Eyeball Shot, Splashy Hike, 0's & 1's

[Note: this is another blog based on my weekly emails to my family on the mainland.] 

2/20/21

Aloha Everybody –

How’s that snow shoveling going?
    
I mentioned last week that I thought I might need an eyeball injection.  Sure enough, the scans of my retina showed considerable build-up of fluid since the time before, so I had a shot.  My retina guy seems to think I may need one every 2 to 2 ½ months and that this last interval (3 + months) was just a little too long.  Ok by me, as long as he’s the one giving me the injections. Anyway, I also had a visual field test that tracks my glaucoma, which has nothing to do with my retina problem.  It showed no change, and along with low internal eyeball pressures, is good news.  BTW, the visual field test is the most unpleasant *painless* exam there is — trying to decide whether you’ve seen about a million dots of light when you’re almost never sure.  Give me an injection any day.  I did have a little reaction to the shot this time because the doc tried a different technique of numbing the injection site.  Next time I’ll make sure he goes back to the way we’ve found works best.  This is the reaction that started about 1 ½ years ago when I developed a sensitivity in my right eye to the numbing fluid.  The symptoms begin about 4 hours after the injection, and last for another 8 hours – a sensation like ground glass in the eye, with pretty disgusting blood-shot look for a day afterwards.  This time was much more mild, so it wasn’t agonizing, but I’d rather not experience it.  The shot itself hurts a little more, but it’s well-worth it.
     

On Monday Karen played golf and I went on a short shoreline hike just south of our airport.  This is a

special area that is a natural preserve and is an important source of plants that sustain a kind of bee that is found only in Hawai’i.  It is also a place where surf really crashes during the winter, when storms far to our northwest churn up the ocean.  (In the summer the higher surf occurs on the east shores, because the storms that produce it form to the southeast.)  Anyway, it was a pretty good hike and it was interesting that directly up the slopes of Hualalai was where Karen was playing golf – I was nearly at sea level and she was at about 3k feet.

We worked out at PF on Thursday, a week after our 2nd Covid 19 vaccination.  This was "MI-Day," the day we hit maximum immunity to the original virus strain, a very good feeling!  The variants that are developing from mutations in the original virus so far haven’t made inroads here, and if we can get most people vaccinated before they become prevalent we’ll be ok.  I’ve done a lot of research on this, and my conclusion so far is that we need more data from real-world cases where vaccinated people are reinfected before we declare that all is lost.  We should keep in mind that “effective” in medical jargon when talking about a vaccine means *no* symptoms whatsoever.  The laboratory studies that have been reported show a reduced effectiveness of the current vaccines, but it is very likely the cases that vaccinated people might get will be much less severe.  Nothing I have seen would warrant not getting the vaccine if you have a chance.  In the meantime, we aren’t altering our precautionary behavior, but we do feel a lot more relaxed.  Adding to the relaxation is that this past week our island had several days with either just 1 new case or 0 cases, definitely making us feel even more fortunate to be right here, right now....

I am, of course, fascinated and awed by the successful landing of our new rover on Mars this week. What a technological feat! And how awesome would it be if they can get that drone flying! At last, some good news instead of a steady bombardment of political, cultural, medical, meteorological and economic crapola.

Take care.  Stay warm, safe, and sane.

A Toast to Double Shots, Higher Sodium Happiness

[Note: this is another blog based on my weekly emails to my family on the mainland.]

2/13/21

Well, the BIG event here this week was on Thursday, when Karen and I got our second Covid vaccinations.  Whoopie!  Went like clockwork, even more efficient and smooth than the first time.  They already had our info and after filling out a brief questionnaire about reactions to the first one (nil for us), we went to the injection station, this time with several more people giving them so it went very fast.  Even though it was quick, everyone was Hawai’i friendly, helpful, and upbeat.  Many of the injectees were people returning from three weeks ago, but there were also quite a few first-timers, and the pace was definitely much quicker and more streamlined.  We celebrated with a seafood lunch at an open-air restaurant (poke nachos and coconut shrimp), and then later with a sunset champagne toast.

Both of us had somewhat stronger reactions to the second shot than the first. Sore arms, a bit tired, and for me a brief round of body aches, chills, and joint pain beginning about 12 hours after the shot but going away in about 4-5 hours. Friday I was still pooped until things started to turn around about 4pm, Oh, and my appetite for a nice tender leg of toddler returned, along with my urge to give Bill Gates all my money. Not too bad today, though.  I think I'll be able to resist both.

Our island is doing very well in terms of the virus, in part because of the vaccination program and also because of our pre-arrival testing requirement for travelers and the fact that most people are being responsible regarding mask wearing and distancing.  Twice this week we had only one new case reported.

Also on Thursday I had another blood test, exactly 2 weeks since I quit taking the diuretic. According to my online results, my sodium level has risen well into the normal range. BP is holding steady so far, and acceptable.  All is good.  I will close out the week with yet another medical event, with a eyeball exam later today.  I may need a shot of Eylea, and I’m going to keep a low threshold for getting one, because the temporary coverage my insurance has granted runs out later this month. I’ll update you next week.

Karen played golf on Monday and we went to PF on Wednesday.  The weather was gorgeous for Karen’s golf game, and our workout was good in terms of few people in the facility.  Our reward this week was a lemon grass sandwich from our usual Vietnamese restaurant, which we ate on a beach picnic.

Ok, watch out for frostbite and stay healthy.

Jurassic Hiking, Doctor Woes, Unmaking Travel Plans

[Note: this is another blog based on my weekly emails to my family on the mainland.] 

2/6/21

Aloha All –
                       
Hope you’re staying warm (heh, heh).  We are now in the depths of winter here and it is of course terrible.  Three times this week the low temp on our bedroom lanai was down to 62d and last night it plummeted to 59d!! Can you imagine?  Of course, you guys have furnaces to crank up.  We have heating pads and more blankets.  What a hard life!               

Last Saturday Karen went golfing and I went on another short hike.  This one is a favorite of mine, dubbed “Jurassic Park” by locals.  The name is misleading, because plants during the Jurassic Period

A true "Cloud Forest"

were nothing like the foliage on the hike, but it is definitely a primitive-looking forest of ferns and odd-looking trees.  It is on the side of Hualalai, not far from where Karen was playing golf but higher, at about 3000k ft. elevation, in what is called a “cloud forest.”  The name is apt because almost every afternoon at this elevation, clouds form from the meeting of cool air high up and warm moist air rising from the ocean and land below.  This is the kind of misty environment native ferns and other flora love, as well as our native Ohia and Koa trees. It is also a place that visitors can hear and maybe see some truly indigenous birds, because at this elevation they have largely escaped the devastation of avian malaria brought in by introduced birds

Fern fuzz --very soft

who stay at lower elevations, along with the mosquitoes that spread the disease (also introduced).  Most visitors rush along the trail, which is only 1.5 miles long (but with several hundred feet in elevation change), and don’t appreciate the uniqueness of what they are seeing and hearing (and even smelling).  I like to take it slow and stop occasionally.  Anyway, it was good to get back here – I haven’t done the hike in almost a year.

On Tuesday I had a follow-up blood test and got the results on Wednesday.  The test was done exactly one week after the one that caused my dust-up with my doctor last week on Thursday.  Thursday was the day I stopped taking the diruetic that had lowered my sodium level, and in just 4 days it rose by 3 points to just one shy of the normal range.  No change in fluid intake, so the improvement was entirely due to stopping the drug, which in my opinion I shouldn’t have been taking in the first place.  I’ll have another follow-up next week just to make sure things are back to normal.  I’ve investigated the idea of switching physicians, and was pleased to find there are more alternatives now that the last time I had looked into this.  There’s no rush, and I’ll probably wait until it is time for another check-up. On a final and much more pleasant medical note – I had my yearly skin check by my dermatologist’s assistant and all is good. My little pre-cancerous thingies on my face are behaving themselves nicely.

We cancelled our May/June freighter cruise in Polynesia this week. Tahiti is now totally closed to visitors again, and even if they open up by the date of the cruise, the uncertainty will be just too great to make definite plans.  The cruise company offered either a refund or another rescheduling, and we chose to take the money.  Last year they offered only to reschedule us, so this was a chance to get out of it entirely.  Instead of Tahiti we may opt for somewhere on the mainland where there is nice spring foliage and flowers, like North Carolina.  We’ve always wanted to visit the Biltmore estate, and this might be the time to do it.  I’ll keep you posted.

That’s about it.  Stay safe and healthy.  Remember, only a month or so until spring!

Is Wombat Poop Really Square??

Ok, I must draw your attention to my long-standing and possibly pathological preoccupation with all things scatological, i.e., having to do with poop (see, for example Cleaning Up Poop In Paradise, or At Last! A Poop Museum!, among others).  If you find this alarming or offensive you should stop reading now and go do something more productive, like sorting your socks.

The answer to the question, "Is Wombat poop really square?" is "yes."  There's a bit more to it than that, however.

Cute little buggers. (Science Mag.)

A wombat is a racoon-sized marsupial that is native to Australia.  My wife and I encountered them in person during a visit to Tasmania, first at a wildlife park and then in the wilds at a place called Cradle Mountain.  And it was at Cradle Mountain that we observed first-hand the marvelous phenomenon of square(ish) Wombat poop.  We were walking along one of the boardwalks maintained by the Cradle Mountain Lodge and came across several specimens of poop that kind of looked like charcoal briquets.  Being the poop-o-file that I am, I conducted a careful up-close inspection that confirmed it was indeed excrement.

 Later, on a guided walk with a naturalist, we came upon a Wombat in nearly the same spot. The naturalist confirmed that Wombat poop is square, but explained that it comes out as a blob that the Wombat pats into cubes to mark its territory -- the shape makes it harder for rivals to move it off the path. Clever, eh? And definitely a candidate for the Poop Museum! 

Poop in Progress

 

Perfect! (Science Mag)

That was the state of our knowledge for many years until very recently, when I saw a thorough scientific analysis published in the venerable Science Magazine just a few days ago.  It turns out, the poop actually comes out of the Wombat as cubes!!! The article, by Tess Joose, summarizes research done by a group of scientists at Georgia Institute of Technology and in Australia.  Their study was published in a hard-nosed scientific journal with the delightful name, Soft Matter.  It seems the intestines of Wombats are unique in the animal world, and have evolved to produce "poop-cubes."  Here's an excerpt from journal article's abstract, or summary:  

Wombat dissections show that cubes are formed within the last 17 percent of the intestine. Using histology and tensile testing, we discover that the cross-section of the intestine exhibits regions with a two-fold increase in thickness and a four-fold increase in stiffness, which we hypothesize facilitates the formation of corners by contractions of the intestine. Using a mathematical model, we simulate a series of azimuthal contractions of a damped elastic ring composed of alternating stiff and soft regions. Increased stiffness ratio and higher Reynolds number yield shapes that are more square. The corners arise from faster contraction in the stiff regions and relatively slower movement in the center of the soft regions... (Yang et al., 2021)

Got it?  Bottom line:  Wombats poop out cubes.  

So the "what" and "how" are now clear.  But the "why" is more speculative.  So far the best explanation is still that it serves to keep these little territorial markers in place, particularly in rocky or steep locations.

Oh, and there is still one more unanswered question:  "Does it hurt?"

Covid Hike, Cockroaches, Fighting with My Doctor

[Note: this is another blog based on my weekly emails to my family on the mainland.] 

1/30/21

 Aloha, Everyone!

This is the time of year when I really get to gloat about the mainland weather versus ours.  No matter how bad ours seems, watching videos of blizzards and snow-shoveling is a good reminder of how

relentlessly benign our weather really is.  We are still in our unusual cloudy and rainy period, there was snow on both Mauna Kea and Mauna Loa this week, and nights at our elevation are chilly (64d).  But then, the highs temps around the country this time of year might reach 64d only in SOCAL and maybe parts of Florida. It’s all a matter of adapting, though, because nearly everyone says they like the weather where they live.

Its now been a little more than a week since Karen and I received our first Covid 19 vaccine shots (Pfizer). No significant bad reactions at all.  By Saturday we were feeling good enough for Karen to play golf, and for me to do a 3-mile hike in the National Park just north of our small-boat harbor. I’ve even lost my urge to eat children and to control the world.  Not everyone here is on board with medical science, however, and we have a small number of anti-vaxers who are trying to convince others that the vaccine is dangerous.  The evidence they claim supports their position is, like the voter-fraud evidence, scant, flawed, and countered by a mountain of real data obtained from carefully done studies of tens of thousands of people in the clinical trials, and now millions of people (like Karen and me) who have taken the vaccine.  Get a grip, people.  This, and the current BS being promoted by some of GOP legistlators over the role of T**** in the capitol violence, reminds me of the difficulties of getting rid of cockroaches – as soon as you think you’ve succeeded they reappear.  To really be effective, you’ve got to correct the conditions that led to the infestation, and sometimes that may even mean discovering that you might be as blameworthy as the cockroaches.

This week I had my bloodwork done for my routine 6-month followup.  I get the results online, and of course they’re sent to my doctor as well.  I always look them over and compare the numbers to the last time before seeing my doctor.  Most looked fine, including the dreaded cholesterol test which showed no change.  The one thing out of whack was a lower than desirable sodium level which last time was ok, even though it was at the lower limit of the acceptable range.  Six months ago I reported to him that I noticed my diastolic bp level was creeping up while my systolic was being well-controlled with a small dose of Losartan.  The doc prescribed a diuretic to take in addition to the Losartan.  I was leery, because we tried this several years ago and I had to stop taking it because of......wait for it....low sodium levels.  Now the usual remedy for this is to cut way back on fluid intake, to 32 oz. max, so that the lower blood volume concentrates the sodium rather than diluting it.  This sounds great, except that 32 oz is very little fluid.  If you have a cup of coffee in the morning, a small glass of something with breakfast, another glass of something for lunch, then maybe a beer or some wine with dinner and another cup of coffee afterwards, you’ve met or exceeded the limit.  Note – no sucking on a water bottle during the day or drinking water when you take pills. And no glass of water in addition to whatever you may drink with meals.  Even when I did that, my sodium levels were still too low.  I tried to point all that out to my doctor when he suggested another attempt to use a diuretic.  Well, lo and behold this latest result shows the same damn thing.  When I had my video conference with him on Thursday he suggested I must be guzzling water or drinking excessive amounts of something else.  I blew up.  It seemed like news to him that we had gone through this before, with the same result.  In other words, he hadn’t really reviewed my history before the conference.  So, he suggested I stop the diuretic!  Hmmm.  I’d switch physicians but there simply aren’t many alternatives here.  I’m going to try looking again, though.

Whew!  To end on a more positive note, Karen and I had a good workout at PF on Thursday, and today she’s playing golf and I’m going to take another hike.  Carpe Diem!

Stay warm, stay safe, stay sane.

 

Covid Shots, Triumph of Reality

[Note: this is another blog based on my weekly emails to my family on the mainland.] 

1/23/21

Well, by any measure this was a good week!  The paper announced last week that Covid vaccinations would start for Group 1a, the geezers above age ** (number censored by spouse), an age lower than
some on the mainland are getting but also higher than some.  Anyway, the phone system for making reservations at our local hospital opened Tuesday at 8am for appointments beginning Thursday. I was on the phone at the magic moment, but of course the line was jammed, as it has been the rest of this week.  Even so, as we began our walk on Tuesday, I tried again at about 8:30 and pow!  A human took our info and we were scheduled for Thursday at 11am.  We arrived expecting chaos, but it was all impressively organized, with designated parking, quick check-in, a thorough briefing on the vaccine, side-effects, and instructions on how to report adverse reactions.  Then as a group of five, we went to another location for the quick jab, then we had to wait in another area for 15 minutes to make sure no geezer keeled over.  The whole thing took less than 1 hour.  It was a typically Hawaiian scene – all done outdoors or in MASH style tents, and everyone was chatting and upbeat.  The staff was friendly, considerate, and even helped when Karen and I wanted photos.  We’ve already been scheduled for the 2nd shot in three weeks.  The only reaction so far is a sore arm, equivalent to the flu vaccinations sometimes.  Well, I have noticed a sudden urge to eat a small child, to give all my money to Bill Gates, and to worship Opra Winfrey, but I’m sure those will pass, right?

More venues will open up soon, including our new Safeway store. The pharmacy told us they are ready, and even have the necessary refrigeration. The issue will be how much vaccine we can get, and lining up enough qualified staff to manage a large-volume effort like this. Remember, we have a shortage of medical personnel and infrastructure here. We’ve heard from a number of friends on the mainland (Oregon, California, Colorado, Ohio) who have either just received their first shots or are scheduled to get them shortly.  Hurray!

The other piece of good news is that Wednesday came and went. I’m not so much overjoyed as I am relieved. We will soon have competent and experienced people in charge again, rather than a stable of revolving sycophants, convicted liars and cheats, and unqualified buffoons.  I’m not a radical left-wing liberal, and I do have real issues with socialism, “wokeness” and critical race and gender theory, but the Democrats don’t have a mandate here, and I think that is a good thing.  Otherwise we’d be right back to where we were in 2016 the next time around.  Let’s keep it sane and reasonable, please!  That would be a refreshing change, wouldn’t it?

OK, had a good workout at PF on Wednesday, a day early because we didn’t want to interfere with getting our vaccinations on Thursday.  Reward lunch was a self-provided picnic at a nearby beach.  It had been cloudy up until we arrived, but just like our spirits it cleared and became sunny as we ate enjoying the view, finding ourselves breathing deep again.

Our weather this week has been cloudy, wet, and “cold.”  We got 2.2 inches of rain early in the week, and nighttime temps have been down to 63-64d.  The pool has dropped below our acceptable level, so we’ve skipped going in for several days now.  Yesterday was fairly sunny, and today looks good so far, so maybe it will gain enough for us to start using it again.  Karen is playing golf today instead of her usual Monday or Tuesday, and I’m planning on doing a short, easy hike along the shore this morning.  It’s been ages since I’ve been hiking, so it will be good to get back to it.

Enough. Hang in there. Stay warm.  Stay healthy.  We reached the light at the end of the tunnel and it was real, not a mirage......

A Well-Behaved Eyeball, A Yawning Volcano

 [Note: this is another blog based on my weekly emails to my family on the mainland.] 

1/16/21

Aloha, everyone.  Well, as the saying goes, “We live in ‘interesting’ times.” I’m trying hard to stay positive, but my memories of traveling in countries with violent political upheaval, harsh economic disparities, and armed soldiers ringing government buildings to protect lawmakers keep coming to mind. Those experiences used to make me appreciate the uniquely positive situation here at home and to feel fortunate to return to the U.S. Not so sure about that at the moment. Anyway, maybe I can be more hopeful and positive this time next week. We’ll see.

As I mentioned previously, I had an appointment for a retina checkup for last Saturday afternoon. Happy to say it went very well!  No injection needed – the longest interval since my problem began about 6 years ago.  I will go back in 5 weeks for another check up.  My doctor warned that it is very likely I will still need injections in the future, but possibly only one every six months. Note – my vision loss in the right eye is permanent, but I’ve finally come to accept that, and the longer interval is way, way better than the once-a-month trip to the doctor for another injection. Oh, and somewhere down the line I may need cataract surgery.  Geezerhood may have its upside at times, but the overall reality is that it sucks.......

Kilauea volcano has settled down to a steady ooze feeding the lava lake at the summit. The level of the lake is very slowly rising, but it has hundreds of feet to go before it overflows. And since the caldera is wider at the top, it takes more and more lava to raise the level.  The SO2 emissions are much lower than at the beginning of the current eruption, and our vog has subsided considerably, though conditions are not nearly as clear as during the two quiet years we had.  But those were historically unusual – this volcano has been erupting more or less continuously for hundreds of thousands of years.  Mauna Loa, also to our south, has been very active over that time but more intermittent in terms of human time scale, as has Hualalai, the volcano we live on. We knew this before moving here, and we’re prepared for the consequences.

The main geological event of the week was on Thursday, when there was a 4.0 earthquake down south.  We didn’t feel it but I guess some people as far away as Oahu did.  Earthquakes are common here, but not because of tectonic plates and fault lines.  Ours are due either to the movement of magma below the surface or to the settling of the island as it compacts under its own weight.  This seismic activity is very helpful to the volcanologist for forecasting where and when there will be eruptions and our island is “wired” to the hilt with monitors to detect the activity.

Had a good workout at PF on Thursday, though I kept mine light because I’ve been fighting something like a cold this week – no, not what you’re thinking.  As usual, we rewarded ourselves after with a nice lunch at Foster’s Kitchen, an open air restaurant on the bay. No doubt we totally nullified the benefits of the workout....

Ok, it's a bit rainy this morning, but we're still off to beach breakfast (maybe under a pavilion) and a bit of shopping.  Take care and stay physically and mentally healthy if you can.