Gumption

The Indigo Girls' Zoo Tunes Concert

The Indigo Girls gave a concert Sunday night at Woodland Park Zoo's Zoo Tunes 2008 Concert Series that was, note for note, the finest music I've ever seen and heard live. I've attended - and reviewed - a fair number of other great concerts, but all of them have had at least one relative "low spot": one or more songs that just don't inspire or otherwise positively affect me (such low spots, of course, open up opportunities for bio breaks, of course). Last night's concert was just one, long, uplifting set, with no dips whatsoever ... which was fortunate, as I'd heard that lines for the honey buckets can get long at the Zoo Tunes concerts.

The concert was held on the closing day of Seattle PrideFest, and while it was not an official part of that event, it was clear that a large proportion of the audience was made up of gay and lesbian fans. I have a vague recollection of hearing / reading something about Amy Ray and/or Emily Saliers being lesbians, but I guess that sort of thing just doesn't matter to me - connection and alignment with spiritual and/or political views matters far more than sexual preferences, and I was reminded throughout the concert just how strong of an alignment I feel toward the music of the Indigo Girls.

I'm embarrassed to admit that while I've long been a fan of the Indigo Girls, and I recognized most of the songs they played, I didn't know the names of many of their songs (I scratched a few notes on what sounded like key lyrics in each song, and was able to search out the titles in composing the set list below). The rest of the audience, though, clearly knew the lyrics to many of these songs. I was initially surprised at the audacity of inviting the audience to sing along on the third verses (vs. choruses) of at least three songs - how many people know the third verse to, say, America the Beautiful - but the Indigo Girls clearly know their audience, and their audience knows them, as people were singing along loud and strong.

I'm also embarrassed to admit that I hadn't listened closely to many of their songs, but given the opportunity of a warm summer evening to relax and listen attentively, the "goose bumps" were flowing with every song (most significantly during "Galileo" and "Closer to Fine"). I have always enjoyed their music, but in the setting of the concert, I found deep, emotional resonance with nearly all of their lyrics. It dawned on me that by the time the band was producing commercial albums (1988), I had become more immersed in my "professional" vocation - I was a professor of computer science while in grad school to get my Ph.D. in the field - and less attentive to the domain of my early vocation - leader, lead guitarist and songwriter in a band I formed while in high school (two of whose five members are no longer alive). Thus my "use" of music had largely shifted from being a primary focus of attention to a background accompaniment as I read, thought about, taught about, and wrote code for and papers on technology projects. I don't foresee a big shift [back] in the near future, but I have been feeling a growing reconnection with my musical roots over the past several months, since joining Strands.

Getting back to the concert, Coyote Grace opened for the Indigo Girls, playing a great folksy bluegrass set to warm things up. Unfortunately, Amy (my wife) and I were in the beer garden for most of their 45-minute set, and with a cup of beer in my hand, I did not take any notes on their songs. However, when we got back to our blanket, just before they finished, I was surprised to hear one of the main duo, Joe Stevens, say something about "when I was a young girl" during an introduction to a song. Fortunately, I had my iPhone with me, so I opened up my Safari browser, googled "coyote grace" and read about their tag line - "Girl meets Girl. Girl becomes Boy. Girl and Boy become a band." - and further on, about how Joe is a "transman" (a term I hadn't read or heard before, but could instantly understand given the context).

Brandi Carlile, who has been touring with the Indigo Girls, made several appearances throughout the show, and her entire band, along with Coyote Grace, came out to join the Indigo Girls for their final few songs. Amy and I'd seen her play at Chateau Ste. Michelle a year or two ago, and enjoy her music (though not as much a the Indigo Girls ... and, to be honest, not as much as we enjoyed Coyote Grace, either). I'm not sure why Coyote Grace was the opening act for this particular show - perhaps something about it being PrideFest? - but we were glad to have the opportunity to enjoy some exposure to some great new music.

Before closing with the set list, I wanted to share a few tips for anyone considering attending a concert at Woodland Park Zoo. We parked in the south lot (off NE 50th Street, just west of Stone Way). Parking was easy - in and out - but it was a long walk to the concert grounds, which is at the north end of the zoo grounds. We lined up at 4:00 at the south gate, and were probably among the first 20 people in line. However we did not get very close to the stage, so next time, we'll try parking - and lining up - near the north gate or west gate. We set up near some shade near the back, but the shade shifted ... and we were sitting near a number of people who seemed more interested in talking with each other rather than enjoying the music (as a primary focus of attention). Next time we'll try getting close to the stage and forego the prospect of shade ... and I'm really glad that we have premium seats for the upcoming James Taylor show (one of our worst concert experiences was trying to listen to James Taylor at Tanglewood in the early 80s amid all the gabbing people who paid general admission for a nice summer evening picnic that just happened to have a live performance nearby).

Speaking of James Taylor - who we'll be seeing at Chateau Ste. Michelle in a few weeks - reminds me of one more thing I wanted to mention: rock stars, and how well they "age". We've seen James Taylor three times over the past 25 years, and he has put on fabulous concerts every time. In contrast, we were rather disappointed in the Crosby, Stills and Nash (CSN) concert at Chateau Ste. Michelle in 2004: the vocal range of all three had diminished considerably over time - especially Stephen Stills, still one of my guitar heroes - as had their energy ... and ability to energize me. Fortunately, though, when we saw Crosby, Stills, Nash and Young (CSNY) at White River Amphitheatre last year, the addition of Neil Young was a tremendous energy boost, and that concert was great.

There was no visible or audible signs of "wear" in the Indigo Girls - they still have full vocal range and lots of energy ... although they have only been performing (in the large) for half as long as either Taylor or CSN[Y]. One thing I was rather surprised at, though, was the relative absence of politics throughout the concert. The CSNY concert last year was very political - almost uncomfortably so (but I think that was their goal) - and I would have thought the Indigo Girls might also use their podium to promote political causes. They did promote a couple of "get out the vote" organizations, but other than that, they just played their music. We did see a cardboard life-size figure of Barack Obama being carried into the concert, but there were no endorsements of candidates - or causes - during the concert. I suspect that there were few registered Republicans at the concert, and given that the Democratic Party primary is over, perhaps they figured there's no sense preaching to the choir. I do have the audacity to hope, though, that this rather apolitical appearance does not reflect apathy among these voters.

Anyhow, here is the set list, as far as I can make it out:

• Become You (Become You)
• Pendulum Swinger (new)
• Power of Two (Swamp Ophelia)
• Oziline (Come On Now Social)
• Heartache for Everyone (All That We Let In)
• Get Out the Map (Shaming of the Sun)
• Shame On You (Shaming of the Sun)
• Virginia Wolff (Rites of Passage)
• Sugar Tongue (new)
• Johnny Rottentail (Stag)
• Don't Think Twice It's Alright (Bob Dylan cover)
• Kid Fears (Indigo Girls)
• Galileo (Rites of Passage)
• Closer to Fine (Indigo Girls)
• Tried to Be True (Indigo Girls) - encore
• Least Complicated (Swamp Ophelia) - encore

Hanging Loose in Maui: a Whale of a Family Vacation

We spent a relaxing mid-winter break in Hawaii last week, staying at the Polo Beach Club in (or near) Wailea on Maui, the same spot where Amy and I honeymooned nearly 20 years ago. This stay was a little different than the last time - I don't want to say the honeymoon is over, but we are no longer newlyweds (or not "just Mauied", in local tourist T-shirt jargon), and staying there with a 16 year old daughter and 12 year old son added an entirely new dimension to the experience.

The area is far more developed than the last time we visited, when it seemed like the Polo Beach Club was the only sign of human habitation in sight (the photo in the top right is from around that time period)... and in some dimensions, I suppose we are more developed - as individuals, as a couple and now a family. After walking, driving and kayaking around the area, I still think this is the best place to stay in Maui, if one wants to get "up close and personal" with the ocean ... and its inhabitants.

Aside from familial changes, one of the key differences this time was seasonal changes, as we were visiting in February rather than August ... whale season (!). We saw hundreds of whales [and we really saw whales this time, unlike the last time I wrote about watching for whales, but [only] seeing what I wanted to see (rather than what really was - or, more specifically, was not - there) during our last family vacation, along the Oregon coast]. I snapped hundreds, but ultimately uploaded only a few dozen, of photos of the humpback whales we saw off Maui to my Flickr account. We saw them from our balcony, we saw them from the beach, we saw them from kayaks, we saw them from our car, we saw them from restaurants and shops ... we saw them nearly everywhere we went.

We could also hear the whales singing when we went snorkeling - sometimes rather loudly. Prompted by a comment by Dana on an earlier post on music and personality, I discovered a transcript from the log of the 5 year Voyage of the Odyssey entitled The Ocean's Elaborate Composers, which offered more information about the whale songs:

A song can be defined as one or more notes that are repeated in a pattern. Technically, the repeated sounds of birds, frogs and even crickets are songs. Yet, it is the song of the Humpback whale that is the most grand and complex in the animal kingdom.

As Roger Payne wrote in his book, Among Whales -

"They are divided into repeating phrases called themes. When the phrase is heard to change (usually after a few minutes), it heralds the start of a new theme. Songs contain from two to nine themes and are strung together without pauses so that a long singing session is an exuberant, uninterrupted river of sound that can flow on for twenty-four hours or longer".

Themes are sung in a deliberate order, with the entire song lasting anywhere from a few minutes to half an hour. Humpbacks even employ rhymes in their songs; perhaps this helps them to remember them, a trick which is also used in human composition. Male humpbacks have been known to sing for hours, even days.

We made recordings of each vocalization throughout the afternoon. Each song lasted an average of seventeen to twenty minutes before the animal surfaced. The whale took only three breaths in quick succession before diving again.

Remarkably, all male humpback whales from the same population sing the same song, while the songs of each population are quite distinct from one another. This means that the structure and content of all of the songs we recorded today are the same, yet different from a whale that may also be singing today in his mating grounds in the Pacific or Atlantic Oceans. As Roger Payne observed "Humpback whales change their songs continually so that after about five years they are singing an entirely new song and apparently do not ever return to the original".

I was delightfully obsessed with the whales during our stay ... but I'll move on to another obsession: photography. Shortly after starting our Oregon vacation, the scenery was so beautiful along the coast that I went out and bought a Canon EOS 40D / Digital Rebel XTi (my first digital SLR camera). Shortly after starting this vacation, and seeing all the whales, and feeling frustrated with not being able to get closer to them (photographically speaking), I went out and bought a Canon EF 75-300mm f/4-5.6 III USM Telephoto Zoom Lens - and a Dakota Elite Weatherproof 10x42 Binocular (to watch whales without photographing them) from Ritz Camera. While I was happy to be able to take many more closeup photos of the whales during my stay, upon closer inspection, few of the images were not blurred (one of the reasons I uploaded so few photos to my Flickr account), so I plan to return the lens for one of the Image Stabilization (IS) lenses (perhaps the ultracompact Diffractive Optics (DO) version).

We did make attempts to get physically closer to the whales. We enjoyed a two-hour Hawaiian sailing canoe adventure on the Hina (which docks - or I should probably say "beaches" - at the Fairmont Kea Lani Hotel, next door to the Polo Beach Club), during which we learned about the local geography, history, ecology and culture, and saw sea turtles and numerous colorful fish while snorkeling. Unfortunately, although most of the times we saw the Hina from our condo, it was near whales (an example is shown in the photo to the right), we saw no whales from the Hina the day we went out, though we did hear them while we were snorkeling.

So, another day, we rented two-seater sea kayaks - also at the Fairmont Hotel beach - and set off on our own to get up close and personal with these magnificent mammals. We managed to approach within approximately 100 yards of a few whales - which is, as I understand it, the closest that any boat is supposed to get to a whale - but not nearly as close as some other kayaks seemed to get (an extreme example is shown on the left). However, we got close enough to enough whales that the kids decided that they didn't want to go out on a whale watching boat at the Pacific Whale Foundation. We read about a boat that had gone out two weeks before we arrived that had been the victim of a "whale mugging", where they were stranded in the water for over an hour while whales were swimming around the boat (boats aren't supposed to move when whales are within 100 yards). In retrospect, I think it would have been fun to go out on a whale watch boat the first day, if only to learn more about - and thus be able to better appreciate - the whales we saw (and heard) so much of.

We also went snorkeling in the Ahini-Kinau Preserve, down around the southern tip of the island - well some of us did (Amy, Meg and me ... Evan had a sore ankle that morning). We saw more sea turtles, tropical fish and coral ... and as the preserve volunteers warned us, discovered that "the rocks are alive" - I cut my thumb and finger, and got a sliver of some kind in another finger, while walking on my hands out beyond the shallow, rocky area on the shore. We rented snorkeling gear from Maui Dive Shop - $25/week for the "deluxe" package (which comes with better gear than the $15 "standard" package) - and I think it would have been worthwhile to inquire about and/or invest in gloves, as I saw many other snorkelers wearing. Also, even though we snorkeled in the morning (around 9:30 or 10:00), I got sunburned after only 45 minutes, so wearing sunblock and/or a tee shirt, even before "peak" sunlight hours, would also have been worthwhile ... an aspect for which I could have been better prepared if I'd read up on some snorkeling tips before setting out. Fortunately, this happened on our last full day on the island, so it had minimal impact (there).

Back on terra firma, another obsession I / we indulged during the vacation was gustatory exploration. Among our favorite restaurants from this visit are:

• Spago (best combination of food, service, decor and view, most romantic ... and most expensive)
• Sansei (tie for best food and service, with good decor but no view)
• Mama's Fish House (very good food, service and view)
• Tommy Bahama (very good food, service, decor and entertainment, but no view)
• Seawatch (good food and service, very good decor, outstanding view, site of family photo op to the right)
• Who Cut the Cheese (not a restaurant, per se, but a wine & cheese shop where we picked up an array of fine cheeses - including 5 year old Gouda and Roaring Forties - and a bottle of Hartford 2005 Russian River Zinfandel, which we enjoyed back at the condo)

Full reviews for all of these restaurants - with more details about which menu items and other specific aspects we liked (and didn't like), and several photos I took at each one (with my iPhone, not my Canon telephoto lens) - can be found on my Yelp profile page. I'll simply note that we tried - and enjoyed - Ahi rolls of some kind at nearly all of these establishments ... and include a few sample photos below.

We ate a lot of fish while on Maui, and Evan was initially interested in indulging a related passion (that isn't quite an obsession ... for him ... yet) - catching fish. We'd gone fishing during earlier vacations to Cabo, Mexico (which was great), and Tampa, Florida (which was not so great), so we looked into possibilities on Maui. I found an excellent web site on Maui sport fishing, created and maintained - I might say "captained" - by Captain Mike Crawford. Captain Mike was very helpful - via telephone and email - in helping us explore the different options regarding harbors, fishing times, days and the age of my son (and my desire to be simply a "rider", as I'm not much of a fisherman). Unfortunately, I didn't contact Mike early enough to find a boat that would fit our schedule - and our desire for a relatively short trip - but maybe next time.

One dimension of potential obsession that we observed but in which we did not indulge was Mustang convertibles. I've never seen so many Mustang convertibles before. I can't remember what kind of car we rented in 1988, but the 1988 Ford Mustang was not a car that I found particularly appealing, and I doubt I would have been willing to pay an upgrade fee to drive one. In 2008, however, I would have gladly paid extra to drive one of the new 2008 Mustang convertibles ... but alas, with four people, and a full load of luggage, that would not have been practical (or even possible, without renting a second car). Instead, we got a free upgrade to a Cadillac, which was fine.

Speaking of car rentals, some of the lessons we learned about traveling to / from / within Maui include the following:

• The Enterprise Rental Car facility near Kahalui Airport (OGG) closes at 9:00pm. I nearly always use Enterprise wherever I go (I've waxed poetic about my experience of great customer care at Enterprise - and United Airlines - in an earlier blog post), and had a reservation with Enterprise this trip, but when our flight out of Los Angeles was delayed, we were rescheduled to arrive around 10:00pm. Fortunately, although the Hertz counter at OGG [also] closes at 9:00pm, the off-site facility stays open until 11:00pm, so I was able to book a new reservation at Hertz - for a lower rate than I'd gotten many months ago when I originally booked the Enterprise reservation - while we were waiting at LAX.
• The United Airlines ticket counter at OGG has a priority line for their Premier, 1K, First Class and Global Services members. However, the agents behind the counter did not accord any priority to people in this line (while we were in it). There were only two agents in front of the priority queue, and another five in front of the main queue; when one of the priority queue agents got sidetracked - for at least the half hour we were in line - helping one family, none of the other agents to the right appeared to notice or respond by signaling to people waiting in the priority queue ... and, unfortunately, none of the people ahead of us in the priority queue appeared to be sufficiently assertive to compensate for this lack of agent response (perhaps they were still on "island time") ... until I stepped forward to offer some gentle "prompting". This was all after having the unexpected extra measure of some kind of agriculturally-focused luggage pre-screening, and before the long security lines, which unlike SEA and LAX (and SFO and nearly every other U.S. airport I've been to), did not have a priority queue for frequent fliers with "status". I mention all this because we arrived at the airport with the recommended 90 minutes of lead time for our 10:00pm "red-eye" flight, which I expected was more than enough time, given the priority queues I'm used to elsewhere, and we barely made it through all the lines in time for our flight (which they had intended to have depart early). So, [frequent] flier beware!

Despite the sleep deprivation of the red-eye flight, compounded by a [scheduled] 2+ hour layover in San Francisco on the way back to Seattle, we would still choose this option again - though allotting 2 hours for navigating the queues at OGG - as it allowed us an extra day of sightseeing and whale watching (from shore), culminating with a delicious sunset meal at the beach (at Mama's), a fitting end to a Maui-velous vacation.

Locked-in Syndrome: Diving Bells, Butterflies, Freedoms and Families

Amy and I recently saw The Diving Bell and the Butterfly (or, more properly, Le Scaphandre et le Papillon), during an unexpected extended layover in San Francisco. The movie is about the late Jean-Dominique Bauby, former editor of the fashion magazine Elle, who at age 43 suffered a stroke that left him paralyzed except for his left eye, after which he continued to suffer for the next 12 years from locked-in syndrome - aware and awake, but unable to communicate. Fortunately (at least for viewers and readers), a dedicated speech therapist (Henriette) was able to open up a new communication channel for him - through repeatedly reciting a frequency-sorted version of the alphabet and watching for him to blink his eye when she reached the desired letter - and a dedicated transcriber (Claude) was able to navigate this channel with him to help him get his story out. And that story is a powerful one, touching on the challenges he faced in dealing with his highly constrained condition, and its effects on his opportunities - past, present and future.

The diving bell in the title is an allusion to the restrictions imposed by his physical condition, while the butterfly refers to the relative freedom of his mental and imaginative capacities that he appreciated - and indulged - all the more after the stroke. What struck me most about the film was that we all suffer some degree of locked-in syndrome - unable (or, perhaps more often, unwilling) to communicate effectively with the people around us. I do not mean to imply for a moment that most of us suffer anything close to the incredible challenges Bauby faced, but the movie did offer me an opportunity to reflect on how often I underutilize communication channels in my own life (this blog notwithstanding).

I remember one time, at the beginning of a surgical procedure, I had been given anesthesia, but it had not yet taken [full] effect before someone started inserting a tube down my throat. I tried to alert the medical staff to the pain I was feeling during this part of the procedure, but was unable to move or talk, and the fear I felt about being so incapable of communicating my predicament was at least as painful as the insertion itself. This was a far more dramatic example of feeling locked-in than most of my experiences, in which I am able to communicate, but unable to effectively convey something I am thinking or feeling to another person ... or situations in which I consciously or unconsciously choose not to communicate at all.

Bauby, of course, could have also chosen not to communicate. It required far more effort for him - and for the people with whom he was communicating - than it typically does for me (and presumably, however ponderous my writing and speaking may be, for the people with whom I communicate), and his willingness to make that effort to not only communicate with the people around him in his activities of daily living but to dictate a book about his experience is inspiring. I was reminded of a Richard Bach quote,

Argue for your limitations and sure enough, they're yours

as well as the lyrics to the Eagles song, Already Gone [video],

So oftentimes it happens that we live our lives in chains
and we never even know we have the key.

Another aspect of the film that moved me was Bauby's relationship with his children ... and their mother (Celine, to whom he was not married). After his stroke, his ability to interact with them was extremely limited, illustrated by a picnic on the beach, during which they play the word game hangman. Amy and I were watching the film on the eve of my "homecoming" - after having commuted nearly every week from Seattle to Palo Alto (or other business-related destinations) for 16 months - and so the lost opportunities for enjoying time with his children was especially poignant ... as was his continued underappreciation for Celine.

Bauby's relationship with his father was also very poignant (for me). Early in the movie, while Bauby is shaving his father (Papinou), his father expresses how proud he is of his son, which brought back memories of my own father expressing pride and approval - as best he could - for his son ... as well as more painful memories of him not expressing pride or approval ... for his son or himself. [In writing this, I'm struck by how my father suffered from a form of locked-in syndrome, tightly bottling up his emotions, which eventually started leaking out in various ways, shapes and forms.]  In my last conversation with him before he died - in 1996 - I was talking with him about the three job offers I had as I was nearing the completion of my Ph.D. One would have enabled me to continue working text-based information extraction; a second would have enabled me to work in the related area of speech interfaces; the third, which seemed both the most promising and the most challenging - what he called "the big job" - would have enabled me to work on something completely different. His last words to me were "Take the big job. You can do it!" I did take that big job - I felt the fear and did it anyway - but I never saw him [alive] again. Although I have many memories of episodes in which I did not receive much-desired approval (from him ... and other authority figures in my life), I'm glad to have the most recent - and lasting - memory be an example of explicit and enthusiastic approval.

During the shaving scene in the film, Bauby expands on this theme, noting "We all are children. We all need approval." Andrea Gronvall expands this theme even further, in her Chicago Reader review:

The Diving Bell and the Butterfly inter-twines the need for validation—which is tied to the impulse to create—and the inevitability of isolation and death. Locked in, Jean-Dominique Bauby wrote a luminous treatise on life and love, leaving behind a work of art that says “I was here and I mattered.” [Director Julian] Schnabel honors that impulse with this mature, resonant portrait of an artist.

This need for approval ... for validation ... for appreciation ... for mattering ... is something I continually struggle with. As I noted in an earlier post on living without a goal, and mattering without being useful:

I can't honestly say I'm entirely willing to release my attachment to others' [expressions of] appreciation at this moment -- despite the opportunities for practicing such detachment currently being offered me -- but I'm at least willing to re-open the question of whether and how I matter ... and if it is possible to matter without being [acknowledged as] useful to others.

And so I guess I'm still in the question ... perhaps locked-in to the question ... and in the current context, I'm wondering whether the answer - or the key - lies along the path of the butterflies.

Six month update on my elbow Platelet Rich Plasma (PRP) treatment

Amid the broad range of emotions and activities in which I'm engaging this week - a sad last week at Nokia before an exciting new start at MyStrands - I was able to schedule an appointment for my 6-month followup visit with Dr. Mishra regarding progress on the platelet-rich plasma (PRP) treatment for my right elbow. [I am very grateful for Kevin's recent comment on an earlier PRP-related post, and an email from Mark, who had commented on my first elbow PRP post - and who has since also undergone the PRP treatment - which reminded me that I needed to schedule this appointment before I leave town.]

I was not looking forward to the visit, in part because I have not been diligent in my theratube exercises (probably averaging once every three days rather than three times per day since my three-month PRP checkup), and in part because I thought that if I wasn't 100% back to normal by now, I would have to choose between surgery and living with my elbow's current status, which is probably around 90% of pre-tendonitis strength (and absence of pain).

However, my fears, as is so often the case, were unfounded - at least with respect to the latter one (I should [still] resume more diligent theraband exercising). I found out that it can take up to 12 months for the full effects of PRP to manifest themselves, so the fact I'm not completely "cured" is not surprising, and in fact, my current status, in which I rarely feel pain greater than 3 (on a scale of 10) - even after moving a humongous solid oak entertainment center from our bonus room to the garage last weekend - is a significant improvement over the last checkup.

During this visit, I was able to exert 135 pounds of grip strength with my right hand with a subjective pain level of 1 (vs. 120 pounds of grip strength with a pain level of 4 at the 3-month mark), and was able to resist attempts to pull down my upturned or downturned hand with a pain level of 1 or 0. As I noted earlier, during my first visit, I was only able to exert 65 pounds before I hit the wall (of pain) at level 9, and my resistance was lower and pain higher for the upturned hand exercise. It is relatively rare for my elbow to be sore - except after I move heavy furniture or engage in repetitive motions for extended periods.

Among the differences I've noticed in the past 3 months were:

• being able to carry around and drink from my 20-oz coffee mug with no pain
• being able to carry heavy furniture with some pain (I would not have even attempted to move the entertainment center 3 months ago)
• being able to do pushups with little pain (again, I would not have attempted pushups 3 months ago)

Dr. Mishra was actually quite encouraged - and encouraging - about my prospects for eventually regaining full use of the elbow with little or no pain! And, even better (to me), he suggested that if I have not reached that status by the 12-month mark, given the progress I've shown thus far, he would now recommend a second PRP treatment rather than PRP + surgery (which is what I thought would be the next step).

So, once again, my optimism is restored. I just did a round of theratube exercises (that makes 3x today), and will gradually start experimenting with exercising more regularly - pushups and perhaps even full-scale elliptical training (now that I'll be home - where we have a Precor FX - more regularly) - though ramping up on an [uncharacteristically] gradual slope. I will also restart my yoga practice.

I noted in my response to Kevin's comment that Dr. Mishra's PRP web page had a link to the Total Tendon Network, and that while I was excited about encountering my first Ning network "in the wild", it appeared to be a site targeting [only] tendon care providers:

This is a group of providers dedicated to improving the diagnosis, treatment and prevention of tendon related disorders.

Dr. Mishra told me that the site was, in fact, intended for both providers of treatment and patients who are receiving, or considering receiving, treatment (he said he will change the text on the login page - and said he requires login to ensure some level of quality control on this social network). I've signed up, but am still waiting for "approval", and so will report further on the Total Tendon Network during my next update ... probably around six months from now.

Sex and the Nice Guy: My Cousin, Tom Spath, at the Hollywood Improv

My cousin, Tom Spath (or, as we've always called him, T.J.), is a funny guy, in fact, he's one of the funniest guys I know. He recently premiered at the Hollywood Improv, where he delivered a hilarious 6 1/2 minute standup performance exploring issues such as sex, laundry, serial killers, household appliances, nutrition, gratitude and funerals (and did I mention sex?). Highly recommended.

[Update: as evidence that TJ/Tom can take it as well as dish it out (er, pun intended), The Bobs recently released a song, Tom Spath, in his "honor", invoking the metaphor of a bagel, on their new CD, Get Your Monkey Off My Dog.]

Continuous Improvement of our Thanksgiving Meal

We were searching around for our turkey recipe and then I remembered I'd blogged about brining and grilling a turkey last year, so I just went online to follow the instructions there (or perhaps I should say "here"). The post reminded me not only of the recipe, but of my pledge to not overcook the turkey "next time" ... and that Chateauneuf-du-Pape is a good accompaniment to the meal (my cousin-in-law, Richard Gagnon, wine manager at Brattleboro Food Co-op, first introduced me to this unusual pairing).

Among the variations this year:

• My mother and father-in-law stepfather are visiting (last year, Amy's aunt, cousin, cousin-in-law and their daughter were visiting ... and I forgot to take a picture of the people (!)).
• We bought a heritage turkey (just under 14 pounds) from our local PCC Natural Market.
• I checked the bird 15 minutes before it is supposed to be done (it was done at exactly the right time - 2 hours, 40 minutes, at 350 degrees - and was not overcooked, I'm glad to say).
• A newly discovered bacon Parmeson Brussels Sprouts recipe was a big hit with everyone.
• The mashed sweet potatoes were also tasty.
• The 1998 Domaine de Villeneuve Chateauneuf-du-Pape "Ville Vignes" (which we enjoyed last year) and the 2000 Domaine de la Janasse Chateauneuf-du-Pape "Chaupin" were outstanding; the Janasse had more fruit, body and depth, and [so] I preferred that one. Both are predominantly based on the Grenache grape, and so I may experiment with some single varietal Grenache next year, and perhaps a bit of Cinsault (Chateau Ste. Michelle offered their first single varietal bottlings of each grape this past year, and both sold out very quickly to Wine Club members).

On a separate but related note, an email exchange earlier in the day with Dan, who had posted a comment on last year's blog entry about his own firey experience with flaming grilling a turkey, assured me that he would be practicing safe[r] cooking this year.

Three month update on my elbow Platelet Rich Plasma (PRP) treatment

On Monday, I had a followup visit with Dr. Mishra to evaluate and discuss progress and prospects for the restored health of my right elbow, three months after my treatment with Platelet Rich Plasma (PRP). One week after treatment, things had gotten worse (though, as Dr. Mishra had warned, this is often the case shortly after treatment). At the one-month mark, my elbow was feeling pretty much like it had just before the treatment. At this point, I'm happy to report that my elbow feels better than it did before the treatment, though still not as well as it felt before the initial injury.

Among the daily activities that I have resumed doing with reduced pain are

• drinking my 22-ounce mug of coffee with my right hand
• doing full-form yoga sun salutations (including the elbow-loading cobra pose and downward-facing dog pose, which I'd been omitting from my routine until recently)
• flossing my teeth with regular dental floss (vs. floss picks)
• scrubbing pots & pans

On Sunday, I was moving our four 20-pound Lafuma recliner chairs from the deck to the garage (one at a time), requiring a relatively significant amount of elbow strength and agility (given the rather cramped state of our garage). Although my elbow was sore afterward for a few days, I was surprised I was able to pick the chairs up at all - and, as with some of the activities I mentioned in my last update, I probably should not have pushed (or pulled) that hard.

During the visit on Monday, I was able to exert 120 pounds of grip strength with my right hand with a subjective pain level - at the limit - of about 4, and was able to resist Dr. Mishra's attempt to pull down my upturned hand with a pain level of 3. During my first visit, I was only able to exert 65 pounds before I hit the wall (of pain) at level 9, and my resistance was lower and pain higher for the upturned hand exercise.

I was feeling pretty awful at the one-week mark, and was [still] rather disheartened at the one-month mark (though the email and comments on that post helped cheer me considerably). I have to say that I'm feeling much better at this stage - physically and emotionally - about my present condition and my future prospects for continued healing. I think Dr. Mishra is also encouraged at the progress in the last two months.

So, the current plan is to continue doing the stretching and theratube resistance exercises, hold off on resumption of more comprehensive strength training (for the right arm at least) and repetitive exercises (e.g., elliptical trainer with moving arms) and very gradually [continue to] extend my activities to accommodate more loading of the elbow.

I'll be going back for another followup at the six-month mark (second week in January), by which point I should have achieved about as much progress as I can expect from the treatment. I'm a little more optimistic about full - or nearly full - recovery, but there is still a chance I'll ultimately need surgery.

I've been in communication with a number of people who are considering or undergoing PRP treatments for their ailments. I wish you all the very best progress in your consideration and/or healing processes, and will do my best to honestly share my experience, strength and hope through exchanges of comments on this blog or via email.

[Note: I prefer communicating via blog comments, as many of the emails also contain gems of wisdom - and inspiring experience, strength and hope - that I'd like to share more broadly, i.e., through this blog, but I understand that some (many?) people are not comfortable posting public comments on blogs - er, perhaps particularly on this blog, given my recent tirades on spampliments - and so anyone who prefers email can also use the "Email me" link below my "thinking spot" photo at the top left.]

[Additional note (2007-10-11): NPR ran a story on Morning Edition today on how and why Patients Turn to the Internet for Health Information, based primarily on the recent Pew Internet study on E-patients With a Disability or Chronic Disease and a University of Wisconsin 17-year study called Comprehensive Health Enhancement Support System (CHESS) ... one of the programs in the similarly acronymed Center for Health Enhancement Systems Studies.

Here's an abstract from the Pew study:

About a fifth of American adults say that a disability, handicap, or chronic disease keeps them from participating fully in work, school, housework, or other activities. Half of those living with a disability or chronic disease go online, compared to 74% of those who report no chronic conditions. Fully 86% of internet users living with disability or chronic illness have looked online for information about at least one of 17 health topics, compared with 79% of internet users with no chronic conditions.

Those with chronic conditions are more likely than other e-patients to report that their online searches affected treatment decisions, their interactions with their doctors, their ability to cope with their condition, and their dieting and fitness regimen.

My decision to seek PRP treatment for my elbow was due to chronic tendonitis / tendinosis. I didn't do all that much research on the Internet (compared to other things I research), but since Dr. Mishra offers an alternative treatment (to surgery), is located very close to where I work, and is a blogger himself (!), I decided to visit him. I did get second (and third) opinions, from the doctor I'd seen for earlier episodes of elbow "flare ups", and from one of my cousins, who is an orthopod, and both agreed that non-surgical intervention was generally preferable over surgical intervention, and PRP seems to offer a reasonable cost/benefit ratio (based on how little we know yet on its long-term efficacy from larger-scale trials).

The people who have contacted me through email and comments on my blog posts have clearly done far more online research - and in many cases, suffered more and longer from chronic conditions - than I have ... and, of course, I'm not quite sure how much online research has been conducted by other readers of my PRP-related posts. In any case, I think we offer, collectively, a number of data points to corroborate the Pew findings.

I can't find the CHESS study referenced in the NPR story, but I did find another one that is interesting and somewhat relevant (and also related to my recent rant on fundamentalism in a post on Blessed Unrest), Effects of prayer and religious expression within computer support groups on women with breast cancer (press release), where they found:

As hypothesized, writing a higher percentage of religion words was associated with lower levels of negative emotions and higher levels of health self-efficacy and functional well-being, after controlling for patients' levels of religious beliefs. Given the proposed mechanisms for how these benefits occurred and a review of the support group transcripts, it appeared that several different religious coping methods were used such as putting trust in God about the course of their illness, believing in an afterlife and therefore being less afraid of death, finding blessings in their lives and appraising their cancer experience in a more constructive religious light.

I do not know the religious beliefs of the scientists who conducted the study (or other studies purporting to find a link between prayer and health), but as scientists, we have to be extra careful to not fall into the very human trap of seeing what we want to see (particularly when trying to study others' behavior that I believe amounts to seeing what they want to see). The New York Times ran an article on "Long-Awaited Medical Study Questions the Power of Prayer" last March reporting an American Heart Journal study - "Study of the Therapeutic Effects of Intercessory Prayer (STEP) in cardiac bypass patients: A multicenter randomized trial of uncertainty and certainty of receiving intercessory prayer" - that reports intercessionary prayer - praying for someone else's health (without their knowing about it) - has no measurable impact on the recipient of that prayer. What's interesting in the CHESS study (to me) is that it looks at the impact of prayer on the sender vs. receiver (or subject vs. object) of prayer - the person who is praying ... and although I don't know of any scientific justification for this, I do believe in  the power of positive thinking (and speaking (and writing)) ... which is why I so often find myself preaching what I want to practice, if not praying about it.]

[Yet another update (2007-10-12): Another study verifies the power of positive thinking:

Research is showing the power of expectations, that they have physical -- not just psychological -- effects on your health. Scientists can measure the resulting changes in the brain, from the release of natural painkilling chemicals to alterations in how neurons fire.

Among the most provocative findings: New research suggests that once Alzheimer's disease robs someone of the ability to expect that a proven painkiller will help them, it doesn't work nearly as well.

It's a new spin on the so-called placebo effect -- and it begs the question of how to harness this power and thus enhance treatment benefits for patients.

"Your expectations can have profound impacts on your brain and your health,'' says Columbia University neuroscientist Tor Wager.

The report referenced above contains yet another link to a study reporting that optimists live longer, but I think I've done [more than?] enough lateral drifting for one post.]

Celebrating the Future Within ... Everyone?

Amy and I attended the Jubilee Women's Center's 10th Annual Benefit Breakfast on Wednesday, which had the inspiring title "Celebrating the Future Within" ... and a correspondingly inspiring program that included several women recounting their challenges, and now the Jubilee Women's Center helped them rise to meet those challenges. Our good friend, Mary, is on the Board of Directors for the organization, which is why we were there.

Jubilee is a transitional housing facility that offers homeless single women from ages 21 thru 60 a safe place in which to live and renew themselves. Women pay $250 / month for rent - the rest of which is subsidized through donations (such as those that are made during the annual breakfast) - and are offered a variety of training classes to help them become more self-reliant, both personally and professionally ... as Meeghan Black, of KING 5 TV, the MC for the event noted: these training classes sound like something everyone could use.

Deacon Steve Wodzanowski from St. Joseph Parish led the invocation, which was - synchronistically (for me) - based largely on a poem, The Journey, from Mary Oliver, a portion of which I'd referenced in my last post (on Blessed Unrest (which was based largely on Paul Hawken's book of the same name)), though he recited the full version, which I'm going to include here:

The Journey

One day you finally knew
what you had to do, and began
though the voices around you
kept shouting
their bad advice -
though the whole house
began to tremble
and you felt the old tug
at your ankles. "Mend my life!"
each voice cried.
But you didn't stop.
You knew what you had to do,
though the wind pried
with its stiff fingers
at the very foundations,
though their melancholy
was terrible.
It was already late
enough, and a wild night,
and the road full of fallen stones.
But little by little,
as you left their voices behind,
the stars began to burn
through the sheets of clouds,
and there was a new voice,
which you slowly recognized as your own,
that kept you company
as you strode deeper and deeper
into the world,
determined to do
the only thing you could do -
determined to save
the only life you could save.

This, in turn, reminded of some of my earlier ruminations on Ralph Waldo Emerson's writings, which brought into focus my conflicting views on self-reliance vs. interdependence, inherence, adherence and coherence - essentially, the self vs. society. There does seem to be a conflict, or at least tension, between teaching self-reliance (independence) and yet preparing women to re-enter society (which is, by definition, highly interdependent). One of Emerson's observations closely aligns with Mary Oliver's poem (and the overall theme of the event):

Trust thyself: every heart every heart vibrates to that iron string. Accept the place the divine providence has found for you, the society of your contemporaries, the connection of events.

Getting back to the event, it turns out that the average age of the women residents of Jubilee is 45. That fact, together with the unexpected events along their unanticipated path toward homelessness - for which I kept thinking "there, but for the grace of God the flying spaghetti monster, go I" (leaving aside, for the moment, the gender issue) - got me thinking about Dante, and his observation at the outset of The Divine Comedy:

In the middle of the road of my life I awoke in the dark wood where the true way was wholly lost.

Susan Fox, the Executive Director of the organization, noted the stigma often associated with women who are victims of domestic violence and/or homelessness, and stressed the importance of the positivism that pervades all aspects of Jubilee's programs. She encouraged us - and everyone - to look for (and celebrate?) the essential goodness within each of these women, a perspective I try to adhere to ... and, yet (as with so many things), often feel conflicted about.

I suspect that Susan would extend this suspension of negative judgment and appreciation of essential goodness to all women, not just those whose paths happen to lead to / through Jubilee. Returning to the gender thread I suspended earlier, this got me to thinking about whether we draw the line at women, or whether we ought to suspend negative judgments and appreciate the goodness in all people, men and women alike.

Pushing further along this edge, I wondered whether / how we can offer the same graciousness to the men who perpetrated violence on the women residents of Jubilee (not that I mean tot imply that all residents there are victims of domestic violence). Can we - ought we to - celebrate the future within every person (not just every woman)?

I find this to be an immensely challenging proposition. Philosophically, I cannot justify the drawing of lines of demarcation - this person is essentially good, that person is essentially evil. However, in practice, I do this all the time (I've noted several times before my personal challenges with seeing the essential goodness in George W. Bush, who, in my judgment, is one of the biggest perpetrators of violence - scaling back social programs, reducing protections for our environment, supporting capital punishment, war and [other forms of] torture - on the face of the planet). Who knows, maybe more obvious expressions of goodness lie in his future ...

As usual, I don't have any good answers ... just good questions ... or, at least, questions about goodness.

An update on my elbow, one month after Platelet Rich Plasma (PRP) treatment

I had my one-month followup visit with Dr. Mishra today, to review progress since undergoing a platelet rich plasma (PRP) treatment for chronic elbow tendonitis (or, based on an earlier comment, tendonosis) on July 12. I'd posted an update at the 1-week mark, and given all the comments I've received on the blog and via email, I wanted to post an update at the 1-month mark (well, the 5 1/2 week mark, technically speaking).

At this point, my right elbow feels pretty much like it did before the treatment - normally very little pain, a dull ache that starts after even light exercise (e.g., just standing / walking around for 20 minutes with the elbow unsupported ... or typing / mousing for that long), and occasional very sharp pain when I pick up something too heavy or otherwise overextend the elbow. I've regained most if not all of the flexibility in my elbow, e.g., I can now touch fingers from both hands with arms crossed diagonally behind my back, and can use my right hand for eating, drinking (though not my 20 ounce coffee mug) and brushing my teeth - though I'm still using the floss sticks. I can also wash and [towel] dry my hair with relatively little discomfort.

I confessed to Dr. Mishra that I had not followed some of the recommendations he and/or his assistant, Amy, had made on both specific activities and general actvities. They had recommended against taking both the dune buggy tour and the jet boat tour on our recent family vacation down the Oregon coast, as well as prolonged driving; I did all of the above. They had also recommended that I slow down on my typing speed (and duration), which I did, but only for the first two weeks - I suspect I'm back up to my normal speed, which is probably somewhere in the range of 80-100 wpm. I also did some vacuuming around the house yesterday, which, although they did not specifically recommend against it, I knew would not be good for my elbow - and Dr. Mishra confirmed that vibration, in general, is bad, and recommended that I not do more vacuuming for a while. I have, however, been diligent about avoiding anti-inflammatory medications and have been pretty good about doing the gentle stretching exercises.

Dr. Mishra said it is not at all uncommon for the condition of a PRP-treated elbow to be at the same level - or even slightly worse - at the one-month mark after treatment as it was prior to treatment. He re-iterated earlier recommendations (especially about the typing - so I'm going to try to keep this short), and I have started some theratube strengthening exercises. I'll have another followup visit on September 24, after which I'll post another update.

I'm glad that what I was interpreting as a lack of progress is not necessarily indicative of failure of the procedure. I have to say that during the vacation, I was feeling sad about not being able to so much ... though in writing this, I'm a bit embarrassed, as I know many other people have far more extensive disabilities (or, I suppose I should say, challenges). I still feel a bit disheartened, but writing this has been therapeutic - as has been the support offered through comments and emails - and so I will do my best to practice acceptance.

Update, 2007-08-23:

Pete sent me a note with a link to a Runner's World forum topic on My Platelet Rich Plasma Prolotherapy Journey (so far), started 24 May 2007, detailing a series of ups and downs with a PRP injection for knee tendonitis - including the ability to run 5 miles 3 days after the injection (!) - and ending with a report of 100% recovery on 15 August 2007. I'm glad to read of both the eventual success, and the ups and downs that were part of the journey, but I am a bit confused about the conflation of PRP and Prolotherapy, which I'd thought were different procedures. Clearly I have much to learn (and experience). [In a followup note, Pete sent me a link to the Prolotherapy Nashville page, along with some commentary that suggests that Prolotherapy is the more general term for injecting a specific substance - which may be saline, glucose or PRP - into the region around an injured ligament or tendon in order to stimulate healing. (Thanks^2, Pete!)]

Mark sent me a note detailing extensive experiences with various treatments that included an overuse of Cortisone; he now urges people to avoid the use of Cortisone. Fortunately, the doctor's I've seen about my elbow problems over the years have all been averse to using Cortisone, but I did have two Cortisone injections, and one of them was effective (for a while). I wanted to pass along Mark's (and my doctors') recommendations to avoid using Cortisone, as it is a complicating factor in the potential efficacy of PRP.

While I'm on the topic of avoidance, I'd meant to include a few recommendations for things I would have liked to avoid more (well, things I might have avoided more ... clearly, these are things I like), in the course of the healing process, if I were a bit more disciplined. I already mentioned [not] avoiding prolonged or fast typing [... he types, quickly]. Another strategy is to not buy a new 10-megapixel digital SLR camera during the recovery period. Holding the camera for shooting photos during our recent family vacation along the Oregon coast, resulted in significant pain, but I kept repeating the procedure many, many times, reveling in my renewed appreciation for [digital] photography. Another thing I wish I was more disciplined about is avoiding handshakes, at least with the right hand. I was pretty good about this during the first week, but the social discomfort I feel in reaching out with my left hand - or giving a less than firm handshake with my right hand - often overcomes my good sense about protecting my elbow. I still feel sharp pain during - and lingering pain after - firm handshakes. Another area in which I've not been able - or willing - to be more disciplined is [elbow] safe sex. I realize there are many, er, variations available, but [for me], it just is not a "hands off" (or "hand off") activity. My wife, of course, is far more disciplined than I am - fortunately, she doesn't read my blog, or I might get some extra, unwanted help, in practicing greater discipline in this dimension. In general, It seems that any activity that involves the use of the right arm in which I typically enter a flow state (typing, photography, sex) is a candidate for avoidance ... or perhaps more mindful attention.

Coasting in Oregon: Notes from a Family Vacation along the Oregon Coast

We spent the first week in August traveling down the Oregon coast, covering 1300 miles in 8 days, stopping in Cannon Beach, Florence and Gold Beach then dipping down into Crescent City, California, before heading inland to Crater Lake, with a stopover in Eugene on the way back home to Woodinville, Washington.

The scenery in Cannon Beach was so spectacular that I decided I had to go out and buy a new digital SLR camera (the 10.1 megapixel Canon EOS 400D / Digital Rebel XTi), as my Nokia N95 photos weren't doing full justice to the natural beauty there ... and I knew from a trip along the coast in 1986 (when I also bought some new camera equipment) that we were going to pass through lots of other beautiful places. As a side effect of this purchase, I was taking lots of photos, and the image files are large, so I've upgraded my Flickr account to "professional".  Another side effect is that taking lots of photos with the new camera aggravated my right elbow, for which I underwent a Plasma Rich Platelet treatment a month ago (about which I'll post a separate update on progress - or regress - in the near future).

Before the trip, I'd made heavy use of TripAdvisor to investigate lodging options. During the trip, I tried to use Yelp to investigate dining and other activity options. TripAdvisor was very helpful; Yelp was [surprisingly] not very helpful (given how useful it's been for assessing options in the Seattle and Palo Alto areas). I decided to post a number of reviews of our lodging, dining and other experiences on both sites. I'm not sure if my reviews on TripAdvisor added much value to TripAdvisor, since my ratings were very closely aligned with the existing averages, and my reviews probably didn't add much new information. My reviews on Yelp may have been more helpful, as I was the first to review several restaurants and a bike shop ... though I suppose I'll leave it to others do decide how valuable those reviews really are are.

Since I've posted so many reviews elsewhere, I'll just briefly review our itinerary here, with 5-point ratings, brief comments and links to the full reviews (by me and others) on the other sites, in case our experience might be valuable to other families planning a similar vacation (the preponderance of favorable ratings is either the result of successful research or low standards ... I like to think it's more likely the former). I'll also include thumbnails and links to a few photos along the way. [A much more comprehensive guide to the Oregon coast can be found at 101 Mile by Mile.]

• Late lunch at Coffee Girl on Pier 39 (5 out of 5; great clam chowder [other Yelp reviews]), in Astoria
• Three night stay at The Ocean Lodge, in Cannon Beach (5 / 5; nicest hotel on the trip [other TripAdvisor reviews])
  
• Takeout dinner from Fultano's Pizza, downtown Cannon Beach (5 / 5; some of the best pizza we've had anywhere [other Yelp reviews])
• Takeout dinner from Lumberyard Rotisserie and Grill, downtown Cannon Beach (4 / 5 [other Yelp reviews])
• Dinner at Gower Street Bistro, midtown Cannon Beach (5 / 5; best meal on the trip [other Yelp reviews])
  
• Bike rental from Mike's Bike Shop, downtown Cannon Beach (1 / 5; most frustrating experience on the trip - a rusted chain fell off one of the funcycles and we had to walk the bike a half mile back to the shop [other Yelp reviews] ... Family Funcycles in midtown would get my future business)
  
• Tour of Sea Lion Caves (4 / 5; [other TripAdvisor reviews; Yelp reviews]), north of Florence
  
• One night stay at Best Western Pier Point Inn, in Florence (4 / 5 [other TripAdvisor reviews])
• Sand board rental from Sand Master Park, in Florence (5 / 5; most serendipitously discovered activity on the trip [other Yelp reviews])
  
• Dune tour (5 / 5; with driver Dann) and two-person dune buggy rental (2 / 5; the engine throttle kept sticking at full speed, compromising safety and fun) from Spinreel Dune Buggy and ATV Rental [other Yelp reviews], in North Bend
  
• Two night stay at Gold Beach Resort (4 / 5), in Gold Beach
• 104-mile tour of the Rogue River on Jerry's Rogue Jets (4 / 5; with 23-year veteran jet boat pilot Tom [other TripAdvisor reviews]), in Gold Beach
  
• A drive along a road less traveled (Howland Hill Road, NW from Crescent City) through Jedediah Smith Redwoods State Park (5 / 5; most serendipitously discovered natural scenery on the trip [other TripAdvisor reviews])
  
• 90-minute tour of <