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All Ears

General health problems such as ear infections, pink eye and influenza affect nearly every person eventually. Rod Moser, PA, PhD, shares information and advice here on the most common general health disorders, their symptoms, treatments, and prevention.

Friday, October 30, 2009

Pet Friendly Hotels?
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It has been a while since I have traveled with my pets, since my adult dog, Lexi, hates the car. She shakes and trembles, lies on the floor of the back seat and then throws up. It may be anxiety, since her only car trips now are to the vet or to the groomer - both not high on her list of places to go.

"Herman" / Photo: Rod Moser
Two of my Shelties loved the car. One would actually chase cars while IN the car. We had a van at that time, so she would sit on the front seat until she saw a car, and would then run all the way to back barking at it as it passed. This was annoying. Herman, my late buddy, would try and come with me all of the time; even when I was going to work. As soon as I would open the door, he would jump in. He would lie on the front seat and lick my right hand which rested on the center console. His fearlessness around cars lead to his injury a few years later when his big, bushy tail got caught under my rear tire. He was not able to recover from his injuries after extensive surgery and had to be humanly euthanized. This was one of my saddest days.

About a week ago, I had to take a few days off to put, Cali, one of Lexi's six puppies on the plane to Maryland on Pet Airways. Since the flight left from Los Angeles, about a 7-8 hour drive, my brother and I had to leave the night before. Finding a pet-friendly hotel was a bit more challenging than we anticipated.

There are dozens of hotels near the Los Angeles airport, as you might imagine, but the surrounding communities are not the safest places to stay. We did find a hotel that allows pets near the airport but the reviews were not good; scary in fact. One reviewer referred to this hotel as worse than the Bates Motel. Another advised us to lock our car and doors at all times. We figured that this pet-friendly hotel may have also been crack-friendly and prostitute-friendly, so we canceled our reservation.

There are lots of Internet sites that list pet-friendly hotels, but pet-friendly does not necessarily imply that they are wallet-friendly. Some were terribly expensive, including one pet-friendly hotel that has a one hundred dollar, non-refundable pet deposit! That is $700 in dog money! The lowest pet fee was fifty dollars. Since we were only staying there for about nine hours, we felt those fees were ridiculous.

Photo: Larry & Jeanette Moser
We finally found hotel (one of the chains) located two hours from the airport that allowed pets and did not charge an extra fee. What would this one be like? It turned out that this hotel was one of the cleanest, nicest, reasonably-priced, safest places that I have every stayed - The Hampton Inn Santa Clarita. I think they deserve a plug for being pet (and human) friendly. There were many dogs there, including some scary-looking, but well-behaved pit pulls, but not one was barking or running amok. We did sign an agreement to pay for any pet damage, which of course, there wasn't any. I would stay at this place again, even if I didn't have a pet. They even had a hot breakfast in the mornings that was darn good. I blogged about The Dozen Dirty Places in the past, listing hotels high on this list. I can truly say that this hotel is an exception. If I did the list, I would put my living room or my home office on the list instead.

Photo: Larry & Jeanette Moser
Cali made it safely to Maryland after her thirty hour journey; a longer flight than we originally anticipated. My latest report from Maryland is that she is excelling in house-training and has already been fitted with her life preserver for the boat. It is good that she is house (boat) trained quickly or you could have a whole new meaning for the area on the boat called the Poop Deck.

Photo: Larry & Jeanette Moser
Unlike most of my other dogs, Cali is the one that does not seem to mind car trips. She has already visited my elderly mother (she will be 88 next month) in the nursing home and has made many local car outings without the least bit of car-sickness or anxiety. Out of the six puppies, it seems that my brother got the "good one", although I think all of them are wonderful.

When we go out of town, we hire a house/pet-sitter. In a few years, we would love to buy a tent camper and tour our own country, hitting the best of our National Parks. I would love to take the dogs; not that they would enjoy the trip, but so we wouldn't have to leave them. My brother and sister-in-law do many car (and boat trips) so having a travel-friendly pet is essential. I am glad they got one. Since we have accumulated a menagerie of sorts - three dogs, two cats, tropical fish, and 14 non-egg laying (so far) chickens, we will need that pet/house-sitter for a long time, I am sure. We fantasize with the idea of retiring pet-free, but neither one of us can imagine a life without having a dog (or three) to love and pet.

Photo: Larry & Jeanette Moser

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Posted by: Rod Moser_PA_PhD at 7:10 AM

Tuesday, September 29, 2009

Acoustic Insults
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It has been a long time since I experienced "airplane ear", but this weekend reminded me that all of us are subject to sudden acoustic insults. I spent the last few days at a conference for the California Academy of Physician Assistants in Palm Springs, where I was invited as a speaker. I am proud to say that I started this organization 33 years ago in my living room; funded by $500 of my own money. The organization now has thousands of members and a $1 million budget. This literally blows my mind.

Once you have been in this profession over 25 years, you earn the title of a "Dino", short for dinosaur, of course. I have been a Dino for many years now, so a Co-Dino and I were asked to speak to a group of students. Both of us were PAs before they were born, so it really made us feel very old. Every year, we see fewer Dinos and more of the younger clinicians. This is excellent since the youth of an organization and profession are the leaders of tomorrow. Long after I am gone, this organization will continue to flourish with this new transfusion of fresh blood.

One of the entertainment venues at the conference was a PA Idol competition and dance. When I saw those refrigerator-sized speakers being put up, I made sure that I found a place far away. When the music started, the volume was unbelievable. I put tissue in my ear, but no sooner that I did this act of protection, people started to talk to me. All that I saw was mouths moving. I would usually give an affirmative nod. If they seemed pleased, the nod was appropriate. If they looked shocked, I would shake my head "No". When you think about it, I had a fifty percent chance of responding correctly, even though I had no idea what they were saying.

The bass notes made my head roar and body shake. I had to get out there. Walking outside, I was finally able to achieve some silence. As I expected, this brief acoustic insult exacerbated my tinnitus. My ringing had doubled in volume. I also had a little vertigo. Needless to say, I did not stay and watch the completion. This increased tinnitus continues, but if I stay busy, it does not interfere with my daily life.

On the flight home, I experienced barotitis - ear pain associated with atmospheric pressure change; also called "airplane ears". Periodically, my ears would clog from leaving home (2500 feet) to working in the valley (300 feet), but they would usually equalize after an hour.

This was not a typical flight: faster take-off and rise to cruising altitude, and a faster landing. I suspect all of this was done to make-up time. Our flight was delayed about 25 minutes for some reason. About fifteen minutes into the flight, my left ear felt like it was going to explode. All of my self-equalization techniques failed. My left ear was nearly deaf at this point, with my tinnitus interfering with any remaining hearing. Fortunately, this was only a one hour flight so my ear pain improved, along with my hearing as soon as we descended to a few thousand feet. When I arrived home, I used an electronic device called an EarPopper to further help equalize the middle ear pressure. It seemed to really help.

The last time that I had a barometric-related incident was about twelve years ago while landing in Detroit. For some unknown reason, the plane suddenly descended (I would sure like to know why). The drop was so rapid, I thought we were crashing. I was sitting in the worst seat of the plane - two seats in the back, under the engine, near the stinky bathroom, and with no window. I was sitting with an elderly woman, perhaps in her eighties. She must have noticed the blood draining from my face and obvious fear. I was clutching my painful ear (other people were doing this, too) with one hand, and the other sweaty hand was clutching the arm of the seat. She started to gently stroke my arm.

"Don't worry, Honey. You will be fine."

Of course, we landed safely, but it took four days to be able to hear normally again; my left ear ruptured from this incident.

After my experience this weekend, my left ear is acting up again with loud tinnitus and diminished hearing. That brief acoustic insult from the loud music, coupled by this barometric incident has taken a toll on my aging ears. Hopefully, things will quiet down in a few more days.

Acoustic incidents can happen so fast; so unexpected, that we often have little opportunity to extricate ourselves. I quickly left the blaring music, but I had no way of escape from the plane. The human body has a remarkable ability to recover from these events, so I will be happy when my pre-existing tinnitus goes back to its normal, constant whine and squeal.

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Posted by: Rod Moser_PA_PhD at 11:36 AM

Friday, September 25, 2009

Up in the Air - Again
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I am not a huge fan of flying, but you do have to tolerate this advanced form of transportation if you really need to get somewhere easily. Ever since 9/11, I have been a bit more anxious about flying. It is not that I expect a terrorist attack (although we all think about that now), it is just the whole experience of flying has lost its appeal to me. I don't like lines. I don't like hassles. I don't particularly like crowds. I would much prefer to get in my car and head out to my destination, which in many cases, is not practical or economical.

A few days ago, I fly to Southern California to attend an annual professional conference. As in years past, I am one of the speakers. I really have little difficulty with this type of crowd. I can stand in front of a microphone in an auditorium with a thousand people and feel comfortable. I meticulously write out my talk, practice it (a little bit), and then never look at my notes during the entire lecture. It takes me a few minutes to get going, but then they have to bring one of those big hooks and pull me off of the stage. I am never short on stories.

I flew down a day earlier to visit my old college buddy. He recently had brachytherapy for his prostate cancer and jokes about being radioactive now. He looked great; sort of had that "glow about him". Robert and I, along with his college roommate, sang in a three-man quartet (we couldn't ever find that 4th singer). To this day, we still know those tunes, and he can still play that piano and harmonize. I think we sound pretty-good, but then again, we had an audience of one. When old friends get together it become a laugh-fest. We begin to re-tell stories and try to re-live some of those happier times in our lives. The early 1970's was a turbulent time in the world, but tucked away in a small rural college in West Virginia, we were spared much of the Vietnam war protests, racial unrest, free love, hippies, and drugs. There was a little bit on campus, but most of the time, our lives revolved around classes, complaining about cafeteria food, and just shooting the breeze.

During school holidays, we would hitch-hike somewhere; another lost mode of transportation. We didn't seem to think very much about getting picked up be axe-murderers and crazed hillbillies. We just wanted a cheap and relatively-fast way to get from point A to point B. Our longest trip was from West Virginia to New York City. All of us, in teams of two, made it in one day. We would proudly share our ride experiences; both good and bad. Maybe we were oblivious to the risks of this practice, but teenagers tend to ignore risks.

The last time that I hitch-hiked was about twenty years ago. My wife and I had a long weekend without the kids so we decided to take a three day trip down the Eel River in Northern California on a canoe; camping out along the river. It was a nice float; a bit too many portages - a problem if you pack heavy and your canoe is aluminum - but nice nonetheless. There is nothing more relaxing than floating down a river in a canoe. We passed many, neatly-cultivated fields of marijuana, tucked in among the fields of wine grapes. They were tended by nervous-looking ex-hippies hoping that we were not Narcs. We didn't look like Narcs, but paranoid people see Narcs everywhere. We had to pick our camping spots carefully, since I had no idea we were traveling at the height of the pot harvest. Many people do not realize that marijuana is California's number one cash crop. Grapes are number two, if you want to know. Even in my college days, I was never a fan or user of marijuana, or alcohol for that matter.

Well, I got off-track again. I wanted to blog about air travel. I packed (tightly) everything that I needed for five days in one carry-on. My laptop and camera filled my briefcase. I beeped through the metal detector - my new watch and my belt buckle, but it was my bag that troubled the x-ray screener.

"Please come with me," he said politely.

The TSA officer took my bag for a physical inspection. Of course, I am in my bare feet waiting for my laptop and camera to come through before someone ripped it off.

"Do you have a Leatherman's Tool in your bag?"

"No, I don't own a Leatherman."

"Well, we see one in there..." I am thinking, "Great, I always wanted one of those."

So, he dug and he dug through my neatly packed rolls of underwear, socks, dress shoes, and assorted electronic gear that charges your laptop and cell phone. I had nothing to hide, and I had come in plenty of time.

My "Leatherman" turned out to be the buckle on my shaving kit (Yes, men with beards shave!), overlying some other junk. No Leatherman, of course, but no one will take your word.

Many years ago, I was traveling with my son to fulfill a promise. We went to Cooperstown, NY, to the Baseball Hall of Fame to see Mike Schmidt be inducted. Mike Schmidt was my son's idol. On the way home, my son had bought a pewter disk about the size of a coaster with Mike's face embossed on it to add to his impressive collection of Schmidtobelia. This time, we were pushing the clock to make our flight. And, wouldn't you know it - the metal disk prompted a bag search.

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Posted by: Rod Moser_PA_PhD at 6:35 AM

Monday, August 24, 2009

Airing Some Dirt
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Airplane cleanliness was one of my twelve Dirty Dozen that I discussed on a past Blog. My experience on my most recent cross-country flight has not changed my views. Like most businesses, the airline industry has to cut corners. I guess if I had to sacrifice cleanliness for safety, I would chose safety, hands down.

Hurry Up and Wait
We have to get to the airport now about two hours early due to safety inspections, and I did just that. However, I had to wait in line while only a few people checked us in. I had no bags to check. Now that I have my Rick Steve's travel bags, I can haul a weeks worth of clothes and several books, including a suit, into a backpack. My briefcase has my camera (I always carry it) and my essentials - toothbrush, comb, medications, and busy paperwork. Since 9/11, I have been more anxious about flying, so I try to remain busy. As a non-drinker, I do not have alcohol as an anti-anxiety crutch.

I stood (patiently) in line for over an hour. Once I checked in (I should have printed out my boarding pass the night before, but I worked too late and forgot), I was directed to my gate, about a mile away. That heavy backpack wasn't so convenient at this point. As you might expect, there was another line at security.

People were standing around in bare feet and all I could think about was foot fungus. I saw some pretty funky feet in that line. I was wearing sandals, but I had to take them off, too. I didn't think the space between my toes was much of a security risk, but I guess the soles of my sandals could have been an issue. I had gone to great detail making sure all of my liquids - shampoo, cologne - were in tiny bottles. I had nothing sharp, except my wit, of course. For some reason, my bags were set aside for the sniff-test, checking for explosive residue. I do not deal with explosive, so I had no worries, except that maybe I fit the profile of a mad bomber.

Frequent Flyer Seats
I was able to use my frequent flyer miles to upgrade to first class, although there are several degrees of first class. Every time that I do this, I get into seat 6A - the last row of first class. This is really much better than the first row, of course, since this row is the waiting area for the toilet. Not only do occupants in these seats get frequent whiffs from those open doors, but a few whiffs of those anxiously waiting for that one door to open.

I apparently have a huge bladder, since I can hold it for many hours. I don't like to use public restrooms, especially on an airplane. Turbulence tends to start about the time you try and pee anyway.

The last row of seats gets the meals that are not chosen first. On this breakfast leg of the flight, I just knew I would get cold cereal. So, as I ate my corn flakes, I thought about the cleanliness of my tray table that I forgot to wipe off. Was there a pile of used Kleenex sitting there from the previous passenger, recently diagnosed with H1N1 flu? How many sneezes did that tray get? I made sure not to touch it, or sit down my microwave-heated muffin. Between flights, airline personnel will empty the trash, but they do NOT sanitize the trays or arms of the seats. Since germs can remain on hard surfaces for hours, this concerns me.

Announcements
We live in an age of electronic marvels, so why do announcements on a plane hiss and echo like a New York subway. Granted, my hearing isn't what it used to be, but I had absolutely no idea what the pilot or flight attendants were talking about. They could be announcing a water landing, but I would not have a clue. In the event of a water landing, your seat cushion can be used as a floatation device. I can tell you right now, if we were making a water landing, my own seat cushion would not be suitable. I always listen to those safety briefings and notice where the emergency doors are located.

Pull Back and Wait
Airlines treasure their on-time statistics. This is why they pull back from the gate on-time, only to wait another 30 to 45 minutes on the tarmac. We had a 30 minute delay in Dallas, sitting there in the 100 degree heat, and a 45 minute "weather" delay in Washington, DC, on the way home. I don't mind weather delays, since I absolutely hate the storm cloud roller coaster. Once, while flying into Detroit, our plane hit some unexpected turbulence, the kind that will field test those seat cushions. The look on my face must have concerned my elderly female seat mate, because she took my hand and said, "It's okay, honey, I have been in worse than this. You'll be fine."

Seat Mates
On the first leg of my flight, I was entertained, non-stop, by an embittered newly divorced man. He was ragging about his ex-wife, her attorney, and his child support/alimony responsibilities. I picked up a new seat mate in Dallas, a cowboy (naturally). He was pleasantly quiet, drank a lot of free booze, and was miffed that he had to eat a salad for lunch. I sort of aced him out by choosing the last pasta dish.

A seasoned soldier, home from Iraq, shared one of the travel legs. He was Cuban, having immigrated in the late 1960's, after the Bay of Pigs. He still had a Spanish accent.

My seat mate on the way home was a young woman armed with an array of antibacterial hand lotions, wipes, and other forms of disinfectants. I did admire her recognition that planes are not the most sanitary modes of transportation, I think she overdid it a bit. I don't know why these sanitizers have to smell so much like perfume. It reminds me of those old ladies in church who use gallons of cologne to mask unwashed body odor. I coughed a few times from the fumes, which concerned her a great deal. If she had a mask, I am sure she would have worn it, or at least handed it to me. Incidentally, our clinic now has a "flu table" set up, complete with hand sanitizers, masks, gloves, and even gowns for people to use if they want. The airline industry should take a hint.

Idle Time
I had several books and bought a few magazines at the airport. Just likely eating all of your popcorn before the movie starts, I read nearly all of my magazines before the plane took off. My book is a bit boring, so I did nod off a few times. I am so concerned that I will loudly snore that I tend to avoid sleeping on the plane. My last seat mate had loaded a lot of movies on her laptop and was listening to them on some nice Bose headphones. I would glance at the movie from time to time, and wished that I would have brought my own laptop this time. Knowing that my brother, a Born-Again Apple user again, has one, I decided not to bring mine. I was thinking that I was sparing the extra weight, but your own in-flight movies on a laptop are sure a nice distraction for idle time.

Window seats give you the ability to spot clouds that may cause some unexpected bumps. Over California, I spotted several active forest fires - a seasonal threat to many of us who live in wooded areas. When I saw the deep, blue waters of Lake Tahoe, I knew I was nearly home. Soon, I spotted the rice fields adjacent to the airport. It is always nice to travel, but it is even better to be safely home.

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Posted by: Rod Moser_PA_PhD at 11:37 AM

Friday, May 01, 2009

H1N1 Flu: But, They're PIGS!
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Photo Credit: Laurel Fan
I knew this would happen. The Swine Flu is not a nice name. It sounds kind of dirty and unappealing. Jews and Muslims do not like pigs; animal rights activists do. The pork lobby and the commodities market for pork bellies do not favor the name. You have to change it, so let's call it H1N1. I guess everyone will know that the "N" stands for neuraminidase. Everyone else can just call it the H1N1 (high-knee) flu.

When there is a pandemic on the horizon, governments must have scapegoats, or in this case, a scape-pig. During the last major pandemic, we called it the Spanish Flu just to tick off Spain who refused to provide information about flu deaths in their country during World War I. We could have called it the German Flu, but everyone already hated Germany and we already named a type of measles after them. It should have been named the Kansas Flu since this is where it started, but Kansas is such a nice place. There is no place like home, Toto.

Later on, we had the Asian Flu or Hong Kong Flu. This may have been more appropriately named, since this strain of influenza did originate in China. God forbid that we call this one the Mexican Flu. Mexicans are having enough problems as it is with those drug wars and a crash in the tourism business. Just yesterday, a patient informed me that their Mexican cruise has been canceled by the cruise company due to the flu pandemic.

I wish they would have had a contest and let the American people name this flu. There could be call-ins and text messages, like the American Idol. How about the al-Qaida Flu? I thought this was a good one until I heard there was a guy in Cleveland named Al Kida. That would not have been fair to him. He already lives in Cleveland. Oops, I did it again. What I meant to say was, "I love Cleveland." WKRP! Wait, that was Cincinnati. Now I have Kansas and Ohio upset. How about the Kim Jong-il Flu? This is another good one; it already has "ill" in the name.

This morning as I was getting my morning flu briefing from Matt Lauer, I discovered that the name was changed yesterday to the it's scientific name - the H1N1 influenza, after many pigs were needlessly slaughtered in Egypt and people stopped buying pork in the grocery stores. Regardless of the reassurance that you cannot catch swine flu from processed pork products or uninfected pigs, people are not convinced. I am sure glad that pigs do not cause autism, or do they? Now, I did it. Oops.

A slip of the tongue or joking can really backfire nowadays. Poor Joe Biden. Much of the morning news was filled with White House spokesmen that were trying to explain what Joe "really meant" so the American people can relax and say, "Whew! Now I feel better." VP Joe is staying home and will not be traveling on commercial airlines, subways, and buses, like he normally does (sarcasm). The air transportation czars were up in arms with the approaching summer travel season defending the cleanliness of their planes. Personally, that would be like defending the cleanliness of those Mexican pigs.

Granted, most commercial airlines do have HEPA filters to scrub the air of pathogens. While this may help a little bit, it is not going to protect you against the sneezer in the seat behind you that just blew up the back of your hair, or the snotty-nose kid that wipes his hands all the way down the aisle to the bathroom, where God knows what happens inside. Between flights, airline personal empty the seat back pouches of all of the trash we stuff in there, including napkins, Kleenex, and I am sure, but have no conclusive proof - dirty diapers. They probably vacuum up the pretzel crumbs at some point at the end of the flight days. Peanuts are no more. They may try and sanitize those stinky toilet closets and load up the TP containers, but they DO NOT SANITIZE those planes. How can they? Viral pathogens can remain on surfaces for hours, and we only have a short time when people disembark and others board. Pathogens will remain on those tray tables, even in the upright positions (germs do not fall off). They will remain on those cloth seats. They are on the call button and that little air deflector that you point at the sneezer behind you. Pathogens are everywhere, so if you are going to get sick, this is the place. I included airplanes high on my list of the Dirty Dozen - the Twelve Dirtiest Places. My feelings have not changed any more than the airline's traditional hygiene practices.

Pigs do have hygiene issues, but we do not hesitate to harvest heart valves from them, or use them to test our pharmaceuticals. It's not bad enough that we make fun of their appearance and eat them, now we have to blame a pandemic on them. Researchers feels that AIDS originally came from monkeys, or from someone monkeying around with monkeys. If that is really true, then why haven't we taken it out on those monkeys? Monkeys are cute, that's why. Pigs? Not so much, although those Vietnamese potbellied pigs are sort of cute in piggy sort of way.

Arnold on Green Acres was not only cute; he was one of the more intelligent mammals in Hooterville. Porky Pig, in spite of the fact that he does not wear pants, is an American icon. Of course, not having genitalia sort of excuses him. People love to "pig-out" or go hog-wild. Actors ham it up. Pigs wear lipstick. Politicians talk about pork-barrel spending. Little girls wear pig-tails. Hell's Angels ride hogs. People hog seats on the bus, assuming they are still riding a bus now that Joe gave 'em up. Sue-EEEEE!


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Posted by: Rod Moser_PA_PhD at 4:36 PM

Tuesday, April 24, 2007

Taking It on the Road
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Moser

Although WebMD Health Experts are not obligated to post every day, it sort of becomes addicting, even when on vacation.

Over the last eight or so years, I have posted responses from cruise ships in Mexico and Alaska, the District of Columbia, Maryland, Maine, West Virginia, Pennsylvania, Oregon, Idaho, Washington, Nevada (Vegas!), Canada, England, Scotland, Wales, and Ireland, just to name a few places.

When I list all of these places, it appears that I am some kind of world traveler. I attend a lot of medical meetings, and I do like to travel. After 9/11, I don't travel quite as often. I can't remember a time that I didn't take along the laptop.

I have used wireless networks in restaurants, hotel lobbies, conference facilities, and some of the oddest Internet cafes you can imagine. I have sat next to some dubious characters (probably setting up those infamous Internet scams), and waited my turn at the library when my satellite service fails, which is quite often (I won't mention the name, but it rhymes with Mirth Link.). I have even posted from my car outside of a hot link that I found.

I post quite often from my clinic desk (see photograph), between patients, when there are "no-shows," after my 12-hour shift, and of course, while eating lunch over the keyboard. If there ever was a global famine, I could live for several days on the crumbs that I could shake out of my keyboard.

Mostly, I post from my rural home nestled in the Sierra Foothills between Sacramento and Lake Tahoe. My window looks out on the snow-capped mountains, lots of beautiful Japanese maples that I planted, and my neighbor's shack. He inherited the property from his grandmother and "improved" it by building an outhouse-like shack, where he spends the weekends, perhaps writing his manifesto. I like to keep an eye on him. We call him "Ted" and his shack, "Ted's shed." He likes to burn stuff; not a good pastime when you live in a high fire risk area.

When my home network is functioning, I can post from my vegetable garden, from the garage, or sitting out in the grass alternating between typing and dog-petting. I won't show you a picture of my home office, but I can describe it to you...

I enlarged my desk with a huge sheet of oak plywood (finished nicely, of course) so that it will hold the stacks of papers, bills, and stuff that I should throw away. My computer is about six years old. I would like to replace it, but my Internet connection is so unreliable that I would be like having a Ferrari just to drive around the yard. My laptop is newer, but not by much. As long as they work, I am fine with them.

I have three printers (I like to take digital photographs), a copy machine, two scanners, a paper shredder, and a television. I threw my fax machine away, since it wore out one day when a real estate office accidentally printed my fax number on their business cards. I had just added a whole ream of paper, too.

Behind my desk, you will find three bookshelves filled with my reference materials, two file cabinets, and a big, glass case that holds my lifelong collection of antique medicines, including my award-winning collection of antique laxatives. All of these (and more) will soon be on permanent loan to the new Gold County Medical Museum when it opens in the fall.

The floor (carpeted, I think) is my desk extension and axillary file. There are several piles of neatly stacked papers that do not fit anywhere else. In a cleared space by my desk, you will find my dog, Herman. He has been my constant companion since his birth in our bedroom seven years ago next month. Herman's mother, Maggie, is downstairs looking out of the window, hoping to see our seasonal coyote attempting to get another one of our cats.

I don't know what I am going to do without Herman. He was in a terrible accident about a month ago, and is slowly dying from his injuries. I was told on Friday that he needs to be euthanized; he will not recover from his wounds. We have done everything we can to try and fix the damage, but there is about a 99% chance that I will have to make that painful decision soon. While I know it will be the kind and compassionate thing to do for him, I have to come to terms about it myself.

This is why I am posting on the Ear Disorders Board and writing this Blog at 3 AM. I can't sleep and there is a sad rain outside. It even got my face wet...

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Posted by: Rod Moser_PA_PhD at 10:15 AM

Friday, March 30, 2007

Baja Connections and the Trip Home
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We arrived safe and sound in Loreto, Mexico. Expecting primitive conditions, I was pleasantly surprised to discover that this little town has better Internet service than my own community. It was a pleasure to log in to my WebMD Ear, Nose, and Throat board to catch up on my postings. When you miss a few days, you feel like you haven't answered your phone. I pride myself knowing that I try to answer every posting over the last 7-8 years.

After driving 1,400 miles, it was time to rest and have some fun. The next day, we did some hiking and kayaking along the beautiful beach. The following morning, we were given a private tour of the neighboring islands, teaming with seals and birds. Much to our delight, we were accompanied by a school of bottle-nose dolphins that seemed to be playing in the wake of our boat; leaping in tandem out of the water and darting back and forth. About noon, our hosts decided to swing by a little restaurant out in the middle of nowhere -- a thatched hut run by a wonderful family who recently relocated from Los Cabos. The tide was out, the restaurant did not have a dock to tie up, and my friend did not bring the anchor for the boat. No problem.

The owner of La Picazon (means "feeding frenzy") actually waded out to the boat carrying an anchor for us to use. He then carried the women, one at a time, on his back to shore. You don't find that kind of service in the States. We then were treated to a wonderful meal of fish cooked by his wife and speared by his two teenage sons' just hours before. The specialty of the house (hut) shrimp dish was baked inside a fresh pineapple and was unbelievably superb.

Our Loreto friends rent two other units, so we met Jules and Marilyn from the Chicago area. On our last day in Loreto, we decided to meet at a local lobster restaurant. We drove, but they were going to take a local taxi. Thirty minutes after we were to meet, they arrived with an interesting story. Apparently, the taxi got a flat tire, so he sent a friend in his pick-up truck to pick them up. The driver had a note from the taxi driver stating it was "okay" to go in the truck.

About the time we were just relaxing, it was time to make the 2 1/2 day trek home again. Other than being cheated at a gas station (my gas tank does not hold 50 gallons!) and the four-hour wait at the boarder crossing back to the U.S., we made it home safely. Not wanting to leave our purchased pottery and iron work unprotected in the back of the truck at some obscure motel, we decided to make a marathon run back to the Sacramento area -- a 22-hour drive.

We plan on going back again next year with a truckload of clothing to distribute in some of the more remote Baja villages. Children need shoes, socks, and jackets. I suspect I will have no problem getting donations in my practice. Next time, we will stay longer, I can assure you.

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Posted by: Rod Moser_PA_PhD at 5:30 PM

Monday, March 26, 2007

Baja - The Connections Continue
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I have always wanted to drive to Baja. I have a four-wheel drive truck; I need a vacation; I have been graciously invited to stay with friends, so why not? So, we loaded up our truck and headed South on a 2800 mile (round-trip) odyssey.

We started off with a three day pediatric continuing medical education course in San Diego. We stayed at a wonderful, upscale hotel (for once) and visited with our youngest son, who is an RN working in a local emergency room. We couldn't wait to start our real vacation, so at 6 AM, we were in our car heading for the Border. It was an uneventful crossing at that time of day; taking only a few minutes. For those of you that have never ventured past the tacky trinket stalls of Tijuana, you have not seen the real Mexico, or met the real Mexican people.

First stop: Ensenada for breakfast. Next Stop; La Bufadora - the site of an unusual blow-hole; a geyser caused by the ocean, located just a few miles from Ensenada. Twenty years ago, this was once our southernmost point in traveling the Baja. It was a tiny, seaside community with no electricity. A handful of fisherman shacks lined the picturesque hillside. La Bufadora is now no different than Tijuana - a tacky, tourist trap. This little community has been irreversibly ruined in my opinion. If you are looking for a ceramic donkey or a blue sombrero, this is the place. We took a picture of the blow-hole and quickly left; disappointed.

Final stop of the day: A long trek, hundreds of miles and hours south on the Baja Highway to the town of Guerrero Negro - Scammon's Lagoon is one of the three mating areas for the grey whales on the Mexican coast. This was our goal for the next morning. We have most likely seen some of these same whales in Vancouver Island and in the inland passage of Alaska. I doubt they will recognize me.

That night in the restaurant, we met a Canadian couple that spends a month each year volunteering at a local orphanage. They have been coming for four years now. They drive down in their travel trailer during the cold Canadian winters. Working in the orphanage warms their souls, more than their bodies. On our next trip (and there will be a next trip), we plan on dropping off a truck load of children's clothes that we are going to collect. Another connection.

Scammon was a whaling captain that nearly killed all of the whales that came to this lagoon. I find it interesting that they have his name attached to an area now highly protected. Early the next morning, we hopped on one of the pangas (small, open boats) operated by Mario's Tours -- a side business of a little, thatched hut restaurant. There were five of us: my wife and I and three Indian people from San Diego -- The Reddys. Dad was a gastroenterologist in San Diego that knew my RN son from the ER. His son was a student in Los Angeles that spoke fluent Spanish. The grandmother was along for the ride, wearing her sari and a bit worried about the whales. At one point, she told me that she was afraid they would eat her.

The boat buzzed past one the largest salt evaporation plants in the world, owned mostly by Mitsubishi. In no time, I spotted the first spouting of a whale. In the next half hour, it seemed we were smack in the middle of hundred of grey whales; too many to photograph. The four of us madly snapped our photos and grandmother sat in the geographic center of the boat. Suddenly, a baby whale popped his head up over the boat and stared at us. We touched him (or her) - the whale didn't get out of the water that high. It was wonderful.

"Did you hear what the whale said?" I exclaimed. This caught the grandmother's attention.

He said, "Hey, who likes Indian Food!?" The grandmother couldn't stop laughing. Her son told her not to worry since Indian people are much too spicy for whales.

After this wonderful experience, we headed across the Baja desert for the costal town of Mulege; another 175 miles away. The desert was not at its peak with flowers, but it was still unbelievably beautiful. We passed dozens of tiny towns, bordered on both ends by axle-breaking "topes" or speed bumps. You only go over those once while going fast. We also passed hundreds of highly-decorated roadside shrines of people that were killed along this challenging stretch of road. These were the sites that took the lives of fathers, mothers, or children; often still placed near the broken guardrail that failed to protect them. It made us sad; and reminded me to drive a lot more carefully.

We arrived in Mulege safely before dark. Only a fool would drive these roads at night, where cows often congregate to get warmth from the blacktop. Our hotel had its own dirt runway where U.S. private pilots land for the weekend. After driving the roads, I can see why someone would choose to fly. It only took a few minutes for someone to notice the license plate on our car. They were a couple who live about four miles from us. We shop at the same grocery store. Another connection.

Tomorrow, we head for our final destination: Loreto.

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Posted by: Rod Moser_PA_PhD at 10:33 AM

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