he’s alive to tell the tale.

Update: Of course, I mean innervated, not ennervated.

Arsenic poisoining

According to the WMTW website:

Maine State police said Thursday that they’re treating the arsenic poisoning death of a church elder as a homicide investigation.

Steve McCausland of the Maine Public Safety Department says the source of the arsenic that killed Walter Morrill and sickened more than a dozen others was the brewed coffee served after church.

McCausland says tests done on the tap water, the sugar and the unbrewed coffee from the can are all negative for arsenic. He says the investigation has produced no evidence that supports a conclusion that arsenic was introduced into the brewed coffee accidentally.

The state medical examiner’s office has now ruled that 78-year-old Walter Morrill died from acute arsenic poisoning. Two other victims remain in critical condition today at the Eastern Maine Medical Center in Bangor.

This highlighted to me that I needed to refresh my memory on arsenic poisoinings. Guess what? It looks like a ton of other stuff.

Acute poisoinings (like the case above) start with some difficulty swallowing and a ‘metallic’ taste in the mouth, and depending on the dose can quickly progress to nausea, vomiting, abdominal pain and watery diarrhea. Seizures with coma can follow a severe ingestion, followed by brain and kidney damage if you live that long.

I see that presentation about once a shift in the ED (though none have progressed to seizures and coma), and as far as I know, none so far have been arsenic overdoses. Even more insidious are those with a chronic toxicity, being quite difficult to diagnose.

Taking a thorough history wouldn’t help in the case above, in fact, it would seem to be a cluster of food poisoning (sick people after church – potato salad!), not arsenic poisoining, unless the patients were alert enough to do some of the epidemiology history (what, exactly, did you eat/drink, and when), which is one of the things state health departments and the CDC usually do well. The trick is to suspect it, and that would be hard (it looks like everything else).

Whoever made the diagnosis no doubt saved the lived of those still left alive, and should be congratulated.