Tired isn’t a word I use lightly.

For years I worked a full time job while getting a few degrees, then teaching as an adjunct professor, sometimes supervising student clubs, and also, you know, having a life. I’d race around the office all day long, then grade papers, then lecture for two and a half hours, maybe do some research, eat dinner at midnight and get up at 7 a.m. the next day and mainline coffee while complaining I was tired.

I did not know what tired was.

I thought tired meant only reading the first and last chapter of a book in order to be able to follow the class discussion but still make time for an extra 2 hours of sleep before the history seminar I needed to graduate on time.

I thought tired meant asking the department to hire a graduate assistant to teach the lab so I could grade papers and still be able to drive myself home without falling asleep behind the wheel.

I thought tired meant needing to throw an extra shot in my latte before lecturing non-physics majors about calculating reverberation time.

I did not know jack about tired.

I was an amateur in the world of tired.

In 2004 I turned Pro.

In 2004 a couple of hereditary inflammatory autoimmune disease came out of hiding and kicked my ass. Eventually, I had to stop working, quit teaching, quit planning on well, being able to make plans. It’s a situation that requires a lot of adjustments.

You know what goes great with tired? Searing joint pain. Together they’re like milk and cereal. Leather and lace. Peanut butter and chocolate. Crocket and Tubbs.

Actually, they’re like none of those things. The new migraine medicine my doctor prescribed has a lot of codeine in it and I strongly suspect it just kicked in.

So what was I saying?

I have no idea.

I just got an adaptation of Alice in Wonderland that stars Gary Cooper, Cary Grant and W.C. Fields and it’s hard to pay attention to this post.

It’s also a situation that comes with a lot of interpersonal frustration. People – no matter how well-meaning, don’t understand how exhausting pain and fatigue are. They say less than helpful things like, “I wouldn’t ever tell anyone I was sick, I can’t afford the damage to my career.” Or, “I get tired too, but I just suck it up.” Or, “If you’d stop eating tomatoes, you wouldn’t be sick.” Or, my personal favorite, “My (mother/sister/imaginary friend/neighbor) had cancer and she had a really good attitude never missed a day of work,” followed by a long pause during which I can only surmise I’m supposed to cheerfully reply, “Well slap my ass and call me Susan! What was I thinking? Thank you so much for helping me see the light!”

Sarcasm, by the way, is not an accepted trait if you’re to accept the role of Saintly Sick Person.

So here’s the deal, being extremely sick gives one lots of blogging material – the ridiculous medical adventures, the various physical therapy modalities, the challenges of keeping your friends and your sanity when life becomes super-unpredictable, and the sometimes bizarre alternative therapy suggestions that well-meaning relatives offer up when you least expect them. (Not that Western medicine can’t be pretty bizarre).

I’m going to withhold any personal details or specific diagnostic information I see fit to withhold but hopefully I can still be useful, engaging, and realistic without waving my underwear in the wind.

I’ve slogged through a lot of the prospects both Western and Eastern medicine have to offer and the results haven’t always been pretty, though some of them have been rather hilarious. Hot yoga? Hot yoga is hot. Very very hot. And it’s not something you should try while wearing hand lotion.

On Tuesday, doctors announced that a condition cited in medical journals for 34 years was actually just a hoax.

The bogus condition, called “cello scrotum,” was described as raw and swollen loins of men who play their cellos a tad too long, or too vigorously. The malady has been cited in several papers discussing other musical ailments, such as “fiddler’s neck,” finger dermatitis and permanent muscle twitches.

The cellist/husband of a knitting buddy was interviewed for this article:

Of course, someone might have asked a cellist in all these years. Roger Shell of New York City has been playing the cello for 40 years and said he never even heard of “cello scrotum.”

“I can’t see how that’s possible, actually,” said Shell.

At most, Shell said it’s possible for cellists to chafe the inside of their thighs, “if you’re wearing shorts,” he said. “There are really no other contact points other than the chest.”

I’m sure I had more to say about this, but I got distracted by a headline about toxic fish testicles.

So I tweeted about the number of people I’ve encountered recently who either have no understanding of basic science or are just plain stupid about some of the ways humans (and other animals) can get sick. What set me off most recently was a so-called health care professional who was holding forth about how influenza is not contagious and the only way to spread it is via vaccine. (There were other pseudo-scientific gems, but I’m trying not to digress for a change).

I got lots of hilarious commiseration from friends and twitter followers – I’m pretty sure everyone in the world has that co-worker or friend who claims to never be sick, even though they’re constantly complaining about being sick. Sadly, the fact that these people don’t like to admit that they’re wrong to the point of making others around them sick isn’t so funny.

The vaccines aren’t perfect and they can’t cover every viral mutation. You can still get sick – but why take the chance you’ll get a flu you can prevent, which weakens your immune system and leaves you more vulnerable to a host of other infections you might otherwise shake off?

The CDC has a rather thorough website on the matter of the flue, as does the World Health Organization.

Since most people get an average of 4-6 colds or other viruses-y things a year, statistically speaking many of them are either sick and asymptomatic or get sick soon after they get a flu shot and mistakenly believe the shot gave them the flu. Or they’re very prone to the power of suggestion and are so sure the dead vaccine will give them the flu they develop symptoms. Or, they’re just stupid. We can’t rule out stupidity.

I’m going to avoid a digression into how sad it is that many healthcare workers – doctors, nurses, EMTs, lab techs – need to be threatened with sanctions before they’ll be vigilant about washing their hands, getting vaccinations, or following other basic protocols. It hurts my brain. It hurts my brain that people who claim to care about the public good are reckless and it hurts my brain to rein in so many digressions. But I’m digressing about digressions…

Yes, there are people who are allergic to eggs or have illnesses that preclude vaccination, my issue isn’t that people who don’t get a flu shot are automatically the devil. I’m just annoyed with the arrogant idiots who think they have superior genes and, when they do get sick, refuse to admit it or keep their germs at home.

I don’t even think flu shots should necessarily be mandatory for the general public, but I think that people need to take the time to be better informed about the flu and I think they need to show better common sense when they are sick. Sadly, common sense seems to be in short supply.

It’s not worth arguing, or at least not worth my energy to argue anymore – I just do my best to avoid them. Colds, flu or mucous-spraying viral infections of any kind are no laughing matter to those of us on immunosupressing drugs. I had several people who “never get sick” persist in coming to events last year even though they were clearly sick. One of them coughed up the mucous equivalent of Lake Michigan at a small gathering, all the while insisting it was just a sinus infection and couldn’t possibly be contagious. Four days later, everyone else who was there got sick with the same symptoms. Coincidence? Maybe. Maybe not. After that I spent almost 2 months with pneumonia and almost drowned in my own lungs, so as you may imagine I’m a little bit prickly about the whole thing. I say that not to be selfish, it’s your decision how to manage your health and personally I have no problem being aggressive about making sure that I do all that I can to avoid people who’re sick even if it hurts their feelings. I think people want to play games with their own health, that’s fine, but I think it’s selfish not to think about their families and the people who rely on them, to not take simple precautions not to spread more germs around than them than have to because they’re afraid of shots or arrogant or whatever. Really folks, this is not brain surgery.

Incidentally, when I say I heard hilarious stories – I don’t mean that sarcastically in reference to the ones about the deaths of children or loved ones, I mean the ones like the manager who announced she “doesn’t get sick” minutes before she threw up all over the clients conference table while her minions (my friends) tried to look appropriately concerned but really wanted to fall down laughing.

An influential psychiatrist who was the host of the popular NPR program “The Infinite Mind” earned at least $1.3 million from 2000 to 2007 giving marketing lectures for drugmakers, income not mentioned on the program.

What could possibly go wrong with that? Or with this:

Dr. Goodwin’s weekly radio programs have often touched on subjects important to the commercial interests of the companies for which he consults. In a program broadcast on Sept. 20, 2005, he warned that children with bipolar disorder who were left untreated could suffer brain damage, a controversial view.

“But as we’ll be hearing today,” Dr. Goodwin told his audience, “modern treatments — mood stabilizers in particular — have been proven both safe and effective in bipolar children.”

That same day, GlaxoSmithKline paid Dr. Goodwin $2,500 to give a promotional lecture for its mood stabilizer drug, Lamictal, at the Ritz Carlton Golf Resort in Naples, Fla. In all, GlaxoSmithKline paid him more than $329,000 that year for promoting Lamictal, records given to Congressional investigators show.

What possible part of any of that was even remotely ethically acceptable to Dr. Goodwin?

Allergists aren’t pleased with President-elect Obama’s search for a “hypo-allergenic” dog. The up-side is that it’s giving a boost to an issue that’s long vexed some animal-protection/animal shelter advocates – unethical breeders selling so-called hypoallergenic dogs to desperate families, many of those dogs then ending up abandoned or neglected.

The American Academy of Allergy Asthma and Immunology has issued a statement that includes this advice:

According to the AAAAI, it is a common misconception that people are allergic to a dog’s hair, and it is falsely believed that a dog that sheds less will not cause a reaction. However, allergies to pets are caused by protein found in the animal’s dander (dead skin cells), saliva or urine.

These proteins are carried on microscopic particles through the air. When inhaled, they trigger reactions in allergic people. As all dogs posses these proteins, there is no allergy-free dog.

Though some dog breeds are considered more allergy friendly, it is likely because they are groomed more frequently – a process that removes much of the dander.

[read the entire statement, which includes some advice for allergy sufferers]

The AAAI website also links to WebMD’s Hypoallergenic Dogs and Dog Allergies FAQ

Hypoallergenic dogs have gotten a lot of buzz lately as the Obama family searches for a dog to bring with them to the White House — without triggering dog allergies in older Obama daughter, Malia.

A quick glance at the Internet shows lots of web sites devoted to “hypoallergenic dogs” and “hypoallergenic dog breeds.” But no dog may be free of potential allergens, cautions allergy and asthma expert Corinna Bowser, MD, of Havertown, Pa.

WebMD talked with Bowser about hypoallergenic dogs and dog allergies — and what the Obamas might consider to help avoid triggering Malia’s dog allergy.

[read the whole FAQ]

The number of news articles that have sought advice from the ASPCA and allergists instead of some of the shady dog-breeders who make ridiculous claims is a positive sign. The ASPCA has made good use of this national platform to try to quell the spread of misinformation.

“No breeds are completely hypoallergenic. However, some breeds have a tendency to cause fewer problems — mostly those that don’t shed and need to have their coats trimmed regularly, or those that tend to shed less, said Stephen Zawistowski, an executive vice president for the American Society for the Prevention of Cruelty to Animals.
Relatively common no-shed breeds include poodles, bichon frise, Portuguese water dogs and Maltese, but these breeds need professional grooming, which can be expensive. Other breeds that have a tendency to shed less are Schnauzers, Westies (West Highland white terriers) and Scottish terriers, Zawistowski says.”

I cringed when I heard President-elect Obama refer to hypo-allergenic dogs, but perhaps the public education campaign that has resulted has been worth it after all.

Katherine Hobson has a post up related the latest news that running or related exercise can, in fact, be good for you. The post itself is quite short, but it’s full of interesting sources and references:

Every person who takes up running has, at one time or another, been confronted by a helpful critic who is more than happy to reel off the reasons running will ruin your life. It will cripple you in your later years; you might drop dead in the middle of a marathon; and on and on. As an avid runner, I have a lot riding on whether or not these ideas about the sport are true. Here is a look at four questionable claims about running and health, including results from a new study looking at running, longevity, and disability.

My favorite is when someone tells me running is stupid and runner are stupid just because they don’t like running. What are you, five years old? When you control the universe you can make other people stop doing things they enjoy just because you don’t also enjoy them. But before you make too many plans, keep in mind that there’s always the chance you won’t get put in charge and I will.

Although I’ve been on what amounts to the injured-reserve list for Serious Academic Researchers, I follow developments in my fields, particularly medical ethics and technology. While the August 4th Washington Post article, “Prescription Data Used To Assess Consumers – Records Aid Insurers but Prompt Privacy Concerns” contained no new information for me, it reminded me I just got another idiotic letter from the prescription drug managers for our health insurance plan. I get these letters every couple of months. You probably do, too, if you fill prescriptions at a brick and mortar pharmacy.

The letter cheerfully tells me how much I can save my using mail-order instead of my local pharmacy, and then it usually lists the 4 or 5 drugs I take according to their records. Usually between 1 and 3 of the drugs listed are correct. These drugs also aren’t available through their mailorder service, which I know because I always call about the letter and they tell me I can’t mailorder, as if it were my idiotic idea to try to order them in the first place. The other drugs on the list are usually ones I’ve never even heard of, let alone taken.

I’m sure I’m not the only one this happens to. It isn’t just irritating, it could have a profound impact on our lives, particularly since this data is increasingly available to prospective insurers, life insurers, prospective employers, and the Federal Government. Additionally, a person’s access to health insurance or life insurance or whole fields of employment doesn’t just impact them, it impacts their entire family.

I’m reminded of a lunch at a conference a few years ago. One of the (European) participants at the table mentioned what a vital tool it would be to compile a list of all individuals in the E.U. with “Arab-sounding” names who take anti-depressants (which are, incidentally, described for a wide range of conditions). Presto! Instant watch-list of potential suicide bombers. Chilling. The Americans at the table seemed to feel that this would never happen in the U.S. because of our privacy rules. The sad part was, these were people who should know better, which makes me feel rather hopeless about whether the average person will understand the path we’re on before it’s too late.

In February, the Federal Trade Commission issued an order saying that MedPoint and IntelliScript are consumer reports under the Fair Credit Reporting Act, so the companies must notify insurers that consumers denied insurance on the basis of these reports have the right to request a copy of the report and that errors be corrected. The FTC’s order followed a settlement of allegations that the companies violated the credit-reporting law by failing to provide such notice to insurers.

Bob Gellman, an independent privacy consultant in Washington, said the FTC’s decision not to fine the companies sends “the message that it is okay to ignore the law.” That, he said, “is absolutely outrageous.”

As more health records become electronic, he said, more parties will compete to sell more comprehensive patient data to insurers, driving down data prices. “It will all likely be lawful,” Gellman said, “but consumers will likely continue to have no real meaningful choices if they want insurance.”

Consumer groups have got to speak up and speak up soon about creating a mechanism to audit and correct this kind of data. The unfortunate thing is that, in order to correct an insurance record, the pharmacy needs to be contacted and the doctor or doctors needs to be contacted to confirm a drug was or wasn’t prescribed. Many doctors will find a way to bill this, probably to the insurance company, who will find some way to hold the consumer accountable for the charge for an action that is necessary to clean up their data in the first place.

Someone needs to put this issue into plain language and start a serious national conversation. It’s ever-so-slightly heartening to see articles on the front page of the Post, but that’s not enough to effect change.

The barracks at Fort Benning that house wounded soldiers with Post-Traumatic Stress Disorder are next to the firing range. According to the Washington Post:

The soldiers are part of a growing group of an estimated 150,000 combat veterans of the wars in Iraq and Afghanistan who have PTSD symptoms. The mental disorder has been diagnosed in nearly 40,000 of them.

PTSD symptoms include flashbacks and anxiety, and noises such as fireworks or a car backfiring can make sufferers feel as though they are back in combat. Health experts say that housing soldiers near a firing range subjects them to a continual trigger for PTSD.

“It would definitely traumatize them,” said Harold McRae, a psychotherapist in Columbus, Ga., who counsels dozens of soldiers with PTSD who are at Fort Benning. “It would be like you having a major car wreck on the interstate” and then living in a home overlooking the freeway, he said. “Every time you hear a wreck or the brakes lock up, you are traumatized.”

Fort Benning, which covers more than 180,000 acres, is one of the Army’s main training bases, with 67 live-fire ranges. The base has thousands of housing and barracks units. “There is no excuse” for the housing situation, said Paul Ragan, an associate professor of psychology at Vanderbilt University, who treats veterans with PTSD. “Charitably put, it’s very untherapeutic.”

Brig. Gen. Gary Cheek, director of the Army’s Warrior Care and Transition Office, which oversees 12,000 wounded soldiers, said: “I can see how that would be a problem. It’s something we haven’t considered” but should. “We have alternatives for housing the soldiers who have issues” with the ranges, he said, adding that the barracks for wounded troops at Fort Benning are an interim facility.

The gunfire “makes me crazy,” said a soldier who lives in the barracks and has PTSD and traumatic brain injury from a roadside explosion in Iraq. “It makes me jump and I get flashbacks.” He spoke on the condition of anonymity for fear of retribution from the Army.

It leaves me speechless.