Birthday Ramblings: A Place for My Stuff?

I have determined that I am not among the mental elite of our species. Not that there were any allusions to the contrary. But the evidence is stacking up quite convincingly. I lack the necessary skills and abilities. In fact, I may be subpar. I can't find things. Sure, I can't find my hair, my feet, my breath – I expect that with age. It's the other stuff that eludes me. My family hides stuff from me all the time. I can't find it. I know there are little stashes of goodies all over the house. I see the wrappings left behind. I never get any. Halloween candy vanishes on November 1st. Easter candy leaves behind a few strands of plastic grass. Christmas stockings are mysteriously empty. I'm missing out. Where are they hiding their good stuff?

I also can't find car keys, hairbrushes, my wallet, my tools, peace. Even when people tell me where stuff is I can't find it. Case in point, I submit the following little exchange. I'm at home. Phone rings. I answer.

     "Hello."

     "Hi honey," Gailyn's cheerful voice greets me. "I am going over to pay for the cell phones now. Can you grab the Verizon bill and tell me how much Jessica went over last month and how much it is?" To ascribe cheerful as an adjective to Gailyn's voice is redundant. But to be cheerful when going to pay the cell phone bill is just not natural.

     "OK. Where is it?" I ask.

     "It's right there on the counter, by the phone."

     "I don't see it."

     "It's right there on top of the pile of bills – I put it there before I left."

     "I'm looking but I don't see it…I've gone through the pile here…twice now. I don't think it is here."

     "Did Stephanie clean up before you got home?" Stephanie's idea of cleaning is to create stacks of stuff. She clears 98% of a room area by condensing any matter down into about 2% of the cubic square feet. It's like coming across those giant termite hills you see in the desert. You have miles and miles of wasteland, then boom, you come across this huge tower rising out of nowhere. That would be Stephanie's modus operandi if she were straightening up the desert.

     I say, "I don't think so – there are a bunch of dishes around, but they aren't stacked to the ceiling. Look baby girl, I just can't find it."

     "It has to be there. I just looked at it when I grabbed the checkbook. Is it over by the microwave?"

     "That's where I'm looking now, but there aren't any bills at all over here – wait, did we pay our auto insurance premium? Never mind, this is for 2005. We don't even own these cars anymore - why do we still have this? Here are all the paystubs for 2002. And we have something about a Thomas Kinkade Christmas Village – dated 2008. Why do we have Arby's coupons that expired last summer? Publisher's Clearinghouse - 2007? Did we win? They probably came when we weren't home. Hmm…and I don't even know what this is. Why are we being charged for a destroyed science textbook? Do you know about all this?"

     "Yes. Those are all mine. Don't mess up my order. Did you check against the wall in the dining room?" (This is our default junk overflow location)

     "I'm over here on my knees right now…but…no…unless it is under the kids' report cards for last year. Do you think it would be mixed in with the ten years of editions of Family Fun Magazine?" 

     "All right, never mind, just forget it. I don't know how the bill would have gotten in there anyway. I'll just ask the store clerk to pull up the amount at the counter. See you when I get home."

So, you can guess what happens when she gets home. She walks in. Puts her purse on the counter and picks up a nice little envelope with a Verizon logo that just happens to be sitting right there on the corner. I can see the lips tighten and her eyebrows pull down on the sides. She waves it at me. I'm confused. Am I supposed to take the envelope from her? She says, "Here. Here is the cell phone bill. It's right here." This is not so much a statement of fact as it is an accusation of incompetence or carelessness. In response I swear that it wasn't there earlier - yada, yada, yada. And she sighs and gives me one of those uh-huh noises that lets me know she is convinced that I would lose my head if it wasn't screwed on.

I admit it. I can't find stuff. I'm excellent at the find-the-hidden-figures-in-this-picture puzzles, or choose the dinner plate which has a long strand of hair hidden in the food. But real life seems to evade me. Now, I can pretty much live with this flaw. It gets me out of having to do a lot of stuff. My soul mate just sighs and says "never mind" and she takes care of things for me. It is just easier on her that way. It does bother me some when I can't find the stuff I need. But what really bothers me is that I can't seem to hide stuff either.

If you've ever read a Dan Brown novel you know that there have been geniuses throughout history who were able to conceal the greatest secrets of mankind in plain sight. You could tour Rome, Paris or Washington D.C. and never be aware that the keys to enlightenment and apotheosis are close enough to touch. The great thinkers, scientists and artists of the last 1000 years have carefully preserved the ancient secrets of mankind against the suppression and tyranny of the church, government, and common ignorant masses. Only a Robert Langdon type has the mental wherewithal to uncover the mystery. And he does it all in just a few short hours, all the while running from the police, the bad guys and the secret societies.

I'm either an incompetent hider or my children are all little Robert Langdons. I can't secret anything away. All my stuff is quickly found and consumed. Sometimes I get there just a little too late. The only stuff left is like those little pieces of chum left in the water after the sharks feed. I bought one of those 10 packs of razors. I took one out and hid the rest in my dresser. I come back a few days later and there is one left. Just one. I bought a box of Little Debbie Devil Dogs and hid the box on the top shelf of my dresser – under a pile of sweaters. I come back and there are little cellophane wrappers all over the bedroom floor. I don't even know who to blame.

This happens constantly. I can't keep any of my stuff. Sometimes I know who takes it, i.e. my razors (daughters use for legs), my shampoo (son uses in morning), any comb (?), candy (Michael has paranormal abilities), etc. The kids are bad enough but even my wife takes my stuff. Gailyn has a 24 hour rule on chocolate I might bring home. If I don't eat it in 24 hours then it is hers by default. This applies to desserts left in the fridge as well. Back when I was working for Dow Jones and gone in the evenings I would come home late at night to find a cheese cake pie pan in the sink. There might be, I stress, might be one little piece left in the refrigerator. If I didn't eat it then, well, let's just say that by the next day there would not be a piece in the fridge. Guess who ate it? Yeah, the one with all the willpower in the world except when it comes to staying out of my yummy stuff.

I tested her though. It happened on my birthday. I got Banana Cream Pie. That is my favorite dessert. This year she asked me if I would like her to prepare a couple of those instead of a cake. I said yes. And to ensure that I would get some I asked her to make one that would be just mine. She did. I enjoyed a big slice and left 2/3 of it in the refrigerator. And you know what, she didn't eat it; didn't take a single piece. Neither did the kids. She may have had to threaten them with a slow and agonizing death if they did, but they all left it alone. After about 48 hours I ended up splitting the rest of the pie with her and we lived in decadent pleasure for a happy hour. This is about as decadent as we can manage these days. I did mention it was my 45th birthday, right? (JK, Hon.)

So that's the secret. I have no stuff because I have no power. It all resides in the perky little inamorata that I married. I have stuff if she mandates I have stuff. And sometimes she even has willpower - when she wants to.  And it seems she wants to about once a year.

Dems Begin Their Decline

Scott Brown wins.  I'm surprised that Coakley didn't win, indications of the polls aside, voters normally return to the safety of their party candidate when they pull the lever, regardless of what they say in a survey.  Ted Kennedy is to blame for the loss of the seat.  To be sure the arrogance and the "we're ramming this down your throat" approach of the democrats since last January made the voters of Mass angry - but Uncle Ted is the reason Scott Brown is even a public name.  The Democrats want you to think that Coakley was a horrible campaigner, that Massachusetts is racist, that Massachusetts is sexist, that the American public is just dissatisfied and ready to vote out any incumbent.  Bull.  This was a referendum on Washington and a big slam on the Big O himself.  The margin between Brown and Coakley actually widened after the President took off his tie and robo-called the good people of the Bay State.

This is all true.  But it would have been a non-factor if Theodore Kennedy (D) who served for 46 years - longer than I've been alive - had not tenaciously held onto his seat even when he knew he had a fatal condition and would die in office.

The question is - just who, really, is Scott Brown?

My Completely Useless, But Fun, Best Foods Ever List

Nov. 7, 2007 - The Frrrozen Haute Chocolate is unveiled at the Serendipity-3 restaurant in New York City. Guinness World Records determined the $25,000 frozen hot chocolate was the most expensive dessert in the world.

 January 15, 2010 – I still haven't gotten any. Nor do I understand any idiot who would pay $25,000 for a dessert item. How do these people keep their money?

 More down to earth, these are some of my favorite things to pick up at specific locations (and none of them cost over $25):

#1 - Wegman's brand Chocolate Milk.  Cream O' Weber in Utah was my favorite, but 15 years out I don't remember exactly how the two brands stack up.  But Wegmans is good.  I don't know what the mix is or how creamy the starting product but it puts other brands and mixes to shame.  This is a brand to hide from the kids.  They can drink the Nestle and the Ovaltine.  Leave my Wegmans Chocolate Milk alone!

#2 - Shearers Baked Cheese Curls (Giant Eagle).  I am not a cheesy poof lover.  They make you have orange sticky fingers that can be traced through 3 counties and they gum up your teeth.  Not worth the trouble.  Most of them are pretty tasteless or nasty anyway.  Not Shearers.  I actually will put up with discoloration just to down a half bag (or more) of these.

#3 - Goya Brand Guarana (Tops).  Guarana: the official soft drink of Brazil.  Delicious.  Wish they sold Antarctica brand here but... enough said.

#4 - Mighty Fine Donuts (Erie PA).  Krispy Kreme - sugary dough.  Winchell's - kid stuff.  Dunkin Donuts - maybe worth the trip for the coffee, but for real melt-in-your-mouth donuts, head for Parade Street and Mighty Fine Donuts.  Show up early to get your fresh pick.  Some varieties go fast.

#5 - Graeter's Ice Cream (Ohio locations).  Best ice cream since Nellie Thames' homemade ice cream for the church picnic in Beaufort South Carolina.

Isabelle Nelson

Lived Well, Loved Much. Isabelle Fickenworth Nelson, age 87, of Erie, passed away Friday, January 8, 2010 at Sunrise Assisted Living. She was born in Erie on June 15, 1922, daughter of the late George and Anna Depner Fickenworth. She was a lifelong Erie resident. Isabelle's life was centered around her home and family. Her home personified her skills of cleaning, cooking and gardening. Family and friends always felt the peace and love that abounded there. Family gatherings were very special to all and each new addition was lovingly welcomed. Isabelle was a devoted member of the Church of Jesus Christ of Latter Day Saints. She served many years with the children and youth as a leader and teacher, as well as holding many other church callings. She and her husband, Earl, also served a one year mission in Texas in 1984. She had previously worked at the Boston Store and then Blue Cross/Blue Shield prior to retirement. She was preceded in death by her husband, Earl A. Nelson; her 11 brothers and sisters; and one step-grandson. Survivors include her daughter, Marjorie Nielson (Deon) of Erie; her son, Terrence Nelson (Patty) of Girard; nine grandchildren; one step-grandson; 21 great-grandchildren; several nieces and nephews. Friends may call at the Dusckas Funeral Home, Inc., East, 2607 Buffalo Road on Tuesday from 6 to 8 p.m. and Wednesday from 9 to 10:30 a.m. at the Church of Jesus Christ of Latter Day Saints, 1101 South Hill Road, where the Funeral Service will take place at 11 a.m. conducted by Bishop James Moore. Interment, Erie Cemetery. Memorial contributions may be made to Alzheimer's Association . Greater PA Chapter, 1128 State St., Suite 301, Erie, PA 16501. Special thanks are extended to all her caregivers at Sunrise where her last years were spent. To send condolences visit http://www.dusckasfuneralhome.com/.

Published in the Erie Times-News on Jan 10, 2010.

Mental Issues and Treatment - Dementia Brief

by Rick Doray*

In the field of medicine there are three categories of diagnostic errors to which a doctor or clinician can fall prey. First, there are lack of data errors. A health condition may present silently or atypically. It may be a new disorder. Sometimes health care providers just do not have enough data to make an accurate diagnosis. This type of error is very difficult to eliminate. Hopefully, these errors will be reduced and committed less often as medical/health knowledge advances. Type 2 errors are healthcare system errors. These errors can be caused by specialty competition for resources in a health facility or by system redesign changes. Health systems can be overtaxed and errors can result due to a lack of available resources.

Type 3 errors are cognitive errors and are committed by the provider. These types of errors are caused by insufficient data collection; data misinterpretation; a lack of system-level checks, such as second opinions, specialist consultations and laboratory results; or even carelessness (Graber, Gordon, Franklin, 2002). Clinical personnel should be careful to not make rushed analysis or avoid using system level checks to ensure their diagnosis. Residents and Physician Assistants need second opinion approval from qualified supervising providers to enter a diagnosis on a patient's chart; it might be well if all chronic condition diagnoses were peer reviewed to ensure consensus and accuracy.

There are more than 70 conditions which can cause dementia. Clinicians may fall into the "trap of commonality" to diagnose a condition as dementia when it may be something else. Clinicians may also misclassify a temporary dementia condition as permanent. This misdiagnosis can haunt a patient even after the condition causing the dementia has been ameliorated or cured. It is important that health service providers be alert for reversible dementia conditions so timely treatment can follow. If not, permanent damage can be done to the patient's nervous system. Clinicians should not be in such a rush that delirium is diagnosed as dementia.

Apparent Dementia may be due to other conditions. Polypharmacy, the interaction between multiple drugs that the patient may be taking, should be watched for. The mix of different medications may produce temporary conditions in a patient that mimic the onset of dementia. The patient improves as the drugs are secreted from the body. This process normally takes longer to happen in the elderly as opposed to younger people.

Normal Pressure Hydrocephalus, or NPH, causes the ventricles of the brain to fill with fluid. Sufferers of NPH begin to have cognitive and motor complications that present as dementia. NPH is treatable and the patient can return to precondition functionality, but only if caught before permanent damage has been done to the brain. Depression may be another condition which can be misdiagnosed as dementia. A patient under assessment may give a multitude of lack of response or I don't know answers which may be seen as a mild onset of dementia. In reality they are suffering from severe depression. This pseudodementia may show considerable improvement as the patient is successfully treated for depression.

Clinical assessment should take a multifaceted approach. A clinician needs to take into account the patient's physiological and social state as well as their psychological one. Clinicians should be just as careful to rule out all possible diagnoses as they are to code one. Assessment needs to take into account the particular needs of the patient, both cognitive and physical. For example, a slowed motor response may be due to arthritis and not to reflex inhibition. Difficulty in answering written questions may be due to poor eyesight or lower education achievement.

The clinician needs to be sensitive to the particular cultural differences of the patient and how that difference may affect the interaction between provider and patient. These differences can be particularly pronounced between male providers and women of certain cultures. For example, Muslim women may be reluctant to fully engage younger male staff members. Older Veterans with PTSD may not wish to interact with clinicians who are perceived to be of the nationality of an opposing force in a previous military engagement*. Clinicians need to be familiar with the 2003 APA approved guidelines for clinical work with older adults. These guidelines will help providers become proficient working with older adult populations.


1. Graber, M., Gordon, R., & Franklin, N. (2002). Reducing diagnostic errors in medicine:  What's the goal? Academic Medicine, 77, 35-46.

* Note: Aug 31, 2010 - This is my brief.  I didn't originally put a byline on it since I figured it was being posted on my blog.  But I have found this article posted without attribution around the web.  Which it is fine to post it if you want - but I want to maintain my rights as the author, so please make sure you add the byline as well.  Thanks. 

Gotta Tat the Guns!

Josh

&

Mike

The influence of a big brother!