Archive | November, 2013

One More Month to Get It Done

30 Nov

Will I make it?  Well, let’s see.  I at least feel more optimistic about November.  And look at this:  I actually pulled up the original new year’s resolutions so I can see what I’m supposed to be doing!  Super-NOT lazy!  Next year, I make a physical sign or poster of the goals so I can see and remember them always.

coffee owl


It’s usually a touchy subject, but things are going great.  I’m hesitant to say it, because it’s jinxy and these things can go sour in a hurry.  Have I mentioned I adore my new schedule?  Even though it keeps me locked in town, and even though I’m pretty much constantly tired Monday, Tuesday, and Wednesday?  It is still the best change in my life.  And knock on wood-everyone is being as nice as they are able to me right now.


We’ve been trying to cook again lately.  And we had a few massages this month–though I think that may be what set off last week’s terrible headache. . .  Her meds may or may not be back of track, it’s difficult to tell.  My loyality, responsibility, reminders, and finances end up conveying how much I care–I still am not the greatest at doing little things to show I care.  I want to work on that more.


I have really succeeded in making this my number 1 priority.  There is no keeping up or getting ahead on class work and studying, but I’m pulling through the best I can.  I just have to make it another week, and then 2 more semesters!  I can, and I will keep that 4.0!


I drank the special Walla Walla wine (but nothing at our fancy restaurant lunch) for our 4 year anneversary.  The second time I drank was some of our ice wine (that I said I was going to finish) at my Aunt’s house.  It would have been very uncharacteristic not to have anything there, and I would have had to offer an explanation–which I didn’t want to get into.  And the whole drinking thing over there ended up making me feel alone and empty.  I don’t want to be THAT person that gives it up, then judges others about their habits.  But I was concerned.  My aunt had begun drinking before we got there.  Disregarded my feelings/health (I was legit-ill with headache and stomach issues that night), and pressured Cool to open another bottle of wine after we had gone through the first two.  I was drinking slowest and only had 1.5 glasses of wine (to their 3-4?), then gave the remainder of my glass to Cool because I felt icky.  But even after I indicated I didn’t feel well and wanted to leave soon, my aunt waited until I went to the bathroom, and guilted Cool into pouring more wine.  The whole scanario made me feel worthless, like they didn’t care about me, and I knew it was the alcohol doing all the talking that night.  I can’t go over there again, if that’s the situation.  I’m going to attempt only breakfast meetings with my aunt from now on, to avoid the pressure, and that ugly feeling.  I have done very well otherwise, and feel so much better about life in general without it.


I have been getting caffeine a lot lately–the Starbucks was a frequent stop this month.  I just felt very tired, but didn’t want to forgo the studying for sleep.  After finals, I need to get back to more economical energy practices.  Also, it’s been a little rough without food stamps at all.  The cupboards are often bare, and frige empty.  This is more from lack of planning, then complete dire straights–I need to be smart and stick to necessities and ingrediants rather then blowing a bunch of cash on small, processed easy-prepare foods.  Mission stop being tired, and therfore lazy!


Ugh–complete and utter fail.  I do nothing outside of my normal routine–which is luckily fairly active.  Next semester I MUST establish a treadmill, Wii-Fit, circuits routine and really stick with it, for those cold weather, studious months.  I’m getting too old to be sedentary.


Water consumption is still hit or miss.  I AM drinking some water each day, which is a vast improvement from the none, and dehyrating beverages of the past.  I need to have more though.  It’s imperative that I chug water in the early morning at work.  I think this is one reason I’ve had daily headaches this whole week.


And I’ve skipped a few flossing days, mostly because I wait until I’m too tired sometimes.  But for the most part, I’ve done that daily as I should.

As you can see I fizzled out by the end of this.  I must be tired.  I’ll do a big month and year wrap up in December, and have 2014 resolutions as well.

A Day Late: My Thanks

29 Nov

I had a sort of bad day yesterday:

-I was awake the night before fretting over this stupid, “small” paper that’s due Monday.

-I spent the majority of the day formatting my sources.

-Cool was being a turkey–as she does every time I get a full day off.

-When we went to make our Indian Tacos, I discovered we were short on flour.

-We suddenly had the kitchen of a crack-whore.  Just bare.

But at night, before going to sleep Cool and I did an exercise of everything we’re thankful for.  Here’s mine:

-First and foremost, I’m thankful about my new Friday schedule.  It’s just one day, but it changes my whole attitude and outlook.  I’m way less worried, annoyed, stressed, tired, and frustrated.  I had been dreading Fridays all week, for a long time and it was really bringing me down.  I feel SO much better now!

-Rusty.  I am very thankful to have a dependable car that I don’t have to pour a lot of money into or worry about. Rusty I’m thankful for the 4×4 so I can get to work and school as needed, the AAA so I don’t have to worry about a breakdown or be stuck when bad thigs happen.  And mostly–the remote start.  I LOVE that I don’t have to go on that cold, dark (dangerous) street and scrape my windows or sit in a freezing car.

-My family being in one state.  I’m so glad Goose can finally live with us.  And I’m also glad that it improved my relationship with my parents.  Things with them are going very well, and it feels great.  I’m also glad Choco-Luv is healthy and happy and gets along so well with Cool.  It feels good to have my own little family.

parasailing 001

-Netflix.  It saves a lot of money to be able to stream shows and movies.  And commercial-free.  Saves money in not paying for satellite, not buying DVDs, and not going out for entertainment.

-I’m also thankful for the electric throw blankets, electric blanket, goose-down comforter, and infrared light in the bathroom.  It makes life a lot easier not to be constantly cold.  Everything seems better when you’re a cozy recovering from sxtemperature.  AND those things don’t ramp up the utility bill too much.

-My new clogging shoes.  I had so much fun with the whole talent show experience.  And having the shoes makes me excited and hopeful.

-Obviously, I’m thankful for Marble and the internet.  I would be a lot less happy if I were without those!  And Spotify music which makes everything I want to listen to available so easily and free.

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Using Abstracts for Sources

27 Nov

As I explained to Cool, using the interbet to find legit, peer-reviewed journal articles for a school paper–is like trying to write a 10 page research paper using only the outside cover of all the books in our personal library.  You look for certain, specific information, but can only see the back general description of the book’s contents.  That’s what I’m doing now.  But it’s still better then putting on clothes and trying my luck at a physical library.  I’m not sure if my school’s library is open, or what the hours of operation might be.  And I’m fairly certain the city library doesn’t have anything as specific as I require.  So here’s my list (in progress) of the facts I need and their journal sources.

Introduction:  One broad paragraph summarizing your topic (no more than 1/3 of the page) the style is similar to a journal abstract.

-J Ramsay Hunt, who described various clinical presentations of facial paralysis and rash, also recognised other frequent symptoms and signs such as tinnitus, hearing loss, nausea, vomiting, vertigo, and nystagmus. He explained these eighth nerve features by the close proximity of the geniculate ganglion to the vestibulocochlear nerve within the bony facial canal. Hunt’s analysis of clinical variations of the syndrome now bearing his name led to his recognition of the general somatic sensory function of the facial nerve and his defining of the geniculate zone of the ear. It is now known that varicella zoster virus (VZV) causes Ramsay Hunt syndrome (4).

Ramsay Hunt syndrome (RHS) type 2 also known as herpes zoster oticus (20).

-Herpes zoster oticus (HZO) is a viral infection of the ear and when associated with acute facial paralysis is known as Ramsay Hunt syndrome (?).

-The strict definition of the Ramsay Hunt syndrome is peripheral facial nerve palsy accompanied by an erythematous vesicular rash on the ear (zoster oticus) or in the mouth. J Ramsay Hunt, who described various clinical presentations of facial paralysis and rash (14)

Population:  Discuss the population affected by the pathology such as: men, women, race

-children are not usually affected (9)

-The overall annual incidence of zoster was 4.97 cases per 1000 people, with women having a significantly higher incidence than men (5.20 per 1000 vs. 4.72 per 1000, p < 0.001). The incidence increased stepwise with age, with 5.18 cases per 1000 in people 40–50 years old, 8.36 in those 50–60, 11.09 in those 60–70, and 11.77 in those above 70 years old. The estimated lifetime risk of developing herpes zoster was 32.2%. Zoster-related hospitalizations and medical cost per patient increased with age. In conclusion, about two-thirds of Taiwan’s zoster cases occur in adults older than 40 years old and about one-third of the population would develop zoster within their lifetime (2)

-VZV is found in a worldwide geographic distribution but is more prevalent in temperate climates (7).

-Herpes zoster has been described in all age groups, and lifetime risk is estimated to be 10%-20%. The incidence of herpes zoster is about 150-300 cases per 100 000, with the incidence dramatically increased in patients older than 60 years [Ragozzino MW, Melton LJ III, Kurland LT, et al. Population-based study of herpes zoster and its sequelae. Medicine (Baltimore) 1982;61:310-6.].6 Ramsay Hunt syndrome is much less common, approximately 5 cases per 100 000 population; nevertheless, it is the second most common cause of atraumatic facial paralysis [Adour KK. Otological complications of herpes zoster. Ann Neurol 1994;35(suppl):S62-4.].7 The incidence of herpes zoster in patients with peripheral facial palsy is 4.5%-8.9%. Compared with Bell palsy, Ramsay Hunt syndrome generally has more severe paralysis at onset, and patients are less likely to recover completely (18).

-occurred more often in patients older than 50 years. Of the patients with partial facial nerve function at disease onset, 66% recovered completely, whereas only 10% of those who presented with complete loss of function recovered complete (18)

Time of onset:  Discuss whether the pathology is congenital or acquired or delayed in onset

-In the only prospective study of patients with Ramsay Hunt syndrome, 14% developed vesicles after the onset of facial weakness. Thus, Ramsay Hunt syndrome may initially be indistinguishable from Bell’s palsy (4).

-His mother had been infected with chickenpox during the second trimester of pregnancy (9).

-Compared with Bell’s palsy (facial paralysis without rash), patients with Ramsay Hunt syndrome often have more severe paralysis at onset and are less likely to recover completely (14).

Etiology:  Discuss whether the etiology is genetic or environmental or idiopathic

-Varicella-zoster virus (VZV) is a ubiquitous human alphaherpesvirus that causes varicella (chicken pox) and herpes zoster (shingles). Varicella is a common childhood illness, characterized by fever, viremia, and scattered vesicular lesions of the skin. As is characteristic of the alphaherpesviruses, VZV establishes latency in cells of the dorsal root ganglia. Herpes zoster, caused by VZV reactivation, is a localized, painful, vesicular rash involving one or adjacent dermatomes. The incidence of herpes zoster increases with age or immunosuppression. The VZV virion consists of a nucleocapsid surrounding a core that contains the linear, double-stranded DNA genome; a protein tegument separates the capsid from the lipid envelope, which incorporates the major viral glycoproteins (7).

-Varicella, usually a benign manifestation of primary infection, and zoster, a result of reactivation of latent virus, can cause considerable morbidity in patients with immune impairment (6).

-A new case of Ramsay Hunt syndrome will occur every 52 minutes, compared to every 10 minutes for a new case of Bell’s palsy (8).

-Varicella zoster virus (VZV) is an exclusively human neurotropic alphaherpesvirus. Primary infection causes varicella (chickenpox), after which virus becomes latent in cranial nerve ganglia, dorsal root ganglia, and autonomic ganglia along the entire neuraxis. Years later, in association with a decline in cell-mediated immunity in elderly and immunocompromised individuals, VZV reactivates and causes a wide range of neurologic disease (12).

-He explained these eighth nerve features by the close proximity of the geniculate ganglion to the vestibulocochlear nerve within the bony facial canal. Hunt’s analysis of clinical variations of the syndrome now bearing his name led to his recognition of the general somatic sensory function of the facial nerve and his defining of the geniculate zone of the ear. It is now known that varicella zoster virus (VZV) causes Ramsay Hunt syndrome (14).

-Varicella zoster virus (VZV) is an exclusively human neurotropic alphaherpesvirus. Primary infection causes varicella (chickenpox), after which virus becomes latent in cranial nerve ganglia, dorsal root ganglia, and autonomic ganglia along the entire neuraxis. Years later, in association with a decline in cell-mediated immunity in elderly and immunocompromised individuals, VZV reactivates and causes a wide range of neurologic disease (15).

Symptoms:  Describe the symptoms of the pathology

-Otological complications of varicella-zoster virus (Ramsay Hunt syndrome) include facial paralysis, tinnitus, hearing loss, hyperacusis (dysacousis), vertigo, dysgeusia, and decreased tearing. Cranial nerves V, IX, and X are often affected. Gadolinium-enhanced magnetic resonance imaging demonstrates enhancement of the geniculate ganglion and facial nerve. These manifestations are identical to Bell’s palsy but are more severe and carry a graver prognosis (8).

-frequent symptoms and signs such as tinnitus, hearing loss, nausea, vomiting, vertigo, and nystagmus (14)

-Ramsay Hunt syndrome is a disorder characterized by herpetic eruptions on the auricle, facial paralysis, and vestibulocochlear dysfunction, and is attributed to varicella zoster virus infection in the geniculate ganglion. Although it is a common cause of acute peripheral facial paralysis (9)

-Ramsay Hunt syndrome is defined as herpes zoster oticus associated with an acute peripheral facial nerve paresis and quite often with other cranial nerve lesions. The combination of motor, sensory and autonomic involvement leads to a variety of neurological damage patterns, i. e. facial muscle paresis, hearing and balance disorders, sensory problems and disturbances of taste as well as lacrimal and nasal secretion. Additional variability of the clinical picture of Ramsay Hunt syndrome is produced by varying patterns of skin involvement explained by individual anastomoses between cranial and cervical nerves (10).

-severe burning pain referred to the ear and adjacant skin areas characteristically preceeds facial palsy that differentiates it from Bel’s Palsy (19).

-HZO patients with vertigo had facial palsy on the lesioned side and spontaneous nystagmus beating toward the healthy side (11)  he nerve trunks within the internal auditory canal are widely affected in HZO patients with vertigo. Both superior division and inferior division of the vestibular nerve attribute to the vertiginous attack (11).

-14% developed vesicles after the onset of facial weakness. Thus, Ramsay Hunt syndrome may initially be indistinguishable from Bell’s palsy (14).

-Finally, some patients develop peripheral facial paralysis without ear or mouth rash, associated with either a fourfold rise in antibody to VZV or the presence of VZV DNA in auricular skin, blood mononuclear cells, middle ear fluid, or saliva. This indicates that a proportion of patients with “Bell’s palsy” have Ramsay Hunt syndrome zoster sine herpete (14).

-Three major symptoms, auricular vesicles, facial paralysis and vestibulo-cochlear dysfunction, were found in 57.6% of the patients although these symptoms did not always appear simultaneously. Auricular vesicles appeared before (19.3%), during (46.5%), or after (34.2%) the onset of facial paralysis (16).

-causing otalgia, auricular vesicles and peripheral facial paralysis.  Vesicles occurring anywhere along the sensory distribution of the facial nerve, including the anterior two-thirds of the tongue, the pinna or the external auditory canal.  Otalgia.  [Takasu T, Furuta Y, Sato-Matsumura KC, et al. Detection of varicella-zoster virus DNA in human geniculate ganglia by polymerase chain reaction. J Infect Dis 1992;166:1157-9.]  (18)

-3-day history of gradual increasing right-sided head pain overlying her right ear, exacerbated by traction on the pinna. head pain was different from her past migraines, especially in that it radiated to the right mastoid.   (18)

-5 days post:   including right-sided pulsatile tinnitus, right-sided aural fullness, vertigo, reduced ability to close the right eye and decreased taste sensation. She had no hearing loss.  mild right-sided facial weakness with sluggish right eye closure (18).

-syndrome characterized by a painful, unilateral vesicular eruption in a restricted dermatomal distribution.4 Dermatomal pain may precede lesions by 48-72 hours and total disease duration is 7-10 days. Immunocompromised and elderly patients may have a more prolonged and severe course.5 Ramsay Hunt syndrome can be precipitated by reactivation of VZV in the geniculate ganglion, resulting in peripheral facial paralysis, otalgia and auricular vesicles (18).

– In approximately 10% of cases, there is no vesicular rash with the facial paralysis, but there is either a 4-fold rise in antibody to VZV or the detection of VZV DNA in skin, blood mononuclear cells or middle ear fluid. This condition is known as Ramsay Hunt syndrome sine herpete (18)

-Facial palsy is not associated with otitis externa.14 Trigeminal neuralgia is manifest by sudden, usually unilateral, severe, brief, stabbing, recurrent episodes of pain in the distribution of one or more branches of the trigeminal nerve. Most importantly, trigeminal neuralgia does not cause neurologic deficit, and the pain cannot be attributed to another disorder (18).15

Hearing Loss:  Describe the resultant type (nature) and degree of hearing loss

-variable hearing loss if present from mild to profound, with prognosis worse in more severe (19; 21).

-Diagnosis is based on the sudden onset of unilateral peripheral facial paralysis, usually over hours, but sometimes more gradually. Additional symptoms such as decreased tearing, hyperacusis, loss of taste sensation over the anterior two-thirds of the tongue and ear pain are variable. Bell palsy does not involve the presence of vesicles in the external meatus [Adour KK, Byl FM, Hilsinger RL Jr, et al. The true nature of Bell’s palsy: analysis of 1000 consecutive patients. Laryngoscope 1978;88:787-801.] (18)

-Otoscopy revealed herpetic eruptions in the right ear canal. Otoacoustic emissions were absent in the right ear and auditory brainstem responses confirmed moderate sensorineural hearing loss (9).

-swollen right external auditory canal with a normal tympanic membrane (18).

-right auricular swelling and redness with 3 small vesicles on the concha. The right tympanic membrane was not visualized owing to meatal swelling, but the left tympanic membrane was normal (18).

-The neurotropic herpes virus family may have a special relationship to ISHL, in addition to the Ramsay-Hunt syndrome; Nakajima et al (1976) have detected the herpes virus in the cerebrospinal fluid (CSF) of two of three patients studied with sudden hearing loss. Elevations of antibody titers to the herpes virus usually occur in association with two or more other viral titer elevations (Wilson, 1986), suggesting a possible reactivation of this virus (13).

-Hearing loss was observed subjectively in only 20% but objectively in 48.2% of the patients. Hearing loss appeared before (34.3%), during (34.3%), or after (31.3%) the onset of facial paralysis (16).

-Complete recovery of hearing was also achieved in 45.4% of the patients, and the recovery was better in patients having light hearing loss, less than 35dB (16).

-on the basis of BAEP findings, to suggest that in Ramsay Hunt syndrome both cochlear and retrocochlear involvement may occur (17).

-sudden, unilateral HL, usually sloping (21).

-Otitis externa, inflammation of the external auditory canal or auricle, commonly presents with otalgia, pruritus, discharge and hearing loss. Examination usually reveals pain with tragal pressure and a red edematous ear canal [Agius AM, Pickles JM, Burch KL. A prospective study of otitis externa. Clin Otolaryngol 1992;17:150-4](18).

Treatment options:  Discuss if the condition is permanent or treatable, if treatable, discuss treatment options such as surgical or medical. (No need to describe surgical procedure itself.)

– Prognostic indicators of poor hearing recovery include advanced age, retrocochlear hearing loss, male gender, vertigo, and speech frequency hearing loss (1).

-Antiviral agents are the standard first-line treatment for herpes zoster infections at other body sites and are thought to reduce or minimise nerve damage, thereby improving outcomes. It has been suggested that these agents improve the chance of facial weakness improving or resolving completely in patients with Ramsay Hunt syndrome (3).

– In the light of the known safety and effectiveness of antiviral drugs against VZV or HSV, consideration should be given to early treatment of all patients with Ramsay Hunt syndrome or Bell’s palsy with a 7–10 day course of famciclovir (500 mg, three times daily) or acyclovir (800 mg, five times daily), as well as oral prednisone (60 mg daily for 3–5 days) (4).

-Although the antiviral agent acyclovir is currently used for the treatment of Ramsay Hunt syndrome, its effects on facial nerve and hearing recovery remain controversial. We retrospectively analyzed the effects of acyclovir-prednisone treatment in 80 Ramsay Hunt patients. Of 28 patients for whom treatment was begun within 3 days of the onset of facial paralysis, the recovery from paralysis was complete in 21 (75%). By comparison, of 23 patients for whom treatment was begun more than 7 days after onset, recovery from facial paralysis was complete in only 7 (30%). A significant difference in facial nerve recovery was found between these groups. Early administration of acyclovir-prednisone was proved to reduce nerve degeneration by nerve excitability testing. Hearing recovery also tended to be better in patients with early treatment. There was no significant difference in facial nerve outcome between intravenous and oral acyclovir treatment (5).

-An experimental live vaccine also prevents varicella, but problems regarding its virulence for immunosuppressed patients and the durability of the protective response are still being addressed (6).

-We retrospectively analyzed the effects of acyclovir-prednisone treatment in 80 Ramsay Hunt patients. Of 28 patients for whom treatment was begun within 3 days of the onset of facial paralysis, the recovery from paralysis was complete in 21 (75%). By comparison, of 23 patients for whom treatment was begun more than 7 days after onset, recovery from facial paralysis was complete in only 7 (30%). A significant difference in facial nerve recovery was found between these groups. Early administration of acyclovir-prednisone was proved to reduce nerve degeneration by nerve excitability testing. Hearing recovery also tended to be better in patients with early treatment. There was no significant difference in facial nerve outcome between intravenous and oral acyclovir treatment (5)

-Appropriate treatment resulted in slight improvement after the first week and complete recovery within 4 months (9)

-he patients younger than 16 years old showed better recovery from both facial paralysis and hearing loss than the patients older than 60 years (16).

-another retrospective study of 26 patients treated with acyclovir and steroids, age greater than 60 years, diabetes mellitus, essential hypertension and associated vertigo were identified as prognostic factors for worse outcome and decreased chance of recovery (18)

-recovery of facial, cochlear, and vestibular funct is unpredictable (19).





4; 14)








12; 15)






20)  Hunt JR (1907). “On herpetic inflammations of the geniculate ganglion: a new syndrome and its complications”. J Nerv Ment Dis 34 (2): 73–96. doi:10.1097/00005053-190702000-00001



-Don’t copy this or steal my sources, mmkay?  This seriously sucked to compile and I was going to publish it on Monday (after it’s due) but my cut & paste is doing that awful white highlight crap that makes me crazy, so I have to get it on the blog in order to put it on my word document.  Karma will come back to you if you cheat.


Six Chapters Proved Too Much

26 Nov

And really–did the professor ACTUALLY expect the class to read 268 pages in 40 days? That’s almost 7 pages every skull 1day–it doesn’t look like much, but focusing on dry, factual info and remembering and comprehension takes time.  I tried, really I did. But on top of keeping up with the lecture notes and handouts, the papers, and studying–not to mention other classes and work, I didn’t get through the reading for 1.5 of the required chapters. I feel like if I didn’t, then nobody did.  And I’d like to, because the textbook seems well-written and helpful–but it’s just not a priority with 2 weeks of school and a million things to do within that short time. I wish professors would write a PRACTICAL syllabus. . .

That’s where I’ve been. Writing papers (trying to at least), accumulating the important facts for each class, and slowly studying what I can. I can tell both my professors want to get through more material then the semester allows for, because the amount of info tripled–it feels like.  It’s overwhelming and frustrating and makes me feel CI jewelryguilty and nervous. Which I guess, is how every student is SUPPOSED to feel with finals approaching. And to compound the issue, I lost yesterday to work and the worst headache ever!

It came on around 9:30 or 10 in the morning. I attributed it to having too much coffee between 4:30AM and 5AM, and drank loads of water to rehydrate. But the headache stayed. So I took some Ibuprophen thinking, maybe it was due to waking up at 2AM for an hour, getting up in the 4s, and working. It got worse. At lunch, all I had was corned beef hash (really salty) and I only ate a little not wanting to exsacerbate (where the eff did my auto spell-check go?) the problem. And I layed my head down, trying to cat-nap in order to feel better. But everyone is loud and sleep was evasive. After lunch, I could hear my heartbeat in my ears–that’s how bad the headache was. And if I tilted my head forward a milimeter, the pain brought tears to my eyes. My job requires me to bend and lift often. And obviously, I couldn’t leave work–being a vet tech and all. In fact, I really felt like crying because of the pain. I took Alieve, but that offered to relief either. The only thing that gave any relief at all (maybe up to 10%) was rubbing a certain spot at the base of my CI holidayskull. So I thought maybe the previous night’s massage might have caused the headache–toxins from all the trigger-points, or too firm of a rub or something.

I went to bed at 7PM, hoping sleep would help. And I woke up at 10:30PM with headache pain so bad it made me nausous (Jesus, I want spell-check!). So I took one of Cool’s migrane pills. And, boy, was that the best night of sleep I ever had! I slept without waking, to my alarm–which never happens. And woke up refreshed, without headache. But the point is, I lost study/school project time Monday. So today, I’m a little stressed out about it. Why am I taking the time to write a blog post, you ask.  Well, because I just spent 4.5 hours writing papers, taking notes, and memorizing flashcards and I’m going a little crazy.  Also, seeing this in print makes me feel like I’m accomplishing something–and have a good excuse when I’m not.  And it generally makes me feel more organized and motivated–and who are you to ask such hard questions of me, I don’t have to explain myself to you.  OK, just to myself.  So I’ll try to do one little thing at a time, get a good night’s sleep, and plug along for the rest of Thanksgiving break. With the exception of cooking and eating Indian Tacos on Thursday of course.

fry bread


Veterinary Flaws [prequel 0A]

25 Nov

Veterinary Medicine has many problems:  Overcharging clients and advising unnecessary tests and procedures isn’t one of them. And when 20/20 or another journalist bring up an “expose” on veterinary medicine–the public is more then happy to accept it. They eat it up.


And that’s why veterinary medicine has so many problems–the legit problems that’s I’ve mentioned about the Wal-Mart employee issues. The small business woes.  The general public still sees pets as a commodity. And the law sees them as property. So veterinary medicine is easily portrayed as a shopping rip-off. These exposes are not advising that veterinarians aren’t doing enough for the pet (as some might with, say, the topic of obesity), they are telling the public that their vet wants TOO much healthcare.

Anyway, in all my experience (14 years now) as a vet assistant, sometimes a very unhappy one, I have never had an employer charging a fair or comparable exam fee. Of all the nail trims I’ve done–probably one-tenth was charged to the owner’s bill–the rest were free. We routinely give baths, clip matts, or do other small procedures that do require time, but don’t go to the owner’s bill. And unlike human medicine, if there is a mistake, miscommunication, or just buyers remorse, they fees will be reduced or eliminated altogether (by the vet).  So the problem is actually the OPPOSITE of what the exposes/news stories challenge–vets charge too little, and constantly have to negotiate on the behalf of the animal to do ANY gold-startests/treatments, because people choose not to make their animal’s health a priority.  Veterinarians rarely get to employ the *gold standard* diagnostic or treatment.  They have to cater to low-budget options instead.  And that affects the business, wages, and future hiring ability.  Give away enough services and suddenly, there’s no money for bonuses, raises, or to replace a missing worker.  It all trickles down.

So vets aren’t in the business to make money and gouge you. If they were–well they would be dentists, and I and all the other skilled workers like me, would be paid appropriately. Veterinarians would be making the salary they are WORTH.  Instead of having the highest school debt, and lowest pay of any professional.  Instead of making a couple of dollars above minimum wage for my experience, BS in Animal Science, and dedication–as well as SKILL–I would be getting the pay (and benefits) of a human nurse.  Substantially higher.  AND, instead of having people just off the street working at vet hospitals, and largely unregulated employment rules/policies, there would be more eyes on the business if public perception of veterinary hospitals switched from shopping-service to medical necessity.

The public’s perception of animal importance and the media’s coverage of stupid things coupled with silence about actual problems in the career is the real problem with veterinary medicine–but where’s the expose on that?

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When did 10:30 PM become the new 3 AM?

22 Nov

Written yesterday:

I am so non-functional today, and it’s 100% due to the fact that I didn’t go to sleep until 10:30 last night.  But my body still woke up at 3:30 AM as it is accustomed to doing these days.  There were nights in my early-mid 20’s that I was OUT until 3:30AM, then went to work at 7AM!  You know you’re 30 when you can’t stay up past 8PM anymore. . .

The reason I was up late was the Talent Show.  I was very nervous.  I hadn’t performed in 14 years.  I had never THE shirt anteriordanced in those particular shoes.  The tap on my left heel is stiff and I have to stomp really hard to get sound out of it.  My living room carpet muffled my taps, so if I wanted to practice clean-steps I had to do it in my tiny kitchen.  And the stage was in a room used as a classroom so I couldn’t practice there until our actual room reservation–when other people were already there.  So I was never able to practice both full movements, facial expression, AND clean steps simultaneously before I was actually in front of my audience.  And the afore-mentioned music-loudness issues.

rainbow 3 (2)I had started working on this dance, specifically for this occasion in August.  So I wanted to really do the very best version of the dance I knew I was capable of.  And when I got up there–it was magical.  That sounds super-cheesy and overwroght, but I really felt good about everything.  It all came together, and I actually had fun with it–instead of worrying–what move is next, put your arms here, keep smiling, breathe. . .  I just did it.  And truly enjoyed myself.  Which showed, and got the crowd excited.  It was, without exaggeration, the best performance of my life.  Better then team or individual shows or competitions in my prime of dancing.  Better then team or duets with our clogging class.  Better then previous talent shows.  And better then any band, cheerleading, or other performance.

The stars just aligned and instead of worrying about logistics I enjoyed the moment.  And I was proud that the dance was all mine.  My special song, a costume I had spent hours and hours working on (my anatomy muscle shirt, if you recall those struggles), my choreography.  I owned it.  And I love the feeling that I did the best I could.  And of course the surprise, excitement, and praise from the audiance.  I feel like those classmates and teachers see THE shirt posteriorme differently now.  And that feels great.

I had forgotton how much clogging meant to me.  Or maybe at the time, it never felt like the cool thing to do and I sort of took it for granted somewhat.  I feel a renewed excitement, and like this is one of the things that makes me who I am.  And I had forgotten.  Now I’m motivated to choreograph another routine.  I guess for next year’s talent show since I really have no other performance venue/outlet.  Maybe I’ll make my own clogging YouTube page.  Whatever it’s for, I’d like to start writing another routine and making it even more spectacular to top this show.

But today I was too tired to do much of anything.  I couldn’t focus, but I couldn’t nap either.  I tried 3 seperate times to sleep, but couldn’t.  And you know how not studying makes me feel so, so, so guilty and unproductive.  But now I have a week for Thanksgiving break and I promise myself I will really buckle down and do what I need to and work ahead.  So Today will be my break and my reward for doing the very best I could last night.


Talent Show: 11-20-13

21 Nov

Here it is: My clogging dance to “So Much to Say” for my Speech & Hearing Sciences Talent Show.


19 Nov

I guess that’s the wrong word.  I mean, it’s accurate, but sets a more negative tone then I want.  My mind is in a million places:

-the talent show is tomorrow!

Talent Show Flyerfall2013-1-1 copy

I am very nervous.  I’m surprised how much, because I used to perform a lot, and really important team competitions too.  I never used to worry about a small, show for fun.  I also never, never used to worry that the music would be too quiet to hear.  I am disproportionately preoccupied about this damn music level of tomorrow.  I have only 4 counts to make sure I’ll be able to hear it over my footwork.  And I feel like the whole thing will get messed up if I can’t hear well. . .  Also, I want to practice on that stage–though I rarely, if ever, got that chance in my clogging prime.  I am getting more anxious as I age.  And I will cry if I don’t do the very best that I know I can do.  I’ve been working on this since August and I really want to do my best work.  And a prize wouldn’t hurt my feelings, but I don’t NEED one if I’ve done the dance cleanly, with smile and arm movements, and WITH the music (that I can hear).

-My lips are getting off-the-heezy chapped

This happens every winter, and I wish it could wait until after the talent show.  Of course my face broke out just for the occasion as well.  At least my fever of Friday and Saturday went away.  I have no idea why I’m getting sore throat/fever spells with such frequency this fall/winter.

-I had been dreading work this week

And I do not want to jinx it in any way, but it’s actually going very well, and I’m coming home normal to happy instead of stressed, worried, tired, disgruntled, and frustrated as I had anticipated.  Maybe my life is turning around!!!!  Maybe.

-What happened to Sheryl Crow???

It goes without saying that I’ve been a long-time fan.  In 1995, she was one of the first 12 CDs I ever owned (thanks BMG!).  And I had her poster on the ceiling of my bedroom.  She used to be brown-eyed, curly, brown hair, and folk/rock/indy.  Things have changed.  Now she’s country?  And looks like a wannabe sorostitute.  And too thin for her age.  Don’t women know that losing weight after a certain age makes you look weird and wrinkly and unhealthy?  I used to really like her, but maybe I’ve changed my mind?  I’m not certain.  I think it would be better if she was more–authentic?  Is that the word I’m looking for?

-I can’t decide if something is wrong with Rusty (my car) or if I’m just paranoid

It feels heavy sometimes.  At first, I thought my tire might be low, and it would need repairing (again).  And of course I was nervous about that since it happened twice in a month.  But it’s been a week, and no flat.  So is it in my head–or is there something else?  Now, I don’t know if there’s a problem or not.  So I need to decide if I should take it in or not. . .

-How could I not mention this!

To mark the talent show location, which is in a sort of random place, unfamiliar to many–I got balloons.  How could I not know about glow-in-the-dark balloons??!  So awesome!  I’m totally excited to use these tomorrow.  I hope they’re not terrible environmentally unfriendly, but suspect they might be.  But I am really excited to utilize them so I woun’t look that up until afterwards. . .  And of course, Cool and I will keep a couple for ourselves.  Though I don’t know what 2 homebodies will do with glowing balloons.

-I forgot why I originally opened a new post

So that’s all I’ll say.

why i hate soup

15 Nov

I woke up to pee in the night, and was horrified that I suddenly had a sore throat.  This is always, always the first sign of an impending cold.  And when I get sick, it really sucks, because 1)  it’s never the vomit and diarrahea stuff that keeps you at home, so I’m obligated to keep all my comitments.  2)  It’s always the same:  Invisble sore throat, into invisable fever that really makes me feel miserable, into a messy head cold.  Runny noses in silent 75 min lectures are the worst!  3)  I don’t sleep well–and this unleasehes a chain of events like being crabby, non-funtional at work, and extra worrying.

San Fran bridgeMost people want soup when they’re sick.  But the only soup I like is chowder–in a bread bowl.  Preferably in San-Fran at a Fisherman’s Warf stand-up table over-looking the water.  So today I’m pretty miserable.  I did stay an extra half hour at work, because they really over-booked the morning (and social tensions were actually low and I want to keep it that way) and I studied very productively.  But I feel rotton.  And of course guilty about leaving when there was still so much work to be done–and worried that social tensions will be at a peak again tomorrow because I did leave.  Maybe that’s just the tiredness talking.

But no one wants to hear about that same ‘ol stuff.  Here’s more about why I dislike soup.  Disclaimer when I didslike things (with the exception of french fries, which I will never, never, ever touch, let alone eat, in my LIFE) I just mean I don’t prefer them and wouldn’t chose them.  But I still eat them if need be.  Anyway, why soup is disargreeable to me:

It’s slow and unruly to eat.  As a rule, I dislike food you have to work at:  Lobster in the shell, ribs, caramel apples crabon a stick.  No matter how good the taste, I resuse to struggle around with my food.  I want things that I can quickly shovel into my mouth.  Soup has to be spooned, slowly, and slurrped.  Soup is better out of a thermos, because you can drink it–but why (when there are so many better things to pack in a thermos) would I chose soup?  It often drips down my chin from the bowl, and I hate that.

After all this work, I find that it’s not even filling.  Maybe the salt fills you up short-term, but usually I’m still starving after soup.  Salads too, for that matter.  Soup, is only tolerable when there’s bread to sop it up and fill you up–but again, why bother when you can just eat the bread?

Besides, super-hot temperatures hurt my mouth.  I hate all the waiting, and blowing before you can slurp soup.  I want to dig in–so I do.  And then I pay the price of scald-tongue, roof, cheecks, throat.  Not awesome.  Especially, when you can’t taste things for the next couple days because your skin has sloughed off.  That’s one of the things I love about Cool–she knows just how “hot” to make my beverages or foods.  To most people it’s leukwarm, but that’s just enough for me.

celestial cow

Even after braces, removal of impacted wisdom teeth, and gum-grafts–I had real food.  Like steak.


Sources for Ear Pathologies

13 Nov

I think we have a paper due this next Friday?!  But it hasn’t been mention IN class (annoying) so I haven’t worked on it at all.  But here’s what I did at the beginning of the semester.  I need to pick something and get going!

ear art 3

-acute otitis media *I don’t think I’ll be able to use this–we’ll probably cover it exstensively in class*

is characterized by a short-lived infection (aural hematoma (feline)???


an injury to your ear because of changes in barometric (air) or water pressure. [D]

-bullous myringitis,

-Carhart notch

sensorineural component at 2000 Hz due to stapedial fixation; occurs with otosclerosis [C]


Invasion of Epithelium Cells of the EAM into the middle ear. Causes damage to ossicles, facial nerve, ad can be life threatening; Results from Chronic otitis media, marginal perforation of the TM, long periods of negative pressure with infection or PE tubes insertion [E]

-eosinophilic otitis media

Eosinophilic otitis media is an intractable middle ear disease associated with bronchial asthma and nasal allergy that sometimes induces deterioration of sensorineural hearing loss. How eosinophils accumulate in the middle ear has yet to be determined; active eosinophilic inflammation may occur in the entire respiratory tract, including the middle ear, in patients with this disease. EOM often produces a yellow and highly viscous middle ear effusion and can cause symptoms that range from prolonged hearing loss and otorrhea to sudden deafness. The middle ear symptoms are unresponsive to conventional treatments for otitis media and are instead treated with steroids [A]

***-Glomus Jugulare

Dilation of the internal jugular vein impairing ossicular movement. Can hear heart beat.

-Goldenhar Syndrome

-granular myringitis,

*-Malingering *we talked about this in class a little, plus it’s not really a hearing/anatomical problem*

Individual is actively faking a hearing loss. [E]


Mastoid air cells become infected. Life threatening Meningitis [E]

**-Meniere’s disease., {pics} *I’m sure we’ll cover this in detail*

could be progressive, Sx: fullness,dizziness [B]

Meniere Episodes = Rotary vertigo, tinnitus, ear fullness or pressure, nausea, and hearing loss. Can last minutes to hours. [E]

-meningitis *I wrote my Aural Rehab paper on this, so I have a framework to start.  It’s such a huge cause of hearing loss that we might discuss it in class though*

-mumps *part of meningitis–the agent that gets it started?  Along with chicken pox?*


Fixation of stapes (calcified), so increase in mass of ossicles. Conductive HL, seen in audiogram at 2000 Hz called “Carhart Notch”. Tx: stapedectomy [B]

Fixation of the foot plate of the stapes in the oval window; Autoimmune disease. Higher occuring in caucasians and women.

–>parasites (feline)???

*-Perilymphatic Fistula

Rupture of the oval or round window causing a loss in perilymph. This causes hearing and balance problems. [E]

*-Psychogenic  *Nope, psychological*

Individual does not have a hearing loss but they truely believe they do. Usually result of emotional trauma [E]


acquired– abnormal narrowing of ear canal [C]

**–>Suppurative otitis: (feline)???

The ears of kittens and cats are liable to infection from pus producing organisms

-Swimmer’s Ear {pics}


a roaring in your ears, can be the result of loud noises, medicines or a variety of other causes. [D]


-Usher Syndrome

-vestibular schwannoma

An acoustic neuroma is a slow-growing tumor of the nerve that connects the ear to the brain. This nerve is called the vestibular cochlear nerve. It is behind the ear right under the brain. An acoustic neuroma is not cancerous (benign), which means it does not spread to other parts of the body.

-Waardenburg Syndrome

ear art 2