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Cameron lesion--an ulcer within a hiatal hernia. Usually asymptomatic, can cause anemia. Caused by ischemia and trauma from diaphragm? Especially seen in large hiatal hernias.
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Under weird things I learned in training (I'm thinking it was residency) was a tip once when people obviously want to talk about something but don't feel comfortable bringing it up...ask them if someone is in jail (or is using drugs).  Either the person will be so glad that it's not that bad, or they will be surprised at how well you hit it on the head.  Medical cold reading.  And then they can open up and talk to you about it.  Worked today.
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I've temporarily stopped duplicating my crossword times here, and am keeping them all on my home computer only;  we'll see if I feel a need to change that.  I'm going to concentrate more this year on getting crosswords right rather than on time.  So far, I'm not writing down (in my list or the other lists) any crossword times if I get something wrong, and next time I finish a crossword book I will go back and count the number I had all correct.  I can record those on my librarything page.  And look for patterns of what I get wrong...did I not read crossing clues?  Not erase a partially incorrect?  Left a space open?  Let's pay attention.

I saw my first post-vaccine shingles case today.  I think it was shingles, it had the right pattern, but he complained of itching rather than pain.  Which means the vaccine is doing its work in attenuating the disease, and preventing PHN.
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I was talking to a state epidemiologist this week, about the risk of rabies from a vole bite.  The vole in question having been brought in by a cat, it sounded like perfectly normal behavior to want to bite someone.  The interesting bit was that voles, mice, etc in general will die of rabies before becoming infective due to their low body mass.  A good thing.  I'm not sure the rabies virus picked a good strategy for propagation.

At a talk on chronic pain management, they brought up the idea of pill counts, which seems like a good idea.  Also, let the legal system worry more about what folks do with their meds outside of the office, concentrate on clinical outcomes (until they hit a red flag.)  And neurontin + morphine has improved effect than either.

In curling...I went 0 for 2 this past week.  And 0 for 3 the week before.  Today I practiced some take-outs, and upped my force, with hopefully little change in my aim. 
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 Too rainy today to go to the BigE.  Hopefully it will be better weather next weekend.  I'm still going if it's lousy weather.  The other activity for next week is the Mancuso quilting exhibit.

Working on 'sashiko inspired quilt', aka my japanese-fabric quilt.  Oh no, my 20" squares of blue aren't enough to form a 21" border.  Fabric shopping will have to ensue.

Things to remember about it may be co-infected with erlichiosis, specifically human monocytic erlichiosis, which may not show up on our labs.  HME would need separate treatment with doxycycline;  which would also treat a co-infection with Lyme, so all the better. 

And, hey, you can treat some of the more obnoxious personality disorders with medications, in particular to help with irritability and impulsive behavior.  Actually all the personality disorders can be obnoxious.


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March 2017



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