Sunday, January 28, 2018

Arthritis update (personal note)

My familial arthritis showed up in one finger a few years ago, but in December of 2015 it became a bigger deal [1]. It looked like an early and fast moving symmetric osteoarthritis (OA), but then so did my mother’s before it morphed into something like RA (which ate lungs, joints, etc). OA is really a junk drawer diagnosis so I ended up calling it “familial arthritis”.

After a bit of personal research I ended up with an eclectic rheumatologist who suggested hydroxychloroquine (HCQ). This is a popular Lupus and RA med that started life as an antimalarial. It’s generally well tolerated with one minor side-effect — you can lose your vision. [2]

HCQ has been since tested experimentally in osteoarthritis — and it didn’t seem to do anything. [3] It did work for my mother’s RA though (where it is known to work), and her disease started out looking like mine …

So I’ve been on the HCQ for about two years.

Has it worked?

There’s no way to know, I can only present circumstantial evidence for one person. I have no idea what the disease would have done without treatment.

The joint deformity has not progressed much. To track joint changes I bought a ring sizing set and I use it to measure a selection of PIP (small, distal finger joint) and PIP (join in mid finger) sizes. There hasn’t been much change in joint deformity over the past two years; interestingly the worst measurements were the first set. That’s probably measurement error or some initial soft tissue swelling that’s diminished. 

I don’t have any finger joint redness or pain any more. Sometimes I forget to take the HCQ and I imagine I have some hand stiffness and joint aches — but that seems too fast to be a med effect. I think it’s my imagination. (Though we don’t have a good story for how HCQ works, so who knows.)

My knees aren’t worse; they are better than they were before I started the HCQ. I still do 230 lb CrossFit deep back squats. (I’m a wimp. Average strong guys do well over 350 lb.)

And, yes, I’m still doing the CrossFit. The rheumatologist approves. I thought I’d have to take up underwater hockey instead but I put that one off for now. 

It’s only been two years though. I’ll be more impressed if this is still true in two more years.

- fn -

[1] When I search the blog I see a few prior posts on knee and wrist exercise related aches that were, in retrospect, part of the arthritis.

[2] There are eye exams to try to spot this early, but we know in animal models that the chorea disease progresses for some time after the medication stops. We don’t know the real frequency of this complication — there’s at least a 1/20 chance I’ll get it.

[3] OA, like autism and schizophrenia, is an ill defined collection of things that’s damnably hard to study.

Wednesday, January 24, 2018

Scientific American forgot to tell me how to activate my digital subscription. Here's how.

When I renewed Scientific American last September I had a “deal” that included 1 or 2 freebies and digital service for $40. (Today I’d use Amazon — $35, much easier to manage, great subscription manager, etc).

The magazine eventually showed up but not the free extra book/special edition and not the digital service. Maybe there was an email that went into my spam filter, but I have gotten other email from them.

Turns out I had a digital service all along. I went to their customer service site and followed a link to manage my subscription account. From there I saw a link to activate digital service. That worked.

Now I have to figure out what happened to the freebies.

Sunday, January 21, 2018

Year one of post-imperial America

The Berlin Wall fell on November 9, 1989. That was the end of Russia’s Empire, the end of the USSR. I was 30 years old. I may still have a newspaper from that day.

When did America’s empire end? It’s not so clear. Was it 9/11/2001 when the towers fell? Was it 3/20/2003 when the US split from its NATO allies and invaded Iraq?

Historians will decide, but I think most will settle on the election of Donald Trump on November 8, 2016, 27 years after the fall of the USSR. The symmetry is irresistible.

Both left and right agree, America is no longer a hegemonic power. The GOP’s collapse and Trump’s incoherence have made America a mighty but brainlessly blundering behemoth. The world has shifted from a unipolar to a multipolar system ten years earlier than expected. Everything frozen is in motion, from Korea to the West Bank. The sun has set on the American Empire, Putin’s revenge has been poetically perfect [1].

Was America’s Empire a good thing? I think the rebuilding of Europe and Japan was a good thing. I think containment of the Soviet Union was good. The long peace, without direct conflict between world powers, was good. Avoiding the end of human civilization was probably good too. Most of this came between 1945 and 1989 though. The record over the last 27 years has been more mixed. Perhaps the world will do better without America.

Where do we go now? I have given up on the prediction business. What I hope happens is that the GOP is swept from power on November 3, 2020. By then much of America’s federal government will be severely damaged or devastated, but we now know that our system was rotten and ready for a fall in 2016. After 2020, without the burden of empire, the United States can begin rebuilding. Like a city leveled by flood or earthquake, we can return better than we were.

- fn -

[1] Do read that Atlantic article. I’d forgotten Anna Chapman from 2008! Among other things we learn that Russia is justly proud of its astounding coup, but not entirely sure it was a good idea:

… The original aim was to embarrass and damage Hillary Clinton, to sow dissension, and to show that American democracy is just as corrupt as Russia’s, if not worse. “No one believed in Trump, not even a little bit,” Soldatov says. “It was a series of tactical operations. At each moment, the people who were doing this were filled with excitement over how well it was going, and that success pushed them to go even further.”…

… The head of the FSB’s elite cyber unit and his deputy were forced out; two other top officers from the unit ended up in Moscow’s most notorious jail.  “They’re now under incredible pressure both from the inside and the outside,” Soldatov said. “Sometimes,” says Michael Hayden, a director of the National Security Agency under George W. Bush, “you have successful covert operations that you wish hadn’t succeeded.” …

… What Russia showed in the 2016 election—and what it has continued to show in the election’s aftermath—is not so much its own strength, but American vulnerability: that it doesn’t take much to turn the American system on itself. “Covert-influence operations don’t create divisions on the ground; they amplify them,” says Michael Hayden, the former NSA chief. John Sipher, the former CIA operative, agrees. “If there’s anyone to blame, it’s us,” he says. “If we accept the stoking, it’s our fault.”