On Monday Aug 14 I flew to Bellingham,Washington, on Alaska Airlines. Marili was working in Yuba City so I went to SMF in a Smart Car. It was a last minute flail but worked out; the driver, Sucha, a Kasmiri drives a new car which he is paying for through his fares, coordinated for him by a hired scheduling service. It will take him another two years to pay off his loan, but then it will be his. He’s a well established immigrant with two children, both in Sac State Collge, the American Dream being lived. My return flight would arrive near midnight so I reserved a BlueVan for that trip.
For many years My Sister Sally and husband Gary have liked to go to the Oregon Coast, staying in Yahats at the Fireside Inn; it’s a nice place, even though owned by foreigners, Californians. The coast there is quite different from most, because there are so many rocky outcropings off shore that the wave and surge is diminished. Many homes are built right over the low beach bluffs, and along an Oregon Ocean Trail open to anyone. There is typical cold water of the NW coast.
Two days before the eclipse promised to appear, we drove Kelso and stayed the night in a Super 8 and on to Yakuts the next day. I took a couple of long walks on the beach trail, probably four miles, twice. I didn’t move fast or push it, yet found that by the fourth mile I was quite unsteady. I later found that can happen with exercise when I forget about the effect on my blood glucose; I try to keep my BG as close to 85 as possible using twp kinds of insulin. But if I carelessly forget the effect of prolonged exercise that can be a problem. Thimk.
We were concerned that, being on the ocean, fog might obscure the eclipse. Further, Yahuts was not quite on the eclipse path center line. So we decided to drive abput 30 miles north to Newport, and find an open beach there, if the sky was not clear we would drive inland a half hour or so, to escape the sea fog.
That morning at Yahats and at Newport there was moderate fog. We went to big beach, with a lighthouse and park, north of Newport. But the light house was, quite logically, placed high on a big upthrust of coastal rock which promoted uprise of cool air, and of course, fog. The place was fully prepared for a crowd, with a big eclipse display; it was very busy but.. no sky to be seen.
A parking lot attendant, a teen who had lived there all his life, said if we were to drive back to Newport, and head uphill to the East of town, we would find sun after a only couple of blocks. We did just as he advised, and there it was, a clear day! At a big parking lot in front of a Fred Meyer store people were gathering, settng out chairs, clutching black opaque glasses. More arrived. The stores across the street closed, spilling people onto the sidewalks. The Fred Meyer closed and their employees appeared.
At 0915 a faint dark spot began to invade the sun’s orb at its right uppe edge. It gradually grew, spreading downward and to our left. To my surprise, the light around us didn’t fade much until the sun was fully covered, nor did we cool down much until then. At almost complete, Venus and Satur brightened up to watch. Faint stars appeared. About an hour after the beginning of the eclipse, it was complete. The excitement was palpable. People began to clap and cheer and whistle. Gary it was, I think, who started the call
“ GO MOON!”
We were in total for about two minutes, when, as suddenly as it started, a big bright diamond of light appeared at the same place the shadow first appeared. With the lens covered by dark eclipse glass, I took photos with my electronic camera; but even at full eclipse, when one could look at the black sun without glasses, there was still too much radiant energy; it blinded the frightened camera. But Gary, using a regualr reflex camera, got fine photos. Later, always thinking, Sally took the picture into Fred Meyer to have it printed on T shirts!
Looking Southeast from the partly darkened parking lot, when the eclipsed sun was just beginning to uncover, the planet shown seemed very bright and very large; but it — Saturn?– was much enhanced by the camera eye seeking more light. The eclipse itself was almost directly overhead.
It was a an unforgettable experience. The thing that impressed me most of all, though, was that the moment a tiny sliver of sun began to appear, light and warmth both began to return immediately. I had expected it to be a slow process. Apparemt;y there is so much energy pouring out of the sun that even 1/2% of it is powerful; and maybe some energy is gravity- bent around the moon, as Mr. Einstein demonstrated. I have heard that the energy hitting earth is so great that it should make life here impossible; but that doesn’t happen because of earth’s atmosperic overcoat, and the fact that so little of that energy is electromagnetic photon radiation. It mainly consists of protons, whose energy decays very fast, based on distance… so what we get are attenuated bullets of photons that have already given up the largest part of their energy to: distance.
We drove all the way back to Ferndale the next day, leaving early and arriving after about 12 hours on the road. Gary and Sally did he planning, organizing and driving; I was simply a happy opportunist. It was a surprise to learn that there are several total eclipse tracks across the earth every year, in different parts of the globe. The next USA track will be in the Southern States, especially Texas. If one is ecliptophilic, or an ecliptomaniac, with time and money, there are many options. But for me, this eclipse is enough for this life, this earth and this Sun.
I realize, dear reader, that it has been more than 300 years since I last penned an edition of The Tattler; and that the United States, didn’t exist back then. But over the years I have always followed events assiduously. The cybernet is limitless, and allows me to reach you now in America ( I should say in the USA, because America refers to an entire hemisphere, right? My bad as you Yanks say.) What seems to be happening there stirs up my quiet conscience and dormant public spirit.
Over the centuries, I have resisted reacting to crude and violent uncivil rage, like the kind that is everywhere around you in the Colonies. (Sorry, as ‘you guys‘ say in that gender warped way) , it is tempting for me to ignore that Revolution. But I take comfort that language is still something we share; more or less. Bet you don’t know what lucubrations are!
It is specifically the chronic reports of the death of a prominent political pretender to high US office that forces me to comment. I do so with reticence and some embarrasment, because I am rather a coward; I will not name that candidate, in order to avoid being economically destroyed by those, not excluding government, who by comparison to me, commnand unlimited funds, and unlimited time to prosecute!
Although I am still in England, America has a long reach; who knows what a bity of my old DNA permit, or 23 & me turn up; I must think as a US citizen should. The average person there, facing your system of justice, can neither expect the speedy trial promised by your constitution, nor pay a multimillion cost of defense in the case of an abusive opponent having unlimited funds. The choice is bankruptcy, or a plea of guilty, deviously termed ‘a ‘bargain’, in exchange for an unjust result; it’s a legal kind of blackmail or coersion. Moreover, today, in an atmosphere of national outrage, certain defendants can face ugly threats from enraged or uncaged partisans.
That is why, dear readers, to face US justice, ‘ain’t me, babe,‘ in your parlance; so I rely on you to supply the name, which should be easy, since the news of the most recent death is echoing across the cyberworld ceaselessly, like joyless monotonous waves on an ocean beach.
The candidate first died in Nov 2008; and again in Nov 2016, but still appears everywhere, claiming to be alive; to have been alive for many decades; saying a far flung conspiracy exists to lie and decieve. With due respect, because the eminent candidate clearly merits that, I urge acceptance of the dead state bravely and wisely; though the legs and arms may still appear to perform animal functions, the art is not there; the candidate is gone. I hope these lucubrations help to make that more apparent.
Adapted from The Tattler No.1 April 12, 1709.
A few years after my mother Melba died, Bob did also. We went through their home and put numbers on items; then, by turns, made selections of what we hoped to keep in rememberance of them. At my first turn I chose Melba’s books. There were not many, but they are a wellspring of memory. When I read them, or even see them as I walk by, they speak. She was an English Major and an English teacher who taught us in a one room 10 child school in Santo Domingo, Mexico using the Calvert System1 , a home school program still in existence. In the early 1940s it provided for the equivalent of our eight grades; there was not much history of the US included then, but we learned about Britain from 1066 on. Melba also filled our lives with books and poetry, often reading aloud, as when Bob worked on our Holden Washington miner’s cabin in the evenings.
She was always a writer and a poet. It was common to memorize poetry in her youth; in her 9th decade she could quote long strings of poems. Dad tried to do so also, but he couldn’t get out more than a few lines before he began to tear and choke up. Despite that sentimentality Dad’s books were like he was: An engineer. A miner. Melba’s books were mostly British and American poetry and literature of the past few centuries.
150 feet of books line the walls of our home today, where 6 feet are Melba’s, and 15 feet are my grandfather Leon’s. Even when I walk by they whisper. Melba’s is the voice of Poetry from many anthologies, Tennyson, Browning, Gibran, Longfellow, Yeats, Lowell, Kipling, Frost, Poe, Coleridge; Leon’s oft quoted poets, include include Shakespeare and McLeish beside a first issue of the 1908 Brittanica,and the Harvard great books series. Melba’s kitchen writing desk was always decorated with cuts and clippings from poems of all kinds including Silberstein and Seuss.
Lost in Melba’s forest of poetry, are some Lakeside Press publications 2. The Southwestern Expedition of Zebulon M. Pike; The Border and the Buffalo by J R Cook; Bidwell’s Echoes of the Past; Commerce of the Prairies by Josiah Greg; , and My Life on the Plains by George A Custer3. Why?
Melba always wanted to write her own book about her grandparents crossing the plains in covered Wagons during the mid 1800s; but she didn’t collect much first person material or didn’t have it sufficiently to memory; maybe sheep and orchard farmers had more urgent concerns. So she collected and studied about overland U S travel. I have a chapter of the book she began to write; but the rest was stillborn. What is left behind are mainly the books she collected for research.
The mid 19th century was a time of Westward US exploration and expansion; a time of agressive and roughshod Manifest Destiny. Among the Lakeside series are expeditionary books that may have influenced Gregg: the incomparable and magnificient Lewis and Clark Expedition; three less successful reports of Zebulon Pike; The reports of Cook, and Custer, filled with historic names and connections, and well recounted details of the times. They are plainly written, clear, though sometimes – no,often- shocking to 21st century sensibilities. As in reading Mark Twain, we must forgive Gregg and Cook and Custer for living in their own times, while honoring their contribution to our own history.
Commerce of the Prairies by Josiah Gregg is exemplary; he was a physician but became so sickly, with stomach problems and tuberculososis that he could not work. In those days an oft reccommended treatment for chronic illness was good air and exercise.4 Gregg, became a traveling saleman of sorts: a commercial trader, joining wagon trains moving manufactured goods from Independence Missouri to Santa Fe, Mexico, and later to Chihuahua. His health improved so quickly and dramatically, that he continued to make trips back and forth during the next ten years until his death.
His book is rich with details of the journeys, the people, the land, and the problems on the way.
This is a cut from Gregg;
and this is a map of the Coronado expedition of 1540, made to discover Quivera, a supposed ‘seven cities of gold ‘:
If one is fortunate enough to be born into a place, and a time, or into a family who read, and who write, that is where you will find one another always; among the words and pages that survive life. Those connections are far more alive, more acessable, more real and more personal than a grave or body ash.
If one does not have the kind of inter-generational tradition or inter- connectedness that good fortune, and family, and reading and writing provide, I urge their creation: Read. Write. To do so is far easier and more pracrtical and attractive than centuries ago. Word processing, browsing, and self publishing and even social media, make all the difference. I urge anyone who can, to read and to write, both for self, and for those with whom life is most closely and dearly shared.
Sometimes, If I wonder who I am, I listen to my Mama’s and Grandfather’s books, and their words. Thank you, Melba and Happy Mother’s Day! Thank you, Leon!
2https://en.wikipedia.org/wiki/Lakeside_Pres Lakeside Classics is a series started in 1903 to reprint neglected classic works. In 1910 selections turned to first-person narratives of American history, especially those which were rare or out of print. Themes included the Civil War, the Old West, exploration and frontier life. . The first was Ben Franklin’s autobiography. By 2015, the series included 113 volumes.
3 George Armstrong Custer was always a cussed rebel, graduating last in his class at West Point. Yet he became, above all, a lifelong member of the US Army calvalry. He earned fame and success during the Indian Wars on the Plains. In his book he makes very clear that it was Warfare with great cruelty on both sides. The interaction between tribes, the Indian Bureau, Settlers, traders and plaines people are described in much detail. Especially where warfare is concerned, the Indians and Custer made up rules as they went. In that sense they were perfect enimies. His book begins with a detalied description of ‘the Great American Desert’: The Great Plains. He.served with many historic figures like Sheridan, Billy the Kid, and Gen Hancock; his book is rich with descriptions of soldiers, Chiefs, settlers, guides, and the motives and nature of buffalo slaughter; His campaign, understanding and defeat of the Witchita, and his insightful, tough and politic negotiations with the Cheyenne are remarkable. Of course, we know the ending of Custer at Little Big Horn, in another great historic event. Cook, Gregg. and Custer are great ‘reads’!
4Coincidentally, my grandfather Leon went West for the first time in about 1900 when that was reccommended to improve his vision, possibly over- strained by studies. My grandmother, Anna Hart a native of Nova Scotia, joined him, and like Gregg they became incurable Westerners. Leon was an ordained Methodist Minister for 60 years in California, Hawaii, and Panama. He maintained connections with the East of course, but intermitteltly and at a distance; viz, he was a longstanding friend and compatriot of another Methodist minister, Martin Luther King. Yet the West in them dominated. Leon attended Stanford briefly when it was still a farm; he and Anna attended Stanford School of Medicine as volunteer cadavers when they died. He left many books, including the Harvard Classics, and a first edition of the 1908 Brittanica. Leon was also a writer. He left hundreds of sermons, though cryptically abbrevited, pamphlets, letters, and several history books.
The subjects are jailed minor boys and girls awaiting deportation, hearing or trial. The facility where they are kept is among the best, both physically and operationally. It is an older but well maintained juvenile detention facility, with a large gymnasium, an astro-turf sports field and an extensive library. There are many opportunities provided by volunteer groups, and various departments at a nearby College…For example, the art department promotes inmate art works; the results are visible inside and outside: sculptures, mosaics, and murals, created by juvenile inmates: The facility is uncrowded; local inmates are housed separately from the illegal alien children — all, by definition are under age 18– The subjects of these brief interviews are confined to a secure facility because they have a violent or criminal past, or both. They speak, read and understand their primary language fairly well but their ability in English is very limited.
One never knows, in such circumstances, what is exaggeration or lies, but I have been doing similar interviews for a number of years, and in time one becomes more able to evaluate them. These, of course, were children; yet they were far more frank, open and expressive, less manipulative, than many adults.
Considering the alleged situation in their country of origin, and the unique opportunities available in the facility ( the jail), one might think they would be happy, or at least feel fortunate. But they are not, despite nourishing food, shelter, medical care, training in English, access to books and both video and classroom teaching.Why unhappy?
First, they are children, and moreover, teens, who by some law of nature are often unhappy and unhinged. Second, they are not free where they are. As Children their views are short-sighted and self focused; as humans they value freedom. It should not be surprising that they don’t like the strange food; but they hate worse the confinement. They want out; even if they go back to a situation that was dangerous or intolerable, it would be a place where they might Try Again to return. The reader may note that most had somehow had access to enough money to hire a coyote. Why? I cannot say, but wonder whether if criminal or drug activities were responsible, directly or indirectly. Their individual stories are moving. Here are condensed versions of a few.
Male Age 16, El Salvador Crossed on foot TX in 2014 at age 14; coyote $7k paid by parents. However, after crossing had no further assistance. Lived on street, Las Vegas; arrested for theft. Sleepless, wants sleep med and pain med for back problem. We spoke at some length about the dangers of using addictive medications for sleep or chronic pain, both best treated by being active physically! I doubt he wanted to hear such stuff, though; he didn’t seem impressed.
Male Age 17, Honduras Coyote paid $ 10k by family, 5k deposit, 5k due on arrival. Arrived age 14. Reached a relative in Las Vegas but later arrested after caught in robbery. Says he may be sent back, but will return, and is taking classes in English. The food is terrible in the USA, but the country is great!
Male age 17, El Salvador Crossed the border at San Diego asking for asylum. Sent to Oregon, placed in a shelter; but fell in with folk who lived on the street. Was arrested for theft and assault. Allowed that the request for asylum was not really valid; it was just a door that he opened. If he is sent back he will come again, this time without a claim for asylum… will cross some way, probably on foot. ‘ Better illegal here than legal there.’
Male Age 16, Honduras Dad paid for coyote, but when he got here dad sent word: ‘Good Luck, you are on your own’. Lived on the street. Arrested for assault. Expects release soon, wants to go back to Honduras because he has family there who are not without economic advantages. I asked: drug business? Yes. ‘Better a rich criminal there than poor and illegal here’.
Male Age 16, Mexico Was a ‘mule’ for marijuana smuggling; entered into Arizona on foot, but was immediately caught. Sent to Phoenix. Expects to be deported. However, in Sonora, his home, he doubts he will be able to avoid going back to being a mule. Why? Realistically there is no other choice
Male age 17, Honduras Caught while crossing near Houston; has family somewhere in US but they did not respond to attempts to locate them. Seems a bright kid, communicative, but didn’t know who his namesake, Roosevelt, was. I told him briefly about two presidents by that name. both, and he plans to look them up in the library and ask the English teacher to comment.
Female Age 14, Mexico Coyote crossed border AZ in a car trunk. Placed on bus to Las Vegas. Arrested prostitution and theft. Jailed then transferred here. Is awaiting hearing, pending transfer motion. On zoloft and resperidol not sure what it is or why. C/O tooth problem. Whether released or sent back home thinks she will return one way or another, this time with some English. She understands she has no skills and no advantages except quite a few years ahead for profiting from her looks. I expressed surprise that plan in place at her age, but she looked at me sideways, and commented that she lives in the real world where people have to deal not with ideas but with facts; besides, she said, ‘I have a good connections in Vegas.’
Male Age 16, Honduras Crossed on foot to reach his uncle here. But the uncle was unable to take him in. Lived on street; theft, prostitution, drug abuse. Arrested states he was ‘beat up’ and remanded to Foster care. Has HIV, probable source uncle? Hep C?He doesn’t know. On medication now. I asked him about his unusual first name. He said it was from a famous poet; he knew nothing else, but says he likes poetry. I suggested he try to look up two poems that may have something to do with his unusual last name. The first is by Oscar Wilde:
The lily’s withered chalice falls
Around its rod of dusty gold,
And from the beech-trees on the wold
The last wood-pigeon coos and calls.
The gaudy leonine sunflower
Hangs black and barren on its stalk,
And down the windy garden walk
The dead leaves scatter, – hour by hour.
Pale privet-petals white as milk
Are blown into a snowy mass:
The roses lie upon the grass
Like little shreds of crimson silk.
The other poem is by Brazilian Eduardo Alves da Costa, fairly easy to understand for Spanish speakers: Essentially: The first night they robbed a flower from our garden. We said nothing. The second night they openly trampled the rest of our flowers. We said nothing. Until the weakest among them entered our house by night and stole our light; and knowing of our fear, ripped our voice from our throats; then we could say nothing.
Na primeira noite eles se aproximam
e roubam uma flor
do nosso jardim.
E não dizemos nada.
Na segunda noite, já não se escondem:
pisam as flores,
matam nosso cão,
e não dizemos nada.
Até que um dia,
o mais frágil deles
entra sozinho e nossa casa,
rouba-nos a luz e,
conhecendo nosso medo,
arranca-nos a voz da garganta.
E já não podemos dizer nada.
Comment: These histories pose a problem: they put a face on illegal immigrants even though in this case they are criminals. The last three cases in particular suggest that it is risky to look at them, or to hear them, too closely. The same is often true of all criminals, and illegal immigrants. While our country cannot open our borders to billions of people from all over the world, we share a hemisphere with many other Americans, North and South; we share a common cultural and ethnic past with people on our borders.
In fact, as always, the USA needs immigrants. If all illegal aliens were to disappear instantly, there would be an economic and social crisis here; in gardening, building, hotel maintenance, restaurant work, and farming, to say the least… and arguably, even in child-bearing! We North Americans are too often unwilling to raise enough children to replace ourselves. That is too great a sacrifice! Houses, cars, travel, education, health care, and entertainment are expensive priorities, and it costs several hundred thousand dollars and tens of thousands of hours to produce and to raise a child conscientiously.
A child, as often claimed, is a hostage to fate: a risk. But without children there is only past. Frankly, it seems possible that within 20 years we will offer to pay people to immigrate to our big beautiful USA. To relate stories like those above is not meant to glorify illegal immigrant children; yet, their desperation and decisive, high risk attempt to change their lives is the recurring story of the USA. Unfortunately, many of these illegal children come from criminal and drug dealing environments, or worse; they bring that with them. Some are MS13 members. But the first illegal immigrants who crossed the atlantic in wooden ships were often undesirables, rebels, or troublemakers. Some were criminals. All are kin to those, criminals or not, who pay coyotes or cross nations and deserts to reach our beloved land.
Adults who are illegal immigrants today are people whose journeys are even more hazardous, more sacrificial, than that of most child criminals; yet they also reveal an intense desire to find a better life in the US. As a consequence they create a better North America, and in a wider sense, better Americas.
My son Fred, a master carpenter, once again this April, drove from South Dakota to Baja California pulling a trailer full of equipment. He joined a group of Methodists to build small homes. In this case that is not simply a charitable act; the recipients of homes are limited to people who 1) work 2) have their own a half hectare lot, where they live in very marginal conditions, and 3) have children who regularly attend school. I go to build or to work as a translator for Lighting for Literature, providing small solar lighting units in the homes of the same kind of families, so schoolchildren have light to study in the evenings.
The clear majority of such families have a connection with the USA; it is generally with a close relative, usually one who has, during most of a lifetime, regularly sent money to their relatives to make their present and future more promising. That sort of story of immigrants and cross culture exchange is as old as time. It is the stuff of progress, and of civilization.
This is to suggest that when there is a “Take Care Of Your Diabetes” conference nearby it is worthwhile for those with, or at risk of, diabetes; likewise for medical professionals. I attended the TCOYD conference here in March 2018, though I had never done so before; it was offered for about the 6th time in Sacramento, and many hundreds of times in the nation. For professionals at this session the conference cost was $30, and less for others. It was held at the Convention Center, attended by at least a thousand people. There were no openings for walk- inns. The general idea is this: People with an inherited predisposition, or diabetes, or abnormal diabetes screening tests of any sort, are encouraged to do simple things themselves to prevent later problems. Moreover medical providers may discover more about ways technology promotes patient personal involvement in the care of chronic disease; and, I believe, about the direction and future of medicine. Joan Borbon clued me in to TCOYD. We volunteer at a local Student Free Clinic. So I signed up. For me, personally, the whole day was a triple delight.
First, because the general thrust concurs with one I have long practiced: That in chronic disease treatment and prevention, people must be their own principle care-givers and managers. Diabetes is the perfect example. Why? No one can manage the illness without the direct personal understanding and involvement of the diabetic or pre diabetic; no Doctor, Legislator or friend or family member. But technology places the means to do so in the hands of the individual. For example, in diabetes, the personal Blood Glucose Monitor allows people, 24/7, to measure and control their own disease. No more time consuming lab or office visits, days long waits for test results. Moreover, in the forseeable future, access to reasonable, personal technology and information will make self care ever more practical and efficient. In my own little lifetime, it seems to me the most significant development in diabetes care has been the personal BG monitor, which has become acessable, reasonable, and simple to use.
Second, because I, a stubborn, arrogant macho man, ignored my own clear symptoms and family history for at least 15 years before discovering my own diabetes…never listening to my life, never thinking about it.* Maybe signs of diabetes were so easily overlooked because my routine screening tests were always normal; my doctors and I relied on them without another thought. But if we had considered my family history, or even listened to the voice of my body, we could have discovered my type 2 DM much earlier.
Many people with an interest in diabetes attend the conferences over and again, gradually learning more and more about the disease. And yet, while the conferences are very informative, perhaps it's wise to keep some things in mind:
- Even if addressed mainly to the general public, these are medical conferences; they are funded completely by people who want to sell stuff–caveat Emptor — Buyer Beware.
- The eloquent and impactful speakers, aided by great media, are partially bought and paid for.
- The literature is as skillfully crafted to subtly mislead as are magazine or TV ads.
- The booths are staffed with highly trained professional salespeople. Beautiful, engaging people.
Third, The program is varied and relaxed enough to allow for casual unhurried conversation. A personal note: I like to run and sniff the world like an escaped hound dog. But always, even in childhood, Northern California has been the home where I return ever, where my family history and heart and dearest memories also live; as a physician, it’s been my medical home since 1959. Therefore in this broad focused meeting I often met up with old colleagues or friends who share an interest in diabetes. Steve Edelman, who many years ago concieved and organized TCYOD, was a Med student at UCD when it was still on the Davis Campus where I occasionally lectured; Demo Pappagiannis who coached and wrote several papers with me on coccidioidomycosis, was there. There were many other friends, colleagues, and physicians from Kaiser, UCD, Woodland, Davis, and Sacramento. And nurses; perhaps most of all. .
Nurses and P As are the Hands and Heart of medical care. Brooks Smith and I were the first lecturers for the UC Davis Rural Family Nurse Practitioner training program. It was in the Dept of Family Pracitce headed by Hughes Andrews, and managed by Mary Fenley and Leona Judson. Since then,– 45 years ago– it has evolved fast, grown, changed names, and fled the skirts of the Med School into the arms of Nursing. At the conference every local Nurse Practioner and PA I spoke with was a graduate of that particular program.
TCYOD is based in San Diego) at the center of a world of Spanish speaking folk with diabetes and prediabetes. Therefore A Cuidese Su Propio Diabetes– CSPD– is needed. If I were still crazy I would volunteer; but I am less insane now. Maybe someone can use material in Spanish I wrote for diabetics in Colonet, Baja CA. ¡Quizas!
* But during the first years of symptoms I was working day and night 7 days a week, rather doggedly doing My Thing with migrant worker night clinics, and Regional Rural Health which they grew to be, and Salud, an inner city clinic in Broderick, CA. At the same time I worked at UCD to establish an Occupational Medicine Program, and took on many consultant jobs in order to provide for my family, 6 people whom I supported but otherwise mostly left on their own. I was Sick, Out of My Mind. Over time I gradually developed severe bilateral lower extremity neuropathy. As my usual diabetes tests were normal, neither I nor my doctors explored diabetes further. A neurologist confirmed the neuropathy, but asked: Do you drink? Yes occasionally. Well! He said, Don’t. A podiatrist ordered some $400 shoes. I had had a laminectomy in 1975 for and acute disc with foot drop, with lipiodol studies, so a CT was done. Nada. I ignored some other things: that my neuropathy was better when backpacking – and burning a lot of glucose. That the cold bothered others it didn’t trouble me. That my balance was slaightly off. Only after several years of worsening neuropathy did I order an old fashioned four hour Glucose Tolerance test. Bingo! Ironically, today anyone with a personal blood glucose test kit can do that home alone. I”m happy to say that the neuropathy has receded with control of my disease.. like many people, I detest initialisms and acronyms but they are epidemic;; as they say, It is what it Is. IIWII. So, TVOYD; Listen To Your Body. LTYB; Listen To Yor Family, their words acts, troubles, and History. LTYF; Hear, Think, And Do. HTAD.
I recently took a friend to the hosipital with severe septic shock from acute influenza. After one day of typical acute flu– sore throat, fever, headache, tight cough and prostration– she developed most of the characteristic signs of sepsis. On registering at the emergency department, the symptoms of sepsis were recognized, and she was admitted immediately. Within minutes after appearing at the registration window, more than two liters of saline were pumped into her through to IV lines; more would follow. After about 10 hours all her vital signs, pulse, temperature, and respiration, gradually returned to normal, and she was released. The diagnosis and treatment were immediate and effective.
Septic shock can be the result of any overwhelming infection that causes the body blood circulation– and therefore multiple organs– to fail. It is seen most often with a bacterial infection, but in this case was caused by a virus: type A influenza. When someone comes to the ED with fever over 100, heart rate over 100, and respiratory rate over 20, (an important but often overlookied vital sign!); and in the worst cases, mental confusion and low blood pressure– it is Sepsis, septic shock requiring immediate treatment, just as with heart attack or stroke or poisoning or respiratory failure; it’s that urgent. Accurate diagnosis and multiple lab tests are far less urgent than immediate treatment, based on symptoms and findings. Over the next few hours her lab tests did come back, consistent with influenza, including a nasal rapid test for type A influenza.
Sepsis sometimes kills people during the current flu epidemic, or pandemic… It can also kill from influenza pneumonia, or complications of preexisting heart or respiratory problems, especially in the aged, and paradoxically, the very young. Type A flu constantly mutates, changing so much that the old flu vaccine is little help, precisely because it’s derived from the last few epidemics, while influenza has moved on, evolving and changing ever since. So in this and most epidemics, people are almost all on their own, even after a flu shot, although arguably that immunization does no harm.
With symptoms of influenza, one should go to bed and stay there, drinking at least a liter of liquids three times a day, until you are without fever and well hydrated. If the symptoms of sepsis are suspected, go to the nearest hospital. Tylenol/ acetaminophen/ ibuprofen/Motrin, may relieve symptoms some, but aspirin is not advisable. If one get by for 4-5 days, expect gradual recovery over a few weeks, with productive wet cough. Tamiflu (oseltamivir) helps at the very first. It’s expensive, and requires a prescription, unfortunately. Of course the manufacturer suggests it be taken for much longer; in my opinion, that is profitable, but isn’t as effective as taking it on the very first day. ( I confess. My bias is: ‘follow the money’. )
It is curious that the last great worldwide lethal influenza epidemic took place almost exactly 100 years ago: The pandemic of 1918 killed many tens of millions, then a great part of the world population; deaths were comon among people with ongoing serious chronic health problems, or malnutrition, when treatment was less effective than it is now, especially treatment of secondary bacterial infections.
Well, that’s my take on the 2018 flu. But then, thankfully, I am only an old ex-doctor, ( I love that!) So you,the reader, must realize this is just gossip, worth less than what you pay for it!