Jun 29


I don’t have any significant health updates to report, but I can report some insignificant ones.

The re-shave of a site on my left forearm took place as scheduled on June 9. This was where a severely dysplastic mole had been previously removed, and Cary Dermatology just wanted to make sure that all traces of it were excised. This reopened and enlarged the wound, but it’s healing nicely now. There was some redness around the site for a while, and I showed it to Dr. Raman (my primary care physician) at a routine exam in case it was infected. She didn’t think so, but prescribed an antibiotic just in case, while saying that she didn’t think I would need it. And I haven’t; the redness cleared up on its own.

When I got a haircut recently, the hairstylist made me aware of a horizontal red line across the back of my neck. I hadn’t noticed it because you can’t see the back of your own neck without using two mirrors, and I only have the one on the wall in my bathroom. It looked like a scratch, but given the location, I realized what it must be. Because of my sleep apnea, I use a CPAP machine when I sleep, and the mask is held on my face by “headgear,” a set of straps across the back of my head and neck. The headgear is adjustable, but it has to be tight enough to ensure an airtight seal against my face, and this had caused the lower edge of the strap to dig into the back of my neck, injuring the skin.

I had been aware of some minor irritation in that area, but I wasn’t concerned until I actually saw it. A quick Internet search showed that pads for CPAP headgear straps are readily available and inexpensive, so I picked one that looked right and ordered it. While I was waiting for it to arrive, I used a temporary pad: a folded washcloth, placed between the strap and my neck. It worked well enough. But I have the real item now, and it’s better. It’s a fleece cover that wraps around the strap and is secured by Velcro strips. It’s very comfortable, and my neck is already healing.

Other than that, my health has been uneventful in recent weeks. Dr. Raman described it as “boring,” but in an approving way. She’s pleased with my recent weight loss and my not-at-all-high blood pressure. I like it when my doctors are happy, and right now, they all seem to be.

Jun 01


I called Cary Dermatology and got an explanation of my test results. The biopsy found that the mole was severely dysplastic. This just means that it was irregular in a way that is considered pre-cancerous. Some moles of this type eventually develop into melanoma, at which point you have skin cancer. For this reason, we need to make sure that all of it is excised. The American Osteopathic College of Dermatology puts it this way: “Most dermatologists usually recommend that all patients with these severely dysplastic moles have them removed with a margin (0.5 cm — about a quarter inch) of clinically normal skin.”

I will have this done on June 9. I assume it will be similar to the Mohs surgery on my face after I had the basal cell carcinoma removed in 2019. But this isn’t a surgical procedure, just a “re-shave.” The incision may be small enough not to require sutures, which I did have as a result of the Mohs procedure. But I’ll come home with a bandage on my left forearm, and I’ll eventually have a small scar. I already have a few of those (who doesn’t, after six decades of life?), and I don’t mind adding another if it helps me avoid skin cancer.

I slept without the LifeVest for the first time since January 2, which meant that I didn’t have to place the defibrillator next to my pillow and arrange the cable to avoid lying on it. During my daily activities, the cable had a tendency to catch on things, especially the drawer handles in my kitchen. I’m glad I no longer have to put up with that. I wasn’t aware of the LifeVest most of the time, so I mostly don’t notice its absence. But I certainly won’t miss it.

May 31


Today I had my first appointment with my cardiologist, Dr. Desai, since my echocardiogram on May 10. He is pleased with the way my heart health is improving, as indicated by my increased ejection fraction. He is also pleased with my weight loss. There really weren’t any negatives to discuss. I’m making progress, gradually but steadily. As I told Dr. Desai, I wish I could take credit for the progress, but I attribute most of it to the medicines that I’ve been taking. There’s no reason to change any of that, and he didn’t. All of my meds remain the same for now.

So, as expected, the topic of the LifeVest came up. That’s the wearable defibrillator that has been my constant companion for five months. Dr. Desai told me that I don’t need to wear it anymore, and when I got home, I removed it. For the first time since I left the hospital on January 3, I am walking around my apartment without it. It feels good to be free and unencumbered.

The LifeVest will have to be returned to Zoll, the company that manufactures and leases it. That should be a straightforward process. I have the box that it came in and all of the materials that were included with it, so packing it for shipment will be simple. I already have a preprinted shipping label. However, I will talk to Zoll customer service tomorrow just to make sure that I am following the correct return procedure.

I have to make another phone call tomorrow. This afternoon, as I was on my way out the door for my appointment with Dr. Desai, I received a call from Cary Dermatology about the test results for the irregular mole that was shaved off my left forearm and sent to pathology last week. I explained that I didn’t have time to talk unless they could tell me the results very quickly, and the person who called me said that wasn’t possible, because they will need to schedule another appointment. So we agreed that I would call them tomorrow morning.

Reading between the lines, I think that means that the test results for the mole were something less than completely benign. If it’s something like the growth on my face that turned out to be basal cell carcinoma, an additional procedure may be needed to ensure that every trace of malignancy is removed. But I’m just speculating. I won’t know the details until I speak to the Cary Dermatology people tomorrow. Whatever I find out, I will report here. Stay tuned.

May 21

Fifty per cent

I received the results from my echocardiogram this week. My ejection fraction was estimated to be 50%. That’s the low end of the normal range. It’s also double what it was when I was admitted to the hospital five months ago. So that’s good news. I’m still using my Life Vest wearable defibrillator, but I have an appointment to see Dr. Desai on May 31, and I’m sure we’ll be talking about whether I still need it.

I think he’ll be pleased with my weight. After he expressed concern about it on April 26, I made some changes to my diet, and I’ve lost eight or nine pounds since then.

I completed my home sleep study and returned the kit to the sleep lab on May 11. That must have provided the data they needed, because Dr. Vora called this week to tell me that he’s submitted an order for a new CPAP machine. I probably won’t get it for a couple of weeks, but there’s no rush, since I can keep using my current machine.

I visited Cary Dermatology on May 18 to have a growth on my right arm looked at. Candace, the PA that I usually see there, said it was benign and froze it with liquid nitrogen so that it would crumble and flake off (which it’s already doing). She also froze a couple of other small spots on both arms, and examined the moles on my left arm. One of them was irregular, so she shaved it off and sent it to pathology. A sensible precaution, given my history of skin cancer. So I have a couple of Band-Aids at the moment.

My COVID-19 symptoms are long gone, and I feel fine.

May 13

Too healthy

I visited Cary Cardiology as scheduled on May 10 to have a second echocardiogram, as requested by the cardiologist, Dr. Desai. I couldn’t remember which kind of test an echocardiogram is, but it turned out to be an ultrasound of the heart. This will enable Dr. Desai to measure my ejection fraction, which will help him decide what to do next. (The last time we spoke, he was leaning heavily toward getting rid of the defibrillator that I’ve been wearing since January 3.)

While I was there, I also had some blood drawn for various laboratory tests, and I received a phone call from a nurse today to let me know that the tests were all normal. She said that Dr. Desai hasn’t read my echocardiogram yet, but I can expect another phone call next week to tell me the results.

I got another phone call yesterday that was rather encouraging. I am on the mailing lists of a couple of research organizations in this area that run various studies using paid subjects. It’s a good way to pick up a little extra money while also contributing to medical research. My most recent one involved being a test subject for a new avian flu vaccine — one that has already been approved by the FDA, but they collecting information about side effects. I don’t know whether I received the actual vaccine or a placebo, but I didn’t experience any side effects.

Yesterday’s phone call was about another study for which I had filled out an online questionnaire. It was for heart failure (HF) patients. The call was to ask me a question that wasn’t included in the questionnaire: what class of HF do I have, according to my cardiologist? I wasn’t familiar with that term, so I had to ask for an explanation. It turns out that there are four classes of HF:

  • Class I: No limitation of physical activity. Ordinary physical activity does not cause symptoms of HF (shortness of breath, fatigue, or chest pain).
  • Class II: Slight limitation of physical activity. Comfortable at rest, but ordinary physical activity results in symptoms of HF.
  • Class III: Marked limitation of physical activity. Comfortable at rest, but less than ordinary activity causes symptoms of HF.
  • Class IV: Symptoms occur even at rest; discomfort with any physical activity. Unable to carry on any physical activity without symptoms of HF.

I told the researcher that my cardiologist had never mentioned a classification to me, but I undoubtedly have Class I HF. I described how I was almost certainly Class III when I was admitted to the hospital on December 29, but by the time I was released on January 3, I had none of the listed symptoms. She congratulated me on doing so well, and then said, “Unfortunately, that means you are too healthy to participate in this study.”

I can’t say that I’m disappointed. A little extra cash would be nice, but I would much rather be rejected because I’m too healthy.

May 06


In my last entry, I mentioned that I was sick with a cold. The day after I posted it, Ben contacted me to let me know that he was experiencing “very similar symptoms: fatigue, runny nose, ache, [and] feeling warm despite not reading a fever.” He used an at-home COVID test and got a positive result. So he was letting me know that I might have COVID too.

I didn’t have any home COVID tests, so I requested some from the Postal Service website. They arrived in today’s mail, and I tested myself this evening.

Positive. I have COVID-19. A very mild case, to be sure.

Now what? I checked the CDC guidelines to find out what I am expected to do in terms of isolating myself. It says that asymptomatic and mildly ill people (that’s definitely me) should quarantine for five days after the onset of symptoms. I noticed the first symptoms a week ago, on the evening of Friday, April 29, so my quarantine period was complete at the end of Wednesday, May 4. (At that point, my symptoms had been gone for a couple of days, and I felt completely normal). CDC also says to wear a well-fitting mask for ten days following the onset of symptoms to limit spread to others. I will do that if I need to go out during the next three days.

And that’s it. After more than two years of living in COVID World, I finally got the virus, and it was so mild that I thought it was just a cold. Kind of anticlimactic, but I’m certainly not complaining! Mild is good.

I had planned to go see Doctor Strange in the Multiverse of Madness tomorrow. In fact, I reserved a seat at a matinee showing. I could go to the showing as planned, and just wear a mask in the theater. But it would be more considerate to wait a week, so I have requested a refund. The movie just opened today, and it won’t be going anywhere soon. I’ll see it next weekend.

This has been an eventful year in terms of my health. First heart failure, then severe lower back pain, and now COVID-19. And 2022 isn’t even half over. But I’m still standing. If Friedrich Nietzsche is right, and anything that doesn’t kill me just makes me stronger, then this year has already made me tougher and more resilient. That’s something to be grateful for.

May 02

Health stable, not much happening

It’s been a while since my last health update, but that’s because there hasn’t been much to report. I had an appointment with my cardiologist, Dr. Desai, on April 26. He remains satisfied with the state of my heart. I’ve been wearing the defibrillator for four months now, and it hasn’t had to do anything. Dr. Desai thinks we can dispense with it soon, but before deciding, he wants me to have another echocardiogram. My first one was on December 31, while I was in the hospital. Comparing the two should be useful for measuring my progress. The new echo is scheduled for May 10.

Dr. Desai also commented on my weight. It seems that I have gained a few pounds (four or five, I think), and he would prefer that this trend not continue. He doesn’t think it’s fluid this time, just calories. I told him he’s probably right about that, since I’m been focusing mainly on sodium and fluid intake, and not on calories. After the appointment, I decided that the wisest course of action is to rejoin Weight Watchers. I’ve actually signed up for the service already, but I probably won’t start rigorously tracking my food for a week or so.

I had an appointment with my pulmonologist, Dr. Vora, on April 18. He wasn’t aware of what had happened since the last time we met, so I spent some time bringing him up to date. He listened to my lungs and said they sounded healthly. He asked if I could remove the SmartStick (basically, a USB flash drive) from my CPAP machine and bring it in so that he could download the data. I was a little surprised, because I’ve been using the machine for many years and have never been asked for the SmartStick before. After I dropped it off the next day, his practice called to say they couldn’t read the data. I made a few phone calls and, after talking with a local medical supply store and the customer service line for the company that made the machine, I concluded that it’s probably not possible. The problem is that the machine is so old that nobody really supports it anymore.

I was told that insurance companies will pay for a new machine every five years, and I’ve definitely had mine far longer than that. Current CPAP machines don’t use USB sticks for data — they connect to your Wi-Fi and upload the date over the Internet. They’re also smaller and lighter than the one I have, which will be nice for travel. I called Dr. Vora’s office and asked him to write a prescription for a new machine.

But there’s a snag. The insurance company will want to see the sleep study data that indicates a need for a CPAP. My original sleep study was close to twenty years ago, and I have no records of it. I don’t even remember who conducted it or where. Dr. Vora suggested that we repeat the sleep study. Fortunately, I won’t have to spend the night in a lab as I did the first time. I can do a home sleep study. I have appointment to pick up a sleep study kit tomorrow, at which time they’ll instruct me on how to use it. Afterward, I’ll drop off the kit and they can analyze the data it recorded.

One other health note: I am currently sick with a cold. Nothing major, just a runny nose, achy joints, fatigue, and possible fever. (I feel rather warm at times, but I’ve tried measuring my temperature with one of those forehead thermometers, and it always says 97.6.) I started feeling ill on Saturday evening and spent pretty much all of Sunday in bed, resting. Today is Monday, and I felt well enough to work. But I’m probably going to bed early tonight.

And that’s it for now. Nothing much going on with my health, which is how I like it.

Update: I called Dr. Vora’s sleep lab to tell them that I was sick, and we agreed that it makes sense to postpone my appointment to pick up the home sleep study kit to next week.

Mar 18

That barbecue map

An online magazine called Chef’s Pencil (no, I’ve never heard of it before, either) stirred up a cauldron of controversy involving a cuisine that many people have strong opinions about: barbecue. The magazine analyzed TripAdvisor ratings of the barbecue restaurants in America’s 75 largest cities, and compiled a list of what they claim are the ten best cities in the country for barbecue. This was accompanied by a map showing where those cities are, and here it is:

The map, and the analysis that it was based on, made a lot of people angry. This Newsweek article sums up the controversy pretty well.

I won’t try to enumerate all of the things wrong with this map, because many people have already done that. (Matt Mitchell’s video is a good example.) I’ll just point out a couple of things.

The biggest outrage is that Texas is completely ignored. Now, I’m the first to admit that I’m not objective about barbecue. Of course I’m biased: I was raised on Texas-style barbecue because my father was born in Dallas, and he loved to make that kind of barbecue in his backyard grill. He was always tinkering with the sauce recipe and the way he cooked the beef brisket, in the hope of duplicating the sort of barbecue served in east Texas restaurants. He was never completely satisfied with the result, but I certainly enjoyed eating the meals that he produced. So it’s difficult for me to believe that no city in Texas made it into the top ten.

Some of the cities that did make it seem bizarrely inappropriate. Seattle, Newark, and Miami do not come to anyone’s mind when you ask them where they would go for great barbecue. As Matt points out, New Orleans has incredibly good food, but barbecue is not what it’s renowned for.

And Charlotte? Really? I grew up in the Charlotte area, and I’ve eaten in the city’s restaurants countless times. If it has some of the best barbecue in the country, I sure didn’t hear anything about it. And maybe I wouldn’t, but you can bet that Dad would have known about any good barbecue restaurant in Charlotte, and he would have taken the family to eat there. I don’t think that ever happened. (Maybe the excellent barbecue places in Charlotte only appeared after he died. Okay, I’m game. What are their names? I’d love to try them out. Update: According to TripAdvisor, these are the best barbecue restaurants in Charlotte.)

I think this project was doomed from the start, because its methodology was wrong. If you want to find the best barbecue in the country, why would you look only at the biggest cities? It’s not an urban cuisine. In my experience, some of the best barbecue is to be found in small towns and even rural settings. You’re more likely to find great barbecue at an Alabama church potluck than in any metropolis.

I can’t claim to know where the best barbecue in the country is. But the best I’ve ever tasted was at Bodacious Bar-B-Q in Longview, Texas. Longview isn’t a metropolis by any standard; it’s only the 47th largest city in Texas (81,653 residents in 2019). So the Chef’s Pencil analysis would have ignored it completely. And that’s why the map they produced is meaningless. If you’re only looking in big cities for great barbecue, you don’t understand barbecue at all.

Postscript: I notice that the barbecue analysis, including the top ten list and the map, has disappeared from the Chef’s Pencil website. I can understand why.

Mar 14

Setting the clocks

Most people dislike Daylight Saving Time, myself included. Debates about it can get convoluted, but in my experience, the arguments against it boil down to two objections:

  • The time change gives everyone jet lag twice a year.
  • Resetting every clock you own is an annoying waste of time.

There isn’t much you can do about the first one, but it is possible to reduce the effect of the second. How? By replacing your dumb clocks with smarter ones that reset themselves automatically.

Most of us already have some of the smarter kind, although we may not think of them as clocks. Your smartphone, for example, always displays the correct time. When the twice-a-year time change happens, your phone makes the switch without any action on your part. Your computer probably does the same thing, and if it doesn’t, that’s because the feature is disabled. (In Windows, right-click the clock in the lower right corner of your screen and click Adjust date and time. Then make sure that Set time automatically, Adjust for daylight saving time automatically, and Set time zone automatically are all turned on.)

But what about the other clocks? Most people don’t know this, but you can buy clocks that know how to set themselves. I learned this a decade or two ago when I needed to replace my bedside clock-radio, and while shopping for a new one, I stumbled across an Emerson SmartSet clock-radio that automatically resets itself to the correct date and time “as soon as you plug it in and after every power interruption.” That sounded too good to be true, but I bought one, and it works as advertised. (The model I bought back then has been discontinued, but Emerson makes several similar ones, which sell for prices as low as $15.)

The instruction manual didn’t explain how it performs this miracle, but a little research revealed the answer. The National Institute of Standards and Technology (NIST) is a part of the U.S. Department of Commerce, and it’s in charge of providing a national time standard. The correct time from NIST’s atomic clocks is made available on the Internet (which is what computers and phones use) and by radio signal on several different frequencies. The Emerson clocks are designed to receive that signal and adjust themselves accordingly.

Emerson isn’t the only clock-maker that offers this feature, and it’s not limited to digital clocks. A couple of years ago, the analog wall clock in my kitchen stopped working (it was at least twenty years old), and I decided to see if I could replace it with a self-setting model. After a little browsing on Amazon, I ordered a La Crosse Technology clock that looked almost exactly like its predecessor, except for the words ATOMIC TIME on its face. But despite its old-school appearance, this clock listens to the NIST time signal and resets itself whenever the need arises.

At this point, I have very few clocks left that have to be reset by hand. The analog wall clock in my bathroom still requires that, but I’ll eventually replace it with a La Crosse or something similar. There’s also a digital clock in my living room that has to be set by hand. I replaced my old analog wristwatch with an Apple Watch at the beginning of this year, and it synchronizes with my iPhone. The only other holdout I can think of is the dashboard clock in my car. (My microwave oven has no clock, which is fine with me.)

Someday, I will have no clocks that need to be reset manually. Won’t it be nice to eliminate that minor annoyance from my life?

Update: Since writing this entry, I’ve realized that I have two other clocks in my kitchen. They’re built into my coffee maker and my digital kitchen scale. I normally don’t even notice these, so I suppose it doesn’t matter whether they’re correct or not. But I went ahead and reset them anyway.

Mar 12

A gift for Dad

Health update: I’m almost completely recovered from my flareup of lower back pain. Still some pain when I first get out of bed in the morning, and some stiffness when I get up from a chair if I’ve been sitting for too long. But once I’m up and moving around, I feel fine. I suspect that in a day or two, I’ll be completely pain-free. The muscle relaxant really helped, and I’ll make sure to thank Dr. Raman for prescribing it when I see her for my annual physical in a couple of weeks. Once again, I have my life back, and I’m grateful.

Recently, I was reading one of the blogs I follow, and I found myself looking at the following image, which was presented without any context or explanation.

I was immediately intrigued. A USB flash drive that looks like a vacuum tube? That’s really cool, and I want one! But is it a real thing, or just a picture someone made in Photoshop? After a quick image search, I determined that this is absolutely real, and it’s for sale on Amazon.

Sadly, my design to own one was extinguished when I saw the prices. They vary depending on storage capacity: the cheapest is $49 for 8 gigabytes, and the most expensive is $119 for 256 GB. (For comparison, you can buy a SanDisk 512 GB drive for under $50.) Those prices seemed exorbitant to me until I read the description, and learned that this thing doesn’t just look like a vintage vacuum tube, it actually is one. Each of these drives is made by hand (in Latvia) from a vacuum tube that was manufactured in the Soviet Union in 1981. A genuine collector’s item. Suddenly, the price seems appropriate when I consider the scarcity of the raw materials, and the skilled labor required to craft the finished product.

It’s still too expensive for me to buy just for my own amusement. But if my father were still alive, I would buy him one of these in a heartbeat. Dad was notoriously difficult to buy gifts for, because if he wanted something, he would usually buy it for himself before anyone had a chance to give it to him. So the trick was to find something that he wasn’t aware of, but that he would like if he knew it existed.

Dad was a ham radio operator and electronics hobbyist from the 1950s onward, when vacuum tubes were still in a lot of radio and TV sets, although transistors were gradually making them obsolete. He was quite familiar with these tubes, and I’m sure he would have appreciated the combination of retro and futuristic tech. He had fond memories of the tube-powered radios and TV sets of his youth, but he was also an avid early adopter of cutting-edge technology. It was because of him that our family had a home computer in 1976*, at a time when you couldn’t just buy a functioning computer; you had to build it from a kit.

Dad would have loved this. I wish I could have given it to him for Father’s Day. Seeing the look on his face when he unwrapped it would have been worth the price.

*Correction: Bob informs me that we didn’t get the computer (a Processor Technology Sol-20) until 1977. That’s still years before the arrival of the IBM PC (1981) and the Apple Macintosh (1984). However, a bit more research shows that several home computers that did not have to be built from a kit made their debut in 1977: the Apple II, the Commodore PET, and the Tandy TRS-80.