Archive for August, 2013

Confessions of a Weekend Hacker

Saturday, August 24th, 2013

I have had a love-hate relationship with the game of golf for going on forty years. I’ve probably quit more times than Sinatra retired from show business or Brett Favre retired from the NFL. I began playing on a nine hole pitch and putt course at Ashleigh Road with my dad in Swansea, and entered putting contests held on the Promenade near the Guildhall where I worked for 28 years. My dad had great hand/eye co-ordination but never took the game seriously. Pity really because I believe he would have been a very good golfer. He could hit a ball a country mile with a five iron, but had no interest in putting pleasantries.

I’ve received a few lessons over the years, studied instructional videos and watched the Golf Channel religiously since its inception several years ago. I’ve learnt the basics of grip, alignment and stance and so forth, but it’s such a technical game and any subconscious change in your mechanics can completely change your swing detrimentally. Just think of the coaches, trainers, psychologists and gurus that professional golfers include in their touring entourage.

Take for example my round of golf yesterday which prompted me to write this blog. Recently I have the tendency to slice the ball when using my driver and I’m possibly losing 40-60 yards of distance. Something prompted me to stand closer to the ball on the tee when I was about to drive. It had the desired affect because for a few holes I was hitting the ball straight down the fairway. I thought I had cracked the formula, but began slicing my drives while standing nearer to the ball. Go figure.

In theory the game of golf should be quite simple to play. You are attempting to hit a stationary ball with a myriad of clubs. It shouldn’t be too difficult. The ball is not moving while you are addressing the ball, but it comes down to your damn mechanics again. I don’t care what coaches preach but woods and irons require completely different mechanics. You use a sweeping motion when hitting the woods and you hit down and through when striking the irons. Chipping and putting also require specific skills.

I used to be a good iron player but lately I’m hitting them either fat or thin. I’m more comfortable using a 3, 5 and 7 wood these days, so I’m really tempted to buy some hybrids to replace my irons. Unfortunately they haven’t yet designed a hybrid to replace the pitching or sand wedge.

I popped in to Dick’s Sporting Goods in the afternoon to look at some Adams hybrids. The assistant asked whether I had been measured for the correct length of clubs which he claimed made a big difference. However he was less convincing when trying to explain the merits of graphite or stainless steel shafts.

I often wonder why we spend hundreds dollars on drivers, woods and irons when half of our shots are made with the putter on the greens. If I had applied logic to this game I wouldn’t get out of bed in the wee small hours to make the early tee time.

I can’t remember the last time I broke 90, and you may be wondering what enjoyment I derive from playing the game banally. Well I sometimes achieve a good drive, hit a fairway wood fairly well, or occasionally sink a 60 foot putt. It’s the intermittent good shot which gives the hacker hope of better things to come. The hacker keeps telling himself that it is possible to string a series of good shots together which encourages him to come back next weekend.

I have played some beautiful courses: Royal Porthcawl, Pennard, Chateau Elan, St. Elmo and St Pierre to name a few and probably haven’t done them justice. But along the way I have experienced breathtaking sun rises and serene sun sets across fairways sparkling in the morning dew or bathed in shadows as the light fades away. I have enjoyed the company of several friends who play the game the same way with humor and rancor. There’s always to-morrow.

 

A Soap Opera to rival Downton Abbey-The English Premiership

Sunday, August 11th, 2013

The English Premiership is a mere seven days away, and if the melodrama in the off season is an indicator, the action on the field promises to be a corker. Last season’s top three teams Man Utd, Man City and Chelsea, have new managers. Jose Mourinho, the self-proclaimed “special one”

 has returned to Chelsea. David Moyes has moved from Everton to replace the legendary Sir Alex Ferguson at United. Moyes has a hard act to follow and has not endeared himself to fans with the lack of activity in the transfer market. Moyes’ futile month long chase of Cesc Fabregas is mercifully over with the player declaring he never had any intention of leaving Barcelona.

Manchester City sprung a surprise by hiring Manuel Peligrini from Malaga to replace the hapless Roberto Mancini who fell on his sword in the shape of Mario Bolotelli. In contrast to David Moyes, Peligrini has been on a spending spree. At the time of writing approximately 86 million pounds has purchased 4 new players (Fernandinho (Shakhtar Donetsk, £30m, Stevan Jovetic Fiorentina, £22m, Jésus Navas Seville, £17m rising to £22.9m, Alvaro Negredo Seville, £16.4m rising to £20.6m.) City recouped 10 million with the sale of Carlos Tevez to Juventus.

However the football headlines have been dominated by three prima donnas wanting to leave their clubs for new and richer pastures. Real Madrid has pursued Tottenham’s Gareth “Cornelius” Bale relentlessly for the past couple of weeks, but recoiled at the asking price which is a staggering 85 million pounds. Nevertheless the Spanish giants have turned the Welshman’s head and he appears desperate to be fitted for his sombrero and run with the bulls. Prediction: it’s only a matter of time before a deal is agreed upon.

Liverpool’s Luis “Twilight” Suarez is an enigma. Henry Winter in the Telegraph called him a toxic cheat. Here is a very talented player with a penchant for scoring goals, but I agree his D&A is quite suspect. He has openly rebuffed Liverpool demanding to leave for a club that will play in the Champions League. He recently signed a four year contract which has little meaning these days. I don’t understand why Arsenal’s manager Arsene Wenger would want to sign a player who last season served lengthy suspensions for racism and biting an opponent. Prediction: Liverpool will not sell him to another Premiership team but a transfer to Paris St Germain or Real Madrid is a possibility. Prediction: Suarez will be shipped to the Continent: darkest Africa, the mystical Orient or the Australian bush perhaps.

Meanwhile at Manchester United Wayne “Fat Boy” Rooney is very disillusioned with his lot at the club. His ego suffered a massive blow when new manager David Moyes declared that Robin Van Persie was the club’s No 1 striker despite Wayne ruling the roost for the past seven years. To my mind Rooney has never lived up to expectations, but it could be that the media has an over inflated opinion of his talents. He was touted as the poster boy for English football but failed miserably at the 2010 World Cup. I believe he lacks the nous to apply himself correctly, and talent alone is not enough at the top level. Chelsea has made three bids of around 25 million all of which have been rejected by United. Prediction: he will probably remain at United for at least another season.

My home town team Swansea City is preparing to embark on their third season in the Premiership with an improved squad. Paper talk had manager Michael Laudrup shortlisted for every managerial vacancy during the summer, but mercifully he is still at the helm. He has bought very shrewdly breaking the Swans transfer record in the process: Wilfried Bony (Vitesse Arnhem, £12m), Jonjo Shelvey (Liverpool, £5m rising to £6m), Jordi Amat (Espanyol, £2.5m), Alejandro Pozuelo (Real Betis, £425,000), Gregor Zabret (NK Domzale, Undisclosed), José Cañas (Real Betis, Free), Alex Gogic (Olympiakos, Free), Jernade Meade (Arsenal, Free), Jonathan de Guzman (Villareal, Loan), Jernade Meade (Unattached.)

The Swans campaign will have added spice for the new season with the promotion of arch rivals Cardiff City. Who would have thought two Welsh clubs would be playing in the English Premiership in 2013-14? On a final note congratulations to Arsene Wenger for surviving 17 years as Arsenal’s manager. Longevity in Premiership management is the exception rather than the rule.

 

A Four Week Roller Coaster

Friday, August 2nd, 2013

This is a very long blog, totally self-indulgent, but dedicated to the nursing staff of North Side Hospital Atlanta. It all began very happily. My son’s fiancée gave birth to a beautiful baby girl Alice Violet on 21 May. Four days later I was experiencing severe stomach pains which I related to an unfortunate confrontation with a Friday Subway special.

Twelve hours later my wife drove me in the wee small hours to the Emergency Room at Northside Hospital. Following several knee-jerking lunges with the physician’s assistant, X-rays, and finally a cat scan it was confirmed I had appendicitis and the infected organ would be whipped out later in the afternoon. “Routine procedure; nothing to worry about”, said the affable but rather coiffured surgeon.

I had never been in hospital save to visit people, so initially in a strange macabre way the whole hospital experience and the” journey on a gurney” to the operating theatre was a novelty which I may add quickly wore off.

The key-hole surgery went according to plan and there was a possibility I could be home in three days. Unfortunately my intestines reacted to the anesthesia and promptly shut down; initially unbeknown to doctors, nurses or technicians. A three day stay turned into a two week nightmare. My stomach became distended resembling an over inflated beach ball.

I was diagnosed with an ileus (1.) A Hispanic nurse told me that it was commonly referred to as “a lazy gut.” It would wake up in its own good time and eventually I would be as good as new. I was discharged the following Saturday, but two days later I was readmitted with terrific stomach pain and suffering from severe dehydration.

The ER doctor determined that four liters of gunge needed to be removed from my stomach which required installing a NG tube (2) up my nose and down into my stomach to suck the damn stuff out. The NG tube was taped to my face to minimize movement and I now resembled “The Elephant Man.” I can honestly attest that the discomfort caused by this apparatus was unimaginable.

I was wheeled back into a private room and later that afternoon I was introduced to the PICC line (3) which supplied me with nutrition intravenously. The PICC line was effectively my lifeline. The saline drip, antibiotics and nutrition were all fed through the mechanism. Blood samples were also drawn from it which thankfully meant I was no longer a pin cushion.

By the way you are not allowed to sleep in hospital. Your vitals are checked on a regular basis including visits by a nurse and technician in the early hours. Blood pressure, temperature, and oxygen levels are carefully monitored to the exclusion of a good night’s rest. To be honest it was difficult attempting to sleep with a plastic tube stuck up my nose.

I endured the NG tube for two days until Nurse Stephanie mercifully removed the contraption with minimum fuss and pain. I understand now why nurses are respectfully known as “Angels.” My wife also falls into the “Angel” category. She is not normally the nursing type but she stepped up to the plate for me and proved to be a rock star.

I was tentatively re-introduced to solid food for the next few days and my internal plumbing slowly began returning to normal. On Friday 7th June, my son-in-law phoned from England to inform me that my daughter had given birth to a baby boy, Alexander Charles, weighing in at an even 9lbs. Things were definitely looking up, and I was discharged the following day; hoping I would not be returning again in the immediate future.

I was home but weak as a kitten. I was looking forward to flying to California the following Friday (14th June) to celebrate our 20th Wedding Anniversary. The trip had been planned for months and the doctors had given me the green light to go. I had a few days to rest up before we boarded the plane, and despite feeling and looking like one of the “walking dead,” my rehabilitation was progressing in the right direction.

Unfortunately, the night before our departure (13th June,) Atlanta was subjected to a violent thunderstorm. In the early evening I heard the wind howling viciously around the house followed by tremendous thunder and lightning and heavy rain lashing at the roof and windows. I decided to take refuge in the basement and momentarily I heard the huge crash of trees somewhere on our property. Three “sixty foot” trees and one “eighty foot” poplar had been uprooted in the backyard; one narrowly missing the side of our house and another crashed onto the roof of our neighbor’s house. Our power lines had been pulled to the ground by the fallen trees, but remarkably we didn’t lose power. Nevertheless the backyard resembled a war zone.

My neighbor insisted that we continue with the trip on the basis that the insurance company would take care of the damage to his house. My friend also assured us that he would keep a watchful eye on the house while we were away. Nevertheless, I couldn’t speak for my wife but I was beginning to think we weren’t supposed to get on the plane to California.

Despite my trepidations our flight made it to San Francisco, and we made our way up the coast of Northern California to spend eight relaxing days in a beautiful house perched on a cliff enjoying panoramic views of the Pacific Ocean. Just what the doctor ordered.

(1)   What is an ileus?

An ileus is a blockage of the intestines (also called the bowel).  The ileus prevents the movement of food, fluid, and gas through the intestines.  The blockage is due to the lack of movement of the intestinal muscles.  The intestinal tract is made up of small bowel and large bowel.  The small bowel has three parts: the duodenum, the jejunum, and the ileum.  The large bowel has four parts: the ascending, transverse, descending, and sigmoid colon.  An ileus can occur anywhere in the intestinal tract.

(2What is a Nasogastric tube:

 A tube that is passed through the nose and down through the nasopharynx and esophagus into the stomach. Abbreviated NG tube. It is a flexible tube made of rubber or plastic, and it has bidirectional potential. It can be used to remove the contents of the stomach, including air, to decompress the stomach, or to remove small solid objects and fluid, such as poison, from the stomach. An NG tube can also be used to put substances into the stomach, and so it may be used to place nutrients directly into the stomach when a patient cannot take food or drink by mouth.

 

(3)   What is a PICC Line and Why Do I Need It?

A PICC line is, by definition and per its acronym, a peripherally inserted central catheter. It is long, slender, small, flexible tube that is inserted into a peripheral vein, typically in the upper arm, and advanced until the catheter tip terminates in a large vein in the chest near the heart to obtain intravenous access. It is similar to other central lines as it terminates into a large vessel near the heart. However, unlike other central lines, its point of entry is from the periphery of the body ? the extremities. And typically the upper arm is the area of choice.

A PICC line provides the best of both worlds concerning venous access. Similar to a standard IV, it is inserted in the arm, and usually in the upper arm under the benefits of ultrasound visualization. Also, PICCs differ from peripheral IV access but similar to central lines in that a PICCs termination point is centrally located in the body allowing for treatment that could not be obtained from standard periphery IV access. In addition, PICC insertions are less invasive, have decreased complication risk associated with them, and remain for a much longer duration than other central or periphery access devices.

Using ultrasound technology to visualize a deep, large vessel in the upper arm, the PICC catheter is inserted by a specially trained and certified PICC nurse specialist. Post insertion at the bedside, a chest x-ray is obtained to confirm ideal placement. The entire procedure is done in the patient’s room decreasing discomfort, transportation, and loss of nursing care.