Month: October 2017

09:41 – It was 35.5F (2C) when I got up at 0700. Colin must’ve been tired. Instead of following me out of the bedroom as usual, he just stayed crashed out on the bed with Barbara. He finally wandered out at about 0745, looked up at me, and whined. So I took him out.

The antibiotics appear to be doing the job. I’m still not breathing completely freely, but it’s a whole lot better than it was.

I thought it was interesting that Dr. Ambler prescribed both azithromycin and cefpodoxime to be taken at the same time. My guess is that he was concerned that whatever organism is causing the problem might be resistant to azithromycin, and he didn’t want to dick around.

Co-dosing antibiotics and similar dosing strategies are getting more and more common as resistant bacteria become increasingly common. Using older antibiotics that have fallen out of favor is also getting common. For a long time, sulfa drugs were seldom prescribed, both because of their side effects and because many bacteria had developed resistance. After a decade or two of being used infrequently, the side effects are still an issue, but many formerly-resistant bacteria have lost that resistance. Even chloramphenicol, which kills about one in 20,000 or 30,000 patients who receive it, is being used a lot more frequently than it has been for the last 50 years.

One coping strategy that intrigues me is alternate dosing. Rather than administer antibiotics A and B simultaneously, you administer a dose of A but when it’s time to administer the second dose of A, you instead administer B. Then A, then B, then A, then B, and so on. So far, that’s known to work with only a few antibiotics with a few specific bacteria, but research on it continues, and it’s yet another arrow in the quiver. It’s odd that a specific species of bacteria can be immune to either A or B administered separately, and to A and B administered together, but not to A and B administered alternatingly.

09:39 – It was 33.6F (1C) when I took Colin out at 0645, mostly clear, chilly, and breezy. Our first real frost of the season is forecast for Wednesday.

It seems that I have some sort of lung infection. Before I went to the doctor yesterday, Barbara said she suspected walking pneumonia, which is the old term for an atypical pneumonia (one not caused by the usual suspects).

Barbara called Alleghany Family Practice and got me an 11:15 appointment, with Dr. Ambler. We signed up with the practice a year or so ago and both of us were assigned to him. I’d never seen him, and Barbara had seen him only a couple of times. She said he struck her as a good doctor.

He’s young. Mid-thirties, I’d guess. He and his wife, also an MD, moved here last year. They’d been practicing on an Indian reservation out in the Pacific Northwest, but decided that wasn’t where they wanted to raise a family. They were looking for a small-town, rural environment, which they found here.

Dr. Ambler seemed in no hurry at all. He spent probably 20 minutes asking me questions and checking me over. I weighed 181.4 pounds. My blood pressure was 130/80, which he said was fine given how I was feeling and where I was sitting. My pulse-ox was 97. (As he was using the clamp-on pulse-ox meter, Barbara said we needed one. I told her I’d get one on order.)

After he listened to my lungs, he said there was definitely something going on and he couldn’t be completely sure what it was without running CBC and Chem-7 panels and getting PA and lateral chest x-rays. He set those up while we talked, and then said he wanted to start me on antibiotics. The conversation went something like this:

Him: “Have you had any problems with your joints or tendons?

Me: “Oh, boy. I hope that doesn’t mean you’re going to give me Cipro or some other fluoroquinolone.”

Him: “I was going to prescribe Levaquin. Is there something else you’d prefer?”

So we talked about that for a while. I suggested doxycycline. He said that ordinarily that’d be fine, but there was quite a bit of resistance to it in this area. I asked if amoxicillin/clavulanate would suffice. He said he’d use it in cases of aspiration pneumonia (upper lobe), but what I had was lower lobe. He suggested azithromycin, which I agreed to. He also wanted to co-dose with a 3rd-generation cephalosporin. So I ended up with six 250-mg tabs of azithromycin, two to be taken the first day and then one per day for four more days, and 14 200-mg tabs of cefpodoxime, to be taken bid for seven days.

On our way out of his office, they drew blood to run the panels and then we headed across the street to the hospital. He’d set up the chest x-rays, which I got. While we were signing in for those at the front desk, I noticed a stack of those multi-color drug discount cards. Why not? I grabbed one for each of us and asked Barbara to try using it at Walgreens when we picked up my prescriptions. It worked, at least for the cefpodoxime. With just our insurance, that one would have been $84. With the discount card, it was half that. Still pretty outrageous at $3/tablet, but a lot better than $6/tablet.

As I expected, the effect was immediate. By yesterday evening, I was breathing a lot more freely, and wasn’t nodding off every few minutes. I probably should have just taken the levofloxacin, but the side effects scare me, in particular because they can be delayed weeks after one finishes the course of treatment.

09:21 – It was 52.6F (11.5C) when I took Colin out at 0700, overcast, damp, breezy, and nasty.

I’ve been ill since early this month. It started with some congestion and insomnia, which I almost never suffer from. My temperature was normal, so I figured it was just an allergic reaction to something that had started dumping pollen.

When I inhaled it felt like I was only able to inhale half as much air as usual. Barbara gave me a 12-hour Mucinex, which helped a lot. The first time. The second time, it helped, but not as much. After a couple of days on the stuff, I felt a pain in my lower back. Ruh-roh. Kidney stones are a side effect of guaiphenesin. Also, my fluid intake was down from my normal gallon or so (4 L) per day little over half that. So I discontinued the guaiphenesin and starting trying to force fluids. No lower back pain since then. I think the insomnia is an artifact of the breathing issue. I just can’t get comfortable, lying down, sitting up, whatever.

This morning, around 0400, I was thrashing around trying to get settled. I woke Barbara up, and she announced that she wasn’t going to go on her trip. She’s due to leave Friday. She said there’s no way she could enjoy herself, worrying about me the whole time.

So we talked about it some more, and I agreed to go to the doctor and get checked out. I hope it’ll just be a matter of him prescribing an antibiotic that’ll clear up the problem in a day or two. But even if that is the case, it wouldn’t surprise me if she decided to bag the trip and stay home to keep an eye on me.

I hate that. Barbara deserves some downtime doing things she enjoys. She shouldn’t have to stay at home to babysit me. But, on the other hand, I confess that the idea of being on my own here for ten days does concern me.

If she does decide to bag the trip, I’m going to insist that she still use that ten days as the closest she can come to being on vacation. Eating out a lot, taking day trips to various places near here, and so on. It won’t be the same as a real vacation, but it might be better than the daily grind.

09:21 – Friday the 13th falls on a Friday this month.

It was 55.5F (13C) when I took Colin out at 0625, overcast and drizzling. Barbara is heading for the gym and supermarket.

Until June of this year, news articles about the Yellowstone Supervolcano were pretty much background noise other than on some alt-right sites. Then came the news of a big cluster of small to medium earthquakes in the vicinity, which geologists reassured us were nothing to worry about. Then NASA announced that they planned to drill holes to allow them to cool the magma and reduce the probability of a catastrophic eruption. Or increase it, depending on who you listen to. Then came the news that some scientists are now saying they believe a catastrophic eruption is imminent, not just in geological terms, but on a human timescale. They’re saying an eruption may occur today, or perhaps 50 or 100 years from now. They’ve discovered that processes that precede an eruption and were formerly thought to occur over a period of centuries in fact occur over a period of only years to decades.

I’m starting to see MSM articles like this one on Fox News: Yellowstone supervolcano could blow faster than thought, destroy all of mankind

Leaving aside the hyperbole common to all headline writers, it’s pretty clear that a lot of people in and out of government are getting concerned. I’m not, simply because there’s nothing I can do about it. Depending on the scale and duration of an eruption and the amount of ejecta, such an eruption could range from catastrophic for the continental US and extremely serious for the rest of the Northern Hemisphere to an extinction-level event.

Even a modest eruption–if you can use the word modest in relation to a supervolcano eruption–could cover most of the continental US west of the Mississippi with anything from half an inch to three or four feet of volcanic ash. (Even here in Sparta, we could expect 1 to 3 mm.) The Northern Hemisphere would see another Year Without a Summer, if we were lucky. It could easily be a decade, a century, or more without a summer. The planet’s albedo would increase dramatically, and that would probably trigger the next Ice Age. Even if it didn’t, the grainbowls of the central US and Canada would be out of production for years to decades. Scores of millions of people would die from the immediate effects of the eruption, and the follow-on effects would kill hundreds of millions and possibly billions more.

And that’s assuming a moderate eruption, call it VEI 7.5. One on that scale occurred about 70,000 years ago and resulted in a bottleneck in the human population of the planet. By some estimates, we were down to less than 1,000 individuals remaining alive.

But Yellowstone has the potential to produce a VEI 8+ eruption. Call it 1,000+ cubic kilometers of ejecta. That would be a true extinction-level event, and there’s nothing that can be done to prepare for it. Other than relocating off-planet.

09:13 – It was 60.9F (16C) when I took Colin out at 0615, partly cloudy.

They’re still working on the house next door, but it looks as though things are winding down. The last few days, the flooring guy’s truck has been parked up there. It’s the same company and the same installer who did our downstairs and master bath flooring recently. He’s installing hardwood and ceramic tile throughout.

When Ricky and Kim bought the place at auction, they told us they were going to do a lot of work on it, but we didn’t expect as much as they’re doing. They basically gutted the interior, added a deck, replaced the windows, replaced the HVAC, and ripped out the floors and walls down to the joists. My guess is that they’ll end up spending as much on renovations as they spent on the house itself. When it’s finally ready for Grace to move in, I think she’ll be very pleased with it.

I spent two or three hours yesterday trying to get my Epson Perfection V350 Photo scanner working on my Linux Mint desktop. No joy. I’ve been using scanners on Linux boxes for 15 years now, with various scanners and various distros. Sometimes, it Just Works. Sometimes, it eventually works, but is a hassle to get set up. Sometimes, it works fine until a software update that borks it. Sometimes, I just can’t get it to work. This time, I actually started to wonder if my scanner was dead.

So I connected my notebook, which also runs Linux Mint, to the scanner. At first, I thought I wouldn’t be able to get it working, either. I did get it working with Image Scan! for Linux and xsane, although I haven’t tried to get the Epson scanner software working yet.