Normally I would look at a long holiday weekend as a chance to catch up with some work. But not this time. I did get some work done, but my goal was to take it easy and just do what I felt like doing and seeing how long I actually slept over three days—you know, go to bed when really tired, get up when my eyes open and my body says, “get up.” To find out how long I really need each night.
Eight hours. That’s how long I sleep naturally. Three nights in a row, eight hours each night almost to the minute. So now I know: that’s what I need in order to feel functional.
Today I spent a couple of hours getting things into pots and hellebores into the ground. I’ve had no luck with hellebores until this summer—I hope they survive the winter—that will be the true test of luck, to see them bloom in early spring.
Things are lush this year. The mimosa we planted a couple of years ago, maybe three years ago, that wasn’t much more than a tall stick has grown beautifully and is even blooming this year:
The garden in the middle of the yard is going crazy. We planted a clematis a couple of years ago and it is blooming this year—I wish I remembered which clematis it is, but it’s pretty growing around the rosa rugosa (beach rose). I would like to train it to go more toward the center of the trellis, but don’t have the kevlar gardening gloves I need to deal with the wicked thorns on the beach rose:
We planted tomatoes, peppers, basil, and a cucumber vine before we left, and those, too, are doing pretty well (even though we didn’t get any tomatoes by July 4th, as promised by Burpee):
Ginger went out with me so she could play keep-away with her frisbee. She still hasn’t figured out that she gets to run more if she’ll just give the damn frisbee (or ball) back to us instead of making us either chase her or try to outsmart her to get it back to throw it again. She’s a goofus. The prednisone seems to have knocked the swelling out of her lymph nodes again and she’s been pretty perky for the most part ...
... except for the fireworks, of course. She’s had three terrible evenings, and tonight wasn’t so hot either. Here she is looking very worried as she just heard a small firecracker go off in one of the neighbor’s yard—ready to bolt to the back door and beg to be let in the house if she heard another one:
I managed to get covered in dirt this afternoon, planting the hellebores I mentioned, and putting together some pots of rosemary and basil and marigolds. Stanley put in a new peony, a coral-colored one. I noticed an astilbe I planted a couple of years ago is finally growing, and some of the plants I put in the shade garden are starting to show signs of life. I’m trying to grow shade plants that like dry shade that are not hosta—though it looks like I may have to break down and put in some hosta as well. I’m not particularly fond of hosta, but I’d rather look at those (this is the view out my office window) than bittersweet-choked burning bushes. And I wish there was an easy way to get rid of bittersweet—I wonder if somebody could figure out a way to make biofuel out of that stuff; that would be one way to get rid of it.
I’ve been thinking too much lately. My sister asked if I were worried about developing frontotemporal dementia like my mother and her mother. I kind of brushed off the question, telling her that what I’m trying to do is get everything in order so that if I do get it, I won’t be a such burden on Stanley (and if I don’t get it, well, we’ll be in a good spot to enjoy retirement) but other than that, I’m not worrying about it.
And I’m not really worrying about it, but I’ve become almost obsessed with learning about it and paying a lot of attention to how the caregivers in the FTD Forum are doing and what’s happening with their FTD loved ones, and I am worrying a lot about Dad. My mother let her worry about getting FTD like her mother did ruin a great many years of her life, and it did her no good at all. I don’t want to miss living life now to worry about the future. I decided the best thing I could do was get as healthy as I can and do what I can to stave off developing dementia, if it ever happens. So I’ve been working on that.
But it is bothering me a lot, the grief, the long goodbye, I think, more than anything, and that, coupled with Ginger’s cancer and some health problems that people I love have, has pushed me into this place where I feel like I’m sort of underwater, and it’s interfering a lot with being able to get things done. I’m not immobile, but I’m not okay, either. I’m not sure what to do about it. I’ll talk to Stanley about it and see what he says. But right now, I’m going to bed, would like to get to sleep before it starts getting light out for a change. Especially since I can’t get my eight hours in tomorrow by sleeping until past noon—the holiday weekend is over, alas.
When I go grocery shopping, I always look to see if Turkey Hill Tin Roof is on sale and, if it is, I get it for Stanley. For the past couple of months, the price of this ice cream has been $3.99—at least at the Westport Stop & Shop. On Tuesday, I looked at the price signs hanging from the freezer shelves, proclaiming that the price is $3.99, down from $5.99 on November 23, 2007. Wow, a two-buck drop. On a half-gallon of good ice cream. Only ... it’s not a half gallon anymore. No. It’s 1.5 quarts. Well, okay, so the price is down 33% while the quantity is only down 25%, so it’s still cheaper, right? Only I don’t remember if the size back in November was a full half gallon or not. So I don’t really know. I just remember that the cartons were bigger—the whole reason I noticed the smaller quantity to begin with is I noticed the cartons are much smaller than they used to be. We have a small freezer, so I’m very aware of the size of the stuff I buy to fill it.
Anyway, Slink, our Very Bad Cat, has a way of ensuring he gets some attention when he wants some attention:
So he sprawls long enough across Stanley’s keyboard to totally disrupt the flow of whatever Stanley was trying to work on. I swear this cat has ADD. He comes, he wreaks mayhem, and before one can adjust to Slink’s new reality, he leaves to chase a moth or watch the bird in the wisteria or just torment the dog.
Twitch is a very mellow cat. We placed a stem of crocosmia on the desk, and he’s content to just sniff it and see if he can scratch his chin on it and if not, it’s not worth bothering with:
This particular crocosmia is called Lucifer. Slink had to check it out after Twitch finished his examination:
And because Slink is a devil cat, he tried to eat Lucifer. He was shooed away, but later snatched the leaves, which I found shredded all over the office.
July is the time of year to secure heating oil contracts here in New England. You try to decide if it makes sense to pay the market rate at time of delivery, to pay a fixed rate no matter what the market rate is (along with a fee), or to pay a capped rate, which requires an up-front payment of a certain amount. The up-front payment does not count toward your oil bill—it’s just a fee the heating oil supply companies charge you to cover their asses. This is a new thing this year, at least around here.
Then you have to figure out who offers the best rates, which involves phone calls (the websites are usually non-informative or very confusing, especially about this new charged for the capped rate) and waiting for information. Then you need to figure out how much oil you’re going to need this winter, which is a real crapshoot in Southern New England. Last couple of winters were mild, but three years ago it got really cold, but if it’s windier than usual (we live on the coast) it’s colder than usual even though the temperature might be higher ... and last winter we got a new furnace, so I couldn’t even average over three or four years. I settled on 700 gallons.
Then you have to try to guess what the cost of heating oil is going to be. You can’t really go by the price of gas—it’s more like the cost of diesel (since heating oil is diesel with different additives) so you need to ignore the brouhaha over the rising cost of gas and look at other stuff—requiring a lot more knowledge than I have, or have time to acquire and sort out. Fortunately, I have a very smart friend who understands the commodities market, Stu Johnston. He understands it so well he wrote a book about it and put together a database and wrote an application to mine the database that provides all kinds of information about commodities prices and other stuff I only vaguely understand—you can subscribe to this database at Time and Timing (a trial subscription is available). Anyway, I asked him what he thinks makes sense.
We juggled the numbers, ruling out market rate, and looked at the difference between the fixed rate contract and the capped rate contract with the fee (which is 30 cents per gallon from the company we selected, which is Gault Oil of Westport). The capped price is $4.84/gallon plus the fee, or $3,598 for 700 gallons if you pay the cap. The fixed price fee is $4.79/gallon plus a $55 fee for 700 gallons, totaling $3,408.
So the difference is $200, and deciding what to do amounts to whether we want to gamble $200 that the price of heating oil will drop enough to cover the fee (and hopefully then some) or not. Stu also said we could hedge as well, but that’s more thinking that I have the energy for at this time. And he said he thinks heating oil might go down. So do I, especially if we have another mild winter.
We decided to gamble and went with the cap. And now we’re watching as the cost of oil is dropping and keeping our fingers crossed. And doing what we can to tighten up this 200-year-old sieve of a house and wishing there was such a thing as affordable solar heating systems.
After it was all buttoned up, it hit me: $3,500! That’s $700 per month just to stay warm enough so we don’t see our breath in the house and are able to move our fingers enough to keyboard. It’s tight for us—I just can’t imagine how people on fixed incomes or low income families can afford these oil prices. Electricity is just as expensive in this state ... what are people going to do?
It’s so great to have oil men in the White House, isn’t it? Did us sooo much good ...
The cancer protocol the onco vets put Ginger on a couple of weeks ago just didn’t work, and her lymph nodes again started enlarging, which means the lymphoma is back. There is one more chemo protocol they can try, though the prognosis is not good. We’re starting to accept that we won’t have her around much longer, but are hoping she can be comfortable enough for one more trip to Oscoda in late August and early September.
They needed to start her on the first chemo drug they gave her, an induction drug, Elspar. And continue her on Prednisone. Next week she will get blood tests and get checked over, then we start her on yet another drug, but I don’t remember what it is. It’s a pill rather than an injection.
She seemed to be doing okay after treatment on Wednesday. On Thursday, she ate quite well, some wet dog food, a little bit of steak, a bit of baked potato, some broccoli (which she loves—go figure ... ), plus her dog biscuits and her Greenie. Not much of her dog chow. She sometimes gets diarrhea when she eats beef or pork fat (or just beef or pork), so I didn’t think much about it when she had to go out repeatedly starting around 2 am on Friday morning. I was up monitoring a server upgrade anyway, so it wasn’t like I was going to sleep right away. I put newspapers down before I finally went up to bed just in case it wasn’t over.
It wasn’t. Only it was much worse—fierce vomiting was the next event. She snagged the cat tuna and blew it. She drank some water—gone at once. Between the vomiting and the diarrhea, I knew it was bad. I called the onco vet, who prescribed some pills to give her, one for each problem. Pills. For a dog that couldn’t even keep water down. A trip to the vet to pick up the scripts and $40 later, I gave her the meds. Barf in 60 seconds. No pills in evidence, but oh she looked so so sick and in pain. The onco vet said to call her regular vet, Dr. Meredith Re at Strawberry Hill Animal Hospital (we’re crazy about Dr. Re, and the creatures love her too, even though she sticks them with needles and shoves thermometers up their butts).
Dr. Re had us bring her in, and it was very difficult because Ginger just did not want to walk anywhere. She got up into the car, but did not want to get out of the car. Stanley had to half pick her up and half shove her out—we didn’t want to yank her by the collar because of her swollen lymph glands. Then, when we finally got her in to the exam room, Ginger shoved her head between the table and the wall and tried to make herself as small as possible.
Bottom line was Ginger needed IV liquids and pretty close supervision overnight at least, since she was dehydrated because of all the liquid she lost—she lost three pounds in two days and only some of it was the lymph fluid going down (they have gotten smaller, but they’re still very much noticeable). Dr. Re’s hospital doesn’t provide ICU-type care and is not staffed during the wee hours, so she recommended we take her to the VCA Veterinary & Emergency Center—the animal ER here in Norwalk. Off we went. Dr. Re was worried that it might be pancreatitis induced by the chemo. We thought, before we saw Dr. Re, that it was all the stuff she ate, or maybe the potato skin poisoned her (they can if they’re green).
Ginger was first “triaged” by an intern? Or orderly? I’m not quite sure who the guy was. We told him that Dr. Re had already called and faxed over her records, seemed rather pointless and a silly procedure—we wanted her taken care of as soon as possible. He left, and soon the vet, Dr. Vaishali Kamath, came in to take a look. I got a good feeling from Dr. Kamath—I felt like I could trust her to take good care of Ginger. The only times Ginger hasn’t been with me are the few days I was in hospital and when we went to Washington DC on our honeymoon, so it was really difficult to leave her there. The vet got her settled in for diagnosis and treatment, and came back to go over the estimate. After leaving $1,500+ to pay for everything (75% of the high-end estimate), we went home to a very quiet house. I asked Stanley if we were crazy for paying so much for a dog who is terminal, and he said, “probably.” I asked if it bothered him and he said, “no.”
Dr. Kamath said, around 11:30 when I finally reached her to get an update (lot of dogs into the ER tonight, but only one from heatstroke), that Ginger was perking up quite a bit, that her blood pressure was back up to closer to where it should be and her blood work was fine except for some abnormalities which the hospital oncologist said was due to her chemo. Lots of IV fluids, IV steroid injection. Her vomiting was stopped, though the diarrhea continues. She is wagging her tail and had just gone out for a walk. We will probably be able to bring her home Saturday—we will hear from the hospital and Dr. Re Saturday morning. Oh, and the vomiting and diarrhea are the result of her chemo and not us letting her eat beef or potato skins. Just a lot of different poisons in her, a lot for her system to handle.
So it seems like she is not ready to go just yet. We’re not ready to let her go yet, either—as long as she is comfortable and seems happy and not in any pain, we’ll hang on to her. The onco vet told us we will know when it’s time to let her die. She’s not under my chair as I write this and the void is huge—I can’t wait to bring her home.
We brought Ginger home about 5:30 on Saturday. What a difference—Friday we had to nearly carry her in and Saturday she was wagging her tail and lively and very happy to jump in the car.
They wanted to keep her longer, to try feeding her and seeing what happens. But Dr. Re said Ginger should go home as soon as possible since she is so nervous when she’s away from us. So they let us pick her up and sent instructions home for feeding her, with instructions to bring her back if she can’t keep food down or gets diarrhea again. The doctor at the hospital wanted to do a full ultrasound, which we weren’t too keen on unless it’s necessary. Dr. Re told them not to do one unless we had to bring her back, when they would need one to get a final diagnosis—which, right now, is chemo-induced illness and not something like pancreatitis or renal or liver pathology.
Her diet is supposed to consist of rice and boiled chicken sans skin or fat or spices of any kind. And we can feed her oatmeal. We’re supposed to do this for five to seven days. She is not happy about this. She inhaled her first meal at home: a cup of brown rice and a chicken thigh. We gave her another thigh while we ate dinner. She then spent the next couple of hours trying to get us to put her dog chow back down so she could eat it—she parks herself beneath whatever it is she wants and kind of huffs at us until we give in (we didn’t give in. Yet.)
And she’s not allowed to have a Greenie yet. Greenies make her very happy. When Jeopardy comes on and she hears the sounds made while listing the categories at the beginning of the show, that’s her cue, “oh happy happy joy joy it’s Greenie time ... ” Fortunately, Jeopardy isn’t on again until Monday.
So far, so good. Her lymph glands have done down considerably, probably due to the steroid injections she got in lieu of the prednisone, but it makes it easier for her to breathe. She’s still very tired, but not lethargic: she’s interested in what’s going on but is too tired to chase Slink yet. And she reeks—so it’s a bath on Sunday.
Since she didn’t stay for two days, we actually got some money back from our “deposit,” not a lot, but some. We asked if we could just contribute it to a fund for people who don’t any money to pay their pet hospital bill and they were very pleased to do this.
What’s weird is seeing the shaved areas on her foreleg and hind leg where they inserted catheters and IV tubes or whatever. We hadn’t realized they done this so were a little shocked when we took off the bandage.
She gets another chemo treatment this week—I’m a little nervous about this but trust that her oncologist vet knows what he is doing since the hospital is affiliated with the onco vets’ practice. Or her onco vet works there, or something.
I’m just happy that she’s home again and we have her for a while longer.
There was a comment in the FTD Support Forum mentioning an article about insight in the New Yorker. I managed to find a PDF of the article—I would’ve gone to the bookstore to buy it, but it was a bit late by the time I read about it—here is the link (PDF): The Eureka Hunt by Jonah Lehrer as published in the July 28 issue of the New Yorker.
Anyway, the article is about insight: where does it come from? How does it work? How do we suddenly just “see” a solution to a problem versus working through to the answer? Mark Jung-Beeman, a cognitive neuroscientist at Northwestern University, initially began studying the right hemisphere of the brain and became interested in insight during his research. From the article abstract:
“Jung-Beeman decided to compare word puzzles—or Compound Remote Associate Problems (C.R.A.)—solved in moments of insight with those solved by methodical testing. He teamed up with John Kounios, a psychologist at Drexler University, and they combined fMRI and EEG testing to scan people’s brains while they solved the puzzles. The resulting study, published in 2004, found that people who solved puzzles with insight activated a specific subset of cortical areas. Although the answer seemed to appear out of nowhere, the mind was carefully preparing itself for the breakthrough. The suddenness of the insight is preceded by a burst of brain activity. ... the anterior superior temporal gyrus becomes unusually active in the second before the insight. Once the brain is sufficiently focused on the problem, the cortex needs to relax, to seek out the more remote association in the right hemisphere that will provide the insight.”
“The brain area responsible for recognizing insight is the prefrontal cortex. Earl Miller, a neuroscientist at M.I.T., spent five years studying the prefrontal cortex. He was eventually able to show that it wasn’t simply an aggregator of information, but rather it was more like a conductor, waving its baton and directing the players. In 2001, Miller and Princeton neuroscientist Jonathan Cohen published an influential paper laying out their theory of how the prefrontal cortex controls the rest of the brain. It remains unclear how simple cells recognize what the conscious mind cannot. An insight is just a fleeting glimpse of the brain’s huge store of unknown knowledge.”
Kounios and Jung-Beeman found that
” ... people who solved puzzles with insight activated a specific subset of cortical areas. Although the answer seemed to appear out of nowhere, the mind was carefully preparing itself for the breakthrough. The first areas activated during the problem-solving process were those involved with executive control, like the prefrontal cortex and the anterior cingulate cortex. The scientists refer to this as the “preparatory phase,” since the brain is devoting its considerable computational power to the problem. The various sensory areas, like the visual cortex, go silent as the brain suppresses possible distractions.”
The executive function area of the brain keeps directing the search, looking through various areas of the brain such as speech and language centers, until, for example, you give up trying to find the answer or your work out the answer. But, once in a while, on the verge of giving up, the brain finds the answer, the insight, the “aha,” “Eureka,” “by Jove” moment when the answer is right there. Just before the insight, 300 milliseconds before, an area of the brain goes into overdrive: ” ... a small fold of tissue on the surface of the right hemisphere, the anterior superior temporal gyrus (aSTG), became unusually active in the second before the insight. The activation was sudden and intense, a surge of electricity leading to a rush of blood.” What the aSTG is or does or is supposed to do is still mostly unknown, but earlier studies suggested that this area is related to certain aspects of language comprehension ” ... such as the detection of literary themes and the interpretation of metaphors.” It appears that the right hemisphere of the brain is responsible for broader connections. Insight seems to work best when the brain is relaxed—during a shower, upon waking ... trying to get an insight, focusing on getting an insight, doesn’t usually work and actually inhibits insight. It appears that right brainers are more prone to flashes of insight while left brainers solve problems best through analysis. (Are you a right brainer or a left brainer? Here’s a test: The Right Brain vs Left Brain. This is a fascinating test—gotta ask Stanley about it, he probably saw this back in grad school days when he was studying cognitive psychology—I see her turning clockwise and can only see her reverse direction if I look at just a small part of her, like the foot.)
“The most mysterious aspect of insight is not the revelation itself but what happens next. The brain is an infinite library of associations, a cacophony of competing ideas, and yet, as soon as the right association appears, we know. The new thought, which is represented by that rush of gamma waves in the right hemisphere, immediately grabs our attention. There is something paradoxical and bizarre about this. On the one hand, an epiphany is a surprising event; we are startled by what we’ve just discovered. Some part of our brain, however, clearly isn’t surprised at all, which is why we are able to instantly recognize the insight. ‘As soon as the insight happens, it just seems so obvious,’ Schooler said. ‘People can’t believe they didn’t see it before.’ “The brain area responsible for this act of recognition is the prefrontal cortex, which lights up whenever people are shown the right answer—even if they haven’t come up with the answer themselves. Pressed tight against the bones of the forehead, the prefrontal cortex has undergone a dramatic expansion during human evolution, so that it now represents nearly a third of the brain. While this area is often associated with the most specialized aspects of human cognition, such as abstract reasoning, it also plays a critical role in the insight process.
There’s more, definitely worth reading, especially the section on the prefrontal cortex. It is helping to make it clearer to me why fronto-temporal dementia (FTD) (and all the variants) manifests the way it does, or is starting to make it clearer. I have to read it again. It’s kind of like the prefrontal cortex is the conductor of the orchestra that is your brain is forgetting the music, so is getting less and less able to direct the players. I have to think about this some more. So many questions ...