Friday, May 30, 2014

The Truth About My "Glamorous" Life


Drinking your tea from a bone china cup is a small and inexpensive luxury if you already own the cup ! Use the things you already have.

          Yes, I live a glorious and glamorous life.  I eat blueberries, raspberries, baked potatoes I grow myself, and occasionally chocolate. I drink my tea in a bone china cup, because it's a simple luxury.  I am afraid that this is where the glamor ends.

              This is a bit more typical of life here.  Because my husband did not want the demands of  horses, you may recall, my husband allowed me to get my four horses (two at a time) only if I agreed to personally purchase all the supplies, feed them, maintain their hooves,  give the immunizations, brush them, turn them out and return them to the barn each day,  assist the farrier and the equine vet, and pay for it all. (Yes, I know it's a run on sentence.)   This includes, but is not limited to mucking the stalls, the horse pasture, and the disposal of horse manure.   The mucking has given me firm arms and a much smaller waist and so it's not all bad.   However, the mucking and disposal of manure has been a bit more difficult than I had anticipated.    Each morning, I rise very early and I muck out all the urine soaked pine shavings, urine soaked hay remainders,  and actual manure from the concrete floored stalls of the barn.  I place all of it in a large wheelbarrow. After I mop all those floors, I move on to disposal.  The wheelbarrow was quite a challenge at first.  After each rain it was so heavy that ultimately I had to have two holes drilled into it.  Now the rain empties nicely so that all I have in the wheelbarrow is what is intended.  While the horses are eating, I open the gate and sneak the heavy wheelbarrow out of the pasture and quite a distance away on the edge of the forest.  I empty it there, and then I trudge back in my rubberized muck boots which are a little too conducive for my taste, to the development of athlete's foot !  . Later in the afternoon, I muck the pasture.   I haven't thought much about the pile of manure accumulating on the forest edge.   Normally, my husband uses his tractor to truck alpaca manure to a manure pile which is quite a distance from their location. I thought he would probably eventually do this for the horse manure. But, in this instance, I would have been wrong.   A giant mountain of manure has accumulated for the horses in the thirteen months that they have lived here at the farm.   After the first five months, my builder who was here on another barn related issue entirely, took his bobcat and moved five months worth of manure, stirring it into an area I will eventually use as garden. I therefore did have somewhat of a reprieve.   Interestingly,  horse manure composts pretty readily.  It's very hot here for most of the year, and when what I affectionately call Manure Mountain heats up, you can actually watch the steam rise from it.   I wondered if  I could burn it, but my builder thought it was too close to the forest.  I noticed this week that Manure Mountain was growing rather tall green grass, which looks a lot like Kentucky 31.  I don't really want a permanent grass mountain at that location. So, my crack force of me, myself and I really should get going on it.

If my husband is searching for a meaningful birthday gift for me, he really should have a custom silver pitchfork pin made for me.  Unfortunately, he doesn't read my blog since it ultimately resulted in my getting horses !

              Fortunately, the remaining Manure Mountain has composted nicely into really fine blackish brown soil which looks and smells a lot like the soil my Nana used to stir into her garden before she grew carrots, greenbeans, apples and marigolds in England.   If Nana could shovel all that dirt and manage that garden, certainly so could I.

             So today I donned cotton socks, rubberized muck boots, and cool light colored clothing in order to avoid the ticks.  I sprayed my boots with DEET 40% in the hope that I wouldn't be a tick magnet.    The plan was to attack Manure Mountain and redistribute the composted manure to places on the farm where it could be used.    Fortunately, a broad pitchfork picks up a large cluster of composted material not unlike a rather large piece of shredded wheat.   The weather was cool here today and so after animal care, I was able to move quite a bit.   I moved some of it to flower beds which had already bloomed.  I moved some to an area near the barn which is still in recovery and could use some organic material.   By one o'clock, I was getting tired and a little dirty.   At one point I decided to stop manually trucking the bails of manure, and I started throwing them to another region using the pitchfork.   Perhaps a stronger person could do this more effectively, but a couple of times soil wound up on my light jacket.   I decided to break when I found that as the mountain disappeared, the mush below is not completely composted. I marched around in a mashed manure tea until I could do no more.  About that time, one of my sons and his friend finished replacing a serpentine belt on the friend's car and they decided to help a bit.  Funny how two of them were more effective in a short period of time than me, myself and I (all three of us) working for hours were.

This is a highly trained and efficient manure manufacture device !

            There is now a short plateau of composting manure and hay where Manure Mountain once stood. I hope to do a bit more on this tomorrow.   The fact is that farm life, if you decide to raise animals, plant almost anything, and then maintain flower beds, vegetable gardens, yards or anything else is fairly labor intensive. We can save ourselves quite a bit of the backbreaking work by planning what we do there carefully.  Raised beds for many things have proven to be less labor intensive than our attempts in the past to till, amend and plant our rocky and partially clay soil.   Planning some of the more difficult work on cooler days, sometimes even in a misty rain can also be a big help.

            My final point is that in a disaster or an emergency you may well need more physical reserve than you have now.  Most of us have grown to being comfortable using cars instead of walking and slowly diminishing the amount of tedious physical work we do.  In an emergency we might need to walk quite a distance.  We might need to carry a backpack that is heavy. We might need to carry a pet or pet supplies.  I am not advocating that we all start weightlifting. I am not even advocating spending money to commute to a gymnasium.  I am advocating looking at the work that is necessary at your house, and planning ways of doing it yourself in order to remain active. This might be gardening.  It could be raking. It could be walking a dog as much as he needs to stay slim and more than you are doing now.  It could be parking the car a little farther from the mall than you might ordinarily do, and then walking in.  If it's not a comfortably safe place to walk, then consider spending more time walking in the mall.  Meet a friend and tell them your objective is to walk as much as you can.

           My point is not to stretch anyone beyond what they can do.  My point is not to have you increase activity to the point where you lose weight and muscle along with it.  My point is that everyone should be working on simple baby steps to being more fit especially in consideration of any known medical issues we already have.  My parents and my grandparents passed in their eighties and nineties.  All of them were either working full time at a career they loved, or they were physically quite active in other ways.   My Nana walked more than I do now on a regular basis through her eighties. She planted in her garden, weeded and harvested, and looked great doing it.  She carried bushels of apples from her trees to the house and then made pies and cobblers.  I don't remember her dieting, and she did occasionally have a piece of her own apple crumb pie after dinner.  When she went places with me, we walked.  Being British and having lived through the war where it was not a given that women learn to drive there, she and I walked everywhere. This meant that when I had an ice cream, so did she.  I remember on one of the visits my father made to us being amazed at how much he could lift.  Even in his eighties, he walked a great deal, could work hard and could lift boxes of books better than I.   He continued to function that well until he passed.

Okay, so I wouldn't wear this color. But we all should own a pair of comfortable athletic shoes.

            Remember that the weight on the scale should never have been our primary focus. Staying active and busy and enjoying activity in our lives should be.  If we are sufficiently active and healthy enough to engage in activities we like, then chances are that we will be healthy enough to meet the episodic demands that an evacuation or a regional disaster will bring to us, our pets, and to our families.

Thursday, May 29, 2014

Revisiting the Emergency Cabin

In an emergency, it doesn't really matter the style of your getaway home. What matters is that it's secure enough not to be easily seen, and difficult to break into.  It matters that you can access it in an emergency with your family fairly quickly. It matters that it is stocked with supplies which last some time. It also matters that this is something you can afford.  Vacation cabins come up in many places frequently.

          A lot of people, from Europe, South America and the United States are considering the value of an emergency cabin or an emergency home.  The "vacation home" market is thriving in many places in the world, but many people have no intention of using it for vacations.  Many people live near urban centers with their families in order to take advantage of educational opportunities for their children, and for good jobs for themselves and for their spouses.  When emergencies occur, for example, the attacks on New York on 9-11-2001, many people want to leave town  In prior generations we often have relatives in neighboring states and running to family was a pretty good option.  Today, in many nations, we have smaller families. We also tend to have children later in life than many of us did before. The net result is that like me, many families just don't have a relative with whom they can bunk with their spouse and children for a few days. The addition of age 55 plus housing also can make a difference. In many "mature housing units", more than an overnight visit from relatives is prohibited, even if the room exists. Our parents might be older and may not have the option of providing a temporary home to us in even an absolute emergency.

                For this reason, many people are keeping inherited vacation cabins, and fixing them up.  When the economic crash of 2008 occurred, many people took their retirement account, paid the income tax on an unplanned dispersal, and bought a relatively inexpensive home with acreage should the economic crash deepen or broaden.  Some people sold up their urban holdings, left their good jobs and bought a home or farm in a rural community determined to find a less high powered job, but a more satisfying and simpler life.  Sixteen years ago, my husband and I sold our suburban home, and built a home in the country hoping to impact some important learning for our kids and to find a more satisfying life.  Some years later, we moved to another rural area, and built again, using the money from the first farm we had built and sold in a healthier market.   There are no easy or complete answers. We all have to make the best decisions we can within the context of our families, their needs and our abilities.

                  In short, even if just for inspiration, I will continue this series on cabin or second homes. May this encourage you to reorganize or work on a cabin or small home you and your family already own.  Perhaps it will even be part of the impetus for you and your family to plan to relocate, if this has been something you have been considering.

Having a cabin near water and with its own well can be important in emergencies. At this location, water for washing could be obtained directly from the lake, and could be put through a Berkey before being given to animals.

Your getaway cabin doesn't need to be furnished or as luxurious as your normal home.  Room enough for sleeping bags, mattresses on floors, bunkbeds, etc. would be fine.

Bathrooms with deep shelves, cabinets or other storage are a good idea.   Toilet paper, toiletries, etc. should be stocked.

Two or three bedrooms are desirable.   Children could bunk in one room and parents in another. A third bedroom could be used for other family members or for your parents.

A source of heat which is not electricity dependent is an excellent idea.

A basement or some laundry facilities are certainly nice to have.

Remember to make plans for your pets. In a place you do not live often, there may be hazards you don't know about.

Other links to other posts which relate to this topic that I have written:

Saturday, May 24, 2014

Does the Electronic Medical Record Destroy the Process of Seeing a Physician ?


  Lately, a number of friends of mine have said that they "will not be returning to see a physician" and that they "will simply die when they run out of things they can do for themselves". They cite that it is not worth the two or three hundred dollars, not to receive any wisdom or any solutions as "all the doctor did was spend time filling out a check sheet on a computer."    It is disturbing to hear this from many sources at once who use a variety of health systems in several different areas.  It means that both our medical system in the US, and also that the pressures that Obamacare has brought to the fore have destroyed the process of seeing your physician as it was intended. The new system disables using physicians as they were, in fact, trained.

             When you see a physician, you actually aren't paying for a prescription for a particular drug, and many times, not for an actual procedure of some kind.  You are paying for someone who should be fairly bright and engaged in health promotion who has spent four years of college, four years of medical school, one year of internship and then three, four or five of residency in some specialty to look at you, listen to your concerns and make as assessment of your health with recommendations. Many physicians have also completed a fellowship in a sub-specialty, which can also be an additional couple of years.  A good physician, (as well as a good nurse with experience) should be able to pleasantly interact with someone and provided you have their full attention, should be able to notice everything from your demeanor, the manner in which someone is speaking to them, the absence or character  of your movements, a pained look, a waxy complexion, an enlarged thyroid, alterations in normal respirations,  etc.   In fact, the process of continual patient assessment using a glance, is not something that can be turned off very easily once it is well established.  Only an attorney who is not a physician (there are people who have become both)  would have generated an electronic check sheet for documentation which takes the physician's eyes off the patient, and onto a computer screen.  This means that you are no longer getting the full benefit of a physician's impression of your general health for your money.  It means that the focus of your medical visit is no longer the patient, but the simple documentation of an electronic record.  The Obamacare System is less interested, it appears, on the assessment of the patient, diagnosis of a problem and on providing good comprehensive care, but on the documentation of all that is known about your health.

            It didn't take much time for me to look through the literature to see that physicians are also complaining about the effects of the Obamacare imposed seeming singular devotion to the electronic medical record.  Some of them have found themselves leaving private data off the patient's record because there is inadequate room to explain. Others have expressed that the software is limited and does not have the flexibility to insert data and diagnoses which are actually known.

           One of the members of my own family sees a major world class medical center here in Virginia.   He sees the physician for longstanding follow up of Crohn's disease.  Keeping weight on has been a challenge since this diagnosis was  made.  In the past, on one of his ER visits, a nurse or a physician confused which patient's data was on that pod's emergency room screen and someone confused as to on whose medical record they were actually working.  Somehow, my underweight family member wound up with an  erroneous   supplemental diagnosis of morbid obesity !  Of course, this was so ridiculous that at the next visit with the primary care physician, they asked about it.  I said that this was clearly an error from the ER visit and I asked that it be removed.  We were told that incorrect data on the medical record can never be removed.  They simply amended the entry with "problem solved."  It still exists in health history !    Even though I said that the entire erroneous entry should be removed because there may be future implications, they told me this was impossible.   What happens when gonorrhea, morbid obesity, HIV-AIDS, lupus, Lyme Disease, Huntington's Chorea, or schizophrenia make their way erroneously to your medical record ?  What happens if someone enters the labwork of a diabetic on your medical record, and not your own ?  I'm betting the results could be interesting, if not devastating.  The effects may be that on subsequent hospitalizations for the rest of your life, you will have a fasting blood sugar drawn that you might really need and don't wish to pay for,  and you will be placed on a diabetic diet automatically on hospital admission for anything.  The problem with computers is that they make very fast, very accurate mistakes and that corrections are not easily made afterward, if ever.

           A few physicians have started to pay out of their own pockets for a scribe who will write the electronic medical record while the physician keeps his assessment eyes on you.  Of course, this might work well for some physicians and some types of practices, but it also leaves the creation and potential errors in the record to a non-physician.  It also adds another person in the room and could impede the freedom by which the patient discusses things with the physician.

          I do understand that there is value in a computerized  and hopefully neater record of the patient encounter which, at the very least, should be legible, and from that standpoint alone should result in better care.  Patient directions may also be more easily printed and provided to the patient.   However, the devotion to collecting all of our health data in a centralized location which can be accessed by government as well strikes me as simply frightening.  There may be some darker implications for patients too. As a registered nurse, it worries me that some patients, for example, women who may have post-partum depression or even post-partum psychosis might not feel safe enough now to share such a concern with their physician, as soon as they might have before. How private can the data in your medical record ever really be when government has access to it ?

          How long will it be before a criminal underground exists which provides medical care without an electronic record ?  Well at least someone will have a job.

UPDATE:    June 20, 2014

It appears I am not the only person worried about this and noting these challenges.   See this link dated today,  from a physician's blog:

Friday, May 23, 2014

The Landline Phone

True landline phones receive enough electricity to work even when the power is out.  This is not true of cordless phones which are dead when your homes electricity is out.   You should have a corded phone extension on every floor of your house.

      We have an unlisted number in the hope that only family, friends and people who legitimately do business with us, will call.   We also have our land line number on the "Do Not Call" list.   This worked pretty well for the twenty-five years our household has been in business.   However, now with computerized calling for everything from sales calls to political surveys, they often call numbers in sequence.  They might not have any idea who you are, but they are calling 2367, 2368, 2369, 2370 and so on.  In the past several years, this type of call translates into a lot of calls on a daily basis.

               Also in the last few years, everyone in our household has their own cell phone.  Personal calls to individual family members and work related calls usually go to the cell, as do friends calls.  The home landline is there to call 911, and to report power outages, and as a back up during other emergencies. It's also good to have when you need to fax something.   To deal with the high call volume I have a digital answering machine, and when it gets full, the landline has voicemail as part of our phone service.   Both are often full.   I am a very busy person and sometimes it takes me a while to listen to everything on both the digital answering machine and then the backup voicemail.    We have also developed a few policies over the years in dealing with the phone.

1. The phone is there for our convenience, not for anyone else.  We use it when we want, and this means that we don't have extensions to the landline everywhere.  We don't answer when it's not convenient, and we never answer during mealtimes.   I don't answer after about nine-thirty pm because my kids know to call me personally on my cell.

2. When I was in school we were taught that who you vote for and your political leanings are your private personal business, and so we do not, and we will not answer questions for political surveys.  This also goes for our own delegates, our Congressman, and our Senators.  I have already written you about what we want.  Read it, and you'll know what we think.  Don't call.

3.   We don't provide information on the products we use or our feelings about them free of charge to you, over the phone.  We don't exist here for you to farm as marketing information.

4.  We never ever donate money over the phone.  We have selected our charities and we contact THEM when we donate.  If you are doing good things and worthy of donations, mail a letter about it so that our accountant can check you out.

5.  We never ever buy anything over the phone.  There are too many scams and too many opportunities to obtain information for the purpose of identity theft.   If I needed something done on my house, I would call you, when I complete my research which includes the Better Business Bureau.

6.  What makes you think I would buy a vehicle extended warranty from someone I have never heard of, when you don't even know who I am or what type of car I have ?  

7.   Don't call me from India if your English is not good enough to be understood here.  I will hang up when I don't understand you.

8.  Don't suppress your identifying information from caller ID.  Your only hope of my answering is my recognizing your number.  "Head Office" on the caller ID will be ignored.

                I am a little annoyed at the prospect of needing to purge the calls from both my digital answering machine and phone company voicemail twice a day.  I am considering leaving a new message.

             "Due to the high volume of received calls, I may not be able to return your call.   No one here answers political surveys, donates money over the phone, buys products including credit cards or car warranties over the telephone.

              Calls are only returned to individuals we know or companies with whom we are already doing business.   If you are not an individual known to us, or a company with whom we have a longstanding business relationship, please do not leave a message.    Thank you."


                   I think it's a little longwinded.

Thursday, May 22, 2014

Wheelchairs for Dogs ?

Photograph by Dewey's Wheelchairs at

      Sometimes an older dog has a stroke or has a serious illness which causes his back legs to become weak.  Often, people have their pet euthanized at this point.  There are certainly times when euthanization is the best course of action for both your pet, and also for you, his family, but this is not always true. Since dogs don't function on the same level as human beings, they don't drive or balance a checkbook, many dogs can recover from the effects of a stroke, if they can get past the immediate difficulties of eating and drinking.  Many of them regain their ability to use their back legs.  For those who cannot, following an organic problem or an injury, there is another alternative. Some larger breeds who suffer from hip dysplasia can also benefit from a custom chair.

      For those of you who have an interest in this, these are some of the companies who can provide a custom wheelchair for your canine family member:

Dewey’s Wheelchairs for Dogs
P. O. Box 1439
Prineville, OR 97754
  • Phone: Toll free 1-877-312-2122 (8am-3pm PST Mon-Thur) ; 1-541-416-2651 (Outside USA & Canada)
  • Fax: Toll free 1-877-312-2123 (24 hour) ; 1-541-416-2617 (Outside USA & Canada)
  • E-mail:

 Most custom chairs are two hundred to four hundred US dollars.



Another provider:  

105 Route 101A, Suite 18
Amherst, NH 03031
Toll Free US & Canada
(888) 811-7387
West Coast
(818) 698-7387
Phone Outside the US
(603) 577-8854
Fax (603) 589-7107
Mon-Fri:  9AM - 6PM EST

What's In the Box?

1 Walkin' Wheels
1 Set (2) Foam Wheels
or for Pneumatic Air-Filled Tires (add $40)
1 Front Harness with Sleeves (S,L)
1 Set Leg Rings Rear Support Saddle
1 Belly Belt
2 Stirrups
1 Instruction Manual
1 Tote Bag Free (regular size wheelchair)
1 Set Handles that Clip onto Leg Rings and wheelchair

Walkin' Wheels Adjustable Dog Wheelchair


Another supplier has an all inclusive fee starting at $100. He can be reached at:


             A proper wheelchair for a disabled pet can allow him to walk with you on a leash, to urinate and defecate outside, and allow him to retain a decent quality of life.    Sometimes, euthanization is the best course, but sometimes families are astounded at how well their pet does with a dog wheelchair.   (Small horses and other animals have also used such a device successfully.)   Each pet and each situation is different, and so you should research providers and discuss the possibilities with your veterinarian.  I do know pets for whom the alternative of a pet wheelchair has been a godsend.

             Since a devoted pet can be our eyes, our ears and part of a strategy for layered home defense, keeping a loyal friend comfortable and happy can be in our families best interests also.

Wednesday, May 21, 2014

The Earthquakes Are Back


  This evening at around 9:42 pm, a significant earthquake event was felt here.  We immediately thought this was the touchy focus in Louisa which caused the 5.8 in 2011 which destroyed schools and so many homes.  This time it wasn't.  This quake, according to USGS is a 3.2 with an epicenter in Powhatan, Virginia.  Interestingly, I have been seeing USGS trucks out here again recently.

                   This explains why the dogs, horses and alpacas have been skittish and upset for the last several days. I had wondered if another earthquake was coming. Maybe our Siberian husky can get some sleep now.

Info on this quake

UPDATE:    There have been multiple small aftershocks today.  The alpacas have been glum, the horses nervous, and some of the dogs have been unhappy, particularly the highly strung Siberian husky.  In the light of day there appears to be no damage here.

Saturday, May 17, 2014

The Best Portable Vacuum Cleaner


The Eureka Whirlwind Pet Lovers Plus Bagless Vacuum Cleaner.

       Like most of you who occasionally buy online, I get questions directed to me me from the seller of the items, usually from another one of their customers.  One man recently bought a vacuum cleaner and now wants to know since it needs maintenance/cleaning, what the next best model really is.  I could spend my entire day doing favors for the internet collective, and often I don't respond.   This time, I did.   I really like this particular vacuum so well that I have several of them. I even gave one as a gift.  I like them because it is bagless, and once you take it apart for emptying and then  reassemble, you know how, and can do so relatively quickly.  It's also light enough to be carried out to the car and still have the energy to find an extension cord and plug it in to the porch. (The cord is potentially thirty feet long, but I live in the country and everything here is spread out !)  This unit also keeps a cabin that is not lived in often, as clean as a whistle.  All three of mine sustain heavy use and are like new after three years of use.  Although it is bagless, there is a HEPA filter which should be replaced periodically.  The HEPA filter is quite expensive in Wal-Mart but fairly reasonable on Amazon, and so you might want to buy three HEPA filters at once.  I clean out the HEPA gently with a clean dry  toothbrush I keep for this purpose, and this keeps them from clogging.

      This unit is recognized as the very best vacuum in terms of picking up pet hair and fluff, and although my animals reside in their kennels or barns, I still really appreciate being able to keep everything "asthma and allergy clean".

       The reason I have three of these in different areas is that they are relatively inexpensive.   Amazon sells them for $80-$100. US.     They are also fairly widely available in Canada.  Since Eureka products are found worldwide, these are probably available in many places in the world.   They not only vacuum the carpets or floor below your feet quite well, but there is a nozzle which allows you vacuum the top of drapes, or even the farthest recesses of the interior of a foreign car !  It also keeps upholstered furniture immaculate.

        I realize that you can spend a great deal more money on a vacuum cleaner.   I do also have a wet dry vac for the workshop, but it's not really used in the house.  I really think that this is an excellent device.

       There is no vacuum that does not need a small bit of cleaning and maintenance.  They either need a bag changed, or to be cleaned or filters changed periodically.   As you might have guessed, I didn't tell the man seeking the next model up to get something else.  I told him to start doing the maintenance on the unit he has.  It takes no time to empty the dirt each time, and to check the filter every other time.  Once you know how, it's easy and very quick and keeps the unit working optimally.  In fact, it once tried to suck up a spoon with the wand feature !

        As always, I write about the items I like, and no one has paid me to tell you about this.  In the past, I have spent more money on vacuums but not been as pleased.    (I did really like that orange VAX I had when my children were small which was based on an aircraft engine. That company has gone out of business.)

       Hope this is useful information to you !

Info regarding The Eureka Whirlwind Pet Lovers Plus Vacuum Cleaner

This is a smaller version which is also really excellent !

Eureka Pet Lover Oh !

(I have one of these I paid $67. for on Amazon, which we use in my garage)

Thursday, May 15, 2014

The First Two Books of John Rixey Moore


       I don't often recommend books other than my own, but these are a rare treat.

 John Rixey Moore is a former Green Beret, a South Carolinian. an actor, a businessman, and an author.

Please take a look at these fascinating works.    I promise that his use of words and the pictures painted by these books are worth your own efforts to obtain them.

Sunday, May 11, 2014

Prayers for Ukraine


      I have stayed fairly quiet on this matter basically because I have dear friends in Russia from our time in Russia,  and dear friends in Ukraine.  It is difficult to comment in a public forum without offending and there are great passions ignited among both groups.

              First, I understand that Putin's Russia has an important naval base which has been rented from Ukraine which in located in Sevastopol on the Crimean peninsula. (This is where Russia's Black Sea Fleet is housed.)   This has been an important strategic advantage to Russia and something they would be very concerned about losing.  Secondly, Crimea is the seat of many fine houses that wealthy Russians own. It has become, in a sense, the "South of France" in Russian circles.  Eastern Ukraine has enjoyed a positive trading relationship with Russia.  In addition, the television stations in Eastern Ukraine come from Russia, and so a strong identification with Russian ideas is to be expected.   When a regime change took place in Kiev, I can understand that Putin and his group were dismayed to say the least.  At worst, the Russian naval use of Sevastopol could be in jeopardy. (And it's one hell of a distance to Vladivostok !)   There could be new restrictions on the Russian ownership of lands in Ukraine.  Wealthy Russians with grand homes in Crimea could find they can't access them as readily or that their investment values there fall.  Make no mistake,  Mr. Putin, for all his nationalistic ideas for Russia, takes care of Russia.  He was not about to let Russia lose access to a strategic naval base, or to let successful, wealthy Russians lose homes or home values, or access to a regional vacation paradise. There is also the matter of gaslines which travel through Ukraine on behalf of Russia where gas is sold to Europe.  Political instability in Ukraine is therefore very bad for Russian business.  In addition, a lot of ethnic Russians live in Ukraine.   The regime change in Ukraine and the potential political instability there, painted Mr. Putin into a corner where he felt he was forced to act. It also did not help that some of the political stars in Ukraine were saying some belligerent things about Russia and Russians, and they should have been more careful in such volatile times.

              However, it is one thing to defend the naval base you rent.  It is one thing to station Russian troops about your gas lines to ensure their continued safety.  It is one thing to send some troops to Crimea where you can, with permission of the current evolving regime, ensure the safety of Russian citizens.   It is quite another to act as an invasion force, and to invade, occupy and progressively take over one military base at a time in first Crimea, and then Eastern Ukraine. It is also quite another thing to leave Ukraine now land locked. This was also performed dishonestly in that Russia claimed simply to be performing "border exercises".

             Mr. Putin has made a grave error in ignoring the sovereign nation status of Ukraine.  He has invaded a neighbor and this shall have far reaching consequences in the world that he has not yet begun to tally.  (This is without even considering sanctions.) Although the United States presently has a wishy washy leader, Canada wasted no time in expelling Russian military officers who were present for military educational and language exchange courses.  Canada considers the occupation of Ukraine by Russians to be an invasion.  When the Obama administration completed its surveys of everyone's opinions, it too summarized Russia's actions as an occupation.  The United Nations and NATO did the same.  Russia had made great strides in coming into its own as a strong and positive country as a maturing sibling of the nations of the world.  Many people have either not lived in the Cold War era or have relegated the old memories of the Soviet Union to being as dead as the old Bolsheviks who killed the last Czar's children.  However, this has been a wake up call to the intelligence community.  Russia's propaganda ministries have been working overtime claiming that Europe, the US, and other nations toppled the former ineffectual and self serving leader of Ukraine who was deposed.   Russia is working hard to justify its takeover of Crimea.  Russian laws were passed almost immediately making Crimea a permanent part of Russia.  The Russians will never need to pay rent for their beloved naval base in Crimea again !     With this success under their belts and no one to counter them, is Finland safe ?  What about Latvia, Lithuania and Estonia ?  What if Russia wants Sweden, Denmark or Norway ?  What about the Yukon territory of Canada which the Russians persist in planting Russian flags on prior to doing more oil drilling "research" there ?

            In the past few years there has been a great surge of Russian nationality and prosperity there. Russian debt has been paid down, military stores have been built up, and military equipment has been replaced.  Gold stores are being gathered.  Most of the world understands now that Russia has been a sleeping giant.  Very little stops them from taking back border cities with China, or anything else they want.  In speeches domestically, Mr.Putin has said that the greatest tragedy in the last hundred years was the Fall of the USSR.  (Apparently, he doesn't consider the Holocaust a tragedy.)   Is this step one of reassembling "the old neighborhood ?"

           Mr. Putin, the US may be down, but we are not yet out.  We can and likely will turn all of the surveillance ability we have which is focused on US and European citizens worldwide and turn it on you. The rest of the world will be watching you now as you carelessly tipped your hand.  The disregard of the sovereign nation status of Ukraine will not be forgotten. It certainly will impact whether other citizens of the world choose to invest in Russia.  The Cold War II can return in just an instant, and any amount of propaganda on RT America won't be able to change that.

        I pray that people in Ukraine remain safe and self sufficient during this Russian invasion.  I pray that Russia does indeed pull out and begin to act in the role of a supportive neighbor, rather than an oppressor.  I pray that Vladimir Putin realizes that his legacy had the potential to be much more than simply a conqueror. It had the ability bring Russia to a cultural pinnacle and to bring positivity to the world beside Ukraine, not on top of it.  Russia has a great deal of positive aspects of its culture to share.  It doesn't need to be armed while doing it.

Wednesday, May 7, 2014

Discussing Low Dose Daily Aspirin Use


Make sure that you understand the dosage and type of aspirin your physician has ordered.  Sometimes dissolving aspirin is ordered and other times enteric is chosen.  Low dose aspirin is usually 81 mg. per tablet.  The two aspirin you and I might take for a headache is a dosage of ten grains, or about 325 mg. per tablet.

      This week, the US FDA has cautioned people on the unsupervised use of a low dose aspirin tablet daily.  The fact is, that no one should have been using a low dose aspirin daily without having it been suggested/ordered by their physician.

            Aspirin is a remarkable drug. It not only is an effective anti-inflammatory, and an effective anti-pyretic (it lowers fevers), but it impedes clotting.  If aspirin hadn't been in widespread use for centuries, then the FDA would have made it a prescription drug !    It has miraculous properties and those same properties can be devastatingly dangerous when used on the wrong patient or during a particular period of vulnerability.  In a patient who has some degree of coronary artery disease, or who has had a heart attack, one solitary 81 mg (low dose) aspirin can prevent the formation of clots and can be an effective adjunct in the prevention of another heart attack.   However, in an alcoholic, or a person with problematic GERD, or a history of gastrointestinal bleeding, or liver disease, a daily aspirin, even in low dose, can cause gastrointestinal bleeding which can become so severe that I am left in the ICU transfusing a unit at a time in one arm, then the other, and then a third unit in the arm with which we started ! (Later that day, the patient will go for colonoscopy and for in effect, a cauterization of the bleeding area, but they still often need the blood they lost replaced.)
            Sometimes, a patient who really needs a daily low dose aspirin does actually have some other issues which make the practice dangerous, and then it's up to the physician to formulate a plan which manages such risks.  For example, in a patient with a history of controlled Crohn's Disease who also has coronary artery disease, he may need the aspirin, but there are concerns about potential activation of Crohn's Disease and gastrointestinal bleeding.  Sometimes the physician will order regular dissolving 81 mg. aspirin for a week, and then an enteric coated 81 mg aspirin they can alternate. This would at least, theoretically change the place of delivery to the gastrointestinal tract minimizing at least some of the potential for ulceration.
             Some of the patients who may benefit from a daily low dose aspirin a day are those with coronary artery disease, and especially those who have already had one heart attack (myocardial infarction).  Sometimes people with heart rhythm disturbances, especially atrial fibrillation have had low dose aspirin ordered.  This may help to prevent strokes and blood clots for them.  People who have something called anti-phospholipid syndrome also may benefit from daily low dose aspirin therapy. Certain patients who have had transient ischemic attacks, or mini-strokes might also benefit.   Some people with simple hypertension may also benefit.  Women who have a history of preeclampsia/toxemia in pregnancy can often avoid the syndrome using a physician ordered low dose aspirin until the last couple of weeks of their pregnancies. Some diabetics and those with certain types of dementia may also benefit.

            The patients for whom we worry a great deal about a daily low dose aspirin are those with a pre-existing clotting disorder, those with a known brain injury, (which could be bleeding), those with a liver disorder (as they may not clot readily), pregnant women who have had uterine bleeding during their pregnancy, those with known unhealed peptic or duodenal ulcers, those with esophageal ulcers or cancer, those with active Crohn's Disease or ulcerative colitis.

            There is a good recent study which seems to indicate that many patients who benefit from low dose aspirin could take it three times a week and enjoy the positive effects of the regimen while diminishing the bleeding risk somewhat.  This is something you should discuss with your physician.

            If you are taking 81 mg. aspirin daily, do not discontinue or wean this drug without first discussing this action with your physician.

               Be careful not to take aspirin along with other pain relievers (such as ibuprofen, which also impacts blood clotting times and gastrointestinal health.  As your physician or nurse practitioner for guidance when you need pain management and are taking a low dose daily aspirin.

          This one miraculous drug used in small dose is one of the reasons that so many people are attaining such a ripe and still productive old age.  Check with your primary physician as to whether you would benefit from its use, or whether you are one of the patients for whom it is potentially hazardous.

Saturday, May 3, 2014

Staying Marketable No Matter What the Circumstances

                I am very lucky in that both my parents redefined themselves occupationally many times throughout their lives and had multiple successful careers.  Both of them had fulfilling employment well into their eighties. They were each off work for about a week with an illness before they died.  This is an excellent way to spend one's life, and if my own health permits, something I would like to emulate.  Each of them could have retired, and I think they both tried it in their sixties, and then realized they were free to pursue other interests and other careers. I am fortunate in that I saw at least this possibility modeled for me.

They say that employers don't look at resumes longer than about thirty seconds before deciding whether to cast one aside or perhaps interview that candidate.

               Even if you can afford to retire, and fewer and fewer of us can, there are some health benefits to continuing to work, at least part time.  Human beings stay healthiest when we have a modicum of a routine.  We sleep regularly, eat regularly, and are mentally challenged by work, even if just threading the needle by way of the commute !  Through work we maintain attachments with people and continue to have intellectual stimulation.  I am not suggesting that ninety year old Aunt Ida stock furniture using a forklift at the Wal-Mart warehouse.  I am suggesting that perhaps, if she wishes, she could work customer service somewhere, where her politeness, attention to detail and persnickety-ness will be truly appreciated by a company who profits from that type of attention for its customers.   An awful lot of people can't stand their phone calls answered by a machine. They won't buy things without some personal attention, and many of these people who know how things were done the old way, are very valuable in such a capacity. Perhaps by creating more flexible part time jobs, some of our older citizens who actually can converse with prospective customers, can join the workforce.

             When you think about it, I was asked what I thought I wanted to do for a living at about twelve.   In British school, in the 1970s,  the state tells you what they are going to be willing to train you for, based on the recommendations of your teachers. (Who is my case, had known me only six weeks at that time.)   At twelve, we can't possibly know enough about ourselves at that point, let alone enough about the potential professions which exist in the world.  I am still learning about interesting jobs and professions NOW.  My daughter has a job I didn't even know existed !    Interestingly, my teachers in British school certified me at 12 to become either a nurse or a teacher.  (This is no great miracle, as women even in the seventies, in the US and in the United Kingdom were still shuttled to these two female occupational roles.)
           After time in Harrow at my British school, I returned to the US and completed my education in the US.  They didn't inquire as to what I wanted to do for a living until high school.  The recommendations of my guidance counselor based on testing and the Ohio Vocational Interest Survey (which we all took, remember ?) was that I should be a writer or an editor.  So what did I do ?   I graduated from high school early and went to college as a Biology Major on a Pre-Med track with intent to become a physician.  I did well in biology but I had concerns that I didn't want to do a medical residency, which in those years was 70-90 hours a week. It seemed to me that being a physician would squash any wish I had to have a family in my twenties.   I made the switch to nursing not long after.    In deference to all the people in my youth who had a hand in my future occupation, they were all right.    Through college I worked as an activities therapist in a nursing home, the only female employee in an upscale men's suit shop (very useful as an eventual mother of four sons and a daughter), a recording artist,  a mathematics tutor,  and as a babysitter.   Most of my occupational life after college has been spent in one specialty or subspecialty of nursing.  I worked in occupational health nursing for an aerospace company. When we were transferred to another state, my job there ended.  Then I made a living for awhile doing short term private duty in psychiatric hospitals. Eventually, I settled in critical care nursing and remained in related positions for the longest periods in my career.  This was both adult critical care and pediatric. I also spent time in cardiac ICUs, medical ICUs, and surgical ICUs.  I started writing as an offshoot of one of my nursing jobs when I was asked to revise certain aspects of the hospital procedure manual.  Magazine articles and other writing tasks followed.

Yes, every hospital school of nursing, college or university which graduated nurses had a different cap, and we all wore one.  It seems like a long time ago now.

            I am relating all of this because I don't think I am that unusual.  I think most of us come to adulthood with a particular skillset, and that this skillset, whatever it is translates well from one career to another.  For example, I know nurses who are very detail oriented and observant. Some of them translated those skills and trained to become police officers.  One is now a detective.  She has joked with me that the two jobs aren't that different, but that she doesn't have to keep putting a venous access in the people she investigates, and so over all, she prefers being a detective to being a clinical nurse.  So perhaps rather than throwing everything we have behind one career, we should be developing broader skills that translate.   Another nurse friend of mine has always excelled with computers. When I was asked to help to rewrite parts of the hospital procedure manual, she was asked to consult with programmers to help to create software that would benefit the hospital for use by nurses on hospital units.  She works in computers now.

         What I am saying is that we should nurture all of our interests because we cannot be sure that they will not evolve into an occupation at some point.  I think we should always have an updated resume, and that we should not just advertise ourselves as an engineer, a teacher, etc.a nurse.  We have many potentials, and in a changing world may need to exploit more of our interests.

       Interestingly,  the Brits and the Americans were right.   The British would have trained me to be a nurse or a teacher.  The two careers I eventually chose to remain in the longest were as a critical care registered nurse and as an adjunct college instructor.   My American high school guidance counselor wasn't too off the mark because I have written hundred of published articles and two books.

        I think the best any of us can do is cultivate our interests with the thought that any of them could evolve into some type of career, as we cannot fully anticipate the ways in which the world is changing.  It's funny that I spent years in college, when I think that what I do more than anything else is drive a car.  Perhaps I should have spent less time in college and more time honing professional driving skills as I have driven a million plus miles thus far.     I also think that every person should update their resume as often as possible for immediate use.

       In any event, I wish to encourage you, whether you wish to be an employee, or an entrepreneur.  The world is changing and the internet brings far more possibilities for all of us than were appreciated when we first made career decisions.  Like my parents, many of us will enjoy (yes, I mean enjoy) the ups and downs of multiple careers.  You know, I really do enjoy rural real estate Maybe one of my next careers will be as a rural large acreage real estate agent !