Category Archives: beyond repair

nip and tuck

If only it was a face lift.  I could use one.  But this nip and tuck was to fix one side of my face and neck left somewhat distorted by the ordeal of the fibula transplant.  At the same time, the surgeon cut out a cancerous legion on my scalp the size of a half-dollar, leaving me with more stitches on my head, face and neck than I bargained for.

On the positive side, all the muck should result in an improvement.  Still, it’s not without putting up with a load of discomfort.  The other positive was that this procedure was done the day after Christmas and at NYU Medical Center, which was significantly more efficient than the last hospital.

It kills me to write about procedures and hospitals.  I had always thought of myself as resilient, healthy and fit, conscious about what I ate and diligent about daily exercise.  The year this mess started I peddled more than 20 centuries, half of them more than 125 miles.  In one 24 hour period I rode 325 miles.  On alternate days when I wasn’t doing something aerobic, it was anaerobic resistance exercise.  I didn’t take (and still don’t) any medication whatsoever.  I thought of myself as being in great shape.  Hospitals, surgeries and procedures were inconceivable.

So for the last four years of nothing but hospitals, surgeries and procedures and writing about the results, even if for record-keeping, means that the resiliency was a figment.  I’ve always admired a certain amount of hardness, perhaps coming from what I saw in my father.  Yet all the stitching and repairing may have been pointing to a weakness. Nevertheless, I’m thankful to be writing this, and eternally grateful to all those inside the medical profession and out who have helped me along the way.

Although being in an induced coma with the nervous system disconnected is the only way to get sliced up, I’m hoping that I’m finished going under general anesthesia for a while.  Seven times in the last four years has been quite enough.  If I had thoughts before about a full nip & tuck, then the soreness I’m feeling now has erased that idea.

new teeth

Three of them, for the price of one.  And a new piece of jaw, all integrated into a transplanted fibula.  Not the sexiest subject to write about.  In fact, may be a downright turnoff.  But the reason this blog started, in part, was to track the treatment, healing, and recovery process of tongue cancer, which turned into even more processes to treat the symptoms of treatments, leading to more healing and recovery.  Fact is, this post wouldn’t have been necessary if the mandible hadn’t gotten in the way, literally.

My grandfather had tongue cancer, more than likely from chewing tobacco.  The remedy, back in the day, was to have part of his tongue taken out.  I never did the tobacco thing but evidently a passed-down gene had me predisposed.  Fortunately, treatment today involves radiation and chemo, which most of us would trade any day to having parts of our body cut out.  Still, a few decades from now we’ll look back at the radiation process of this era as brutal.

Excess radiation required reconstruction of my jaw (so a part of my face came out anyhow).  Hopefully, I’m finishing the last phase of the painful process this month.  A few days ago I received permanent implants, the result of a seven-month undertaking involving the addition of (more) titanium hardware in my mouth.  But hey, I’ve still got my tongue and I’m thankful for that, even though it received a beating from the installation, resulting in a couple of doozy ulcers and bruises.

Next up this week, I’m back under general anesthesia for touch-up surgery.  With luck, I’ll be good to go by the end of this year.  Not quite as good as new, but I should be able to get those pirouettes back in satisfactory alignment.

There is no violin playing here.  Just record keeping, with a renewed effort on counting those lucky stars, and for the time being, those new teeth.

what was in that fish soup?

Although Medellin is landlocked, there are a few places that have excellent seafood, (if you know where to look).  A couple of local places serve a seafood casuela, which is a mix of different types of seafood (non-fish), kind of like a stew, served with a side of coconut rice or patacones and a salad.  A couple of them also serve a fish sancocho, which is also stew-like and made up of local starches such as yucca, potato, plantain, corn, and of course fish.  I was thinking about one of those dishes last Saturday afternoon.  After a good ride in the morning and the fact that I was returning to NYC that evening, I was looking forward to one of these seafood rich soups.

But before moving on, I’d be remiss not to finish some thoughts on triple crankset riding.  Before moving from Medellin in 2007, I sold my marin bike to a friend (who still has it).  Because I liked it so much, I bought another one in NYC the next year.  I’ve been using it regularly.  I haven’t used the granny gear much, but I like the idea that it’s there.  For longer rides I usually prefer the all carbon BMC which has a standard double.

Why do I bring this up again?  Because I was fortunate this week to have had coffee with a good riding buddy who I haven’t seen in a while.  He’s one of the very few I know who rides a high-end carbon frame road bike with a triple crank.  He’s also one of the strongest riders I know.  Not many guys blasting along the popular road riding corridors around NYC would be caught dead using a triple.  For most, it’s all about speed (and appearance).  But there is a universe of riding desires.

When I started working a full-time winter job after college, I was 20 years old and owned a car and a motorcycle.  Most days though, when it was nice and I had time, I’d ride my bicycle to work.  Some folk where I worked thought I was nuts for doing so.  It was only about seven miles and I didn’t ride for exercise, nor to economize, and I certainly wasn’t thinking of reducing my carbon footprint.  I rode because I loved the action of riding.  It was just pure enjoyment to be on the bike.

Maybe it was just the feeling that riding a bike is the most efficient, by far, mode of transportation.  Besides, riding seemed (and is) so liberating and free, much more so than walking or being in a motorized vehicle.

When I was 29, I moved to San Francisco and packed the same Schwinn 27 speed (yes, it had a triple), that I used when I was 20.  After I settled in and got a job, on my off days, I’d get on my bicycle and purposely get lost in a different district in the city.  Over the course of the next couple of months, I got to know San Francisco fairly well as I had crisscrossed my way across the city by bike.

During the next few years, I made it a habit to take that same bike out every Sunday for a long ride.  It was the least I could do for a bike that had been good to me.  Most Sundays I’d ride over the Golden Gate Bridge and north, every week gong a little further and somewhere different.  I was never in a hurry, never in a race, almost always alone.  The joy, besides the act of riding, was stopping when the urge struck to enjoy a strong cappuccino and local grainy muffin, or a bag of nuts and fresh squeezed juice.  As I got to know the area, I’d head up through Marin, somewhere near or around Sammuel P Taylor State Park, or up through Napa Valley and back through Sanoma, or occasionally down the peninsula to San Jose.  The triple on the old Schwinn was my friend.

But I digress.  During coffee I was reminded that my friend Brian is kind of the same way.  I met him years ago on one of my rides back from Bear Mountain (about 100+ mile rt from my place).   Just two guys who found each other doing something we each love doing.  In fact, he loves riding so much he’s getting ready for a RAAM qualifier in September which is a 540 mile event.  Better him than me.  But it’s riding one of those events, where there are thousands of vertical feet thrown in, that you bow down and give thanks to granny.

Anyhow, returning from a double regress, last week I didn’t pick any of the places I knew that had the delicious seafood soups, rather opting for a local Peruvian place called Pisco y Marisco.  They have a soup called aquadito, which is also a quite savory fish stew, (kind of like the chicken version, but with fish).  It was calling my name.  But when I ordered I noticed they had a special I had not seen (or heard of) before called ceviche a la parrilla.  I couldn’t decide between the dishes so I ordered both as I was feeling a little undernourished and knew there would be no chance to eat again until NYC.

Can I say that the ceviche a la parrilla, which was pieces of barbecued fish served in an complex flavored broth was one of the best ceviche dishes I’ve ever had.  I savored every spoon full and it quickly became my new favorite.

But something strange happened as I was eating the soups.  As I was chewing, I felt something in my left jaw twinge.  It was an eery feeling.  After lunch the feeling persisted.  I tried not to pay attention to it but by the next morning I could feel that the action of chewing was more difficult.  By Sunday evening back in NY, eating a soft vegetable soup set off a pain in the jaw area that sent me to the fetal position for hours.  The next morning my face was swollen face.

My jaw tightened up worse than before.  I could barely get a toothbrush in sideways.  I wrote and called the surgeons office but couldn’t get a hold of anyone so I just went there.  The doctor wasn’t there but the nurse saw me and called him.  The result?  I had to be admitted immediately to the hospital where I spent the next three days (and two nights) receiving antibiotics through an IV.  The swelling has gone down, but the tightness of jaw is still an issue.  Opening enough for anything wider than spoon width is still a problem.

I keep thinking, ‘what was in that fish soup?’   It may have been nothing, and maybe it was the act of chewing something at the time.  Who knows.  But whatever it was set off a chain reaction that changed the direction of what I may need to do to fight the ORN.  Likelihood is, there is something more advanced than previously realized.  And it’s not pretty.

For the ugly, stay tuned for next week’s blog it’s a done deal.

planning little things

It was a couple of weeks prior to this trip that, as always, planning which days to leave and return that make the trip.  GV knows I like to rollover weekends in Colombia as it helps change up the outdoor activity picture.

Medellin, where I frequent, sits in a valley even though the city is as high as Denver (about a mile above sea level).  The airport is up above Medellin several thousand feet.  The view during decent into the city from the airport is worthy of a postcard.  Although there are different ways up and down, this main road is called Las Palmas.  From the bottom to the top it’s 3,200 feet, about 10 miles.  (it’s further and higher to the airport, this is just the main accent/decent portion).

Years ago when I had my Marin hybrid bike there, I’d ride up from the bottom up and occasionally slip into the granny gear.  There weren’t as many riders then as the last couple of years, but still plenty.  But yes, the Marin had a triple crankset but regular 700 rims.  It was a true road-bike hybrid.  I tried to resist going into the granny gear (they call it the lady gear in Spanish) but was sure glad she was there many times.  Unless you are mountain biking, very few road riders use triples.  Still, I didn’t drop into the granny gear often.  My middle crank was a 42 with a cassette that topped out with a 25 ring.  I was satisfied then, when I could get up Las Palmas on the Marin without using granny.

Since those days 5-6 years ago, I’ve been up Las Palmas maybe 100 times.  Some guys go up five times per week.  Once per week is enough for me.

What’s the point?  The last time I was in Medellin I rode up the day I traveled and I was floored.  I almost didn’t make it and at one point, I felt a dizziness coming on.  It was a little scary and slightly concerning.  Bottom line, Palmas kicked my ass that day and intimidated me.

For the last two years I’ve kept a BMC aluminum frame (opposed to my BMC carbon in NYC) with a double crank 53×39 and a 28×11 cassette.  The cassette prior topped at 25 but I needed a new one last year so I bumped it to 28.  And I’m so glad I did.  Age convinced me.

Anyway, the last dizzy trip up I had to use the 28 gear in the back.  I never had to do that on this bike as I always saved that for stiffer inclines (although Palmas is still not for faint of heart).  I’m in the 28, standing and grunting and dizzy.  It played with my head.

I usually start from the bottom.  Many guys (and some girls) start at mile three, at least the more affluent, who live in up off the city in the spread of high rises sprawled up the bottom of the mountain with each building competing for more beautiful views.  Mile three there is a country club so most guys measure their time from the CC to the top.  If you are in the biking scene, you’ve done Palmas.  If you do Palmas, you know your time because that’s what guys talk about.

Two trips ago I visited a very nice denim jeans factory and the commercial director had a picture of a bike in his office.  We started talking biking.  Where did he end up?  His time going up Palmas.

From mile three, it’s about 2,500 feet to the top.  There are no flat parts.  It’s all up.  A couple of easier grades and mostly stiffer ones.  I heard a pro made it up in 36 minutes.  I know of a couple of guys who, on their good days, get close to 40 minutes (but have yet to break 40).  The commercial director of the jean shop was proud to be at 55 minutes.  I’ve hovered around the 55 minute mark when I was in the swing of things, but I’ve been happy lately not measuring.

Yesterday, because I rode with my Colombian associate, I timed it because he is a timer.  He has somewhat of a  typical Colombian physique, but because he’s inconsistent he smartly uses a compact crank (50×34).

The fact that I simply made it was thrilling after the last time’s head trip.  In fact, I said to GV while planning this trip, that I wanted to arrive on a Friday, so that I could walk Palmas Saturday, accomplish a 62 mile ride Sunday, hit the gym during the week early before work with a spin class of two thrown in, then conquer Palmas on the bike the day I travel back, which was yesterday.

Those little plans, the fact that I did exactly as planned, felt so satisfying.  Even though my time today was just under 65 minutes, I was elated.  Perhaps what also helped was that I stopped the antibiotics a few days prior, after after 23 days.  I was supposed to finish them to 28 days but 23 seemed like enough.

But I’m getting off track.  Some times it’s the bigger plans that provide a memorable satisfaction, like the ride brother P and I did a few years ago from Chicago to Lanc-hysteria.  That trip was extremely satisfying.  Even though we could have never predicted what would happen between the beginning and end, it was a plan and it was executed perfectly and provided a load of satisfaction.

What I accomplished this past week was nothing close to the cross country trip plan, but another type of plan nevertheless.   Especially given my seemingly fragile, at times, condition, that small little planned target was rich.  Anything to take my mind off the pending jawbreaker.

So if I bored anyone with this post, honestly, I wasn’t planning on it.

on the way up (or down) Las Palmas

distraught

That’s the best word I can find for what I’m trying hard not to be.  This damn osteoradionecrosis (ORN) is a curse.  It only occurs in less than 8% of patients who’ve received neck radiation and I’m one of them.  Not only that, I got it quickly.  If there is good news, it’s that there is still a chance my face won’t need to be reconstructed.  But that’s still an unknown.

Supposedly, the Maxillofacial Reconstructive Specialist (MRS) I am seeing is excellent.  Everyone tells me that.  What is baffling is that there is no visibility into how extensive the bone degradation is prior to going in.  No type of dental CAT scan?  Direct x-rays?

The MRS works with the surgeon. Together they’ve done hundreds of these.  They’ve done hundreds with others.  They told me this past week that the best option was to go in (under the knife) with the hopes of digging out the ORN and patching things up with skin from my mouth.  If so, I’d be in the hospital overnight and I’d have maybe a 50/50 chance that this would stop the necrosis.  If however, they see that the simple patch up would not result in at least a 50/50 result, then they want my (pre) authorization for a more extensive flap operation.

The flap operation means they’d take the largest vein out of one arm (from my elbow to my wrist) and also take a large patch of skin out of my wrist.  They would also slice into my neck externally and try to reattach the vessel in the jaw area and lay the skin from the wrist over where the teeth were and hope that this process would arrest the necrosis.  This option would mean 7-14 days in the hospital and a recovery of six weeks.  During those six weeks, my face would be swollen.  So essentially, I’d not know going into the hospital whether I’ll wake up and come out the next day or wake up with stitches all over the place and a significantly longer stay.

The whole point would be to avoid the even more brutal operation of a full plate and harvesting bone from the leg.  That would be even a bigger operation.  I’ve seen some of those patients and it’s not pretty.  From what I’ve seen, it looks like disfigurement so I’m trying to keep that image out of conscious thought.

Point is, what a heavy price to pay for getting rid of the tumor on the base of tongue.  I should be good to go, but I’m not good and not going.

So what to do?  Think ‘at least it’s not worse?’  I’m thinking back to my son, who at age 19 was involved in a horrible life-changing accident that left him paralyzed from the waist down.  To wake up discovering that you’ll never again be able to walk must be a mind blower.  I’ve got to admire his strength and understand him.  I’ve got to stop myself in my tracks and shed the distraught feeling when I’m thinking about this pending operation, and think of him.  When I do, all of a sudden what I’ve got to deal with pales in comparison.

This mess is happening for a reason.  It’s never the situation we are in it’s always about how we handle what we are in.  If only I weren’t such a wimp.  Getting out of this wimp head is my biggest challenge.  But it should be easier if I keep thinking of my son and somehow absorb a tad bit of his strength.

Distraught is the enemy.  The trick is not being my own worst one.

At least for today, I was able to squeak in another causal ride.

Delhi

It was an invitation.  What the hell, over. But hey, I’m looking for opportunities anyhow.

They invited me in January, but I flaked at the last minute. I’ve been flakey recently. That time the invitation was to Chennai. This time is was (is) Delhi. They are The Council for Exports (of a particular type of product).

Wasn’t so sure I’d make it this time either. Being that my mouth wasn’t opening so far, I was chewing challenged and looked like a facial retard.  But I stopped in to see the surgeon before I left and he loaded me up with antibiotics. Luckily, the day before I left my face swelling abated, perhaps from an infection that the medicine was taking care of. He said the jaw opening issue was more than likely a result of the infection and would take some time to resolve itself.

A compromise to this trip is that I had to leave on the 4th of July to get here in time for the event I was invited for. The second year in a row I missed the fireworks over the Hudson which are set off nearly at the end of my street.

I didn’t think I’d be able to eat much solid food so I packed enough protein powder for a fallback. Luckily, my mouth has become a millimeter or two more flexible and I’ve been able to get a spoon in if what’s on the spoon is relatively flat. Hence, I even did a slow gobble with the airplane food. Since it was a non-stop from New York, the choice was Indian veg, which was yogurt and saucy soft vegetables. It was actually quite good. Or I was quite hungry. Either way, it took me a while as I fed myself bird-size portions.

The event was two days, but could have easily been one. I was finished in 1/2 day, so the 2-day stretch was, at times, painfully boring.  Since they paid for the flight (most of it) and the hotel for two nights, I had to feign attentiveness, especially since they reimburse  for the flight only at the end of the second day.

The hotel was quite nice, in the middle of nowhere in the middle of New Delhi. There was no walking anywhere outside of the hotel, besides it was 110 degrees. Apparently President O stayed there on his Indian trip last year. As I was preparing for a sauna in the men’s spa locker room one morning, the attendant was proudly telling me how P. Obama (and his entourage) came to visit the spa, and he (the attendant) said he bowed his head with folded hands and said “namaste” (to P.Obama).  After which he said that President Obama shook his hand.  He was beaming as he recounted the story, twice. So I said to him, “in that case, let me shake your hand.”  And while we shook, I said, “now you’ve shaken hands with at least two important people.”  It didn’t seem like he understood but he smiled anyhow.

Then, as I was in the sauna, I was thinking that the probable reason I’m paying the price for this tongue and throat mess is because I’ve just been too much of a smart ass for too long. Realizing that a smart ass is certainly better than a dumb one, but not nearly as good as simply being smart and leaving the ass behind.

This entire experience has been humbling. And by all indications, it will continue to be, being that radiation is the gift that keeps on giving.

The fact that I’ve been able to open my mouth enough to sample a large variety of Indian food these last couple of days have been rewarding, at least in another type of gift way.  The variety, colors and flavors like nowhere else.  Almost everything is spicy.  Even food which they say is not spicy is spicy.

Yesterday I checked out of five-stardom and shifted to a hotel that brought me closer to street level.  As I’m staying a few extra days to see some factories, I didn’t want to feel like I was on a retreat.

Now it’s back to bits of silliness. I stayed up after midnight last night watching a movie on tv figuring that today, Sunday, was the only day I could sleep in. A  luxury. Then the phone rings at 8 am this morning and the receptionist wakes me from a rich, deep sleep to ask me if my hotel stay has been good so far.  So much for the sleep in. I figured she couldn’t have been that stupid and perhaps they wanted to clean the room.

So as I’m writing this I’ve walked a couple of miles to the Bengali Market area and am having a banana shake drink at Nathu’s Sweets.  On the way I had to contend with a couple of different relentless tour guide want-to-be’s and a guy who insisted on pushing his service as an ear cleaner, and it’s only Sunday morning.  If the Indians weren’t mired in their own complexities, they could rule the world.

And just to be clear, that would be Indians from India. Not to be confused with American Indians or Indian Americans, or any other type of indians.  For now, the experience has opened my mouth (slightly) and has been Delhi-cious.

she let me take her picture, the least I could do was buy a matt for $4

$12 for something which took her 5 days to hand-stitch? if only my hand-carry luggage space wasn’t so precious.

O2 + O3 = O s**t

It may have been one of the more reckless things I’ve done lately, trusting the bio-energy doctor in Colombia.  Since he injected me with O3, it’s been nothing but problems.   I went to the guy to find suggestions for relief and he makes things worse.  I trusted him.

The swelling did finally go down last Saturday, four days after the injections.  But since then promptly returned.  It looks like I’ve got a swollen lump on the ridge of my jaw and up into my cheek.  Coupled with that, my left jaw has tightened up so that I can barely fit the tooth brush head into my mouth.  Yes, now the problem is eating.  And chewing.  I’m back on a liquid diet because I can’t open my mouth wide enough to get food in.

A few days ago, I went to the surgeon’s office unannounced to see if I could talk to him for five minutes.  The question was whether I should be taking antibiotics, especially since I’ve got to travel in a few days.  After seeing me he said I should have a “boatload” of antibiotics with the way I looked.  He took a panorix (full mouth) scan and guessed that the jaw joint was affected by an infection.  I’m taking a strong antibiotic for two weeks and may need to have them injected if not significantly improved upon return.

When I told the surgeon about the ozone injections, he just looked at me dumbfounded.  He said that gas is not something that should ever be injected into tissue.  He said they use gas once in a while to open cavities (in the body), but never into tissue.  He said it was dangerous and could cause embolisms.  He said I’d better not do that any more.  He was right when he said that alternative medicine is supposed to be non-invasive.  Once you get into injecting needles, you are leaving the zone of natural healing.  I was properly scolded.

The maxillofacial specialist I had seen the week prior commented that his only experience with ozone therapy was with a high-profile person who had the same throat cancer who flew to California regularly for this treatment being told that it would cure the cancer.  It didn’t.  He therefore didn’t believe in the therapy and told me to come back when I wasn’t so swollen so he could examine me baseline.  I’ve been trying to get there since.

The last two work days of the week I attended an all day conference, meeting new people every hour.  I was self conscious enough to hold my hand over my left jaw the entire time trying to hide the large hideous bulge.  I’m sure I just looked like a weirdo with his hand stuck to his face.

In any event, I can’t go backwards.  And until this is resolved, I can only say, o s**t.

O5

It really should be O with a small 5, but don’t have time to figure out how to make it small (in the title).  O2 is oxygen and O3 is ozone.  O3 is what I had injected into my face earlier in the week.  Don’t know yet whether that was a mistake, but it has taken me almost the whole week to recover.

After the first 20 hyperbaric tank dives, I headed to Colombia on business.

hypobaric tank, sits two

While I was there I took advantage of seeing the bio-energy doc.  I showed him the written results of last month’s PET scan, explained about the hyperbaric treatments, and the increased pain I was having in my jaw.  He highly recommended the ozone therapy.  I asked a lot of questions and he was quite convincing so he injected O3 into two areas of my jaw/face.  I guess I didn’t ask enough questions.

The left side of my face swelled up to twice its size. I could not even see out of my left eye.  He kept trying to move the swell down toward my neck by massaging my face in a downward fashion.  I could hear the bubbles from the gas as it moved.  After about a half hour, I could at least venture out of his office without scaring anyone (myself excluded).  That was Tuesday afternoon.

Flying back on the next day’s redeye was not so fun. I was still looking (and feeling) abnormal.   He said it may be 3-4 days until I was back to normal. Wy didn’t he tell me this before I agreed to the injection?  Anyway, I finished out the workweek looking like a deformed freak.

Maybe the reaction was exaggerated by the hyperbaric oxygen treatments I just finished, which was a heavy O2 infusion.  Perhaps combined it settled into some form of O5.

The whole point of all this O infusion is to arrest the advancement of the ostioradionecrosis.  The fix is still up in the air. Whenever I decide to go under the knife, it’s a crap shoot as to what they’ll find. If there is not too much dead bone, they’ll pull a couple of teeth, do a little scraping, borrow skin from the inside of the cheek (or somewhere else) and cover things back up.  If there is too much dead bone, they’ll do all that and close it up and schedule something later much more involved, (harvesting bone from the leg, metal plates, and other reconstructive stuff).  I’d like to not even think about that.

Until then, I feel like I’ve taken a step back and am again dealing with more pain and stiffness than I (or anyone would) care for.

P.S. I don’t recommend O5

aligned incentives

Popped on Bloomberg News the other day (it seems to be less repetitive than CNN Intl), and heard a guy talking about aligned incentives (as it relates to where we need to drive policy).   He was specifically talking about unemployment benefits and how the longer they are extended, the less incentive there is to be employed.  In other words, if we are giving out a benefit for not working, why work?  He was also mentioning that no one is talking about how the job opportunity market has been rising, but the skills required for those openings are not aligned with the those looking for work.

It can’t be an easy task, running a country.  We say that everyone is created equal and then we structure laws which end up favoring some at the expense of others.  The incentives get all misaligned.  We see this all the time in trade policy, with subsidies, and taxes.

Aligning incentives?  That is one lofty goal.  We know the incentives start with the individual, each of us.  But then how far up the chain to we align them?  The news guy was talking about the state (our country).  But in our global economy, we could roll it up further.

Who understands the logic of our tax code?  Taxing is like a penalty.  The more you increase a penalty, the more behavior changes.  If two people are equal, and one works harder than the other thereby making more money, the harder working person must pay more in taxes.  When I worked at a manufacturing plant in off seasons during my pre-college graduate days, when offered, many workers would turn down double-time pay because of the disproportionate amount of taxes they would end up paying.

I remember feeling incredulous in my early 20’s when my tax rate jumped the day I could no longer file single.  Had I known, (stupid me at the time), that marriage cert would never have been signed.  We let our incentives get so out of alignment.

With so many of us clamoring to fulfill own incentives, it’s damn near impossible to get all of them aligned as a country.  But we should be looking at how rules and policy affect general behavior.  That’s kind of a basic dumb dumb rule of thumb but we seem to miss it many times.

Oh well.  Today, my incentives ended up aligned with a ride in the hills for some fresh air.  Whatever is happening on the left side of my head is totally out of alignment.  I’ve got to go find me some aligned incentives.  Anyone out there have any (extra)?

rode to Palmitas today. a tiny pueblo where they make great cheese bread (I didn’t/couldn’t eat any).

arepa de choclo con queso y aqua de panela. omg, processed carbs, dairy and sugar water. what’s a human to do?

the jury is in

It’s hit and giggle.  That’s what a couple of us said when we were in our early 20s playing pool.  At least we thought we knew how to play pool.  We’d line up the cue ball very seriously and take focused aim and often the shot would not work out and the balls would scatter randomly.  We might have just as well ‘hit and giggled.’  So by a margin of 3 (to zero), the feedback from last week’s post was that this blog works without a theme (at least for three).

And that suits the writer.  If you take aim, you’d better be consistently hitting your target, somewhere.  If it’s a random shot, you’ll be forgiven because it becomes obvious that you are anyhow a hit and giggle kind of aimer.

Which doesn’t mean that one still shouldn’t take aim.  But it can be (and often is) a more relaxed aim, and, in random directions.  I’m not playing serious eight ball.  I’m just hitting, or trying to hit, any random ball if interest.  And then I’ll hit and giggle.

I only wish I had more to giggle about.  The bottom of my left jaw is throbbing.  There is something wrong. That damn radiation made a mess of my neck and mouth area.  The cancer never felt this bad.  It’s a hell of a price to pay.  I’d like to be pissed at the doctors who butchered the area, but I bought into it without enough questioning the consequences.  It almost feels like they aimed, then hit and giggled.  The radiation scattered, creating a mess.

may 26, 2012 in the Palisades Park, NJ during a casual ride, just north of the GW Bridge

But I can’t be complaining. That will get me nowhere.  What’s done is done.  I’ve got to learn when to hit and when to giggle.  Sometimes they are simultaneous.  Sometimes not.

I’d better be content that I’ve been able to spend a casual day yesterday riding my cruiser over to the N.J. side of the GW Bridge to the Palisades Park where I was able to start this post and enjoy coffee and newspaper reading while overlooking the Hudson River through the thickness of trees.

Point is, we all need to find ways to keep hitting, and then perhaps giggle a little (more).  And for the two who responded via comments to this blog, thank you.  And thanks to the person who wrote me a separate email.  The randomness will continue and thanks to you, I don’t need to wrap my head around a story.  I’m giggling and I hope you are too.

May 27, 2012 exiting the Palisades Park on the hybrid marin