bengt-erik norum

there are a few bay area college radio stations that i don't think i could live without.

kfjc is what radio stations should aspire to be. well trained djs with good scope of music knowledge and a free form format. i am a huge supporter of kfjc.

kpfa is good to have around as pacifica reminds me that i'm not all that radical a left-winger.

kzsu is the prototypical college station, complete with 4 hour sets of boston followed by a riot grrrl marathon. i listen often.

i haven't included links to mp3/rm streams, as they tend to move around.

no particular order:

coffee
nicole has instituted a rule in our house. the kids can ask nothing of us until after we've had two cups of coffee. this has helped; note the time of this entry. today celeste asked me to make coffee.

booze
had tapas and drinks at cascal, wednesday. first exposure to mojitos and i'm sold. rum, soda water, sugar (raw), muddled fresh mint, and lime in a highball. the tapas were good, though fairly typical. the service was horrible, though we fell victim to the beer vendors parading through with schwag for the bartender.

i've decided to do a photo-a-day project. http://gallery.norum.org/pad/

dave said that he was afraid he'd wake up in the middle of the night and post something he'd be embarassed of. what can be more embarassing than:

bought 802.11 the oreilly wireless book. lots of the acronym's defined, good diagrams, and overall a pretty useful-looking book.

i got hit; on the way into work today, i was involved in a car accident.

drove celeste to school on my way to work and took the jetta down mission south from celeste's school to 680 south. after washington, i followed mission (south) down to the 880 onramp. the metering lights were still on, though it was a pretty light traffic day; the backup didn't start until after the overpass.

i had been waiting in the line of ~20 cars for probably about 45 seconds or so when i felt my headrest smack my skull. almost immediately, i smelled smoke and something pungent that i couldn't place. it took me a second to realize that i'd been hit. i opened the drivers side door and the headache started. looking back, i saw the car behind me, a white honda hatchback (accord, maybe, bigger than a civic) and a ford f150 that had smashed into it. i held my head in my hands for about a minute, after i saw that both of the other drivers were out of their cars and standing. my head was throbbing... "oh, that's the pungent smell, radiator fluid."

i got out of the car and walked back on the curb to the area between my car and the honda. i didn't even have a chance to look at the damage to my car before the enormity of the situation caught me by suprise. the honda was about 1/3 to 1/2 smaller than it was before the accident. the truck had radiator fluids gushing out of it and into the "back seat" of the honda and had basically lost everything between bumper and hood. the honda's rear axle was inches behind the driver's seat and clearly busted; the left rear wheel protruded from the car by about 5 inches. there was glass from the rear window of the honda everywhere. both front airbags in the honda had deployed and were still smoking "that's the gunpowder smoke smell! got it."

the driver of the honda commented that he was covered in radiator fluids. it had looked like spilled coffee to me, running from his right shoulder down onto his right knee. he was picking tempered glass out of his hair and clothing. his face looked like he'd been smacked by something big and flat. his left arm had been ripped up by the shoulder belt and blood was soaking into his shirt. i mentioned that he'd slammed his right kneecap into the steering column. based on the way i felt, i was pretty sure this guy's head was killing him. he said that he saw it coming. he'd looked in the rear view mirror and had seen the truck coming at him. i pointed out a couple of pieces of glass he'd missed (in his ear and between his neck and shirt collar. "damn, this guy's lucky he's alive."

i noticed that the bmw 5-series (m5, i think) in front of me had also stopped and the driver was milling about seemingly very concerned about his rear bumper. my front license plate had wrapped around his bumper and the impact had broken the lowest reflectors in his tail lights. he spent a fair amount of time saying things like, "this is going to be expensive" (referring to his car, not the overall incident.) i tried hard to show that i was annoyed with him. he didn't really talk to me other than to say that he thought the truck's insurance would pay for all of our cars' damage. hardly what i was thinking about, at this point.

the driver of the truck just kept walking back and forth between the cab of his truck and the two of us and asking if everything was ok. ("does it look like everything is ok, dumbass?") he was wearing a t-shirt from 'e & b engineering' or somesuch. his truck was equipped with the side toolboxes typical on construction vehicles, but didn't have a company emblem on the doors or hood. trying not to pass judgement, i noted that he was stereotypically blue collar, in every detail i saw.

the rear end of the jetta was pretty messed up. it looks like everything from the back of the rear doors dropped by about 3 inches. the wheel wells are compressed and almost touch the tires. the trunk and rear doors don't close. the bumper is split and moves with hand pressure.

someone had called the chp (driver of the truck, i think) and they showed up after about 15 minutes and talked us through a pretty standard accident routine. they made sure that none of us had broken anything, were seriously bleeding or had head/spinal injuries. the more senior (rank?) of the two cops suggested that we move the cars off to the right side of the road, where the on ramp forks (to gateway blvd and to 880). they ran a traffic break for a couple minutes and had the honda owner climb back into his car, something that he was clearly not eager to do, and "gun it in first... you'll be able to drag the back half of the car" the honda broke free from the ford's bumper remarkably easily. smoke everywhere and horrible horrible metal on asphalt noises almost stopped traffic on 880, while we limped down the shoulder in a freak-show twisted metal convoy. part-way down the ramp, resistance between honda and road became a bit much for the engine and one of the two cop cars pushed for the last 40 feet. the smell of burning rubber and plastic made me gag a little, when i got back out of the jetta.

45 minutes of statements, documentation swapping, and procedural stuff and the bmw and i drove off.

i've had a low-grade headache since.

following my wreck on friday, i'm dealing with insurance. this sucks. with the jetta as the second car, we only carry liabilty insurance. usaa said that i had to deal with the truck's insurance.

wow! i spent a good deal of time reading from 'the complete works of george fox' in earlham's digital quaker collection. i dind't know this archive existed, until this morning.

i really should go to meeting, one of these weekends. going to church with nicole (and the kids) feels foreign, still. all the ritual makes me nervous.

celeste flipped her rocking chair over backward, this morning. recognizing her need to thrill-seek, i offered to convert it into a go-kart, with rubber tires, roll bars, an engine and steering wheel. she didn't think it was funny.

i previously posted the bay-area terrestrial radio stations i listen to. it's worth mentioning kexp and kuoi. they're both good streaming alternatives to the poor fm reception i get in my office.

trying to convince my disbelieving wife that "galactic wash" jeans existed as a (misguided) fashion statement in 1986-87, i searched google for "galactic wash" (quoted string). get this: 3 hits. that's it. i'm shocked.

this was a product made by levi's. during the jr. high "acid wash" jeans phase, levi's tried to extend their success, but only succeeded in punishing a couple kids who's parents shopped for school clothes without them. these were dark denim jeans with little bright white bleach dots (they had to have used dry chlorine to get that effect) scattered throughout.

acid wash jeans quickly became lackluster in the face of the ultracool hypercolor clothes (aka. "that girl with the pink shirt and bright blue armpits").

anyway, the most clear proof is some (circa 1987) "anarchy text" at http://nightmare.org/.

disappointing. maybe it was just an "idaho thing."

what's with the asian women wearing blast-shields? they've become very popular over on this side of the bay.

christian science monitor has an article on this "craze" but no explanation.

barney shakur (via memepool) reminds me that mr. rogers "sang" the guns and roses song "used to love her" pretty well.

what ever happened to the barney actimates? they seem like they could do the teddy ruxpin tricks even more convincingly.

see also:
Hacking Microsoft Barney
40 support.microsoft.com articles on barney
(including "ActiMates Barney: How to Play with Barney" and "ActiMates Barney doesn't Play Peekaboo when His Eyes are Covered"

i got a catalog in the mail, on saturday. it was filled with professional greeting cards, open house postcards, and a pile of other crap targetted at realtors. this isn't suprising, as the previous owner of this house is a realtor.

curious, i flipped through it and ran across a "happy birthday" card with a serene photo of a dinghy. i'm 99% sure that this is a boat that my late grandfather, henry "grubby" douglass built. the picture in the catalog is quite small (~1"x1") and the picture on their website is also tiny (127x176), but it really looks like the "grub tubs" that he built.

trying to find some better pictures, i located these , one of which shows at least one grub tub (foreground, white hull, blue interior, wood seats).

i also found a reference a two to my grandfather the most interesting of which is an excerpt from "multitudes: the unauthorized memoirs of sam smith":

During these years, Harry Parker set the sailing standard towards which I strove. So it was with alacrity that I accepted his invitation to crew in the New England men's sailing championships. Harry, Grubby Douglass and Gardner Brown -- the three best sailors I had ever known -- had won the Maine championship, but the New England races were in boats that required a four man crew.

the rec room in my grandparent's house in south freeport had trophies stashed in cabinets, but i can't remember what was engraved on them.

maybe i'll order a box of these horrible cards, just to see if it really is a grub tub. then again, maybe not.

so, i'm driving to work and the most amazing religious postcard scene breaks through the clouds. just as it does, ac/dc's 'who made who' reaches it's first crescendo. conclusion? angus young is god.

"i found god on the butt rock station."

buying halloween candy at the grocery store, last night, i noticed an almost entire aisle of candy canes. dept. stores and "christmas" stores, sure... start in july. but grocery stores?!

no wonder we have a hard time finding dried cherries for thanksgiving.

nicole and i had a conversation about how my grandmother used to say 'your room looks like a tenement.' i realized in the course of the discussion that i had no idea exactly what she meant. tenement connoted 'poor,' for nicole. if that's a common definition, this could have been a somewhat offensive thing to say.

i had just associated the work 'tenement' with 'messy place' and had expanded it (from context in other circumstances, i'm sure) to also mean 'rundown.' roget's (offline) uses the word poor only in the second definition. wikipedia isn't very helpful, here.

as an aside, tenement.org is the lower east side tenement museum. they define their mission as:

The Lower East Side Tenement Museum's mission is: to promote tolerance and historical perspective through the presentation and interpretation of the variety of immigrant and migrant experiences on Manhattan's Lower East Side, a gateway to America.

something to add to the list for some future visit to nyc.

in the end, we chalked my grandmother's use of the word up to the same era that saw people regularly use 'oriental' and 'asian' interchangeably.

living in the silicon valley for the past 7 years has clearly invaded the only remaining unconnected synapses (the rest were connected storing useless facts or soaked in good beer).

fremont voters decided on measure FF in the november election. the election signs read "vote yes on measure 255" to me. even more sad, the second thought i had wasn't "doh! wrong context!" it was "doh! is that 0-based (255) or 1-based (256)!?"

i had a similar experience this morning. driving my daughter to school, we tailed a silver corvette with the personalized license plate "DRMBLVR." my first thought? "wow, proclaiming belief in digital rights management... here? that's brave." clearly, she meant to proclaim her belief in dreams. i guess i believe that dreams exist, too.

side note, what is it with corvette's and personalized plates? there are three parked on my side of the building at work. that's down from four or five, last year. there's clearly something about the personalities of the population of people that decide to drive vettes that also makes them decide that they want personalized plates. if i could pull make, model and plates for a large enough population of cars, this would be fun to check. maybe i'll interview someone.

nicole and i have been planning a trip to europe for awhile. don't remember exactly how i ran across these pictures, but the millau bridge in france has just been added to the list of places to visit.

it's a pretty suspension bridge with the deck hanging off one side of the towers.

the tallest tower is 280 meters tall (918 feet) and the entire bridge span is 2.46 kilometers long (1.55 miles).

i liked one of the proposed oakland bay bridge east-span replacement designs and this bridge is 7 spans of the part that i liked.

(french and french-inhibited)

i wondered what i could have bought for $40 million. a big party, or...

• buy 60 ferrari enzos (and gas) or 4790 Kia Rios
• hire lawyers to file 2000 patents
• completely finance 209 frozen yogurt franchises (and have enough to buy yogurt for your neighbors)
• get 50,000 botox treatments on your forehead
• spend 3595.5 years at louisburg college, including room and board (or 891.8 at harvard)
• burn 8,620,689 acres of grassland
• go to space
• 4000 prosthetic legs (maybe for victims of our habit of leaving land mines all over the world?)
• 80160 mini macs
• more than 8 sony jumbotrons (or 4000 used ones)
• 4000 kilograms of crack cocaine (if you're willing to bargain shop)

how much cash is that, anyway? it's this much: times 40.

i find it really offensive that this much was spent on the inauguration. note that clinton's cost $29.6M. i'm not making a political statement, just wishing we would use the $ for something useful for someone. ok, so my suggestions aren't useful... fine.

i drove through the walgreen's drive-through, yesterday. there was a vinyl window cling on the glass between me and the pharmacist that read "medicare". i saw it as "mediocre". wonder if that means anything.

a couple years ago, i was riding in the back seat of someone's car. we were returning from lunch in the middle of summer. the back seat had that perfect combination of filtered sun, warmth, ambient noise (muffled voices from the front seat), and squishy seats. i wasn't falling asleep, but zoning out pretty heavily. i'd pick up random phrases from the front seat ("almost 400 horsepower... but that's not 68-pin scsi... i can't eat edamame..."). the words "five pound block of cheese" grabbed my attention. i leaned forward and said, "did you just say five pound block of cheese?" appearantly, they had not.

andrew registered fivepoundblockofcheese.com, a couple years back. it had a wildcard forward for @fivepound.. to @microsoft.com.

my senses lie more (fewer false positives get filtered?) when i'm tired.

few weeks ago, i ordered three pairs of shoes from zappos.com. i got a pair of simples, asics running shoes, and a pair of doc marten's. ordered sunday night, received tuesday by ups.

Dr. Martens 1461 Series Black Smooth UK 14(US Mens15) M
Asics Top Seven™ Dolphin/White Men's 15 M
Simple Original Sneaker Sand 15 M

why is this a big deal? see those 15 M indications on the right? they're hard to come by in shoes that don't suck. if i wore hideous basketball shoes or tacky dress shoes, it'd be easy. this site has "search by size" right on the search page. couldn't ask for more. oh, except the `true to size' ratings with customer comments ("these are wide on me and i thought i had wide feet.") tonight, they have 1982 pairs in my size. ok, so i don't want track cleats, but still.

i'm always happy to find a company doing good business with good customer service. free shipping, 365-day free shipping return, and price matching discount for 110% of the difference (online or off).

long time no post. by way of explanation: http://yarnhog.com/archives/2005/02/divorce_sucks_l.html.

aside from the logistics, i've been digging into work really heavily, trying to keep my mind occupied, i guess.

while posting would probably be somewhat cathartic, i've been hesitant to 'open up'. too many reasons that people read blogs and this blog hasn't been focused enough to know whether its the technical stuff or the personal stuff that keeps the (from some crude log analysis) 14 people with rss aggregators pointed here reading mine.

this postcard is stuck to my (yes, my, we've worked that much out) fridge. it has greeted me every morning for a couple weeks, as i get breakfast for the kids. three comments about it:

• lupine (person who sent the card to my soon-to-be-ex-wife), i'm sorry i never got to know you
• i have a thing for the aesthetic feel of these 'retro' images
• i wonder if i find it funny, in part, because it's at my expense. would it be funny if we weren't getting a divorce?

why are us wasps so damn defensive? make fun of me; i know i haven't solved all of my prejudices when i can't respond.

there are a bunch of fridge magnets that can serve the same purpose for you on annetaintor.com.

she silently climbed through the window into my bedroom
crept over and held me in a warm embrace
i awoke and turned to see her
the heat of her fury clawing at my eyelids

the sun is an brutal mistress

i guess i left the blinds open last night. celeste came and woke me up (a few times, at least).. but... damn it was bright.

i wrote this for a close friend and she encouraged me to keep posting (how am i so lucky to have friends like this?). so i'll just share this.

it's another early morning rant.

This, my first day among the living will be my finest. I shall dine upon only the most lush of human flesh and drink only the finest wines. I shall bring great disasters to bear; crushing man and beast alike. A great scourge will set in amongst these lovers of light. They shall fall victim to their own vanity in the wake of my terrible wrath. Their folly shall only hasten their downfall; bringing them to their knees at my mighty throne. I spare none, the banker and bookmaker, the priest and whore alike; all shall fall. My kingdom will crush their feeble bodies and I shall devour their weak minds. The hordes becoming fodder in my army against the light, my dark army. I draw strength from the living, though I am undead.

Or maybe I’ll have a cup of coffee, instead.

i've been told my a number of people that they look for new updates; that they want to know what's going on in my life. this is a quick rundown on the major events in my life over the past few months and some general info.

i'm divorced. my wife of 8 years and 2 children have relocated to idaho falls, idaho. the divorce settlement was done through mediation and was mostly civil, despite how tough it was. i plan on traveling to see them often until we can be in the same geographical location, again. yes, i miss my kids.

i've moved to mountain view, ca. i found a very reasonable 1 bedroom apartment in downtown mountain view. i'm a handful of blocks from 10-15 pretty good restaurants and coffee shops. i have a (supposedly) good sushi place and a middle eastern market at the end of my street. my apartment is still filled with boxes and i've lost the initial motivation to get everything unpacked.

i'm still working at microsoft in hotmail operations. i still like my job.

i've reconnected with a bunch of friends. i'm making an effort to keep in touch with people. i've always been particularly bad at corresponding/replying to email etc., but i've realized that it's something i'm capable of and something that i want to do. if you're reading this and we haven't talked in awhile, say hi. my email address is my first name @ my last name . org (avoiding the insipid spam crawlers).

i'll try to post more frequently and more personally, from here on out.

my bird, an african grey cockatiel named blue (he's yellow), has been with me for 8 years. nicole and i always assumed he was a boy. i think the differentiating feature is the color of the skin/bone/whatever around their nose holes.

today, i have definitive proof that he is female. there's an egg in his food bowl. it's slightly oblong and smaller around than a nickel. it appears to have drops of some kind of light watery fluid on it. blue was intermittently sitting on it and looking at it.

what do i do with this egg? i guess i'll have to throw it away when i change his food. i was on my way to change his (i'm still going to use male pronouns) food this morning when i found it.. i think he has enough to sit with/on it for awhile. cockatiel.org suggests letting him have it for a week or two. they also suggest reducing the amount of light he gets. i can't do that. this apartment is too light. plus, he loves the filtered sunlight.

i ordered a digital slr and it's supposed to be delivered, today. maybe i can take pictures, tonight.

i had some pretty crazy vivid dreams last night. i was waking up and recounting one of them and my phone rang. one of my friends (actually, capital f friends) whom i reconnected with this last weekend, after 9 or 10, called at that moment. she had a crazy dream and wanted to tell me about it. is it something in the water? i think english needs more acronyms. let's start with stst, meaning: "same thought, same time".

i looked up the palo alto monthly meeting. i think i'll go this weekend. the following weekend, i'll be in idaho falls w/my kids (yay!) and will likely go to catholic mass. 7 or 8 years ago, i realized that i have the same centered, peaceful feeling after mass that i have after a quaker meeting. it surprised me, given how differently i'd spent the hour.

blue laid another two eggs, both of them from his perch. i saw them down in the bottom of the cage, all broken and scattered. i removed the first one from his food dish and he (yes, i'm going to continue using that pronoun) seems to be ok with it. my camera arrived the other night (canon 20d, more later); picture of the egg in a 35mm film canister cap, for scale.

didn't sleep well last night and made a mad rush to work when i didn't wake up until late. positive point about new apartment? i can be at work ~20 minutes after i wake up, including shower and coffee.

blue laid one more egg, bringing the total to 4. it was in the water dish, this time. it had a little dimple cracked into it. i wonder how these animals ever manage to reproduce, the way they handle their potential young. he's been chomping pieces off of his cuttlebone. that's supposed to be a good sign: means he's replacing lost calcium from the egg shells. i moved him over to a processed/pelletized diet a few months ago, worried about his nutrition. that was the only other suggestion that cockatiel.org had for egg laying diet. i guess i'll just wait and see, they also say 3 to 6 eggs is normal.

i spent the weekend intentionally undistracted. i've obviously got alot to think through and wanted to avoid keeping myself busy. i cleaned up the apartment, a little. it's looking more reasonable, but still pretty cardboard-ridden.

i did move my micro-atx motherboard into a full-sized case (antec sonata), to support a dual dvi-d out video card (nvidia 6800GT fabbed by xfx). it's now feeding my dell 2005FPW (in "portrait" orientation) and my new 2405FPW (in "landscape"). highly highly recommended. "ultramon" is an indispensible app for dual-head machines. i'll take some pictures and post a review of all the parts, including software, later.

i felt foul this morning. digestive stuff; ew. stayed home and spent most of the day relaxing, save a conference call and a pile of mail i replied to.

blue's laying eggs again. three the last 48 hours. my brother asked if i was eating them. ew.

i've been nasty sick for almost a week and my sleep schedule is all whacked out. i forced myself out of bed at 10:30 this morning, knowing that i need to get back to normal hours.

capable of almost nothing else, last week, i watched the majority of season 2 of buffy and 5 or 6 episodes of jon pertwee era dr. who. i got mono when i was 15 or 16 and watched an entire week of doctor who, since then all the other doctors seem "wrong" for the part. side note, the new doctor is really good. if you haven't seen the first season of the new series and want to, tell me. i *cough*divx*cough* might be able to help you figure something out.

back to laundry. oh, and i need to grocery shop, too.

i'm heading into work today, despite not feeling all that much better. it's been over a week; isn't that enough?

oh well, i got laundry done.

i pulled off a halfway moveable type 3.2 upgrade, the other day. i'm probably going to export the entries, tar off the static content and start over, with a new "mt root" or whatever they call it (base directory?). the nasty hacks i threw into the default templates and my poor css still linger. reverting to the 3.2 shipped templates and css leaves some bizaare remnants in the permalink line including double percent signs ("%% PM") in the date.

returned from a wonderful weekend with nicole and the kids in idaho falls to find the court accepted uncontested judgement in my mailbox.

my divorce will be final on friday.

posted without commentary... mostly.

strange things are afoot at the circle k; pretty significant reorg a few rungs up the corporate ladder.

i'm now in the "Microsoft Platform Products and Services Division"

pirates.
monkeys.
cold nights and warm blankets.
fans.
timepieces.
lighting and lighting stores.
chocolate.
clever and witty jokes.
clever and witty people.
elegant scripts.
coffee.
sunday.
old t-shirts.
new music.
mountains.
big monitors.
learning things.
greasy gyros.
beer.
skate shoes.
computers.

about a month ago, i had a diagnostic esophageal endoscope (which has the coolest long name ever: esophagogastroduodenoscopy). i've known about my gastro esophageal reflux disease syndrome (GERDS) for the last 10 years or so, but suspect i've had it much longer, as i remember having difficulty swallowing from the time that i was 13 or so. this time was supposed to gauge my reaction to the proton pump inhibitor drugs (aciphex) i'm on and any improvement that may have resulted.

the procedure is pretty pleasant, actually, in that you're partially sedated (read: "totally out of it"). it's done as an outpatient procedure, onsite, in this case. there's a surgical center in the basement of the palo alto medical foundation and i scheduled the thing over the phone. showed up at 6am, changed into the "humiliation gown", was given an iv (in my hand, as usual -- my arms seem to hide blood vessels when i'm nervous) and read a magazine for 25 minutes or so. the nurse and anesthesiologist introduced themselves and rolled me into the operating room. they made some jokes about one of their coworkers, "colin" (pronounced "colon"), and tried to get me to laugh. about 5 minutes later, i was given a heavy sedative and a narcotic through my iv. off to lala land. i normally don't like drugs that numb my senses in any way (ok, with the exception of alchohol), but the combination of the warm blanket they'd given me and the drugs they pushed into my bloodstream managed to make me blissfully happy to be lying on a hospital gurney and having a camera shoved down my throat. in each of the 6 instances i've had it done, the drugs have given me medically induced amnesia and retained no detail about the procedure, this was no exception. basically, they have you swallow a large (dime sized) tube with a light and camera on it and look around your insides.

the during my scope, my doc took a number of biopsies. he was pretty annoyed that none of my previous gi docs had taken biopsies and was keen to get them. he suspected that i either had bacteria called "h. pylori" present in my stomach or was having an allergic reaction to food in my esophagus. biopsies would have confirmed either of these cases.

immediately following the scope, in the recovery room, i had a conversation with my doctor. i don't remember a word he said, but appearantly he told me that i had a large hiatal hernia and some acute ulceration in my stomach. he wrote these words on the memorabilia photos of your insides they send you home with. i was pretty spaced out for the rest of the day and spent most of it sleeping.

monday of the next week, he called my cell at lunch and asked if it was a good time to talk. i told him it wasn't, as i was interviewing a candidate for one of my open jobs, at the time. i agreed to call him back at 4:30, that afternoon. at 4:29, i called back and was told that he was running behind, but would return my call. no call that day. no call the next day, so i called back at 4:30 and left voicemail for his nurse.

that wednesday afternoon, he called me back and talked me through the results of the scope, again. he told me that i had a segment of barrett's esophagus (also known as intestinal metaplasia) that he'd visually seen, but waited for biopsy results to confirm. i'd read about barrett's, but hadn't really considered it a possibliity, since it was usually accompanied with the words "rare" and "extreme untreated cases of reflux" and other wonderfully dismissive adjectives. i knew from my reading, that it was a precursor and often accompanied by cancer. i hadn't read enough, or often enough to know what questions to ask. i knew enough to panic and asked some questions that seemed relavent; some were, some weren't. what i knew at the time: i had barrett's and it was considered "long segment", at 7cm. it was of considerable concern and i should get used to the scopes. was he doubled my already heavy dosage of aciphex, and we moved my followup appointment up by a couple weeks and agreed to talk about it then. he kept leaving the option open to "be more aggressive about remediating the situation, though surgery", but i don't honestly think i heard him until after i was off the phone. i spent the night freaking out, with my girlfriend, trying to comprehend what i'd heard.

i had a two day management offsite, in santa cruz, that managed to distract me pretty well. i got kinda panicky on friday night, flew to see my mom in idaho on saturday, and returned to work on wednesday. i spent the weekend reading research and all kinds of very chilling stats like "survival rates at 5 years for patients with intestinal metaplasia" and "morbidity rates in high volume photodynamic therapy for long segment barrett's patients with low grade dysplasia". this all left me with hundreds of questions that i didn't know enough to ask my gi, on the phone. monday, i spent 10 minutes or so on the phone with my doc's nurse. she calmly and very patiently (i know how busy this woman is, from watching her) answered my questions and explained a few details to me. armed with more information, i thanked her, dropped off the phone and resolved to relax a bit .

i have my followup appointment on tuesday. i have 50 or so questions for my doctor, laid out in three or four mental dichotomous trees that i'll use to determine what my likely course of action is. i don't anticipate actually making it through the full list of questions, but i feel better knowing that i'm as informed as i can be. i should come out of this next appointment with a date for the repair of my hiatal hernia and a "nissen fundiplication" (another wonderful word!) and a better idea about how i'm going to treat the barrett's.

i'm currently leaning toward a procedure that's licensed by a company with the same name: barrx. any proactive treatment of barrett's, without the presence of carcinoma appears to be centered around destruction of the barrett's cells and years of "surveillence" (read, "more scopes"). barrx uses high intensity rf emitted from a small catheter to destroy the barrett's cells. there are probably 10's of methods to ablate the tissue, most sound much less nasty than i'm sure they are; they're all pretty ways of saying "burn it out." barrx is really no different, just that the degree of control afforded by rf (over laser, electric, heat, high-intensity uv, or scalpel) appears to be much greater. we'll see.

i'm writing this, mostly so i can get it all out of my head. i hope that others who find this through search engines, later, won't hesitate to drop me mail and ask questions about my experiences. i'll endeavor to keep this updated, as my situation progresses. i also have a huge pile of more fun experiences to share, but hadn't had time to. i took a trip to greece and turkey, devised and attended a vodka tasting party (including activated carbon filtering of really really really cheap rotgut vodka), got hooked on robotics, and found alot of really good music. maybe i can bring myself to blog about some of those, too.

had my followup appointment with my gi, today. he reviewed my biopsy results, in person, and discussed "next steps" with me.

i'm paraphrasing, as the conversation was pretty fast paced and he afforded me almost 40 minutes for questions, but this is the gist of the conversation.

he was advocating a "watchful waiting" stance, at the beginning of the appointment. he wanted me to have scopes every few months, just to see gauge my response to the medication. based on the results of that, he "might suggest" surgery to repair my hernia and the fundiplication. in short, i commented that my medication mostly kept my symptoms in check, but that (ironically, like tonight) i still have reflux that keeps me awake some nights and that he'd previously been bullish on surgical intervention. he didn't disagree and gave me an in-house referral to "general surgery" and called out two names of women who have experience with laproscopic gastroesophageal work. he also mentioned that my insurance would probably also cover a consultation with another surgeon and that i could pick between the two, based on my initial consultations with the two surgeons. he gave me names of two surgeons at stanford that i might follow up with.

this first portion of the conversation was frustrating to me. i felt like he'd calmed on the outlook, over time and would have given different advice, if he'd just completed the scope. i think these feelings stem from his initial tone, when delivering the results, by phone. he'd sounded so suprised by the results and so sure that surgery was immediately appropriate.

i also had this disturbing feeling that the two surgeons from stanford (and the other extneral referals he gave me, through the course of the conversation) were college drinking buddies. my doctor is young, and while his bedside manner is really good, he's still really young. note that i don't hold this against him, having usually been one of the youngest people in my peer group, in professional environments.

regardless of decision to precede with surgical intervention, he explained that he still would like to check that the inflammation and ulceration he'd observed above my barrett's had subsided. this would also give an additional opportunity for biopsies and pathology reports, potentially confirming the diagnosis of and grading of dysplasia.

i talked to my doctor, at length about ablation of my 7cm segment of barrett's esophagus. in the end, he advocated the "watchful waiting" approach, but agreed that, at age 32, my case was atypical and may warrant an atypical approach. he stated that he diagnoses between one and two cases of barrett's, every two weeks and had never seen a patient younger than 45 with barrett's. we discussed ablation technique, in general terms and pdt in specifics. he said that ablation is typically reserved for high-grade displasia or high-grade with presence of stage 0+ cancer.

i asked about pdt (photodynamic therapy), emr (esophageal mucosal resection), and barrx.

my doctor stated that he'd routinely administered photodynamic therapy (pdt) in his medical fellowship and steered me clear of it. the exact phrase he used was "turns your esophagus into hamburger". we used this time to discuss potential complications of ablation. these weren't new to me and fall into two categories: scarring and perforation (taking too much tissue).

he said that emr was definately something he'd consider to be higher risk and also difficult to find a qualified surgeon.

he was not aware barrx, but knew of a local surgeon who has some experience with newer ablation technique. with me sitting in the office, he emailed this surgeon and agreed to call me upon reply. i was hesitant to use a phrase like, "can you add me to that thread?" outside a work context. my doctor seemed confused when i mentioned (barrx) rf, relative to ablation and mentioned "cryo" as what he thought of as a "newer procedure". i was a little thrown, as i'd not uncovered anything about freezing. turns out that cryo spray ablation is a device and technique licensed by "csa medical". it's not yet fda approved for general use, but is in widespread surgical trials. why is it that all the good information about these procedures is always under the "for physicians" links? there are some good articles by dr. johnston (of the cleveland medical clinic), in that section. i also found a reasonably comprehensive overview of treatment options for barrett's that refers to cryo spray.

my doctor highlighted something that i hadn't previously considered. getting the nissen fundiplication might preclude some of the newer ablation procedures and if i'm going to persue that, i should look into it. the newer techiniques and devices tend to be in use in very tightly controlled trials or fda approved for very specific circumstances (general statement, not just for barrett's ablation).

so, i have a scheduled date for my next scope and a date to talk to a surgeon at palo alto medical (consultation only). i've got external referals to some local surgeons. i've got alot of leg work to do over the coming weeks.