Ranger Knees

Ranger’s surgery to correct his bilateral luxating patellas has been completed.  He was in the doggie hospital for two nights and after the first night the surgeon texted a picture of him to us. In the photo the little guy was wearing an Elizabethan collar, otherwise known as the Cone of Shame.  He looks strung out and sad.  If he didn’t have this surgery performed he would be completely lame by the time he was four or five.  His left knee is already arthritic because the distal end of the femur no longer has a groove for the patella to track.  This means his left kneecap dislocates often causing him great discomfort and the right one will suffer the same fate.

How much pain does a dog feel?  Scientists have concluded that they feel pain as much as humans do but they process it in a different way. 

There is little debate about this fact.  The difference is that dogs are programmed not to express pain because in the wild an injury is a weakness and weakness means death by predation.  Because they are masking their pain dogs seem to have a remarkable ability to function while injured, but they are experiencing the same metabolic stresses that humans do and like stoics of all breeds a dog in pain isn’t a healthy animal – physically or emotionally.

Like a dog, a human’s experience of pain is determined by a number of factors: psychological, physiological and environmental.  And although people demonstrate compassion for those suffering from pain, it continues to be seen as a weakness and something to be avoided.  At their best people feel compassion for those suffering because they know pain and it hurts them to see others in distress.  But at their worst humans ignore or discount another’s suffering because they don’t want to experience it in any form.  Alas, as is often the case humans have more in common with wild and domesticated animals than we would like to think because we often forget that we are part of the animal kingdom not an exception to it.

Homo Sapiens have a long-standing relationship (between 16,000 – 32, 000 years) with Canis Lupus Familiaris and there is evidence to suggest that dogs have influenced our behavior as much we have theirs.  Dogs are intelligent.  They scan human faces to determine people’s emotions and they have the capacity to respond to a vocabulary of between 30 to 1,000 words depending upon the breed.

Ranger is a smart little guy who demonstrates both compassion and deception.  He can surreptitiously pick up acorns, a chicken bone that I tossed out side two weeks ago and deer poop (apparently a delicacy) with the stealth of a street urchin.  When I realize that he is holding a morsel in his mouth he looks at me with his jaw open slightly more than neutral and he responds to my accusatory stare with one that says: “What?  I don’t have anything in my mouth.”

This is when I play my master trump card: “Drop it!”

The last time we took Ranger up to the Adirondacks he ran fast, hard and long on Saturday and could barely walk on Sunday.  But every time we went outside he bolted for the door as if his lame left leg wasn’t necessary to sprint across the fields with his buddy Homer, a black lab.   Both dogs are two years old and Ranger, a 40 pound mutt consisting of lab, terrier, chow-chow and probably cattle dog is all muscle.  When I walk him he pulls as vigorously as our previous dog, Otto, a one hundred pound lean German shepherd, did.  Ranger loves to run but he is now in chronic pain.

I had bilateral total hip replacement surgeries before the age of fifty and the similarities between dog and master were too great for me to ignore.  I could not watch my dog (my son) suffer and wind up unable to use his rear legs in just a few years.

What happened and why so young?  Genetics is the answer.  Just as my hips were destined to fail from birth Ranger’s knees faced the same fate, so instead of euthanizing him in the not so distant future we chose surgery.  He was not consulted in this decision and as the procedure rapidly approached I felt guilty for not discussing it with him.  The recovery takes two months and he must be confined to a crate for eight weeks except for bathroom breaks.

I drove him to the vet hospital at dawn.  The facility is an hour away and as we drove with his head resting on my hand he gazed up at me and I felt like I was betraying his trust.  He trotted jauntily to the door curious about what adventure we were in store for this morning.  He looked at me questioningly as if to inquire about our reason for returning to this house of many dogs and cats so soon.  Hadn’t we been here just a few days ago?  They ran the credit card, I signed the receipt and I watched his little bob tailed behind disappear behind a heavy wooden door.

I was now in a void.  The divot beside me in the passenger seat was empty as I drove home.  When I opened the front door to the house there was no supine creature wiggling silently on the rug waiting for me to say hello, so he could approach with his tailless rear-end wagging forcefully.

When we picked him up from the hospital the evening of the third day.  They brought him into the waiting room after an extensive briefing about the protocol for his recovery.  Jamie, the surgical nurse, supported his hind legs with a strap. Both of his thighs were shaved bare and a six-inch scar ran from top to bottom along the lateral side of each meaty drum-stick but the saddest part of him was from the neck up.  His huge Elizabethan collar made it difficult for him to walk.  He was so sedated and traumatized that he couldn’t keep his head up enough to keep the rim of his cone from digging into the ground and anchoring him in place every other step.  I knelt down to greet him and he tried to crawl into my lap.  I stuck my head into the white funnel that cradled his shiny black head to kiss him and to tell him that I loved him and his eyes looked like disco balls.  He was in there, deep inside behind the pain and behind the drugs and what I saw was sadness.  We got him home without incident and the poor guy couldn’t get comfortable.  He slept fitfully and keened throughout the night.  We took turns reading to him and napping.

Now I know what it is like to have an infant.  The only thing that stopped him from crying was when we crawled into the crate with him so he could snuggle.  This usually consisted of him hugging my leg or partially revealing his groin which when healthy is his default position for expressing profound connection.  He loves to have his perineum and inner thighs rubbed.  At present it is a bit difficult for him to spread e’m but he performs a truncated version that allows for a two-finger rub, which elicits the tiniest groan that the human ear can register.

The afternoon of his first full day home I sat just outside of the entrance to his crate and began to cry as he stared deep into my eyes expressing his ennui: a combination of pain and boredom with a tinge of exasperation.  What was missing was accusation.  There was no “You did this to me!” which of course I had.  The credit card receipt for $4,000 sat on my desk as proof.  As the tears rolled down my face a look of concern erased his sorrow and he lurched forward and with stolid determination plowed onto my lap where he settled in like a warm bag of soybeans.

This is why we love dogs.  They love us unconditionally and they want to please us.  Although Ranger was in terrible pain he didn’t want me to suffer.  For the past two weeks our daily routine has been regular.  I feed him, give him his pain meds, antibiotics and a sedative at 5 AM.  I put a towel underneath his belly and attach his gentle leader around his muzzle.  I lift the towel to support his hind-quarters with one hand and steer the cone to avoid the ground and any other obstacles along the way with the other and we begin our odyssey.

He moves like a drunken sailor: the cone bobbing and swaying alternately slamming into furniture and snagging on sharp protrusions on otherwise smooth surfaces.  I lift his skinny ass down the steps (it weighs nothing) and we pause for a moment to breath in the surroundings.  The overly friendly squirrel who hangs out beside the back door stares at us from ten feet away where he has repositioned himself after leaving acorn shards on the stoop.  He likes to tease Ranger by moving slowly and just out of reach.  Ranger has more important issues to attend to but he acknowledges the furry tailed rodent and we head for his favorite pee spot.  The little boy moves slowly on stiff legs and pauses intermittently to listen, look and smell his environment.  Pooping is a big deal at this point but he has delivered several days in advance of his expected delivery date.  That’s my boy!  For a forty-pound dog his turds are substantial.  The opiates he was given and his lack of appetite post-surgery affected his bowels, so we were told not to expect a poop for five days.  He came through on day three.  This Herculean feat was not without incident.  The agony of squatting on newly reconstructed knees to dispel a rock solid dump produced screams that made me wince.  “Good boy!”  He was much improved as I swung his butt up the steps and he kept apace on his hand-feet, I pitched the door open with my free hand having released the towel used to support his hind quarters and back into the crate he went.  “Mission accomplished!”

This experience is a mis-en –abyme.  Ranger, his procedure and his recovery (to the day – both of my hips were done the first week of July) are a microcosm of my experience.  I see me in him. Yes, more anthropomorphism!  We are similar types: we are both high strung, crazed athletes who can’t stop moving.  Pain only adds to the frenzy and recovery is exquisite torture.  After my second replacement for three weeks I couldn’t sleep and I couldn’t get comfortable.  Part of this was my fault: I decided to read Solzhenitsyen’s The Gulag Archipelago.  I thought it might be a good time to tackle some Russian authors.  This was a bad idea that nearly ended in suicide after a physical therapist subluxed my new prosthesis extending my recovery by several weeks.  But I couldn’t justify killing myself after having such an expensive procedure – I might hurt the surgeon’s feelings, but I doubt it.

Now I am caring for a four legged beast I love more than myself.  I see him struggle with the same issues I did but with a much better attitude.  He continues to inspire me and my love for him grows with each day as he becomes stronger.

But this is only the end of week two.  We have six more weeks of recovery and when the staples are removed and the cone disappears on Thursday Ranger will be ready to resume his activities of daily living as they say in the medical industry.  

Unfortunately science disagrees.  This is when the differences between the two of us will come to the fore.  I knew what I could and could not do and although I pushed the limits (especially after my first hip was done – leading 5.10 after seven weeks), I knew when to stop.  The only things holding Ranger back from bolting after a deer and destroying the surgery is me, his mother and the gentle leader.  He is smart and he is going to spend all day in the crate thinking of ways to escape and when we walk him he will be determined to run.

And this is when our similarities will come into conflict.  We both are short on patience.  Yoga and meditation are my tools for dealing with this and Acepromazine (a tranquilizer) is his .  Ultimately this process is his not mine and the pain and anguish he experiences is that of a dog who loves and trusts his parents and we will do everything we can to mollify his suffering.

Sophia

Sophia the Greek goddess of wisdom came to mind as I read a piece in the NY Times (Older Really Can Mean Wiser by Benedict Carey, March 16, 2015) concerning a recent series of studies conducted by Harvard and M.I.T. post doctoral fellows about the benefits associated with the middle aged mind.

It is refreshing to read an article about anything age related that comes down on the side of the "aged."  Those in their twenties and thirties have an advantage when it comes to memory retention and speed when recalling information but what they possess in ease of rapid recall doesn't make them wise.

Wisdom is the domain of those in middle age.  We fifty somethings have a vast amount of knowledge, and a greater ability to read facial expressions than our younger counterparts, which enables us to be...wise.  We understand a situation better than Millennials and Gen-Xers  due to these characteristics.

A study from Germany suggests that the reason we are slower to recall facts than the whipper snappers is that we have far more information to sort through before we can generate a response to a stimulus.  Another factor in the speed of response may be slower firing neurons, but researchers are not certain about this.

People in their thirties are facile with numbers and those in their twenties are quickest on the draw with facial recognition but if you want to identify the crux of a complex issue, especially one that involves peoples' personalities,  leave it to my g..g..generation: we are the wise ones.  Because of the number of experiences we have accumulated, the volume of facts and our emotional intelligence we are best suited to see the truth (loaded, I know) and assess the emotional tenor of the people in a given situation to find the optimal outcome.  What we are talking about here is judgement.

I would like to believe that I have refined my sense of judgement over the years and although I do not believe in God I do think it is a miracle that I am still alive. I should have become a statistic in the Death by Misadventure column of the actuarial tables sometime between my eleventh and thirty fifth years.  As a late teen there were a few occasions when I had no recollection of driving home from a party - sad but true and unfortunately not unique.  What sends a chill down my spine is the harm I could have caused others.  This demonstrates the need for wiser minds and cooler heads in social situations, which unfortunately are in short supply when (especially in teenagers due to the incomplete development of their pre-frontal cortices) group-think takes over.  In many situations, however, two minds in various stages of development are better than one.

Perhaps this is not the time to espouse my belief that no one under twenty one should be allowed to drive an automobile but since I am of a certain age I will demonstrate my better judgement and keep this opinion to myself.   

One of the benefits of having a partner while rock climbing is a doubling of brain power.  When I was learning to climb I often paired with people in their forties and fifties because they had great advice about what not to do.  And my primary concern when climbing continues to be my partner's ability to make wise choices.  I credit my tragedy free climbing career to the company I keep (knock on wood).  But, as mentioned above horrors occur when climbers ignore signs of imminent disaster.  It is usually a string of mistakes that leads to an accident - it is rarely one bad decision.  It is contingent upon partners to question every action, both theirs and their buddy's, to prevent the cycle of errors from moving forward.  Part of this issue is social.  People don't like to confront each other and when you talk to climbers after an accident what they often relate is "such and such was wrong and I should have said something, but..."

I speak from personal experience when I say that one of the greatest parts about getting older is that I feel more comfortable speaking my mind.  This doesn't mean I am more vocal about everything (and more of a pain in the ass) but if something is wrong wisdom makes it easier for me to recognize it as such and to address it than when I was younger.   I am more careful about how I present the information because you can be correct in your determination but if you are indelicate in your presentation people will not listen to you or they will do the opposite of what you suggest because they don't like you.

I call attention to this positive aspect of aging because I have been discouraged by the speed with which I recall facts and when I was attending school recently I was frustrated by how difficult I found Chemistry and math to be.  It is good to know that I am not entering the early stages of dementia (yet).  As I see it my brain has aged like a fine wine that is not as bright and zesty as it once was but has become a complex and creamy garnet intoxicant with a buttery and accessible finish.  But alas - all good things must come to an end.

Unfortunately as we age (seventies and eighties) we lose this edge because for whatever reason we become less able to read people and our memory decreases.  Hopefully, a healthy lifestyle will mitigate this change, either that, or big pharma will design a pill for it in the next twenty years. 
 

Spring?

Spring is almost upon us:  I saw and heard my first red wing black bird this afternoon and I can now see patches of ground where the snow has melted.  I feel a release after a relentless winter.  We broke records for how far the mercury dropped, how long it stayed below zero and the number of inches of snow we accumulated.  Winter sports are fun but no matter what activity I engage in I become cold easily after years of climbing, snow shoeing and fixing houses in freezing temperatures and thawing out my fingers and toes can take hours.

It used to perplex me that people migrated to Florida temporarily or permanently at this time of year.  Now I get it.  This is the last winter I will spend in the northeast without a respite from the cold.  February is the breaking point and next year we will spend one of those four long weeks baking in the sun far south of the Hudson Valley.  Last month I felt as if I were the protagonist in a nineteenth century Russian novel set in a Siberian outpost with Twenty first century conveniences: The pipes froze both at home and in our rental unit (destroying a third of the kitchen), the cars have been parked at the end of the driveway since the end of December (about 50 yards from the front door); between home and the rental house I have shoveled thousands of pounds of snow, due to the ceaseless precipitation the only colors I know are black and white (with the occasional yellow), I have worn the same clothes for weeks on end (changing socks and underwear as needed), I have eaten more chicken and chicken soup for breakfast lunch and dinner for days on end than at any other time in my life, I had long philosophical conversations with the dog and cat about whether or not truth is subjectivity (of course it is.  The dog and I concur but the cat always disagrees), I have burned at least five cords of wood which is good because the propane guys couldn't make it up the driveway due to the three foot drifts of snow and ice that I refused to pay to have removed by plow (I kept thinking they would melt), the fire box of the wood stove crumbled in my hands last week when I had the first opportunity all winter to clean it and it will cost me $750 to fix (parts under warranty no less!), and after the frame of the truck was replaced in January (another recall) the four wheel drive failed and cost $1,200 to fix.  Now I am ready for a vacation.

But I am not complaining.  We survived: neither of us fell on the icy luge run that connected the shoveled portion of the driveway, where we parked our cars, to the front door:  we didn't get the flu, we read some good books (Benjamin Franklin, An American Life by Walter Isaacson was excellent) and we rediscovered yoga.

As winter winds down some people have asked me about the SAD light results.  As I discussed in a blog sometime in February, I purchased a 10,000 LUX UV lamp manufactured by SunTouch Plus to combat the winter blues and I am happy to report that it has become an old friend.  I sat in front of it with a hot cup of tea at 6AM every morning staring into the darkness beyond fairly certain that the sun would rise and that I soon would don four more layers of clothing to meet the day.  The lamp was helpful as evidenced by my continuous lack of a criminal record.  My physical self continues to exist and as the temperatures creep into the forties, I anticipate a return of my conscious self.

Apparently we are getting more snow tomorrow - as much as six inches, but that doesn't bother me because this afternoon I finally put the truck in to four wheel low and rammed my way up to the front door, so nothing can bring my spirits down - unless I can't exit the driveway tomorrow morning.         

Banging Bumpers in Box Builds Big Butts: WSJ or New York Post?

The February 17th article titled "Fans of Crossfit Training Brag About Extra Bulk" in The Wall Street Journal focused on the "re-proportioned" backsides of Crossfit women.  This article didn't surprise me but it did make my head spin.  Red meat (WSJ's op ed section) and sex sell.  The issue of strong and hypertrophic gluteus muscles has played out in the Crossfit (CF) community, or so I thought, so it is curious to see an article about it now.  Of course CF is so popular at present that we will probably see more of these human interest/health/soft porn articles.

As I have mentioned in this blog before, your muscles will increase in size the heavier you lift and the more you eat.  One trainer I know insists that a woman's buttocks will not increase in size unless they eat and lift enough to increase muscle mass.  This may be true but in my experience all the endo and meso women I know have gained some size in this particular area following a CF program.  Ectos tend to become more toned than big in in this region but why are we wasting our time on this?

You go to a gym to change your body.  You want to be bigger, smaller, lighter, heavier, faster, healthier and...to look good!  You define "good."  A trainer is there to help you achieve what you desire without hurting yourself.

If you like a larger butt lift heavy and eat a lot.  If you want more tone but not size perform more repetitions at a lighter weight and eat less.  If your goal is to be as strong as you can be, do as the woman in the article did and throw out the scale, tailor your pants and feel beautiful.

We are all so hung-up on how we look and we will never escape society's standards of what is considered desirable.  Hopefully you have the self confidence, education and guidance to set realistic expectations for yourself so that you do not become a victim of society's norms and your unrealistic goals.  Easy for me to say  - I am a man (who is supposed to be big, strong, have a full head of hair, piercing eyes, a good sense of humor and a nice package).

What I find most attractive in a person is a rock solid sense of self - an inner strength and understanding.  This attitude is often accompanied by a healthy body because one emerges from the other.  The ideal body comes in all shapes, sizes and textures.

One of my friends at the gym had an interesting thought about the thrust of the WSJ piece.  She asked me "What if a man's penis was going to shrink if he engaged in a Crossfit regimen?"  Well, steroid eating body builders have no problem making that sacrifice but for the remainder of the male gym population the answer remains a mystery.  I am certain there are guys who would sacrifice size for size, but there isn't a single answer to that question.  In our culture there are no limits to the aesthetic modifications both men and women impose on themselves to "look good" to others and "others" is the issue. When do you cross over from me to we?  Sometimes it is an inextricable paradox but you have to decide what is most important to you.

Which brings us back to health.  If you are working at the gym to fit into someone else's ideal of beauty - go for it.  If you are trying to get stronger - great!  And if you want to be fit and pain free - excellent!

But spare me the details concerning the size of your ass - that information is personal and by focusing on it you only call more attention to women's bodies as objects, where they stand firm beside the image of uber men, and detract from the benefits of being strong and healthy. 

The Latest Portait of Dorian Gray

I have recently been reading and hearing about anti-aging medications that are just about to hit the market.  Snake oil has been for sale since currency existed, but now Big Phrama has taken a renewed interest in the concept of arresting and reversing the consequences of aging.  There is an unimaginable amount of money to be made for those that can prove that their elixir of life not only works to prolong the age of mice but also the lives of men.

A decade ago resveratrol was the silver bullet.  Studies showed that mice lived longer after ingesting red grape extract in various dosages but after millions of dollars were spent researching its effects on humans it turned out that people didn't benefit the way rodents did.  Needless to say this will not change my nightly dose of grape extract from the Loire River Valley but the conclusion drawn by Big Pharma and Wall Street is that the magic pill must be proven to benefit humans before being brought to market.  Of course this is no easy task because the FDA doesn't view aging as a disease.  Drugs that treat the symptoms of aging, such as heart disease and arthritis, can gain approval because there is a limited focus, but when a drug claims to address multiple diseases and disorders attributed to the aging, approval becomes a long and expensive task.

Speaking of "the aged" or "the aging" I hate these terms.  It sounds like we are fossils that require carbon dating and tweezers when being dealt with.  Besides isn't everyone aging?

Anyway, there is a drug that has existed since the 1980s that is close to hitting the market, which may be the first FDA approved anti-aging medicine.  The bacterium Streptomyces hygroscopicus  (S.h.) was isolated from a soil sample from Easter Island, of all places (Arthur C. Clark and Leonard Nemoy would feel vindicated), and has been used in various forms under different names to combat numerous ailments. The drug Rapamycin,which is S.h., was manufactured by Wyeth to suppress the immune systems of organ transplant recipients.  A derivative of this same bacteria has been used as a coating on the inside of cardiac stents to prevent blockages from forming and a similar compound has been marketed as an anti-fungal agent.  Extensive testing has demonstrated that this bio-agent postpones the onset of  heart disease, cancer and Alzheimer's and appears to "delay age-related decline in multiple different organ systems." It would seem that using an immune suppressing drug would be problematic for old folks who already have compromised immune systems, but apparently if  S.h. is given in small doses over a short period of time the immune system is improved not diminished.  This sounds remarkable. 

Novartis is the current manufacturer of the new version of S.h. that inhibits cell division which causes the cells to engage in autophagy: a recycling of old proteins left over from cell reproduction.  Instead of generating new cell growth this biological OCD like behavior disposes of harmful waste products.  What is interesting to me is that the same results are acheived through fasting.  Caloric restriction really does seem to be the key to longevity.  The advantage of this anti-aging drug is that you don't have to deal with the inconvenience of being hungry.  There are other drugs in the pipeline which address muscle loss, hearing loss and one that restores cartilage in joints - all potentially beneficial for the aging. 

Again we are on the brink of discovering something our bodies already knew.  Before the age of plenty our well programmed systems expected a lack of food and apparently required it for optimal health.  Now we are looking for another easy path to take us back to where we were but without the inconvenience.

The recurring theme of taking shortcuts to ease discomfort is a disturbing human tendency.  It is a quality that is not without its merits, but we continue to push the envelope without considering the long term consequences.  Because our bodies are so good at adapting to new microbes and we have so little understanding of the role of the millions we currently carry around with us wouldn't it be safer to modify our habits instead of medicating?  The belief that we can gain without effort has recently lead us into war with two countries and by privatizing our forces and eliminating the draft, the majority of us don't have to feel the pain of prolonged combat while we continue to enjoy the ease that fossil fuels afford us.  But there are long term consequences associated with these choices and we are now feeling them.

Novartis' new S.h. drug may be a boon to the pharmaceutical industry and may help thousands of patients in the short term but at some point we have to stop taking pills for conditions we can control on our own through diet, exercise and education.

Please watch President Eisenhower's January 17th, 1961 speech concerning the "military and industrial complex" and substitute "medical and industrial complex" for the former phrase. 





   

Through the Looking Glass

I have experienced migraines all of my life.  At times they have plagued me by both their intensity and their frequency, but thankfully as I have aged they have abated somewhat and they no longer immobilize me the way they used to.  Perhaps this change is due to more consistency in my life: engaging in regular exercise, a healthy diet and striving for adequate sleep over the past several years.  That being said I had a doozy last week that put me in bed for an evening and required four milligrams of dilaudid to compartmentalize the pain.  Several days later I am still not quite right.
 
Over the years my migraines have gone from terrifying to inconvenient - at times a major pain the ass.  The discomfort is nauseating but the aura (the prodromal stage) is surreal and at time dangerous.  Whenever I experience the visual cues that alert me to the fact that shortly I will be experiencing distress my reaction is always the same: "Of course! No wonder I haven't felt myself for the past few days. That is why I can't think straight and words are being trapped in the firewall between my brain and my mouth (otherwise known as aphasia)."

The aura is not the same for all migraineurs but there are shared characteristics for those who experience hallucinations in the prodromal phase. My experience is this:  My vision becomes blurry in a way that is similar to my glasses being unusually filthy so I remove them, see if they are smudged and then look at the exact same person, landscape or object that I was viewing seconds before sans glasses as a test.  If the blur remains then I am in for a show.

If I were looking at your face half of it would disappear and your visage would be framed by a chain of jagged pulsing geometric shapes (usually a preponderance of triangles) that are not unlike the gas light liquor signs found in the window of a corner bar.  The reds and greens dominate the blues  and yellows in this broken picture which accompanies a tightening of my jaw that begins at the occipital bone. The band of tension envelopes the temple on the opposite side of my skull from the eye that is most effected by the hallucination.  This tight polar vice is the precursor to the ice pick ramming sensation that will work its way like a worm from the inside of my rotten apple brain out through my sinuses and the soft palate of my mouth.

Often times there is an overlap between the aura and the onset of the freeze dried number 20 rusty nail driven through my skull.  This is the dangerous time because I can't really see and the pain zaps any meaningful ability to focus.  Driving is out of the question and walking is not much better.  When I was a full-time carpenter and a migraine showed up at work I had to step away from the chop and table saws for fear of losing a finger or a hand.  Once the pain takes hold the aura usually disappears.  If it fades gradually that is good, but it can stick around for the duration or it can leave and come back for a second round.

Migraines are fickle and therefore unpredictable.  In my case they can last for a few hours or the better part of a day but the remnants can be felt for a week.  I have learned much about pain management through migraines.  As a child they terrified me, not so much because of the aura but because of what those shapes and colors portended.  Into my thirties I used to throw-up every time I got one but I haven't done that for several years.  Opioids work well for me because they don't upset my stomach.  The newer drugs don't help and the two times I tried Imitrex I felt like the drug was damaging my nervous system.  The strange thing about controlling the pain is that it doesn't go away, with the right drugs you are able to package it, put it on a shelf and gaze at it.   Migraines have taught me to notice the boundaries of discomfort so that I can make decisions about how to work around them.

Out of body experiences (OBEs) are common amongst migraineurs and I am no exception.  When I experience a migraine I (the me that is not physical) separate from my material body and the more sickening the pain becomes the farther afield I wander from my corpus.  I don't know if this is my body's healthy response to the situation (physiological dissonance/neurological denial) or it is another biochemical result of the cause of the migraine, which has been likened by neurologists to an electrical storm in the cerebral cortex.  This hyper stimulation of the brain, raises blood flow by 300% followed by a below normal flow which sets off a chain reaction that alters serotonin and norepinephron levels throughout the brain.

For days after a headache the thought of chocolate or alcohol, two things I love, makes me ill.  And any time I see an MC Escher print I have to look away.  The first time I walked into the Loebe Library at NYU I thought I was going to throw up.  The first floor (the flooring) of the library is a massive Escher print made of stone inlay. I wonder if he was one of us.  Lewis Carroll (Charles Dodgson) was and apparently Through the Looking Glass and What Alice Found There was migraine inspired. And the hallucinations experienced by migraineurs has a medical term: AWS (Alice in Wonderland Syndrome).

There are two noteworthy books that I have seen excerpts of (and recently ordered on line) discussing the subject.  One is titled Migraine by Oliver Sacks and the other is a compilation of art and essays by migraineurs entitled Migraine Art by Clause Podoll.  If you are curious about the visual experiences associated with a migraine google Migrain Art - there are some disturbingly accurate depictions of an event.

The triggers for migraines are varied and for me coffee plays a significant role.  Last week I  exceeded my caffeine thresh hold by drinking a cup of coffee which is a rare occurrence.  After 50 years I now know that my body has a limit for both caffeine and stress which I cannot overstep without experiencing tangible consequences. Irregular sleep patterns - too much, too little, variations in bed-time and wake-up are triggers as are food, sunlight, smells and travel (probably because it involves the aforementioned).

There is a genetic component to this mystery that causes our ion channels and pumps to malfunction.  Ion pumps and channels are the mechanisms by which our cells ingest and expel select ions across the cell membrane that determine PH balance and the firing of neurons in addition to functions that are too numerous and complicated to discuss here. The migraineur's mind is wired differently (termed channelopathy or malfunctioning ion channels) from those who do not have this anomaly.  Our brains are "hyper excitable," which means that they do not function the same as a non migraine brain even when we are not experiencing a headache.

There is something positive to be gained from a migraine.  There is a true sense of being reborn upon the cessation of pain and visual impairment.  I often feel more creative and amorous following this experience.

So why am I putting this in my blog?  Because our abnormalities are important aspects of who we are.  We all have our issues and although we don't discuss them readily with others learning about them is more important than how much weight we lift .  Our differences are our strengths.  Through acceptance and understanding we become greater than our stumbling blocks and the lessons we learn can be used to face future challenges.  What have you learned from your exceptions?

"And then there's the butterfly," Alice went on, after she had taken a good look at the insect with its head on fire, "I wonder if that's the reason insects are so fond of flying into candles - because they want to turn into Snap-dragon-flies."
Lewis Carroll

Where Shall We Meat?

There is a new meat-like substance in town and it tastes pretty meaty.  I read about the Beast Burger, which is coming to a supermarket near you, in last month's issue of Outside Magazine.  What makes this meatless burger stand out from its tasteless drywall like competitors is that it is purported to taste like beef.  That doesn't sound uncommon: most animal protein-less patties claim to taste something like the real thing but Beyond Meat, a small but rapidly growing company in California (where else?), has apparently done it.

Their chicken -free strips fooled Mark Bittman of the New York Times who thought that the strips not only tasted just like chicken, he thought they were chicken.  I have purchased this product twice  to test it for myself and I was pleasantly surprised by how chicken-y the product was but I am shocked that Bittman mistook it for the real thing.  Perhaps if I were used to eating mass produced poultry I might make the same mistake but my locally raised and slaughtered birds taste and feel like what they are: chicken.  I say "feel" because this is when the English language, again, falls short when it comes to the sensual.  Chicken meat has a particular texture as does good ground chuck.  the problem with previous incarnations of fake meat is that even if the flavor was close, the texture missed the mark.  This globby consistency of meatless burgers is due to the use of gluten as a texturizer.  The people at Beyond Meat, through a combination of determination, science, money and ethics, have come closer to any of their competitors in achieving what has long been a dilemma for health conscious individuals (there are lots of people who think it is unhealthy) and those who have sworn off meat for ethical reasons.  The problem is people like the way animals taste, which includes smell and feel.

Ethan Brown, the CEO of Beyond Meat, started his business because he wanted to change the world's reliance on animals for protein and he believes that he is creating meat from plants.  (An interesting note:  it is now believed that the old theory of taste buds and how they are positioned on the tongue is inaccurate.  Scientists now think that we have taste buds throughout our entire body and they are not sure why, but what is clear is that taste does not end at your gullet. Another digression of note:  We have far more taste receptors for bitter than we do for sweet because poisons are bitter, which is another reason we have made it this far on the planet.)

Most of the animal we eat is muscle, which consists of bundles of columnar and parallel fibers that your mouth recognizes as meat.  At Beyond Meat they have extruded pea and soy protein so that the substance that comes out of the other end of the hopper possesses a similar fiber structure to the real deal.  I can't wait to try the Beast Burger, but currently neither of my two local health food dispensaries carries it, so if you see some pick it up and post your results.

Here is the head to head comparison between the beast and the Beast Burger:
Beef burger:19 grams of protein, 0 grams of fiber, 80 milligrams of cholesterol.
Beast Burger: 24 grams of protein, 4 grams of fiber, o grams of cholesterol and it contains more omega 3s than salmon, is rich in calcium, B vitamins (all statistics come from Mr. Rowan Jacobsen's article, "The Perfect Beast" in the January edition of Outside Magazine.) and it tastes and feels like hamburger.

Now for the ethical portion of the Post:
According to the Worldwatch Institute the annual production of meat (22 billion animals) leads to the release of 103 million tons of methane which is exponentially more damaging to the atmosphere than carbon dioxide.  Fifty-one percent of global greenhouse gases are a result of raising livestock for consumption.  A few other startling statistics that Mr. Jacobsen listed in his article: "It takes 9,000 calories of edible feed to produce 1,000 calories of edible chicken...(and) 36,000 calories (are) required for 1,000 calories of beef."  The sad news for all of us grass-fed junkies is that grass-fed cattle produce more methane than factory raised cattle and leave twice the carbon footprint as those that are raised in pens.

My cognitive dissonance meter is bumping around eleven right now because I am experiencing severe discomfort on multiple levels of my psyche.  The notion of "Franken food," the current term for man-made food leaves a bad taste in my mouth.  Even though Beyond Meat is using all natural ingredients this is a highly processed food.  I don't know enough information about the differences in the types of proteins between the Beast and the boeuf (yes, that's my name), so I can't weigh-in on which is healthier.  The fact that the Beast has no cholesterol is a selling point, but there are many who believe, as you have read in these blogs, that cholesterol is less of a concern than was previously suspected.  And what about moderation?  Would you rather have one stupendous grass fed burger or a couple of these Beasts if given the choice?  But perhaps we, as a species, have entered an era where moderation in all things is no longer the best option when it comes to world food supply.  I will make a few enemies with this statement: There are too many fucking people on this planet (and too many people...) and they have to eat, so the production of their food must not destroy the ability to cultivate more of it.  Therefore, a thoughtful and ethical manufacturing model is a better alternative to killing animals for protein and the collateral damage to the environment that process entails.

The second one is the obvious ethical dilemma I have struggled with off and on for decades.  I love animals.  My dog and cat are my greatest teachers, my best friends, they smell good, they feel luxurious, they are more amusing than anything on the computer, they love unconditionally and they are meat.  In various parts of the world my tender young mutt would make a delicious roast and I kid him about that fact.  My seven year old cat, Alice, on the other hand, would require some tenderizing, which could be achieved through parboiling.  She purrs when I tell her this - probably because she and I both know that while my dog, Ranger, would sit faithfully beside my cold and fetid corpse for weeks she would dig right in. And dear baby Alice has hit the nail on the head, as cats often do: If it is in your DNA to eat meat at what point does your over-sized cranium with well-developed pre-frontal and frontal lobes decide the time has come to buck "nature?"

For millennia we killed for food and many people still need to do this to survive, we would not be here without it, but the world has changed.  No, that's not accurate - we have changed the world, and in order for it and us to continue we must alter our behavior.  Many of us now have the economic resources to make a choice.  It is a decision that runs counter to many cultural norms and genetic wiring, but don't most difficult decisions fit this mold?  Is it O.K. for me to kill for food and how far up the chain can I go?  The more I look at it the answer is "No." But I love the taste, smell and feel of meat, and the ritual of cleaning and preparing it, so I am conflicted and perhaps the Beast Burger is an answer.

I have looked for pithy and provocative quotes from brilliant minds to end this piece but I have found none, largely because they were written a century or two ago when the issue was based solely on the ethics of killing for human consumption.  Of course this issue remains germane but the newer concerns are broader, more tangible and portend greater catastrophe.

So I will end at the other end of the spectrum: "Soylent green is People!  It's People!" (the late and not so great Charlton Heston from the movie Soylent Green (1973).)