November 30, 2018

My strep appears to be back.

I've been feeling worse and worse since early September. Tired, tired and more tired. We did our Rainshadow Concert, with three two hour rehearsals in the evening that week, two concerts on the weekend. By Sunday evening my chest ached the way it did with the two rounds I've had with strep A, pneumonia and infected muscles. Strep A of the muscles hurts. All my muscles felt like a bad strep throat.

Anyhow, for October we put Mordechai, the clinic plastic skeleton, in the waiting room in a chair. We change her outfits and have two wigs and sometimes she has no wig or a hat. Partway through the month I gave her a sign: "Please wear a mask if you are sick." I had gotten a cold from someone who didn't put on a mask and I was just so tired. Had to cancel two days of clinic for that cold and then dragged the rest of the week and felt like crap all weekend.

Hoped to rest the four days over Thanksgiving. Now I was noticing the little creeping cough that was getting worse. This strain of strep A is not in the throat. It's lower, trachea and then will creep into pneumonia. Testing again and back on antibiotics.

And then a patient came back in after seeing me and the Urgent Care, creeping cough, in her upper chest, getting worse. The Urgent Care did a urine: she has a little protein. There should not be any protein. That's my bug, this strain causes a very mild proteinuria and walking pneumonia that can build up over 1-2 months. Damn it.

I went to my dentist. Asked how he was. "Fine, but my wife got a strep throat and they had to use two antibiotics. The first one wasn't working."

"Was the first one zithromax?"

"Yes." he said, puzzled.

"And then did they use penicillin or clindamycin?"

"Clindamycin. And that worked right away!"

"We have a strain around here that is resistant to zithromax. Dang it."

I've been seeing it every two years since 2012. Sigh. Guess I will dip a urine on anyone with a worsening cough. Because most of it's viral, but..... And zithromax is the go to for walking pneumonia. Now 50% of the strains of streptococcus pneumonia are resistant to it. Zithromax works still for Bordetella pertussis and Chlamydia pneumonia and Mycoplasma pneumonia....

There are over 4000 known strains of strep A, which is different from strep pneumonia.

Six days into the antibiotics and I am finally feeling human again. The last two weeks was so bad that I was falling asleep immediately after dinner, as early as 4:30 pm. This bug is so sneaky....

IRON NODER: TOKYO DRIFT

Back in September, I visited Chiloé. On the ride back on the ferry, crossing to the mainland, I thought about bow long it had been since I had been on a ship or boat. It seemed like a while. I tried to think back to when it had been a more common occurrence. And then I realized that other than my trip to Peaks Island, Maine in 2014, and to Port Townsend, Washington in 2015, it had been a long time since I had been on a boat or a ship. That, in fact, strangely enough, I had gotten to the age of 39 and had only been on a total of 5 or 6 boat trips in my life. All of those were ferry rides, other than one time in a canoe, and one time on a small pleasure boat ride around Puget Sound for an hour. Boats were familiar to me. The action seemed familiar, the process seemed familiar, but I had spend, in my life, less than 24 hours total on the water.

And I started thinking about that. I wondered how odd my experience was. And I started to research where that might not be true. Were there people where water travel was a normal part of life? I started scanning across Google Maps, mostly in the United States, but also around the world, and found out that for most people in the United States, boats and ships are not a common part of life. And even where they are common, they are not unavoidable.

Water used to be an important part of life. The opportunities that water travel afforded, and the obstacles that water barriers represented, greatly shaped human communities for thousands and thousands of years. In the days of ferrying and rough water, people living across a few hundred feet of water might develop a different community and culture. Or, conversely, someone 100 miles away by water might be easier to reach than someone 10 miles away over a mountain pass. For most of us, this connection, even though it is still important, is not an imperative part of every day life. So out of my own curiosity, I started researching these places, and imagining the ways that water connected and separated communities. I have tried to share a little of what I learned and thought about with you, this month. I hope it is not too tedious!

For me, it is not a trivial issue. I also wrote another writeup, trying to respond to an excellent writeup: The Past They Fantasize about was based upon a lie. People edit their memories, unconsciously. Things that would have been central to life in the past is overlooked by us. By asking seemingly trivial questions: "What would it be like if you needed to take a ferry every morning", "What would it be like to live on an island with only one store", I am trying to get myself to think more honestly about the way I live my life today. And that was my focus this month, and I hope you enjoyed it.

My classic looking mullet headpiece from 1960s mod Europe has been sliding off my sweaty bald head. It is frustrating when trying to conduct small business dealings or to lecture my class at the for profit university where I am a fully tenured professor of ethics who wrote the famous doctoral thesis called Ethics Under the Sea. Save your applause. I am your friend. You support me in everything I do and I will support you in whatever you do that I find myself in agreement with. This is the basis for ethics.

What I did was go down to this apartment in the old "neighborhood" where my mother and I scratched out a meager existence in the early 1970s (when America was great before) by eating live rats even though we had grocery money. We were on a stipend of some kind while my father worked for the CIA (while also serving in the Stasi and a commercial fishing endeavor out of Wales (part of the United Kingdom - might want to jot that down, sailor).

In this apartment lived an old barber, now in his 90s, who had cut all the kids' hair back in the day. I was put back in grammar school in my early 40s because my transcripts from Germany in the late 1930s were "suspect" according to them because they were from what they called "special government schools." I guess they didn't understand that we Germans weren't communists. We were real Americans.

I had this old timer with his shaky hands, wet spot in his trousers, and history of bothering neighborhood children use a staple gun to drive 37 of the longest staples the staple gun would hold through the well aged leathery material that made up the skull cap of the mullet headpiece, through the fleshy part of my head and straight through the hard skull (which is why you need a staple gun with extra long staples with the very sharp points). Despite tingly feeling that continues even now, as well as what can be described as sharp electrical shocks that happen intermittently (especially while I am walking or socializing with the ladies), I am enthusiastic about having taken this very mature and sensible decision. I love making mature, responsible, and sensible decisions. As an adult, I consider these three principles to be as important as The Holy Bible and The United States Constitution, which are the two documents I follow to the letter.

Regardless, tonight I am doing another performance in the "piss pit" at the local businessmen's club. I am enthusiastic to know my headpiece will stay on throughout tonight's show. A bigger bag of heroin would bring a bigger wad of cash with which I can cover my profit projection shortfalls this month. Good stuff.

My friends.