Pie!

This is the first pumpkin pie I've made. I used Cook's Illustrated No-Bake Pumpkin Pie recipie. I'm quite happy with the filling, although it could have been slightly more gelled. The flavor is fantastic. I've never made a crumb crust before, and I made this one too thick at the bottom of the edges. 

Caltech then

There is an interesting article about and interview with Jenijoy La Belle, "the first female hired on the tenure track" at Caltech (1969). She taught literature. The board of trustees had voted to admit women to undergrad programs only the year before, mostly for the benefit of the men, who had many complaints about the absence of women on campus. When the time came, Dr. La Belle was denied tenure. Subsequently the institute being charged with sex discrimination by the EEOC. Dr. La Belle eventually was reinstated and received tenure.

The facts have changed since then, but we still live with many unchanged attitudes from that time.

Miscegenation

I did a double take today when I was passed by a Miata, top down, with a tandem cruiser bicycle mounted to the trunk, extending far off the back of the car. It could have been some fabulous tail.

(image originally from flickr user loosenball, CC license)

Below 70!

For the first time that I can remember this fall, the high temperature is expected to be below 70 degrees. Lately, I've been thankful for temperatures in the 70s rather than 80s, so this is a huge joy.

Even though I drink only intermittently...

Be Drunk

You have to be always drunk. That's all there is to it--it's the
only way. So as not to feel the horrible burden of time that breaks
your back and bends you to the earth, you have to be continually
drunk.

But on what? Wine, poetry or virtue, as you wish. But be
drunk.

And if sometimes, on the steps of a palace or the green grass of
a ditch, in the mournful solitude of your room, you wake again,
drunkenness already diminishing or gone, ask the wind, the wave,
the star, the bird, the clock, everything that is flying, everything
that is groaning, everything that is rolling, everything that is
singing, everything that is speaking. . .ask what time it is and
wind, wave, star, bird, clock will answer you:"It is time to be
drunk! So as not to be the martyred slaves of time, be drunk, be
continually drunk! On wine, on poetry or on virtue as you wish."

Charles Baudelaire

Chemo - Day one

Today the little beast got chemosensitization for tomorrow's radiation treatments that are supposed to shrink his tumor. They also took a needle aspirate from the bone marrow and dosed him with pamidronate for pain and bone strengthening. The tech told me that the oncologist said the sample from the needle aspirate strongly suggests that the tumor is osteosarcoma, as expected, but they want to send it out for culture anyway. Fine by me.

I had more frustrating interactions with the practice. I met the other vet, and I'm not a huge fan. She doesn't have much of a bedside manner, and it appears that she's the junior vet. Anyway, I expressed my concerns about the administration of Mac's care. She told me why she thought it had happened. We made a clear list in the chart of the treatments I authorized. I'm slightly mollified.

He was full of vim when he came out after the anesthesia (for the needle aspirate), but now he's pretty tired. I had to hand feed him treats to coat his stomach enough so he could take his anti-inflammatory.

I'm happy to have taken some action.

Lesson

Lesson: Don't expect the step-stool to stand stably in the shower.
Cost: Shin bruise.
Cost-benefit analysis: considering initial state, not too expensive. Good to learn from the ground rather than from on top of the stool.
Wisdom attained: limited. I went ahead and used it, but cautiously.

Casino Royale: portrait of "an erotomaniacal British toff"

(for a much more withering perspective, the source of the "an erotomaniacal British toff" quote, try this)

I saw it yesterday in a new theater. The first two hours were pretty good. It's a nice action-thriller movie, with high production value. The locations were terrific. The script is fine, exceptional in places. The story is deeper than usual.

Daniel Craig was not bad, in spite of the fact I can't find one particular thing I actively liked about him or his performance. His wardrobe was miserable in several scenes. I don't think he's very good at fights or foot chases or action in general. The first chase scene was nicely planned and fun to watch. The guy being chased was incredibly agile and strong, which probably highlighted Craig's inadequacies. I'm ambivalent about Craig's repartee and expressions. An example of a scene that I enjoyed but also think showed his lack of gravitas is the black and white opening scene, excerpted here). I didn't think I would miss Pierce Brosnan - he was lacking in soul. Yet, here, I do miss him.

Eva Green is fun. I like her accent, and I think she's a reasonably good actress (better than most Bond "girls"). She reminds me of Deborah Winger. Her wardrobe was terrific. There was some inconsistency: even at the end of the movie, I was unable to confidently reconstruct her motivations. Judi Dench's M was wonderful, of course. There was no Q, and it was no loss.

The movie is incredibly long. The last half hour is slow and agonizing. Clearly they tried to make it shorter, but the results were a few painful discontinuities which left the viewer surprised to discover what city we were now in.

I think I'm not conveying the pleasure I took in seeing it - I did enjoy it. If I knew before I saw it how much I would enjoy it, I would still make the same choice. But I'm a sucker for action movies.

Beast Pain

Puppy seems to be in a lot of pain this morning. Last night he licked his knee for the first time that I've seen. He was gimpy after our walk all day yesterday. This morning he's drooled a few times, and he's not putting any weight on the leg when he stands, although he does when he walks. I called the vet today for some opiates; it's something we had talked about a few weeks ago.

Gimpy morning

Today Mac was very gimpy when he got up. He had trouble getting on the couch and was not using his back left leg much at all. He ate his breakfast after a little encouragement. I took him out about an hour after his Rimadyl. He was less gimpy than when he had gotten up. We walked to TL's to collect her mail for her. He was tired and gimpy on the way home, but when I showed him a squirrel he ran and jumped up at it like usual. I spaced out and took him up the stairs when we came inside instead of taking the elevator.

Time to nuke the dog

i started writing this post while watching the dog eat his breakfast while he's lying down. the past couple mornings he seems to be in a lot of pain, and eating kibble standing up is harder on the tile than on the carpet. it also seems harder to for him to reach down to the floor. but even when he is eating his food off a raised platform on the carpet, he's uncomfortable enough that he doesn't eat the whole bowl. after he lies down, i put it next to him and he'll almost finish it. he usually gets hungry later in the day, but i have to make him eat in the morning so he has some food before he takes his pills (which probably make him feel good enough to want to eat, frustratingly enough). a few hours after getting up, he seems a lot better though.

in general, he's in good spirits, racing around the house when i come home, happy to meet new people, always thinking about how he might cadge some food or chase a cat or squirrel. i have decided on radiation over amputation. one of reasons is this: according to statistics, he may only live another couple months (if the radiation and chemo are started early enough and work, it should be more). if he died in a couple of months and had spent two weeks of that time recovering from an amputation, i would regret the amputation. the side effects of the radiation aren't much, maybe a little sun-burn like irritation on the site. his quality of life is pretty good right now, it seems a shame to waste it.

i'm also planning on following the radiation with chemo. the doc said only 20% of dogs have any chem side effects at all and 5% have significant side effects like vomiting or diarrhea. mac is an old hand at digestive indiscretion and subsequent gastrointestinal upset, so the package of odds and symptoms don't seem too bad.

monday is our next appointment with the oncologists. hopefully mac can start radiation next week. apparently he needs some chemosensitization first and administration of a supplementary bone-promoting drug, pamidronate.

i have found the way the oncology practice is administered to be very frustrating. they are bad at returning calls, bad at gathering records, bad at hand-offs between doctors (i should add that once i have an individual's attention, i am completely willing to believe they are at the top of their field). due to this and recent events with my own medical care, i will be treating this as if i were mac's primary doctor, wanting everything that will happen to him at each visit explained to me before it happens, making sure i understand it completely first. i don't trust their disorder. at this point i believe that i can compensate for their deficits in organization and communication with my own organization and focus and will. if i stop believing that, i'll have to find another oncology practice.

in an effort to be informed about our options, i have been doing a lot of reading. scientific and medical research articles are written in code - i'm glad that i've spent the last half decade learning to read at least the scientific side of the code. there are journal articles on immediately relevant topics. if want to buy access to them through the publisher, the articles cost $30. happily i can request copies from my university library for about $6. knowledge is power, but power is power too: if i'm associated with a powerful institution, i can access the knowledge.

and attention is a kind of power. i'm not the best at steady focus, organization and preparation. i think i'll need that for this process. motivation helps.

Ancient Latrine Expert

I came across this on boing boing of course. Why do jobs like ancient latrine expert (ok, palaeopathologist) and official bird flu spokesman of the International Badminton Federation fascinate me so much? Perhaps because my own job has a fairly straightforward career path and is defined enough that children can grow up thinking about it. Deciding you want to be an ancient latrine expert probably does not happen by browsing through a list of possible careers.

More love for wikipedia: my recent wikipedia history

From my November google search history. I have a firefox qucksearch that takes me directly to wikipedia, so this is only a fraction of my wikipedia usage.

Grgich Hills Cellar
Fort Mason
Chemical synapse
Hollaback Girl
Harry Potter and the Half-Blood Prince
Wikipedia talk:Manual of Style archive
Patch clamp
99 Luftballons
California gubernatorial election, 2006
Harvard Board of Overseers
Aleister Crowley
Chocolate
Exponential decay
Itsy Bitsy Spider
Category:Nosology

More wikipedia history, this from my browser history on my home computer:

Percept
Chicken
Mike the headless chicken
Frank Sinatra
Why did the chicken cross the road
Mallorca
Gray (unit)
Piroxicam
Photon
Wizards of the Coast
Surbiton

I heart Wikipedia: The United States order of precedence

I love this stuff:

The United States order of precedence is a nominal and symbolic hierarchy of important positions within the government of the United States. The order is established by the office of the President of the United States and can be changed by the President, though in practice it is fairly established and rarely modified. It has no legal standing (for example, it does not reflect the United States presidential line of succession), and is instead used to dictate ceremonial protocol. The United States Department of State is responsible for enforcing matters of protocol in U.S. diplomacy.

from http://en.wikipedia.org/wiki/United_States_order_of_precedence

Celebrate our Monkey Ancestors Day

so good, i have to quote the whole thing. from "the right was right":

Here is our 25-point manifesto for the new Congress:
1. Mandatory homosexuality
2. Drug-filled condoms in schools
3. Introduce the new Destruction of Marriage Act
4. Border fence replaced with free shuttle buses
5. Osama Bin Laden to be Secretary of State
6. Withdraw from Iraq, apologize, reinstate Hussein
7. English language banned from all Federal buildings
8. Math classes replaced by encounter groups
9. All taxes to be tripled
10. All fortunes over $250,000 to be confiscated
11. On-demand welfare
12. Tofurkey to be named official Thanksgiving dish
13. Freeways to be removed, replaced with light rail systems
14. Pledge of Allegiance in schools replaced with morning flag-burning
15. Stem cells allowed to be harvested from any child under the age of 8
16. Comatose people to be ground up and fed to poor
17. Quarterly mandatory abortion lottery
18. God to be mocked roundly
19. Dissolve Executive Branch: reassign responsibilities to UN
20. Jane Fonda to be appointed Secretary of Appeasement
21. Outlaw all firearms: previous owners assigned to anger management therapy
22. Texas returned to Mexico
23. Ban Christmas: replace with Celebrate our Monkey Ancestors Day
24. Carter added to Mount Rushmore
25. Modify USA's motto to "Land of the French and the home of the brave"

The Big C

To the left are three x-rays of Mac. The far left is his healthy tibia. In the middle is his other tibia. You can see a relative increase in blurriness compared to the healthy one. To the right is the same tibia two weeks later. I'm a bit fascinated with x-rays. This is the first time I can remember really seeing something clearly on an x-ray.

The vet today had a great manner. She told three things:

1) After examining Mac and looking at his chart from his regular vet and looking at his x-rays, she feels that there is no need to do a biopsy. She says she is 99% sure that Mac has osteosarcoma. She says she's acted on this analysis before and hasn't been wrong so far. I'm greatly relieved - it seemed silly to go through a painful and expensive surgery (the biopsy) when it's unlikely to be anything else.

2) She recommended a consult with a radiologist. Since he's still using the leg, he might be a candidate for radiation therapy instead of amputation. I have an appointment with her recommended guy next Tuesday. I'm pleased at the thought of this option. My concern is that I don't want to do things by half measures. I keep seeing that by all measures dogs get 100% pain relief from amputation and usually do very well with it.

3) If I end up having his leg amputated and I have it done at her hospital, it will cost between $3200 and $4000. Nope, I didn't leave a decimal point out. That's more than twice as much as what the local vet estimated. I may not need the fanciest surgeon in LA after all. If it comes to that, I'll ask my local vet what the level of difficulty is and if she feels comfortable doing it. I will say that it was a fantastic practice, by far the nicest I've ever been to. They had the highest level of service, and, from all I've heard, a great level of care.

Naturally, Mac acted like a puppy all day, barely favoring his leg at all. He was more mobile and energetic than he's been in days. His recent slump is due to a little chocolate digestive indiscretion of his (and mine for leaving it where he could get to it). It's great to see him back to his usual self, but ironic. I have to imagine it was one of the things that gave the vet the idea of radiation therapy. She said she doesn't usually recommend it, because usually the tumors are too far along.

Biopsy

I've schedule a consultation for tomorrow. If the consultation goes well, the biopsy may occur tomorrow. I wasn't able to see the Ventura orthopedic surgeon, who did a successful double hip replacement on a lab I know. The surgeon is a friend of a friend and a board certified surgeon, but he wouldn't be able to do the biopsy for the next 2.5 weeks. The recommended surgeon is also board certified and was a strong recommendation from my vet. Here's her bio:

Dr. Mary Somerville, Diplomate of the American College of Veterinary Surgeons.A graduate of the U.C. Davis School of Veterinary Medicine, she served as Director of the Emergency Pet Clinic of South Bay, performing emergency medical and critical care for three years. She completed her internship and surgical residency with our surgical department. She then successfully completed the ACVS examinations to become a Diplomate (Board Certified Surgeon) of the ACVS.

Another advantage of this surgeon is that she's only 35 minutes away, about 30 minutes closer than the other one. Still, all of Los Angeles is between me and her.

dog health: the story until now

I'm planning on posting health updates about bad dog via blog. This is my first one, so it covers a lot of territory. BD started limping about 5 weeks ago, which I'll call time zero. After a few days, I took him to the vet. They took an x-ray, saw a shadow in the bone below the knee in his left hind leg, said cancer or fungus. Bone cancer is very common Rottweilers and in all dogs his size and age. Furthermore, the location of the shadow on his bone is a common location for osteosarcoma. Standard treatment: limb amputation, chemo. It is practically always metastatic. A chest x-ray was clear, so any metastasis isn't advanced. Two weeks after the first x-ray, a follow up leg x-ray showed that the shadow hadn't changed. Often bone cancer is really aggressive and will grow in that time period.

Three weeks after the first x-ray, I found out that the fungal test was negative, which is unfortunate. It means the shadow on his bone is almost certainly bone cancer. It is possible, but unlikely, that the bone damage could be an idiopathic infarct, which means destruction of the bone from an unknown cause.

Monday (week 4) I saw my regular vet to make a plan; she'd been on vacation. The choice was between a biopsy to confirm the cancer diagnosis or proceeding with amputation. The problem with bone biopsy is that they don't always get a diagnostic sample, it's painful, requires anesthesia (which has risks of its own) and, presuming it confirms bone cancer, requires him to recover from two surgeries rather than one. Even if it's not bone cancer, the biopsy carries risk of damage to the bone that can ultimately require amputation. The problem with not getting a biopsy is the chance of amputating a healthy leg. The biopsy test is not fast enough that they can test it while he's still under and then perform the amputation if it's positive.

I'm not especially worried about any significant decrease in Mac's quality of life if he has to have the leg amputated. He's in good shape, and dogs generally can get along quite well with 3 legs. I'm worried about the metastasis. The typical life expectancy after amputation is 3 months, 1 year with chemo. I had always assumed the pain and sickness of chemo wouldn't be worth putting a dog through, especially since they don't have the knowledge of the benefits to weigh against the discomfort. My recent research suggests it's usually not as sick-making for dogs as it typically is for people. Also, it doesn't simply prolong life expectancy but acts palliatively to reduce pain and secondary sickness from tumors. That's huge to me.

Right now Mac is on Rimadyl, a potent (and liver threatening) anti-inflammatory. It seems to be working pretty well. He's just as perky and happy as always, chasing squirrels and begging for food. My goal is to keep him pain free as long as possible. This is all quite expensive, of course, but hasn't exceeded my old-dog health cost expectations.

Here's a link with information about osteosarcoma in dogs. http://www.vmth.ucdavis.edu/vmth/clientinfo/info/onco/k9ost.html

Mac is already past the life expectancy of a dog of his size and (assumed) breeds. Hopefully my mental preparation for this kind of news has helped somewhat, but it's still incredibly hard emotionally. He's been a daily part of my life for eight years. He's got lots of qualities I could do with more in my life: happiness, enthusiasm, friendliness, outgoing (ness?), loyalty, stability. I can't imagine what my life will be like without him. My friends and family have been very kind and supportive, and I can only take it as it comes.

People pay for this weather?

when i came down from my weekend in the mountains (5200 feet) yesterday, it was a massive disappointment to descend into the heated smog of los angeles. the air was so clear up there. when we went for a hike saturday, we started out in fleeces, but soon stripped down to t-shirts. back home, today's forecast is for 89 degrees. vile hell-pit.