6. The "folksy" element she injects into her speeches is fake (or at a minimum, greatly over-exaggerated).

I was flipping channels the other night when I caught a segment on The Rachel Maddow Show (MSNBC) that touched on this. She argued that, for all of the "you betcha," "hockey mom," "doggone," winks and so on that she uses, one moment of real insincerity can erase all of that. Watch how she responds in the clip below of Biden choking up while talking about losing his wife and daughter. Before launching into a canned "maverick" answer you can even hear her make a "tsk" noise. For someone so "hockey mom next door married to joe sixpack and another member of the middle class just like you," she could have mustered up respond that implied she had at least a little sympathy for Joe.

Biden Chokes Up Recalling Family History during VP debate.

14. Whenever she doesn't have an answer to the question being asked, she begins by blaming her lack of knowledge on being a "Washington outsider."

There's a lot of articles being published right now in regards to the current economic crisis. Wading through what's worth reading and not reading can be daunting. Anyway, I thought this article provided a nice explanation of how we might have ended up where we are without being biased:

Who Caused the Economic Crisis?

I've gotten to spend a lot of time watching TV while recovering from the recent surgery (not really sure whether that's a good thing or not). Regardless, after seeing far too many commercials for and against Ohio issues 5 and 6 I decided to do some online research on each.

Ohio Issue #5[url][url]

If your only exposure to this issue is through the commercials advocating its approval, you probably think it has to do with some type of extreme government regulation over borrowing money. They make it sound like the state wants to make it required that you release all of your personal information in order to get a loan. This nonsense really bothers me as it couldn't be any further from the truth.

Voting "yes" on this issue will stop a House bill that caps payday loans at 28% interest (instead of a fucking insane 391%). I know that these loans are how some people are able to get through financial emergencies, but do you really need to rape them at nearly 400% interest?? I'll loan them the money and take a 28% return if the payday loans people don't want to. You're not going to find that kind of return anywhere else right now.

Does anyone actually see themselves voting "yes" on this one?

Ohio Issue #6

This one is a little more complicated. Essentially, the issue is asking for Ohioans to approve the building of its first casino halfway between Columbus and Cincinnati. The theory is that with Michigan, Indiana, Kentucky, and Pennsylvania all allowing gambling, Ohio is missing out on potential jobs and tax revenue. Ohioans who want to gamble are going to gamble, so why not keep them and their money in the state? This all makes sense to me and I would be happy to support a bill that allows casinos here.

But as the opponents' commercials imply, there is a major "loophole" in the legislation being proposed. The proponents claim there is no loophole and that the wording "allows for up to a 30% tax on revenues." The key words there are "up to" because that wording also allows for 0% tax in the right situation. This is because the State is not prevented from allowing the establishment of additional casinos in the future. The Eastern Shawnee tribe of Oklahoma has been trying (unsuccessfully) to open an operation here for years. The federal government allows Indian casinos to operate at a tax rate of zero. The wording of this proposed amendment states:

"In the event that another casino is permitted in Ohio by state or federal law to conduct gaming activities similar to that conducted by the casino authorized under division (A) of this section, the tax rate on gross casino receipts authorized by this subsection shall not exceed the lesser of twenty-five percent (25%) or the lowest percentage rate payable by any other casino subsequently authorized."

Correct me if I'm wrong, but the lesser of 25% and 0% is the latter. If an Indian tribe is allowed to establish a casino that pays zero percent taxes, the law says that this original casino can begin paying zero as well. That defeats that whole purpose of allowing gambling in the first place!

So while I think it's a good idea in theory, the wording of this legislation needs to be changed before you'll see me voting in favor of it. Hopefully enough Ohio voters understand this little detail when they go into the voting booths and cast their ballots. It's hard not to believe differently as the proponents are really working hard to spread a different message with all of their commercials.

(Warning: This post is not for the squeamish. It gets a bit gross at times.)

Fresh off the hospital circuit and it looks like I have one more issue to deal with in the recovery phase.

Friday morning I woke up to a new pain at the bottom of my incision. Upon closer inspection, I found that a hole the size of a pencil eraser had opened up. Even better was the fact that it was leaking a good deal of this mucous-like fluid. At times it was even coming out in a steady stream. I didn't worry too much about it, though, as the wound care nurse was coming that morning to check me out and give me another lesson on changing my ileostomy bag.

Jennifer came and did check it over and said it looked okay to her. I didn't exhibit any of the physical symptoms of infection (fever, chills, vomiting, etc.) and the fluid coming out wasn't of an unhealthy color or odor. Apparently she felt it was worth informing my surgeon of, however, as I later received a call from his assistant. Vicki explained that this was common in some patients following surgery and that I should simply keep an eye on it over the weekend. If things worsened, they could squeeze me in today and take a look at it.

Saturday saw a slight increase in the size of the opening and moderate increase in pain. It was the change on Sunday that had me concerned. I woke up to some serious pain and looked to see that the opening had swelled to nearly the size of a grape. It looked as though it was working its way north, busting stitches open along the way. I called the emergency contact number and talked with the colorectal surgeon on duty. His advice was to wait it out until today if possible. He felt I wasn't in any immediate medical danger and that it wasn't worth my time to drive over and wait it out for a couple hours at the ER to see someone. I thought this made sense as it should be the guy who did the original work who looked it over if possible. So I left Vicki a message explaining what had happened and told her that I had to get in one way or another.

I ended up with a 2:30pm appointment this afternoon. After getting back to the exam room I was eventually greeted by Dr. Remzi, Vicki, and a stoma specialist nurse. They stripped me of my bag and dug into examining my new opening. Although he was surprised at how tender the area was, the doc insisted that there was nothing unusual about its size or the fluid inside. He went on to explain that all of this actually happened for a good reason! Had this not been the case, I would have been extremely ill with an internal infection and probably checked into the ER by this time. Let me explain...

When the first stage of surgery is performed, the rectum is left behind as a holder for the sphincter. While the sphincter is a necessary part of the final product, the rectum is removed in the second stage when the j-pouch is created. Because the symptoms of Ulcerative Colitis are created by an overactive immune system, this organ can still be affected even without any food waste passing through it. Most people experience some level of inflammation as a result and, in roughly 20% of patients, this causes the rectum to "blow out" at some point. The surgeons plan for this possibility by grafting the top of the stump to the abdomen, at the bottom of their incision. That way if the rectum does fail, it weeps to an external drain and not into the internal cavity.

Dr. Remzi said he was pretty certain this was going to happen to me based on how far gone my colon and rectum were at the time of the surgery. He also said he did not go into details of this possibility with his patients ahead of time because of the odds favoring they may never experience it. I understand where he is coming from with that approach, but it still would have been nice to know ahead of time. Then again, there's probably a bunch of other possible complications that I am better off not knowing about because they will never affect me.

They flushed me out and packed the opening with gauze. I was instructed on how to perform the packing so I can repeat the process twice a day for the next few weeks. He tells me that within 4-6 weeks it will almost completely heal from the inside out. The opening itself will never close completely, however, and some small amount of fluid will always drain until the next surgery. Yes that sucks, but it's a healthy process and there's much worse I could be having to deal with. It's nothing that can't be handled by simply coving it with a bandage and some gauze.

The only other issue was the amount of pain this opening was causing. He asked me what pain meds I was sent home on and I told him Vicodin the first time, oxycodone the second. He asked me if I was sure of that and was visibly upset by my reconfirming it. Apparently his standard practice is to prescribe Percocet instead and that Vicodin was not a strong enough drug for patients of this surgery in his opinion. He wrote me a new script and answered any last questions I had about the whole situation.

In the end, it does suck to still be in pain and to have this wound to take care of. The thing is, I really don't care a whole lot because the ileostomy is working so well. I'm hungry all the time now and love being able to pick and choose whatever I want to eat (with a few minor exceptions). Such a huge psychological boost, this alone has really made me feel like I have my life back. I went into this whole process to gain that freedom back and so this other issue is only a temporary inconvenience.

I'd take the lifestyle I have even now over where I was at two weeks ago (pre-surgery) in a heartbeat!

Now that I am home (for the second time) and rested up a bit, I wanted to write out a summary of the last week or so. I've gotten a lot of calls, texts, and emails from everyone wanting to know how I am doing. I appreciate everyone's concern and it has meant a lot to know so many people have been thinking about me. Thank you very, very much. With this post, I can explain the details to everyone without having to tell the story a hundred times.

As I explained in a previous post, I ended up going in a day early when my symptoms got to a point where I was seriously concerned about my overall health. The biggest issue was that I was supposed to stop consumption of all fluids at midnight. I could hardly keep myself hydrated as it was, so I knew I wouldn't make it those 6-7 hours. Add to it that the pain had reached a level that was making me nauseous/shakey and it just seemed right to check myself in. I spent Monday basically resting up for the surgery.

I was informed that I was the first surgery of the day and they would be coming to get me around 6:30. An emergency came up that morning, though, and it was more like 7:30 by the time I was wheeled over to the surgery center.

(side note: I know the Cleveland Clinic is big, but seeing a hallway lined with at least 15 very well-equipped surgery rooms on each side was still an amazing sight! It was almost like being on some futuristic spaceship or something with all the doctors running around everywhere and it being so bright.)

The anesthesiologist's assistant came out into the hall and asked me a few questions about my medical history. Then the gas doc showed up and asked me a few more before giving me an oxygen tube. The next thing I remember is being back in my actual hospital room. No gas mask. No counting back from 10. Not even the surgery room itself. The procedure typically takes between three and four hours, but apparently mine was finished in just over two and a half. They were unable to perform the colon removal laparoscopically (due to how much mine had deteriorated), but I got away with only one incision running from my bellybutton straight down about 5 inches.

I have no memories of the recovery room. I have no real memories of the rest of Tuesday. In fact, my first solid thoughts are of trying to stay awake while visiting with my parents on Thursday. I spent a good deal of time sleeping during those first few days. To control the post-surgery pain, they gave me a pump that allowed me to get shots of morphine at controlled intervals. It helped, but also kept me pretty out of it as well.

Thursday's lunch is when I ate my first meal of clear liquids (soup broth, jello, and tea) and by Friday morning I was up to soft solids. I don't think I'll ever forget eating that ham and cheese omelette, oatmeal, and banana! Lunch and dinner also went down well and my Ileostomy was beginning to function properly. Everything progressed as it should through Saturday morning and so the doctors felt I was ready to go home after lunch.

I spent Saturday and Sunday at my parents' house with Jeanine. We ate real food and I began to remember what it was like to look forward to meals again. Instead of drinking a bunch of liquids to prevent being up in pain all night as I would in the past, I made a snack when I got hungry at ten o'clock at night. I even found myself laying in bed Sunday morning trying to decide what I wanted for breakfast. Eating was no longer a necessary chore, but rather something to enjoy and get excited about.

Things took a quick turn for the worse on Monday morning, however. After seeing Jeanine off bright and early, I went back to bed and woke up at 8am with some pain across the top of my abdomen. It continued to grow worse and by the time the home healthcare nurse showed up at 8:30 I was in serious trouble. She was scheduled to come and get me started on my in-home training sessions for taking care of my ileostomy, but instead spent her time calling the Clinic and getting me admitted to the emergency room. My mom and I headed back downtown and by 9:45 I was settling into an ER room.

The ER experience lasted about 11 hours and was absolutely horrible. It consisted of waiting forever to get the results from my CAT scan, having to deal with being crammed in a room originally meant for one bed with two other patients, and basically getting shitty service from most workers due to obvious understaffing. Luckily we had an amazing nurse who stayed on top of my case's progress and worked with me to find a pain medication that actually worked (morphine was doing nothing for what was honestly the worst pain I have ever experienced in my life). Once I had some Dilaudid in me I could actually calm down and rest a little bit.

Eventually the results came back (four hours after the scan) that there was a small pocket of fluid that had developed near my bellybutton. The colorectal surgeon who came and met with me felt that it wasn't large enough to justify draining, nor was it necessarily the cause of the pain. My white blood cell count was also elevated slightly, which pointed at the possibility of an infection. Without a fever or other symptoms, however, this wasn't her first concern. She wanted me admitted and monitored overnight as there was a possibility that a partial blockage had developed. It apparently happens to a lot of people and is the reason why I must follow a restricted diet for the first six weeks.

So I waited another three hours for a bed to open up and be cleaned on the floor where I had recovered from surgery. The ER had gotten so slammed by the time I finally left that they literally did not have enough beds for all the ambulances coming in--let alone rooms to put them in. I ended up waiting in a wheelchair in the middle of the ER hallway for the last half hour!

Ironically, my new room was right next door to where I stayed the first time. They tucked me in, gave me another morphine pump, and left me to sleep. Early Tuesday I was visited by my surgeon's resident and surgical nurse. They said the white cell count was down to normal and that a blockage still seemed like the most logical answer. The plan was to let me try soft solids again and control the pain as the issue hopefully resolved itself. Things improved slowly throughout the day and by last night most of the pain I still had was at the incision site.

They came back this morning with what they could come up with as an answer to the whole problem. They feel that there was, in fact, a partial blockage that worked itself out. What compounded the problem was that pocket of fluid that some people develop when the surgery is preformed through an abdominal incision like mine. That amount of fluid is enough to put pressure on my intestines when food passes through. It's not enough, however, to justify the amount of work that would go into draining it. They would have to re-open the incision (which is apparently healing perfectly), drain the fluid, pack it, close it temporarily, and repeat the whole process a couple of times.

So we decided to let me eat breakfast and lunch and see how it went. I experience a good amount of pain after eating, but this should go away as the fluid is slowly reabsorbed by my body. They sent me home with the Vicodin I had from before, as well as some oxycodone. The meds seem to be taking care of most of the pain and so all I can do at this point is give it time. They're only concern is that the fluid collection has the potential to become infected. The good news is that the risk of this is low and I know what symptoms to be on the lookout for.

So apparently I have experienced one or two of the most common complications that can develop with this type of surgery. It sucks a lot, but I was warned about the risks beforehand and it's in no way representative of the quality of work done by the surgeon. I still have great confidence in him and look forward to the next two stages. Hopefully this will be the last of it and soon it will all be in the past.

For now, lots more rest and relaxation...no complaints about that!

So far the surgery seems to have been very successful.

More on it later.

Tomorrow is the big day when I have my first stage of surgery. In less than 24 hours I will no longer have a large intestine or appendix--but most importantly, I also won't have ulcerative colitis. I can't think I any thought that could possibly make me happier.

I was originally scheduled to check in tomorrow morning, but my colon finally got the best of me this morning. I was making trips to the bathroom every 30 minutes and the pain was beyond bearable. It worked out for the best, however, as now I am in my room getting IV fluids and morphine--two things I can definitely use at this point.

I think the only thing that got me through the weekend was a surprise visit from Jeanine. She had been planning to come up after work on Friday wihout telling me and then found out she didn't even need to go in that day. So imagine my shock when she walked in at 10am!

Wish me luck with the surgery...I don't forsee there being anything to be concerned about though. My new life begins tomorrow

(No...not the CF website.)

Being pretty much housebound the past couple of days, I've gotten a chance to watch a lot of TV. I've watched many episodes of my favorites as well as found some new ones to add to the list. All I have to say is this:

"Anthony Bourdain: No Reservations" is a great, great show.

That is all.

I got a new phone about a week ago and no, it's not an iPhone. For those of you who know me well this may come as a shock.

The decision came down to one important point: I simply could not justify leaving Verizon. With Jeanine, my entire family, and a good deal of my friends all on the same network my monthly out-of-network usages is usually less than 100 minutes. My total usage, on the other hand, is well over 1000 minutes. It also wouldn't be fair to Jeanine to make her increase her monthly minute allowance just because I want to switch to AT&T.

So instead I went with a Blackberry Curve 8330. It's taken a little getting used to, but I really like it for the most part. My only true complaint may be in how much better Apple has done with rendering websites. Mobile Safari really is "true internet" (or whatever they call it). Otherwise, I think I'll be alright with this guy for the next two years. By then the Apple/AT&T agreement should be over and who knows how far the iPhone will have progressed.

Although things have been pretty rough the last few days, today marks only 10 more until the surgery. When I see things like the article below, it makes me feel all the more confident in my decision:

FDA Orders Stronger Warnings for 4 Arthritis Drugs

As much as I felt that Remicade might just be the thing to get me healed up, all of the potential risks and side-effects never sat quite right with me. At least now I won't have to worry when I come across news like this.

Today I'm at the Clinic for my pre-op appoinment. There's a lot more to it than I would have thought:

12:30p - Laboratory Medicine

1:00p - Admitting Interview

1:30p - Dr. Feza Remzi (surgeon)

1:30p - Stoma Therapy

2:30p - Nurse Patient Education

3:15p - Nurse

3:30p - Dr. Stephen Chen (anesthesiologist?)

Something's missing I think?

Q: What to the following foods and beverages all have in common?

Lettuce
Bacon
Coffee
Cucumbers
Corn
Beer
Nuts
Spinach
Beans
Vodka
Sauerkraut
Pickles
Pizza
Wine
Banana Peppers
Berries
Popcorn
Potato Skins

A: Very soon I will be able to consume all of them (and many more delicious items) once again. 20 days and counting

If you didn't already read about it on Facebook, Jeanine and I got engaged two weeks ago today.

I popped the big question while on vacation with her family in the Outer Banks. I suggested that we take a morning walk on the beach and while on the first half of the trip I scouted out a good place to stop. I had hoped for it to be less crowded so that the experience could be a little more intimate but everyone had set up early on the beach. However, I was able to find one stretch of houses that the beach in front of was fairly deserted.

We were walking back and I started to talk about how the beach has been a sort of ongoing part of our relationship. Not only did we meet near one (Cedar Point), but we've taken 4 different trips to them as well. Huntington Beach in Cleveland is also one of our places to go visit for spur-of-the-moment fun.

I told her that I had messed up because this could have been the perfect spot to propose. I said, "I should have gotten down on one knee, pulled out a ring, and asked you to marry me" while doing exactly that. I gave her my semi-prepared spiel about why I wanted her to be my wife, but by then the reality of what was happening had set in. Jeanine started to cry and I fumbled to find the right words in finishing my thoughts. Obviously she said "yes."

I was never nervous when we talked about it or even after I had planned how I was going to ask her. I wasn't even nervous during the first part of the walk. I did, however, get a few butterflies in my stomach when the "go" moment came. Overall, I am very happy with how it all went down. It's amazing how all of that thought and planning came down to maybe 30 seconds.

As of now we are talking about June, 2010 for the wedding.