Monday, April 29, 2013

NRA Shibboleths

Let’s talk about one of the NRA’s favorite shibboleths about those of us who support gun control. It’s the one where we leftist liberals plan to tie universal background checks to gun registration and follow that up with gun confiscation (that is, if the UN doesn't get their guns first).

The NRA has been promoting this myth for decades, ever since the Branch Davidian Massacre in Waco, Texas, some twenty years ago. Wayne LaPierre tells his rapt audience that, “jack booted government thugs” will come in the night and take their guns, leaving their family defenseless against the hordes. One of the things LaPierre fails to mention in his diatribes against the ATF and FBI is that they were trying to protect children against the sexual abuse visited upon them by the psychotic leader of the Davidians, David Koresh. Never mind, the NRA has shown itself immune to the suffering of children, as their response to the slaughter at Sandy Hook amply demonstrates.

Those of us who demand gun control, believe that universal background checks, as one of half a dozen or so gun control measures, would help keep lethal weapons out of the hands of criminals and the criminally insane. The measure that Senate Republicans recently prevented from coming to a vote -- The Safe Communities, Safe Schools Act of 2013 -- called for universal background checks, but waived such a requirement for transfers between family members and it expressly forbid a gun registry. This was pointed out by one of the bills co-sponsors, Republican Pat Toomey, but this didn’t stop the NRA and gun industry from lying about the bill's provisions. They are shameless and have shown themselves to be shameless over and over and over again.

My recommendation for members of the NRA is to: 1) read the fucking bill yourself, don’t trust what the NRA tells you; and 2) resign your membership in the fucking NRA, and join Ducks Unlimited. 

Response from Sen Pat Toomey (R-PA)

I wrote to Sen Pat Toomey, Repubilcan of Pennsylvania, to thank him for his bipartisan effort to enact universal background check legislation in the Senate. Here's his response.

April 29, 2013

Dear ___

Thank you for contacting me about national firearms policy. I appreciate hearing from you on this important issue.
Like many Pennsylvanians, I have long been a supporter of the Second Amendment. Americans have an individual right to bear arms for self-protection, hunting and recreation. In fact, during my tenure in the House of Representatives (1999-2005), my record of supporting gun owners' rights earned me an "A" rating from the National Rifle Association (NRA). 
As important as Second Amendment rights are, our society recognizes that these rights do not apply to criminals and the dangerously mentally ill. Writing for the conservative majority in the landmark Supreme Court case, District of Columbia v. Heller, in which the court struck down the D.C. gun ban, Justice Antonin Scalia stated, "Nothing in our opinion should be taken to cast doubt on longstanding prohibitions on the possession of firearms by felons and the mentally ill...or laws imposing conditions and qualifications on the commercial sale of arms." In other words, Justice Scalia affirmed that laws preventing criminals and the dangerously mentally ill from obtaining firearms do not infringe on the Second Amendment.
As you know, I recently introduced an amendment, along with Senator Joe Manchin (D-WV), to the Safe Communities, Safe Schools Act of 2013 (S. 649). Our amendment had three parts. The first was to improve state compliance with the existing National Instant Criminal Background Check System (NICS). The second part was to expand background checks to commercial sales at gun shows or through the internet. These first two parts of our amendment were designed to make it more difficult for criminals and dangerously mentally ill persons to acquire firearms. The third part would have provided law abiding citizens with expanded opportunities to exercise their Second Amendment Rights.
With regard to the first part of the amendment, NICS relies on states to provide records of persons who should not possess firearms. Compliance varies greatly with some states providing very few records. The amendment requires states to completely participate in NICS in order to be eligible for certain types of federal grant funding.
Full state participation in NICS would help prevent the kind of tragedy that took place at Virginia Tech in 2007. Prior to that mass shooting, in which 32 people were murdered and 23 were injured, shooter Seung Hui Cho had been found mentally ill by a Virginia judge. However, Virginia did not submit that court record to NICS. The absence of this critical information in NICS enabled Cho to pass a background check and purchase the handguns he used for the shooting. This is one example of how the threat of gun violence can be reduced through improvement of the NICS system, a salient objective of the Manchin-Toomey amendment.
The second part, expansion of background checks to other venues such as gun shows, is not a new idea. In the aftermath of the Columbine High School tragedy in 1999, the NRA supported expanding background checks at gun shows during consideration by the House of Representatives of the Mandatory Gun Show Background Check Act (H.R. 2122). I agreed with the NRA then, and so did many of my colleagues on both sides of the aisle who voted in favor of this legislation.
Current law already requires a background check through NICS for all sales conducted through a federally licensed gun dealer. The Manchin-Toomey amendment would have required individuals seeking to purchase firearms from a non-dealer at a gun show to undergo the same background check as required for purchases from licensed dealers. The amendment would not have mandated "universal" background checks. Personal, non-commercial transfers would not have required background checks.
The third part of our amendment would have been achieved through a number of measures. These measures included allowing active duty military service members to buy a gun in their home state and providing a new legal process for restoring the Second Amendment rights of veterans who, under current law, can be unfairly prevented from acquiring a firearm. Another benefit included protecting law abiding gun owners from arrest or detention by fixing interstate travel laws.
Contrary to some reports, the amendment would not have created or enabled a national gun registry. I have always strongly opposed a gun registry, so our amendment prohibited the creation of a registry and would have established a new felony offense, punishable by a 15-year prison sentence, for any official who attempted to create a federal registry.
Senator Manchin and I posted the text of our amendment on our websites on April 11, 2013, thereby providing six days for our colleagues and the public to review the 49-page measure before a vote. On April 17, 2013, despite bipartisan support and a 54-46 vote in favor, the amendment was defeated due to a 60-vote threshold that was agreed to by unanimous consent.
[The correct thing to say about this is that the amendment was defeated by filibuster. It's a little tricky, but that's the essence of it. The UC agreement under which the amendment (and all amendments to this bill) is considered requires 60 votes; that's agreed to in order to avoid a cloture vote, which is necessary because of the standing GOP plan to filibuster everything. It is wrong to say that "Senate procedure requires 60 votes." Senate procedure only requires 60 votes in case of filibuster. Which, under current conditions, means in virtually all cases. Manchin-Toomey is defeated by filibuster (from, A plain blog about politics).]

I acknowledge that some will disagree with the Manchin-Toomey amendment. I am under no illusion that the amendment would necessarily prevent a determined criminal or dangerously mentally ill person from acquiring a firearm. No system can be 100 percent effective in denying firearms to those that should not have them, but that does not mean we should not try to improve the current system. In my view, keeping guns out of the hands of these people is not gun control, but common sense.
Thank you again for your correspondence. Please do not hesitate to contact me in the future if I can be of assistance.

Pat Toomey
U.S. Senator, Pennsylvania

Sunday, April 28, 2013

Recovering from My Heart Attack

In an earlier post I described my experience with myocardial infarction, i.e., heart attack. It's been 4 weeks and 4 days since my MI and hospitalization. My cardiologist told me it would take 6 to 8 weeks to recover. After the first I felt pretty good and thought I'd beat his prognosis. Now I'm not so sure.

My cardiologist prescribed Coreg 3.125 mg, once per day, and Ibuprofen 200 mg twice per day. The purpose of the Coreg was to reduce blood pressure (BP) and, in turn, the burden on the heart. I am slender, have a relatively healthy diet and life style, and benefit from good, Italian genes, so my blood pressure has always been normal, at close to 120/80, with a pulse of 60. After taking the Coreg with breakfast, I was finding my BP and pulse ranging between 97/63, 59 to 117/79, 59 during the mornings, and 94/61, 59 to 130/81, 58 in the afternoon.

During the first two weeks after my release from the hospital my feeling of well-being varied from a sense that I was getting better rapidly, to a sense that I was weak and unable to exert myself. I often had pain in my upper mid back (which could have been referred pain or arthritis) and occasionally had brief stabbing pains in my left chest, and on one occasion a throbbing pain in my left carotid artery.

On Saturday, the 14th of April, two weeks out of the hospital, I felt well enough to do a lap on the treadmill and a few strengthening exercises. In the afternoon, we went to a movie and dinner. I experienced chest pain and weakness later in the evening, and a throbbing pain in my left carotid artery when trying to sleep. I took an aspirin and a Benadryl (which I find relieves stuffiness and helps me to sleep). Sunday I lay around all day.

Over the last two weeks my BP and pulse has been varying between 100/72, 63 to 126/83, 64. I frequently feel as though I need to take deeper breaths -- to get more oxygen in my lungs. I tire easily; on one occasion I walked a block and felt faint. Frequently, I have pain in my upper mid back.

My cardiologist had me start back on Livalo on April 1st, but I discontinued it on the 19th after again experiencing cramping in my lower left leg.

On April 25th, I started experiencing a dull pain in my right groin where the catheter had been inserted into the femoral artery. The artery was sealed using a collagen plug, which simulates normal coagulation and closure. This plug is expected to dissolve after about 30 days, and this action may have been the cause of my groin pain. The pain went away after the second day.

I'm scheduled to see my cardiologist May 10th. I may call him before then and relate to him my feeling of not getting enough oxygen. It may be that I should stop taking the Coreg.

Friday, April 26, 2013

An Open Letter to those US Senators who voted against Safe Communities, Safe Schools Act of 2013 (S.649)

April 26, 2013

Dear Senator:

Lamar Alexander (TN); Kelly Ayotte (NH); John Barrasso (WY); Roy Blunt (MO); John Boozman (AR); Richard M. Burr (NC); Saxby Chambliss (GA); Daniel Coats (IN); Tom Coburn (OK); Thad Cochran (MS); Bob Corker (TN); John Cornyn (TX); Michael Crapo (ID); Ted Cruz (TX); Michael B. Enzi (WY); Deb Fischer (NE); Jeff Flake (AZ); Lindsey Graham (SC); Chuck Grassley (IA); Orrin G. Hatch (UT); Dean Heller (NV); John Hoeven (ND); James M. Inhofe (OK); Johnny Isakson (GA); Mike Johanns (NE); Ron Johnson (WI); Mike Lee (UT); Mitch McConnell (KY); Jerry Moran (KS); Lisa Murkowski (AK); Rand Paul (KY); Rob Portman (OH); Jim Risch (ID); Pat Roberts (KS); Marco Rubio (FL); Tim Scott (SC); Jeff Sessions (AL); Richard Shelby (AL); John Thune (SD); David Vitter (LA); Roger Wicker (MS); Max Baucus (MT); Mark Begich (AK); Heidi Heitkamp (ND); Mark Pryor (AR).


Please reconsider your opposition to gun control. Surely reasonable people can agree on gun control measures that will reduce the appalling prevalence of gun violence in America. Are we so divided that as honorable persons we cannot devise measures that will reduce the eye-blink destruction of innocent lives in mass shootings, reduce the tragedy of young lives lost in senseless violence, and address the unfathomable grief of parents and loved ones?

I’m sure you’re familiar with all the myriad arguments against gun control and it is not my purpose to examine that sad litany of paranoia, faulty logic, and myth, nor the reasons, admittedly emotional as well as rational, supporting gun control. I simply wish to say that refusing to take up the matter in a reasonable debate on the floor of the Senate, refusing to bring the matter to a vote, is not just ignoring the will of the vast majority of the American people, it is an assault on the bedrock principle of democracy and representative government, “the right of the people peaceably to assemble and to petition the Government for redress of grievances.”
Noah Pozner, 2006 - 2012
Senator, we the people grieve. We grieve for Noah Pozner, shot to death three weeks after his sixth birthday, and his nineteen classmates, who died with him, and the six people who tried to protect these children, and the thousands of Americans shot to death just since Newtown. We grieve for them senator, and we petition you for a redress of our grievances. Senator, please reconsider your opposition to gun control.

Richard V Badalamente, LtCol, USAF (Ret.)
3302 W 42nd Pl
Kennewick WA 99337-2794
The United States of America

Thursday, April 25, 2013

A plain blog about politics: Manchin-Toomey and the Filibuster

From "A plain blog about politics," by Jonathan Bernstein.

A plain blog about politics: Manchin-Toomey and the Filibuster

The background checks portion of the bill will be defeated today. It was being added as an amendment to the bill, and under a consent agreement all amendments needed 60 votes; it's not going to get there.

The correct thing to say about this is that the amendment was defeated by filibuster. It's a little tricky, but that's the essence of it. The UC agreement under which the amendment (and all amendments to this bill) is considered requires 60 votes; that's agreed to in order to avoid a cloture vote, which is necessary because of the standing GOP plan to filibuster everything. It is wrong to say that "Senate procedure requires 60 votes." Senate procedure only requires 60 votes in case of filibuster. Which, under current conditions, means in virtually all cases. Manchin-Toomey is defeated by filibuster.

My Response to a Newspaper Editorial

Our local paper, The Tri-City Herald, recently published this editorial on the Safe Communities, Safe Schools Act of 2013 (S.649). I responded as follows:

I have several issues with your editorial.

First, the bill, Safe Communities, Safe Schools Act of 2013 (S.649), was not “defeated” in the Senate. It never got to a vote because of a threatened Republican filibuster that the bill’s proponents didn’t have enough votes to overcome.

Second, even if the NRA’s claim that it has 4.5 million members is true (and that’s debatable, as the Washington Post has pointed out), that’s under 1.5% of the US population, and if the 2010 elections were any gauge, the NRA’s real get-out-the-vote effectiveness may be overstated. The NRA spent $10.3 million in its unsuccessful effort to defeat President Obama. According to the Sunlight Foundation, in the 16 contested senate races that the NRA poured money into, the organization lost 13 of them. There’s no question however, that Republicans see the NRA as an essential part of their shrinking base, and are clearly willing to do anything to retain it.

Third, it’s true that the NRA is effective in “rallying the troops” to rail against lawmakers who dare to speak positively about any and all gun control measures, but all the hate-filled vitriol spewed by the fringe elements of the NRA mean little without the money the NRA and gun industry pour into congressional coffers. If the American people ever see the light and reform campaign financing, the NRA and its constituents will find themselves on the wrong end of the gun barrel.

Finally, parroting the NRA claim that expanded background checks wouldn’t have stopped the Newtown mass shooting, furthers the misconception that this oft repeated assertion by the NRA is true. In fact, it’s the logical fallacy of negative proof. The statement that expanding background checks won’t reduce gun violence in America, because there’s no proof the statement in false, takes the form X is true because there’s no proof X is false. And angels exist because there’s no proof they don’t.

Furthermore, every time there’s a mass shooting, in Aurora, CO, or Tucson, AZ, or Seattle, WA, etc., the NRA makes the same faulty assertion, and on that basis opposes any strengthening of gun control. That’s not just illogical, it’s stupid and cruel.

Tuesday, April 23, 2013

STOCK Act Reversal Signed by President

John Boehner gives the thumbs up to congressional insider trading
President Obama has just signed a rollback of key transparency provisions of the STOCK Act. Late Thursday night, as we reported last week, the Senate gutted the disclosure requirements by approving S.716, an act amending the requirements of the 2011 law. The House followed suit the next day, and the president signed the bill minutes ago.

The bill doesn't just eliminate a controversial requirement that personal financial disclosures of tens of thousands of high level federal employees be made publicly accessible online. It also reverses two critical components of the original STOCK act: mandatory electronic filing of PFDs by the president, his cabinet and members of Congress, and the creation of a publicly accessible database.

The elements of the STOCK Act that were removed include:
  • Creation of searchable, sortable disclosure of the information contained in reports even for Congress, the president, vice president, the president’s cabinet and congressional candidates.
  • Required electronic filing for Congress, the president, vice president, the president’s cabinet and congressional candidates, as well as high-level executive and congressional branch employees.
Even images of the staffers' filings will not be available for viewing on the web. Without the provisions, the STOCK act is made toothless. Insider trading by members of Congress and federal employees is still prohibited, but the ability of watchdog groups to verify that Congress is following its own rules is severely limited because these records could still be filed on paper -- an unacceptably outdated practice that limits the public's access.

This is not true disclosure. Contact President Obama’s office today to signal your disappointment, and urge YOUR members of Congress to file their personal financial disclosure documents electronically and to propose legislation reinstating the database provision.

Response from Sen Cantwell on My Email re Gun Control

Dear Dr. Badalamente,

Thank you for contacting me to express your views on gun ownership and violence prevention. I appreciate hearing from you on this important issue.

I support the Second Amendment and the rights of law-abiding Washingtonians who own guns. I also remain focused on addressing the deeply troubling violence in this country and making our state and our country as safe as possible for all people, including our most vulnerable citizens, our children. I believe both of these goals are important and can be simultaneously accomplished through common-sense gun violence prevention measures and the enforcement of existing laws.

Senator Harry Reid (D-NV) introduced the Safe Communities, Safe Schools Act of 2013 (S. 649) on March 21, 2013. This proposed legislation included provisions to expand background checks for private and interstate firearms transfers and would have made it a federal crime to traffic in firearms. Additionally, the bill would have authorized funds for the Secure Our Schools grant program under the Department of Justice to help equip schools with safety features and resources, including surveillance equipment and hotlines for reporting potentially dangerous situations.  On April 11, 2013, by a vote of 68 to 33, the Senate voted to move forward with consideration of the bill before the full Senate. During debate over this bill, the Senate voted on several amendments regarding gun violence prevention.

On April 11, 2013, Senator Joe Manchin (D-WV) and Senator Pat Toomey (R-PA) introduced a bipartisanamendment to S. 649 to expand background checks to sales at gun shows and online sales. The amendment would have provided exemptions for background checks in the cases of private sales between family members and friends. On April 17, 2013, by a vote of 54 to 46, the amendment failed to attain the 60 votes necessary to move forward in the Senate.  I voted in support of this amendment.

On April 17, 2013, the Senate also considered an amendment regarding assault weapons by Senator Dianne Feinstein (D-CA). The amendment would have banned certain military-style, semi-automatic weapons, and make it illegal to produce, import, or sell magazines with capacity over ten rounds. The amendment failed by a vote of 40 to 60. I voted in support of this amendment to keep military-style weapons off the streets. 

On April 18, 2013, Senator Reid announced the Senate would put aside consideration of S. 649 to move forward with other legislative matters.   The Senate may take this bill up for consideration at a later date.

Along with addressing gun violence, making services for the mentally ill and their families more accessible will encourage those suffering from mental illness to seek needed care and support. While mental illness is not the cause of violent behavior, mental health care is a critical component of our healthcare system and an individual's overall health status. According to the National Institute of Mental Health, approximately one in 17 Americans suffers from a seriously debilitating mental illness. I care deeply about mental health care and understand the important role access to behavioral health services plays in the lives of both those who suffer from mental illness and their family and loved ones.  This is why I voted in support of a bipartisan amendment introduced by Senators Tom Harkin (D-IA) and Lamar Alexander (R-TN) , the Mental Health Awareness and Improvement Act of 2013, which would improve upon existing mental health programs currently funded under the Department of Health and Human Services and the Department of Education.  This amendment included measures to help school officials recognize and identify mental health conditions and improve suicide prevention and behavioral care resources.  This amendment passed the Senate by a vote of 95-2.

Thank you for expressing your thoughts on this issue. Please be assured I will keep your thoughts in mind as the Senate continues to address this issue.

Maria Cantwell 
United States Senator 

For future correspondence with my office, please visit my website at 

Thursday, April 18, 2013

What Do We Do Now?

Yesterday, Wednesday, April 24th, 2013, the Senate failed to pass the Safe Communities, Safe Schools Act of 2013 (S.649), a bill that would have closed the gun show loop hole and strengthened the background check system. After the Newtown tragedy, after all those innocent children were shot down, after all the grief and outrage over lax gun control, after more than 3500 shooting deaths in America to date since Newtown, our Congress failed to act. What do we do now?

According to national polls, greater than 90% of Americans favor background checks for all gun sales. This overwhelming sentiment for universal background checks, a key feature of S.649, didn't sway Senate Republicans, despite the bill being co-sponsored by a Republican, Pat Toomey (R-PA). Four Democratic senators, facing re-election in conservative, gun-friendly states, failed to support the bill; Heidi Heitkamp of North Dakota, Mark Begich of Alaska, Mark Pryor of Arkansas and Max Baucus of Montana. All but four Republicans voted against the bill.

So, what do we do now?

The NRA and gun lobby have proven effective in turning their strident opposition to gun control into grassroots support for candidates, as well as cold hard cash for campaigns. The problem, as I see it, is that public sentiment has not, at least in the minds of the senators who opposed gun control, translated into tangible support for their campaigns. Nor has it in their minds, translated into effective opposition to their campaigns. We have to change that. Here's how:

  • build a powerful grassroots effort through networking, physical and virtual
  • ensure our efforts are well-publicized by writing letters to the editor, blogging, posting on Facebook, posting on Google+, and by finding opportunities to speak at public events
  • tell members of Congress what we're doing through direct emails, and posts on their Facebook pages
  • build coalitions with outdoor sporting organizations that support sensible gun control
  • ensure that the Democratic National Committee knows that we consider gun control a make or break issue for democratic candidates
  • support the campaigns of candidates who support gun control

The first thing I did today was to email my Washington State senators, Maria Cantwell and Patty Murray and thank them for supporting the measure.

Next, I went on line to Organizing for Action and made a donation, and signed up as a volunteer, doing the sort of thing I'm doing now.

Next, I emailed the four democratic senators who voted against the bill and gave them a piece of my mind. I told them I intended to contact the DNC and demand that they withhold support in the 2014 election. I also went to their Facebook page and made my views known. Once again, they are:
Heidi Heitkamp of North Dakota
Mark Begich of Alaska
Mark Pryor of Arkansas
Max Baucus of Montana

I'll also email the Republican senators who supported the measure; Pat Toomey of Pennsylvania, Susan Collins of Maine, Mark Kirk of Illinois and John McCain of Arizona

In order to make my concerns about these senators known to the Democratic Party, I will write to the Democratic National Committee and tell them that I will withhold financial support to the party as a whole as long as it supports these senators, or any Democratic senators who don't support gun control. My donations to elections will be candidate specific, and gun control will be the top priority. Yes, there are other crucial issues, but in order to get this thing done, we have to be as single minded as the NRA.

I am making a recurring donation to one of the organizations below that promote gun control. Pick one you like and do the same.

When you go to one of these web sites promoting gun control, "like" the site, or otherwise network it to your friends. For example, you can do this on Americans for Responsible Solutions here.

I am once again emailing my local representative, 'Doc' Hastings and demanding that he support sensible gun control legislation. I've done this before, and I'll do it again and again, and the next time he runs for election, I'll support his opponent, as I've done in the past. Yes, Hastings may be hopeless, but he won't get a free pass from me. Here's his contact information:

Washington, D.C. Office
1203 Longworth House Office Building
Washington, DC 20515
(202) 225-5816
Fax: (202) 225-3251

Tri-Cities Office
2715 St. Andrews Loop, Suite D
Pasco, WA 99301
(509) 543-9396
Fax: (509) 545-1972

Yakima Office
402 E. Yakima Avenue, Suite 760
Yakima, WA 98901
(509) 452-3243
Fax: (509) 452-3438

I am continuing to make my voice heard locally by writing letters to the editor and op-ed pieces, by blogging, and by employing Facebook, Twitter, and other social media. I hope you'll do the same.

And remember who you're doing this for. Not the kids who died at Sandy Hook. It's too late for them. Do it for their loved ones and for yours.

Wednesday, April 17, 2013


After slicing, dip in batter and deep fry. Now you know what a migraine feels like.
People have headaches all the time, but some people have headaches that are so painful they are disabling. When they get a headache like this they feel that they can't move, they can't stand noise or bright light, smells bother them, they become nauseous, and they basically just want to curl up in a ball and withdraw from the world. These kinds of headache, especially if preceded by an "aura," are very likely migraines.

The Mayo Clinic web site, a favorite of mine for researching various maladies, doesn't offer much when it comes to the cause or causes of migraines. Mayo staff state that there's a lot we don't know about what causes migraines, but "genetics and environmental factors both seem to play a role."

According to the government’s DHHS Office of Women’s Health, “Most researchers think that migraine is due to abnormal changes in levels of substances that are naturally produced in the brain. When the levels of these substances increase, they can cause inflammation. This inflammation then causes blood vessels in the brain to swell and press on nearby nerves, causing pain.” Also, “People who get migraines may have abnormal genes that control the functions of certain brain cells.” What those gene abnormalities are remains a puzzle.

DHHS Office of Women's Health states that experts know that people with migraines react to a variety of factors and events, called triggers. These triggers can vary from person to person and don’t always lead to migraine. A combination of triggers — not a single thing or event — is more likely to set off an attack. A person’s response to triggers also can vary from migraine to migraine. Many people with migraine tend to have attacks triggered by:

  • Lack of sleep
  • Sleeping over long after exhaustion
  • Skipped meals or lack of a regular meal schedule
  • Bright lights, loud noises, or strong odors
  • For women, hormone changes during the menstrual cycle
  • Stress and anxiety
  • Weather changes
  • Alcohol (often red wine, perhaps because of sulfides)
  • Caffeine or caffeine withdrawal, possibly on a weekend
  • Foods that contain nitrates, such as hot dogs and lunch meats
  • Foods that contain MSG (monosodium glutamate)
  • Foods that contain tyramine, such as aged cheeses, soy products, fava beans, hard sausages, smoked fish, and Chianti wine
  • Aspartame (NutraSweet and Equal)
  • Glare or flicker from computer monitors or TV screens
  • Poor ergonomics at computer causing neck strain

The best way for you to determine what's causing your migraines is to keep a headache diary, noting when you headache started, its severity, what you were doing, what you were eating/drinking in the day or two before your headaches, and what you did during your headaches to moderate its effects. Take this information to your doctor. It will help him/her prescribe a course of action for helping you deal with what can be a very troubling, even disabling health problem.

Thursday, April 11, 2013

Letter to a Good Friend Who Calls Me an "Environmental Wacko"

August 14, 2008

Dear Friend, Andy;

Yesterday was my boyhood friend, Nick’s birthday. He is seventy. We became friends in high school. We spent a lot of time at each other’s home, and were essentially adopted by each other’s parents. After high school, he went to Pepperdine and I went to USC. We still spent a lot of time together, but after graduation, he went to dental school in San Francisco and I joined the Air Force.
We saw less of each other, of course, but still kept in touch via PO Box – no email back then. Once he sent me photos of the cadavers the dental school students were dissecting. Another package contained teeth molds he’d made. I got back to LA on leave and went to see him in SF. We went to see a movie about a man who was a career officer in the Royal Scots Regiment, but could never live up to the legend or expectations of his father. A great movie. Can’t remember the title.
Nick was anxious to get away from big city life and settled in a small community in northern California called Avila Beach, where he opened his practice. He bought some property there, which he intended to build on, but when Avila Beach started booming, he sold to a developer, made a bundle of money, and moved to San Luis Obispo, a sleepy little college town roughly midway between SF and LA.
When I talked to Nick yesterday to wish him a happy birthday, he told me that he and his wife, Hedy are planning to move again. “SLO has gotten too big. Traffic is awful,” He said.
I found it hard to believe. The place was idyllic. A little hippy, as you’d expect in a college town, but nice, laid back, unspoiled. Now traffic clogs winding roads that were never laid out to accommodate the population growth, air pollution is creeping up aided and abetted by smog seeping over the hills from LA and Santa Barbara, fishing stinks, as does the air and water. Too bad, but that’s progress.
There’s lots of progress in California. The population of the state has grown from just under 16 mil when Nick and I graduated from college, to well over 36 mil now, not counting undocumented aliens, who, as the name indicates, are not documented. Some estimates of illegals in California reach 3 million, but the number varies from day-to-day, as they are rounded up and deposited back on the Mexican side of the border and take a day or two to get back. They generally start out in San Diego county, whose population has more than doubled since Nick and I drove through there in 1960 on our way to Tijuana, where we hoped to improve our Spanish language skills.
I blame growing up in California for turning me into an “environmental wacko.” You see, I was born there way back in 1938. You can’t even imagine what it was like there then. In the spring, you could smell the orange blossoms, in the evenings, you could smell the night-blooming Jasmine. I could lie on the lawn at night and see the sky lit up with the billions of stars. In the morning, I could look out across the valley and see the San Gabriel Mts. It took us a while, but we could catch the “Red Car” electric streetcar and go to the beach, cross the sand without stepping in blacktar goo, and swim without worrying about used needles bobbing about in the surf. I watched the Hollywood freeway being built at the bottom of the street on which we lived. I wasn’t smart enough to realize what the implications were when it went in and the Red Cars went out.
I’m afraid Nick isn’t moving far enough from SLO – he’s just moving north fifty or so miles to some out of the way place NW of Paso Robles. Another 10 years and he’ll want to move to Nevada, except there won’t be any water there.
But thanks for sending me the op-ed by Daniel Henninger, a conservative columnist who’d rather be clever than objective. Despite Henninger's snarky word invention, the United States absolutely must transform its economy in order to survive and thrive in the world to come. And the transformation should have started long ago – changing a consumption economy into sustainable economy will take a generation, be costly, and be painful. Corporate America will fight it every step of the way, because they are invested in the way things are, not the way they should be. Your conservative credo of letting unfettered market forces take care of things became untenable when corporate earnings started exceeding most countries GDP. Corporations pay to let democracy work for them, not you. Henninger’s “environmania” is not “messianism,” its righteous indignation.
Why you’d want to trust corporations to operate in your best interests is a mystery to me. Try to picture the boardroom of a corporation and look at the people around the table. They are not abstractions. They are people whose livelihoods depend on making money for the organization for whom they work, not on making the world a better place by providing products and services that work to better the lot of mankind and, in the process, making the organization a profit. That would be socially responsible. Forget about it. Corporate officers actively work to circumvent regulations and, when it suits them, break the law. I could give you examples (like Halliburton destroying evidence in the Gulf Oil spill), but you know the history of corporate greed and corruption. You just choose to ignore it, because the facts don’t jibe with your view of the conservative landscape.
You are so skewed in your thinking that you’d relieve corporations of any tax burden. “Why should they pay taxes? Their employees pay taxes.” Well, you might be surprised to learn that revenues from corporate taxes have fallen to historically low levels, due to subsidies, tax cuts, and a wide variety of avoidance strategies, such as moving headquarters to foreign locations. Our effective corporate tax rates are significantly lower than the rate in many other developed nations. The corporate operations are still employing our highways, waterways, airwaves, and polluting whatever they please, but they aren’t paying any taxes to do it. But not to worry, our budget deficits and national debt are now projected to be so enormous that you won’t have to worry about a transformation of our economy. It is in the process of transforming and the result ain’t going to be pretty.
You might as well send a note to your grand kids and tell them about what a great life you had and say you’re sorry they won’t be able to enjoy the same benefits you had – you used them all up. And oh, by the way, send them the Henninger article. I’m sure they’ll get a charge out of reading it, just as I have, and they'll ask themselves, "Were people really this stupid?"

We do not inherit the earth from our ancestors, we borrow it from our children.

Tuesday, April 9, 2013

Commonly Known as a Heart Attack

I shouldn't have being playing golf Thursday. I woke that morning feeling lethargic. I had a nagging pain in the middle of my upper back. But with my history of pericarditis, and more recently, arthritis, I seldom go through the week without some pain here or there. I decided to ignore the way I felt and play golf. That was my first mistake.

I took an Ibuprofen, threw my clubs in the car and drove to the course. I was playing with my good friend, who'd invited me to play at his club at Meadow Springs, a beautiful course nested along the Amon Basin creek watershed. The sky was overcast as I parked and checked in. By the time we were standing on the tee, about 12:00, a slight drizzle had started. My friend asked if I wanted to take the golf cart. I told him I wanted to walk the first Nine to get some exercise. That was my second mistake.

Because course maintenance was taking place on the Front Nine, the pro shop started us on No. 10, which is an elevated tee crossing Amon Creek at the bottom of the hill. After that, the course regains altitude at a steep rate. By the time I'd negotiated the first six holes, I was having trouble catching my breath. At the No. 16 tee I had a pressing feeling in my chest. Did I quit? No, I struggled on. That was my third mistake. You know what they say about three strikes.

I finished the round, joined my friend for lunch, which I couldn't finish, and went home. I lay down for an hour, took a shower, and joined my wife on the couch. This was about 5 pm. By this time I was experiencing a severe throbbing pain radiating up my left carotid artery into my neck. I went back and lay down.

My wife came in and asked me what was happening. She said I should go to the emergency room. I said I'd take an aspirin and wait it out. Another mistake.

I couldn't sleep. I tried elevating my head and back, something I'd done when I had pericardial pain. It didn't help much. I continued to have the throbbing pain up my left carotid artery, into my neck, and over to my shoulder. I was sweating. I took 3 more aspire @ 325 mg ea over the next 8 hours.

The next morning, a Friday, March 29th, I called my primary care physician and speaking to the receptionist asked to have an appointment ASAP. She said she could get me in Monday. I said okay. She asked me why I needed the appointment. I said, "I'm having chest pain." She said just a minute. Then she came back on the line and said, "Go to the emergency room." This time I followed instructions.
As it turns out, if you're experiencing chest pains, the best advice is to call 911. This way you'll get directly to the ER, you'll get there quickly, and you'll likely get emergency treatment along the way. Going to your primary care physician first is poor policy, if you are having a heart attack. Learn to recognize the symptoms and be smarter about taking action than I was. The longer you delay, the more heart damage you'll have, and the longer your recovery will be -- assuming you recover.
My son drove me to the nearest emergency room, which was at Kennewick General Hospital (now Trios). When I told the person manning the reception desk my problem, he took me right to the triage nurse; the first time I hadn't been asked for ID and insurance when going to the hospital. I was with the triage nurse for no more than 3 minutes before I was taken to a room and placed on an examining table.

Before I knew it, a lab tech had taken blood, I had an IV in my right arm near the wrist, and had been wired for an ECG. After the ECG a technician wheeled in an X-Ray machine and did a chest X-Ray. At some point, a nitroglycerin patch was placed on my chest. The IV contained a blood thinner, easing the blood pumping burden on my heart.

The attending physician came in to see me about 20 minutes into this process. He told me indications were that I'd had a heart attack. KGH didn't have a cardiac specialist available to do a catheterization, so they were transferring me to Kadlec. He asked me who my primary doctor was, I told him, and he said he'd notify him.

Someone from the hospital business office came by and finally collected my insurance cards (Medicare and TriCare), and then I was visited by a social worker. Before the social worker could finish his interview, the EMTs showed up to load me into the ambulance.

I was transferred to Kadlec by ambulance. One of the EMTs sat in the back with me and monitored my vital signs. It took 18 minutes to get from KGH to Kadlec. On the way I learned the EMT liked to read and promised him a signed copy of my soon-to-be-published novel, The Lion and the Sun. I was assuming I'd be alive to sign the book when it was published. I'm an optimist.

At Kadlec I was taken directly to the cardio ward, where ECG sensors were attached to my chest and connected to a transmitter that sent signals wirelessly to a display at the side of the bed. 
An IV drip was started, and additional blood work was done. Another ECG was performed. My cardiologist walked into the room a few minutes later. Friday was normally his day off. He'd be in checking on me the next two days, Saturday and Easter Sunday.

My cardiologist put his stethoscope on my chest and as he listened to my chest he told me that my ECG was abnormal -- I had an inverted t-wave -- and blood work indicated I'd had a myocardial infarction, commonly known as a heart attack. I asked how blood work indicated a heart attack. The doctor told me that my troponin level was elevated.
The troponin test measures the levels of certain proteins called Troponin T and Troponin I in the blood. These proteins are released when the heart muscle has been damaged, such as a heart attack. The more damage there is to the heart, the greater the amount of Troponin T and I there will be in the blood. An increase in the troponin level, even a slight one, usually means there has been some damage to the heart. Significantly high levels of troponin are a sign that a heart attack has occurred. Cardiac troponin levels are normally so low they cannot be detected with most blood tests. Test results are usually considered normal if the results are between zero and 0.10 ng/mL. My Troponin I was 2.64.

Another test that showed evidence of an heart attack was Creatine Kinase-MB (CK-MB). A CK-MB of more than 2.5 to 3 is indicative of heart damage. Mine was 10.7.

This doctor had been my cardiologist for many years. I saw him regularly because of my history of pericarditis. Even though I'd had my pericardium removed, I had over the years experienced pain of the type I experienced when I had a pericardium. I'd assumed it was from residual pericardial tissue left around major arteries. My cardiologist wasn't so sure. He said it might be from that, or from an unrelated cause, such as arthritis, sprains, congestion, infection, or imagination.

Over the years my doctor had performed a myriad of tests to monitor my heart function, including ECGs, Echocardiograms, stress tests, nuclear stress tests, ultrasound scans, and regular blood work to track my cholesterol. Despite my checkered medical history, and high cholesterol, my heart function was essentially normal (I had moderate mitral valve regurgitation, meaning the valve wasn't closing completely and blood was leaking back out). In my most recent stress test, I'd gone 11.5 minutes, which was essentially what I done twenty years ago.

My doctor knew that I was proficient with the Internet and did a considerable amount of research on medical issues. He had always been very open with me and willing to discuss matters associated with my history of heart problems. I'd even offered to will him my heart (I was sure to stipulate, after my death) to use in research on long-term survival of pericardectomy survivors (he wasn't interested).

The doctor told me that he wanted to have coronary angiography performed. I wasn't anxious to have this done, mainly because I didn't like the risk involved in having a wire inserted into my coronary arteries and I wasn't sure the test was required. My doctor convinced me otherwise by pointing out my history of high cholesterol and the fact that I'd gone off my cholesterol medication several months previously because of myopathy brought on by the statins in the medications. He said that with the test we could determine if my heart attack had been brought on by clogged arteries or something else. This would help determine the course of therapy. I couldn't argue with the logic.

I was wheeled to the "cath lab" around noon Friday. My wife and my son accompanied me as far as the prep room, where my groin area was shaved. An angiogram can be done by inserting the catheter through the femoral artery in the groin (most common), or through the radial artery in the forearm. I had the former procedure. An estimated 3 million coronary angiograms are performed in the United States each year to look for blockages in coronary arteries. The radial artery is currently used in less than 5% of them. However, a recent study suggests angiography using the radial artery is just as effective as the technique using the femoral artery, and patients report finding the procedure less uncomfortable. I did not experience any significant pain during or after the procedure.
Cath Lab
During coronary angiography, special dye is released into the bloodstream. The dye makes the coronary arteries visible on x-ray pictures. This helps doctors see blockages in the arteries.  Cardiac catheterization is used to get the dye into the coronary arteries. For this procedure, a thin, flexible tube called a catheter is put into a blood vessel in your arm, groin (upper thigh), or neck. The tube is threaded into your coronary arteries, and the dye is released into your bloodstream. X-ray pictures are taken while the dye is flowing through the coronary arteries. Because the dye can cause nausea and or stuffiness, I was given medication to prevent stomach upset (Pepcid) and nasal passage blockage (Benadryl) prior to the procedure.

The doctor performing the procedure came to the side of the operating table and introduced himself. He described the procedure for me, and kept me informed throughout it. A nurse applied local anesthetic (1% lidocaine) to my right groin. The doctor said, "You're going to feel a slight pinch," and inserted the arterial sheath through which he'd thread the catheter. The pain I experienced from this was what I'd describe as a lower case ouch. My wife told me later that the procedure took twenty minutes. I was awake throughout. Afterward, the doctor came out and told us that my coronary arteries were clear.

The doctor also told us that I had a significant gradient between the apical segment and mid segment of the left ventricle. He thought this likely due to segmental hypertrophy cardiomyopathy (thickening of the muscle). The doctor thought it advisable that I undergo a cardiac MRI and OTE. Hypertrophic cardiomyopathy (HCM) is a genetic cardiac disease that can cause sudden death, or go undetected for the affected person's lifetime. Unless my lifetime is 75 years, I fall into the latter group.

Aside: Even after my 1965 pericardectomy I experienced fairly regular chest pain, reminiscent of the pain I experienced with pericarditis. This has continued with reduced severity all my life. Given this heart attack and the results of tests associated with it, I am curious as to whether the "thickening" noted might be due to recurrent inflammation.

My hospital stay was uneventful -- no "Code Blue" -- and as is generally the case -- little sleep. Hospitals are noisy, and lab techs wake you at all hours. In addition, this hospital had a system of alerts that when initiated, sounded in all rooms, just in case needed staff were away from station. This is a really annoying system -- haven't they heard of pagers? In addition, the bed was programmed to change angles and slopes in order to prevent bed sores for bedridden patients. The movements occurred every 40 seconds (I timed them) and were accompanied by a low 'growl." Eventually, I got used to the bed growling at me and growled back. My second night in the hospital I asked for Ambien (zolpidem), and that helped significantly (I took half at 10 pm, and the other half at 3:30 am, after the lab tech woke me for blood work).

Prior to my release from the hospital on a bright, sunny Easter morning, I underwent an Echocardiogram. According to my cardiologist, the results showed a thickening of the ventricular wall (from the lab report, "moderate concentric left ventricle hypertrophy"), and some other segmental thickening (again from the lab report, "sigmoid shaped septum with focal hypertrophy of the basal septum"). My ejection fraction (EF) was normal, at 60-65% (percentage of blood pumped from the heart's ventricles). This is interesting, since thickening generally results in reduced heart efficiency.

My instructions from my cardiologist were to go home and take it easy. He put me on Coreg to slow my heart, which would aid healing, and Ibuprofen twice a day for pain. He said my recovery might take 6 to 8 weeks. I am scheduled to see him again on May 10th.

One week after my release from the hospital, I'm essentially free of pain, I have no shortness of breath, or dizziness, and I'm going stir crazy.