Wednesday, 03 April 2019 19:12

Trigeminal Neuralgia Sucks

I am sitting in the corridor outside the surgery waiting room, waiting for a team to drill into my spouse's skull and intentionally damage a nerve.

So, if this is a bit of a scattered, random post - eh, no apologies.

Really, I'm just killing time until hunger sets in long enough to drive me to the cafe, which will kill some more time, before it is back to the waiting room to wait/kill time some more.

The odd thing is that I actually hate this less than i thought I would. The OHSU staff so far have been considerate and professional, which alleviates much of my natural tendency to anxiety (the Tanner nerves, my grandmother used to say). I hate being out of control, always have, but It has gotten especially strong since my year of enlisted military service. I also don't trust easily, whether individuals or institutions. So all in all, I anticipated feeling much worse through all this than I do now.

Not that I have cause to complain, I'm not the one who has been suffering from horrific pain for a year, only controllable with heavy-duty anticonvulsant medication that can't fix the problem. Trigeminal Neuralgia is a vicious condition - so much so that I made an allusion to it in my most recent book as a form of torture used in/by Hel (the Norse version of Hades, named for the daughter of Loke who runs the place).

And all in all, despite the poor luck in being struck by such a rare condition, she has been fortunate overall. We happen to live an hour's drive away from one of the world leaders in treating the condition, and even better - the sub-type of TN she appears to have (it actually isn't formally split out definition-wise, but specialists are on the cusp of showing a genetic cause and, fortunately, have developed a procedure to treat it that boasts very high success rates, especially for patients like her - younger than average, and almost exclusively female.

We're also counting our luck/blessings/random number gods that this is the diagnosis she ended up with (and received sooner than most do). Most women in her situation get mis-diagnosed with multiple sclerosis, and she quite nearly did. While MS isn't life-ending, it isn't kidding around.

TN is its own form of nightmare, and the usual procedure for fixing it doesn't work for the sub-type she has. Worse, there's no cure yet - the interim solution is either physically moving blood vessels that are compressing the nerve (more typical in older patients) or doing permanent damage with ionizing radiation when that fails. Unless, of course, you want to spend your life on high doses of a pretty debilitating medication.

What they're doing to her as I type this is actually derived from a procedure used to treat nerve issues like carpaltunnel syndrome. It would be an outpatient operation, except the nerve they need to comb (yeah, that's the actual term they use) is located just at the point the trigeminal nerve bundle exits the brain. So to get at it, they've got to cut into her skull, in what is technically brain surgery.

That's what makes it a major and frightening operation, because who wants someone mucking around in their brain, no matter how skilled? Cutting the skull open isn't something the body was meant to endure, so the recovery period (mostly from the neck muscles that are in the way and get cut up) will be weeks in length - fortunately, all but the first 2-4 days are at home. So after a night in ICU (awake, but monitored to be extra safe) and a couple days in the hospital, we'll be home.

It is moments like these you can't help but be grateful for being in a reasonably stable financial situation, despite my recently abandoning (ok, puting on hiatus, but until I'm making a solid income from writing I have no intention of putting a lot of time into scholarly work) my PhD ambitions (unless I can somehow get a degree in Europe, where all the researchers who do what I'm interested in live.). She, fortunately, is hyper-competent and has already become pretty much invaluable at her work (local universityone that actually cares about education, so not Oregon State University (hell) or University of Oregon (discount purgatory), so through her work we've got solid health insurance and disability benefits for when she's unable to work.

Not that I couldn't provide these things - i have in the past, we kind of switch off who gets to be the breadwinner and who gets to be entrepreneur - but the peace of mind granted by having them is absolutely priceless.

Which is why everyone, everywhere, should have guaranteed healthcare and a sustainable livelihood. Too bad the United States is dead determined to prevent anyone who isn't white or wealthy from having this.

But hey - that will change, at least for those who live in the states that are committed to providing these basic, fundamental services, when DC collapses entirely and they're left to fend for themselves.

And we happen to live in a region that is richer than the rest of the "United" States, and where 2/3 of the population wants these benefits for all citizens. Better times will come, in a decade or so - for us.

Until then, I'm just glad that what turned out to be a career-killing move to Oregon (for me) has turned out so well for her, in every way. I can be an author anywhere, but access to quality healthcare is bound to a healthy economy, and not every place will have that in the coming years.

Also (addendum), At least half of the doctors and surgeons who have saved the lives of members of my family are either recent immigrants themselves or children of recent immigrants. I literally have no honorable reason to oppose immigration, ever, period-point-blank.

Edit/Update (2 hours later) - operation went great, and now to the recovery. Always nice when things work out as planned! To all the people sening messages, thoughts, prayers, and the like - thank you!

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Executive Summary of the Draft New Congress Report on the State of the Union Attacks
[Draft, version 3.62]


Section A - Reconstruction of Events

At 9:12 PM, Eastern Standard Time, the President of the United States began the annual State of the Union Address to a joint session of Congress. In attendance were ninety-three members of the United States Senate, four hundred and seventeen members of the House of Representatives, all but three members of the Cabinet, twelve members of the Joint Chiefs of Staff, six justices of the Supreme Court, and several hundred spectators and members of the press.

At approximately 9:13 PM EST, six "Klub"-type cruise missiles broke the surface of the waters above Delaware Bay. As a tightly clustered group, they ascended to a height of approximately 50 meters/200 feet, moving toward Dover Air Force Base.

After thirty seconds, the missiles turned west. They then descended to an altitude of approximately 10 meters/40 feet above ground level and rapidly accelerated.

At 9:15 PM EST, NORAD was informed that one or several unidentified aircraft had crossed the Delaware-Maryland border, at speeds that would put them over the center of the District of Columbia in three minutes.

Radar operators at Dover Air Force Base and on board an E-3 Sentry AWACS platform patrolling south of Andrews Air Force Base immediately established a radar track upon launch, however in the crowded airspace along the United States Eastern Seaboard such signals are sufficiently common that this in and of itself was not suspicious. Operators report having immediately noted the new radar track veer away from the approaches to Dover AFB and accelerate, but the missiles' maneuvers caused between fifteen and twenty-five seconds of delay in re-acquiring a firm radar track amidst the ground clutter. It took a further thirty to forty-five seconds for operators to notify their superiors of a clear and immediate threat to the national capitol and to send a message via FLASH protocols to NORAD.

Sixty seconds later, at 9:16 EST, the six missiles passed over the Chesapeake Bay south of Annapolis, Maryland, traveling at a speed of 2400 kilometers per hour - two miles every three seconds. At this moment, several events occur almost simultaneously.

- NORAD passes a FLASH warning to the District of Columbia air defense system along with an authorization to intercept what is presumed to be a hostile target or targets.

- NORAD notifies the Secret Service of an immediate threat to the life of the President

- Air defense tracking radars activate, and begin targeting the inbound cruise missiles.

- Three of the Klub missiles ascend to an altitude of approximately fifty meters/two hundred feet, activate electronic countermeasures, and alter their flight trajectories to simulate impending strikes on the Pentagon and White House in addition to the Capitol building.

These decoys generated sufficient electronic noise that electronic counter-countermeasures required between twenty and thirty seconds to re-establish active radar tracking and targeting. The moment after their ECM systems began to transmit, four “SLAMRAAM” surface to air missiles were launched from sites near District of Columbia and Andrews Air Force Base. They are fired in anti-radar mode, allowing them to home in on and eliminate the source of the jamming.

As the ECCM "burn through" the hostile jamming, additional SLAMRAAM missiles were launched and begin receiving mid-course targeting updates in order to home in on identified targets.

However, because of the uncertainty surrounding the total number of hostile inbound objects, the three decoy missiles are able to prevent the detection of their companions for more than thirty critical seconds, successfully attracting all intercepting fire until all are shot down. In the confusion caused by the competing ECM and ECCM systems and destruction of these decoys, an additional fifteen to twenty seconds pass before it is realized that additional hostile targets remain.

At 9:17 EST, the three surviving Klub-type cruise missiles reach the outskirts of the District of Columbia, passing less than twenty feet over rooftops. One of the three repeats the decoying maneuver, and at the moment air defense officers establish tracks on the remaining hostiles and launch another volley of interceptors at the incoming missiles, this new decoy's ECM systems activate, attracting the attention of the half-dozen interceptor missiles now airborne.

While this new decoy is shot down within fifteen seconds, the two surviving hostiles all but disappear in the radar clutter caused by the District of Columbia's complex urban infrastructure. Neither the SLAMRAAM air defense systems nor the portable “Stinger” missiles deployed on the Capitol itself are capable of successfully reacting to a supersonic threat in time.

Immediately before 9:18 EST, the last Secret Service transmission from the Capitol reports that the President has been removed from the publicly-accessible areas, and is in the hallway leading to the emergency bunker underneath the building, with the vice president close behind.

At exactly 9:18 EST, two 5-kiloton nuclear warheads simultaneously detonate within one hundred feet of the Capitol building.

Subsequent analysis confirmed that one warhead detonated to the southwest of the building, possibly thrown off course by a partially successful intercept. The other detonated directly adjacent to the Capitol rotunda.

Destruction of the structure was total: ground-penetrating radar surveys show complete collapse of the subsurface structure, leaving no possibility of survival. Mortality reached 100% within the Capitol as well as the adjacent grounds, with the first technical survivors appearing approximately 1000 feet from ground zero. However, mortality eventually reached 100% for virtually all those within 1/4 mile from ground zero due to the combined effects of prompt radiation, thermal pulse, and structural collapse from atmospheric overpressure. Mortality rates range from 50%-100% between 1/4 and 1/2 of one mile from ground zero.

FEMA estimates a total of 15,000-20,000 fatalities, with more than 100,000 severe injuries. In the subsequent evacuations, several million Americans became homeless, as uncertainty regarding the direction and intensity of the fallout plume spreading over the District of Columbia necessitated mandatory evacuation of the area.

Section B: Responsibility and Response

As members of the committee will be aware, the State of the Union attacks were unprecedented in American history in scale and effect. Most of the federal leadership of the United States of America was destroyed. The senior surviving Cabinet member was ineligible to ascend the Presidency, as she was not a natural born citizen. The “Designated Survivor”, Secretary of Veterans Affairs, was sent aloft in the Airborne National Command Center, and surviving members of Congress were secured in an undisclosed location.

For several hours, the acting President stood ready to authorize a massive nuclear counter-strike in the event that the attack was the first shot in a general war. However, no attack came, and the military and intelligence communities reported no evidence of any nation mobilizing strategic forces to launch a follow-on attack. While a decapitating first strike has long been considered a risk in the event of uncontrolled military escalation with Russia or China, they would almost certainly follow immediately with a wave of strikes against America's nuclear arsenal and military bases worldwide.

But no attack came. No national or credible non-state actor claimed or claims responsibility. In a separate, access-restricted addendum to this report, a Central Intelligence Agency analysis confirms that while carrying out such an attack would require access to nation-state level capabilities, no nation state appeared to have planned for the event or been prepared to take advantage of the aftermath.

Evidence pointing to the responsible party has not been forthcoming. While the cruise missiles themselves are certainly derived from Russian technology, Russian military equipment is widely exported and used by America's adversaries and partners alike. In particular, quiet diesel-electric submarines and sea-skimming cruise missiles have proliferated throughout much of the world since the early 2000s. Russia, China, India all use Russian-derived equipment and technology, and retain the capability to produce domestic versions, perhaps covertly. Algeria, Iran, Indonesia, Venezuela, and Vietnam are all Russian military customers. It is impossible to rule out the transfer of a submarine and cruise missiles from the inventories of any of these nations to rogue actors.

Aside from the fragments of the Klub-type missiles, the navigation and electronic systems that survived the decoys' destruction, and the radiological signature left by the nuclear warheads themselves, no unambiguous evidence of culpability has yet been recovered. Twelve hours after it presumably fired the six cruise missiles responsible for the attack, a submarine identified by U.S. Navy sonar as belonging to the Kilo-type was destroyed thirty miles east of the Continental Shelf, in several thousand feet of water, after unsuccessfully firing torpedoes at a pursuing U.S. Navy destroyer. While recovery of the wreckage is technically feasible in six months to one year, it is probable that any useful evidence was destroyed by the pressure of the Atlantic.

Investigation of the nuclear warheads and their likely provenance has been no more successful. Their explosive power, at 5 kilotons, is within the capabilities of several small nuclear powers such as North Korea and Pakistan, and it is likely that Iran, Saudi Arabia, and Japan among many others possess the technical capability to produce warheads of this size that are also compact enough to fit on a cruise missile. Israel, despite its official ambiguity with respect to possession of nuclear weapons, is also presumed capable of warhead construction. Russia, China, and India are, like the United States, France, and the United Kingdom, mature nuclear powers with the ability to deploy 'dial-a-yield' warheads can produce 5 kiloton-sized explosions from warheads capable of larger detonations.

As a result of the proliferation of nuclear weapons, supersonic cruise missiles, and quiet submarines since the start of the 21st century, it is not possible to identify beyond a reasonable doubt the culprit for the State of the Union attacks. While remnants of Al Qaeda and ISIS have attempted to claim responsibility, it is highly unlikely either has the capability to carry out such a devastating attack. More likely as a culprit is a rogue branch within an intelligence agency, however it must be re-affirmed that no hard evidence has yet been found linking any group with this atrocity.

Because of this ambiguity, no military response is likely to either harm the perpetrators or protect against further such attacks, barring discovery of significant additional evidence.

The authors of this report wish to make clear to the committee that despite their failure to prevent these attacks, none of the personnel involved in the response between 9:12 and 9:18 are in any way at fault for what transpired. In the highly complex airspace and radar ecosystem along the Eastern Seaboard, it was simply not possible for personnel to react with any more speed without posing undue risk to civilian activities. Their equipment was simply not capable of handling the threat posed by high-speed, low-altitude missiles.

Nor can the United States Navy be faulted for failing to detect the inbound threat. While at least two USN submarines reported detecting a faint acoustic signature consistent with a Kilo-type diesel-electric submarine, this is not particularly unusual, given that there are dozens of such vessels in service around the world, and training patrols even in the mid-Atlantic are not uncommon. In addition, such a submarine can effectively hide its acoustic signature by moving into the wake of passing commercial vessels, while also remaining virtually invisible to radar. While anti-submarine defenses could theoretically be deployed in places like Delaware Bay to prevent such an attack from happening again, there are in fact several ways to bring nuclear-tipped cruise missiles within miles of the US coastline without detection. Such weapons can be hid in shipping containers, undetectable until launch. A cruise missile launched from a container ship heading to Baltimore could have traveled the distance to D.C. in under three minutes, further reducing feasible response time.

Finally, the Secret Service reacted both bravely and according to their training, and had the missiles not carried nuclear warheads it is likely that their evacuation of the President would have been successful.

Published in Blog
Friday, 04 May 2018 11:44

Michelle Wolf = Awesomesauce

Michelle Wolf is basically my hero right now. For obvious reasons.

America has a huge problem with cowardice in the media. Driven by the need to compete for advertising revenues, the contemporary American news media long ago made the choice to whore itself out to the lobbyists and politicians in D.C. Journalists get sanctimonious about their supposed role in "speaking truth to power", but few actually do in the United States. By and large, the US media engages less in reporting, and more in myth-making. So to see a comedian stand in front of a bunch of well-connected media types complicit in America's decline, and actually speak some truths, is very gratifying. Though also a bit sad. Because nothing of what Michelle Wolf said should have surprised anyone, and the teapot tempest she started focused entirely on her style and delivery, not the substance of her critique.

Anyone willing to set aside the myths and partisanship and take a hard, honest look at this country can see how bad things are, and how much worse they can get. Right now, the media should be leading a nationwide discussion on how to achieve the reforms we need to keep moving forward as a country. But, nah. Why risk upsetting the readers who have bought into your brand and the companies who want to advertise through it? It is easier by far to publish piece after piece whining about how Americans are reading "fake news" delivered by algorithms on social media, and then without any sense of irony go on cite some nincompoop or other's Twitter commentary.

Michelle Wolf unapologetically called the media out on their hypocrisy, and I hope more people start to do the same thing, wherever they run into people with power who claim a special role in society, but whose actions show that they're actually just another set of self-interested, self-aggrandizing charlatans.

The Fourth Estate in America is dead, and like most other things, old white men killed it. News outlets run by this caste have by and large sold out to become classic rent-seekers, maximizing profits at the expense of the the broader public's need and desire for information about what is happening in the world. Whether FOX, CNN, MSNBC, New York Times, Washington Post, whomever, they're selling a fundamentally biased product while claiming a special place in American society. Which I find morally and ethically repugnant. And, from a pragmatic perspective, also deeply dangerous. Because what they don't cover is usually the stuff that matters most.

So, like Matt Taibbi, I'm pleased to see a nationally televised comedy act that assaults the media's cozy relationship with power. I'm pleased to see these charlatans squirm as their little game is exposed.

You go, Michelle Wolf. Stick it to the bastards. They are probably more responsible than anyone else for the rise of Trump, and the normalization of his morally defunct, illegitimate occupation of the Oval Office. If the professionals won't write what needs to be written about the state of the world today, then I'll listen to the comedians.

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Monday, 30 November -0001 00:00

PHD in Integrated Kitty Studies

Experiments with memes: Cats. Snuggling on an IKEA Poang

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