When you're down and out....

(if i had musical notes to add to the title i would)

When you're having the kind of crappy day when your brain just won't move fast enough to see patients, nothing seems to move smoothly, and you're sure you picked the wrong profession, I suggest the following remedy:

1 salad with orange peppers, cukes, turkey, and cheese with a balsamic dressing
(and when that doesn't work add the following:)
1 Snickers ice cream bar
1 medium Dunkin Donuts french vanilla coffee light and sweet
1/2 boston cream doughnut

(if noone can get a hold of me in about 2 hours you'll know i crashed. hard.)

The ethics of vaccination

In the last 12-18 months the discussion about sexually transmitted diseases and school-age vaccinations has heated up. With the introduction of Gardasil, the human papilloma virus vaccine, onto the market, the discussion has expanded to whether or not it should be made mandatory for young girls.

Naively, I thought this would largely be a non-issue. I mean, who in the world would like to see their sister, daughter, wife, niece, granddaughter, or friend be diagnosed with cervical cancer or geintal warts?

The vaccine protects against infection of HPV types 6, 11, 16, and 18. Together, these four types cause approximately 90% of all cases of genital warts. Type 16 causes about 50% of cases of cervical cancer, and Type 18 an additional 15-20%. In addition, though the evidence is not unequivocal as it is in cervical cancer, Types 16 and 18 are likely involved in the development of vaginal, vulvar, and anal cancers. The vaccine is nearly 100% effective against infection from these 4 types. So far it's only indicated for girls and women ages 9-26.

So how do you get HPV of any type? Sexual transmission. It is the most common sexually transmitted disease In fact, according to the MMWR nearly 80% of all sexually active adults will have contracted some type of HPV by age 50. This means that if you have sex when you are 12 and promiscuous, 18 and responsible, 25 and married or monogamous, homosexual, heterosexual, a boy, a girl, or forced to have sex against your will, or have sex with or without a condom (to be sure, condoms decrease the rate of transmission but are not 100% effective), you can still contract the infection. So, unless you are a celibate human being for your entire life, you are at risk.

So state governments are starting to debate whether or not to make the vaccine mandatory. Why make anything mandatory? Well, usually it has to do with how it is transmitted, like measles or pertussis for example. Not only does vaccinating your kid protect your kid, but vaccinating in groups can theoretically provide some protection to the community as a whole. When it becomes a public health issue we start making things mandatory.

I stumbled upon an editorial in the Charleston Daily Mail where the author suggests that it is medically unethical to require the HPV vaccine. He says: "Here we are talking about forcing a person to undergo mandatory drug therapy (vaccination), when they have no disease, under the presumption that they might get a disease based on future poor behavior."

Woah nelly. Hold up. Wait a minute. Say what?! Poor behavior?

I was a little afraid of this sentiment in the general public. Based on the information I presented above, is it not clear that anyone who is sexually active, behaving well or otherwise, is at risk for this? Obviously if you have multiple partners you are at higher risk. But even a young woman who never had sexual intercourse prior to marriage could still get HPV and therefore is at risk for cervical (and vulvar and vaginal and anal) cancer.

[So far we don't know if it also protects boys and men, who, are the carriers. If it does work, we might get the aforementioned herd immunity and perhaps then the demise of the virus altogether. We will also then have a powerful tool to reduce the incidence of genital warts and anal cancer in gay men.]

The whole issue is clearly at the intersection of moral values and medicine. My guess is we don't like to think of our children having sex, whether our children are kids or adults. But it happens. It happens at school, it happens after school, it happens when parents are home and not, it happens consensually and by force, it happens in marriages and in monogamous relationships, it happens for money, it happens for love and for hate. And sometimes when it happens, a virus goes with it and sometimes that virus causes cancer. And now we have a vaccine which, by all reports available, seems to have nearly 100% protection against it. Why not make it mandatory? Besides, in the end, nothing in this country is really mandatory. You can beg borrow and steal your way out of almost anything. This is no different. If you really don't want your kid to have the vaccine, they don't have to have it. But there will come a time when you have to search far and wide to find a specialist that knows how to treat cervical cancer because it is so rare.

At least I hope so.

I love the label feature

Dearest Katy,

I took the liberty of assigning labels to your most recent post.
I will continue to do this for as long as you do not.
Mostly because I cannot wrap my brain around why you overlook this feature...
I know it is ironic that leaving "blog labels" unassigned seems to bother me-
(Since i have no problem walking away from wide-open kitchen cabinets and drawers, and I have a large cardboard box in our home office with months worth of uncompleted projects, notes, mail, and administrative chores...) But we're talking about blog labels here!!!
Try not to leave me with all the heavy lifting, okay?!?

Love you, T

Nice girls finish....

last?

I watched the Nicole Vaidisova/Serena Williams Australian Open match via sTiVo this morning. I noticed two things: 1. there is virtually no crowd noise. Therefore, Tracy should enjoy watching it with me. Or at least be able to tolerate it better.

The other observation was how nice Vaidisova is. There's a basic understanding in tennis that it's not cool to hit the ball off the net. It's certainly not gentleman-like given the subsequent erratic movement of the ball and that tennis should be largely predictable (except when Federer or Henin-Hardenne or Sharapova hits the ball 150 mph right past you). So in her match against Serena Williams yesterday Vaidisova had two mis-hits that hit the net and fell right over into Serena's court, making it impossible for her to get it. Both times she put up her hand and said, "Sorry" and looked like she meant it.

Compare that to NBA basketball or major league baseball where you just pay the fine and beat the crap out of whomever is taunting you.

Vaidisova ended up losing, which means there will be no look-alike contest at these year's Australian Open Final.

Germ Warfare

Today the temperature finally dropped below freezing.
I had to act fast to use this to my advantage in order to try and free my house of disease before precious guests (okay only ONE precious guest) arrive...

I turned off the heat, and opened all the windows in the house for 20 minutes to let the shit air-out.

My fingers were numb by the time I locked us back in and reset the automatic thermostat.
Here's hoping it works!

GI vs. URI

Kt got a head cold around Saturday morning. She started to look pale and tipsy and talk funny (like there was a bugle jammed up her nose.) That was before she started taking Day-quil and NyQuil. Then she started acting fuzzy. I did my best care-taker impression and set her up on the couch to veg out. Since then, the mucus has settled into her chest, and she begins every morning with a chorus of startled hacking.

Saturday night, I was full of tenderness and concern. I tried to sleep close to her and spoon her to health with my body heat. I ran around house and home all weekend unafraid of disease, only concerned with the comfort of my girl.

But starting Monday at 1am, i endured an 18-hour stomach Blitzkrieg that left me psychologically scarred and 3 pounds lighter. It was one of those violent illnesses that inform the emotional climax (if not the plot) of every Lifetime: television-for-women-who-hate-themselves movie, where a stoic but-soon-to-be-dead woman vows to NEVER again undergo another round of chemotherapy. My skin hurt. My hair was sweating. My stomach lining was panting and peeling...

There is still practically nothing in the refrigerator that I am willing to eat. I threw away a pound of sliced turkey, a 1/2 gallon or skim milk, a bottle of salad dressing, and 2 heads of lettuce b/c they all "seemed weird" to me.

Katy slept through the worst part of my Tummy Tsunami, but when her "back to work" morning routine included a coughing diddy that would have made the Marlboro Man weep, I clutched my abdomen and realized how likely we were to simply trade viruses before the weekend arrived.

We've got a big weekend planned.
I know I have zero control over this, but I'd like to publicly state that
I'm willing to take the hit here...
If there's anyway for my GI bug to pass her by,
I'll gladly hack up a lung every morning for the next several weeks.
That's the story of- That's the glory of love.

Sunday sports

Triumphant again! Liberty win 41-12.

We still haven't really been tested, an easy "non-conference" schedule. Next week we'll see some real competition.

2006

I know it's a little belated but please enjoy a photo journey through our busy 2006...

Girls basketball #1

That's right, it's 7th and 8th grade girls basketball time folks! GO LIBERTY!

The season started auspiciously this past Sunday when we won our first game. It's early in the season, yes, but I have 3 players over 5'8" and that means a lot when you're 12 and 13.

box score: Liberty 24, Comets 10. (no other info available at press time)

Funeral for a friend

This week we lost a friend. Jim Tabor was an avid golfer a big time Red Sox fan, and the man kt and i considered to be our last Grandpa. He was the man my dad turned to when he needed a paternal role model, primarily because Jim could drink without turning ugly, and he could discipline without wielding a belt. But- my parents further observed- Mr. Tabor seemed to know that all kids needed to grow up healthy and successful was love and support. My parents made their decision that they would do their best to follow his example. That included trying to teach me that "home" is a place where you are loved and protected... That family members can be among your best friends... and friends are nothing more than extended family.

I came out to Jim and his family a few months before I came out to my parents, and a few years before I officially came out to my own grandparents. His response at the time changed the trajectory of my coming out process: "As long as you're still willing to give this old man a hug when you see him, it doesn't matter to me in the least." I know that if he and his wife had responded in a less accepting way- with quiet uncertainty, or a polite but awkward level of discomfort, I would have been less sure of how to proceed. I didn't realize until later that I had been testing the waters with Jim and Mazie, I was waiting to see if this ("I'm gay") news would change how loved ones treated me. It didn't change how he loved me at all, but it changed how much I loved and respected him. (Even more than before!)

When I brought Katy to the Tabors for the first time, she got drunk on all the love and acceptance. They were so happy to meet her and wanted to hear all about her. She said they were so kind to her because she arrived with me and she could see how much they loved me. But i told her that from my experience with the Tabors, if she had walked in off the street without any connection to me at all, it is likely they would have treated her the same way.

Mr. Tabor has been sick a lot in the last year. But his hospital stay was short- only a few weeks- and with so little warning, it's hard not to feel abused and robbed. Somehow, he is gone. And it's hard to feel the stinging reality of that. He's not gone from our hearts or our memories, of course, but memories are one-dimensional and watered-down... We'll never get to hear his laugh, or greeting from the door, or give/receive his hugs, or hear his eternally-optimistic spin on things again.

This, i guess, is the definition of mourning: it is a word that that describes not only the action but also the feeling associated with contemplating the void that a death creates and figuring how you will shift to bridge or fill that void.

Mourning blows.

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