Over six months last year, nearly 1,500 pills prescribed to 35 residents of a Sauk Rapids health care facility went missing under nurse Lora Asfeld's watch.
Asfeld later admitted to stealing the drugs, mostly painkillers. She was fired, reported to police and had her license suspended in February by the Minnesota Board of Nursing — one of 13 licensees to be disciplined over a roughly four-month period for stealing pain medication.
While drug thefts have long been an issue in hospitals and nursing homes, top health officials are taking new steps to address the problem. The Minnesota Hospital Association and state Health Department are organizing a coalition of hospitals and licensing boards to identify and close loopholes in drug-handling protocols that make it easier to steal.
"People are starting to realize that this is a serious and ongoing problem," said Keith Berge, who chairs Mayo Clinic's medication diversion prevention committee. "They're starting to recognize what they've been seeing. I think we've been seeing this all along and not recognizing it for what it is."
In perhaps the most dramatic recent case, a nurse anesthetist in Minneapolis was accused of taking most of the painkiller intended for a patient undergoing kidney stone surgery in November. A criminal complaint said the nurse told the patient to "man up" as he endured the worst pain.
Opioid pain relievers like fentanyl or oxycodone are the most commonly stolen prescription drugs, according to the Drug Enforcement Agency. Hospital workers have stolen them by replacing a patient's prescription with ibuprofen, siphoning medication from IV bags, taking leftovers meant for the trash, falsifying patient records and forging prescriptions.
Once someone is addicted to prescription drugs, they'll go to great lengths to get their fix, said Ron Buzzeo, who was deputy director of the DEA's Office of Diversion Control for more than two decades before retiring in 1990. He now consults for hospitals.
"People who are abusing drugs are extremely creative," Buzzeo said. "It's difficult to stay one step ahead of them."
There is no central tracking system for drug theft by medical personnel in Minnesota, and since facilities report incidents to a variety of entities, it's difficult to tell how often it happens. Many facilities don't report all drug thefts to the DEA, despite a federal law requiring that they do, said Jack Henderson, supervisor of the DEA's local diversion group.
Hospitals can be vulnerable if they don't have a thorough tracking system for their medications, ideally an electronic one. Since many drugs stolen are bound for the trash, hospitals should also have a disposal system that includes safeguards such as requiring half-empty bottles or syringes be returned to the pharmacy.
Tracking is generally done through software linked to password-protected medication cabinets called automated dispensing units. That lets facilities check for high-use patterns by a certain employee, or for more complaints of pain than usual from patients who should've received enough medication.
In the past decade, most hospitals in Minnesota have gotten automated dispensing machines. At Hennepin County Medical Center, they look like short, wide vending machines. When a nurse enters his or her password, a list of patients pops up, along with the medications for each. Once a medication is selected, a drawer pops open.
If a drug is packaged in a quantity larger than the patient's dose, the remainder must be thrown away. If it's a narcotic, many hospitals require nurses to have a co-worker verify they watched by typing their password into the machine.
After a 2008 incident in a Mayo hospital in Mankato in which a nurse replaced fentanyl with saline, Mayo Clinic in Rochester formed a committee to improve their protocols. All leftover medication from operating rooms is now collected in a locked drop box that's returned to the pharmacy, which randomly tests them to ensure they weren't diluted, Berge said. That method will soon include all high-use areas.
"This system is expensive, labor-intensive and somewhat cumbersome," Berge said, "but it's the only way you can close the loop on dealing with this problem.'"
In March, St. Cloud Hospital found itself dealing with a rash of unusual infections that it ultimately concluded were caused by a nurse using a syringe to steal painkiller from IV bags. The hospital has taken steps to make that harder, including placing tamper-resistant plastic caps over the ports where medication is added. Plastic bags are placed over the IV bags that can only be removed by perforating them.
High-tech systems such as dispensing machines are expensive. HCMC spent more than $2.5 million on its 80 machines. Smaller hospitals and nursing homes may rely on paper records to spot thefts.
Benedictine Health Systems, a long-term care provider with headquarters in Duluth and Cambridge, typically uses bound notebooks with numbered pages to document medication, and it'd be obvious if a page was missing, said Howard Juni, who provides medications to Benedictine facilities.
Some nursing homes use video cameras. That's how a Burnsville assisted living center caught a health care aide in 2009 stealing OxyContin from an 89-year-old resident and replacing it with ibuprofen. But Juni said placing video cameras in residents' rooms raises privacy issues and can be done only with permission and when there's reason to believe the employee is stealing.
Despite hospitals' best efforts, most experts say it's impossible to eliminate drug theft entirely.
"We could spend an infinite amount of money creating electric fences around these things, and we would still never completely stop the problem," Berge said.
2011年5月29日星期日
One ex-Bloomfield Hills Lahser football coach donates kidney to another
Afew weeks have passed since Bill Hertle picked up the phone one Sunday and called John Tryon.
"I want to say happy Mother's Day to you," Hertle said.
Tryon was confused.
"What do you mean?" he asked.
"Well," Hertle said, "you're the mother of my kidney."
Mother of his what?
"Mr. Hertle
"I feel sorry for you because you have 0 kidneys. I wish I could come to a football game. I hope you don't die. You are going to have 1 kidney and so is Mr. Tryon. You are very lucky."
-- Andrew, second-grader at Beechview Elementary in Farmington.
Hertle, 50, and Tryon, 53, were sitting near each other a couple of weeks ago, just as they had done for years when they were assistant coaches on Dan Loria's football staff at Bloomfield Hills Lahser.
This time, however, they were in Hertle's room at Henry Ford Hospital in Detroit.
Also present were Tryon's two kidneys, but now his left one had taken up residence in Hertle's body.
On the day before Hertle turned 50, Dr. Jason Denny harvested Tryon's left kidney and placed it inside Hertle, who had lost both kidneys to disease.
And it all happened because of high school football.
"It's very cool and they come off the background of teamwork being football coaches," said Denny, a former all-state quarterback at Holy Trinity High School in New York. "Me playing football myself, you understand that the contribution to the group is often greater what you can get for yourself."
Connected for life
"Dear Mr. Hertle,
"You are very lucky to have a friend like Mr. Tryon."
Jason, second-grader at Beechview Elementary in Farmington.
Bill Hertle was hunting in northern Michigan 19 years ago when he suffered severe stomach pains. He learned he had the same gene that led his father to have polycystic kidney disease, which causes clusters of cysts to develop in the kidneys and leads to kidney failure.
It took Hertle's father's life at age 51.
"My internist told me the time line, how my dad went through the disease, will be the same in terms of when it would fail and all that stuff," Hertle said. "I kind of had an idea that at 50 my kidneys would fail, which came to pass."
Hertle's first kidney was removed in 2008 and weighed 10 pounds, about 40 times the weight of a normal kidney.
"I lost a baby," he said.
Dialysis began two years ago and was anything but a picnic.
"Let me put it this way," Hertle said. "The first time they hooked me up I told them to unhook me, I was getting up and leaving. It's a lifestyle change -- four hours squat in a chair with a fistula in my arm so I had to keep the one arm straight and I had a blood pressure cup on the other. It's uncomfortable and it's a four-hour run.
"I could live another 25 years on dialysis, but I wouldn't want to."
Three months later Hertle was placed on a transplant list and continued dialysis that took a terrible toll on every aspect of his life.
And then John Tryon came along with some amazing news.
From football to friends
Hertle, 50, and Tryon, 53, were hired as assistant football coaches at Bloomfield Hills Lahser in 2001 when Dan Loria was putting together his first staff. Loria quickly realized both were knowledgeable football guys, and he also got a sense that Tryon was cut from a different cloth.
"When John (Tryon) interviewed I was explaining the money thing to him," Loria said. "He said he didn't want any money. He said to give it to someone else. He would be a volunteer coach, but he wanted to be a full-time volunteer."
Neither Hertle nor Tryon, who both played football at Bloomfield Hills Andover, was a teacher. Hertle had a printing business and Tryon was a financial planner, and the two grew closer the longer they coached together.
"At Lahser, the varsity coaches also coach JV," Tryon said. "Bill was the defensive coordinator for the JV and I was the offensive coordinator. Bill was also the head coach JV coach and we really became good friends then."
Tryon left after the 2005 season to begin the football program at Southfield Christian and returned to Lahser for the 2007 season.
Hertle, who became Lahser's varsity defensive coordinator, did his best not to let his kidney problems affect his coaching, but it was not easy, especially in 2008 when the Knights advanced to the Division 3 semifinals.
"In our regional championship against (Warren) Fitzgerald he came up to me sweating," Loria said. "He said: 'Dan, I don't know if I can do this anymore.' I told him it was up to him, I didn't want to take anything away from him. But he did it. I'd look at him on the sidelines and he was just dying."
Coaching is not Hertle's profession, it is his passion. If there was anything that kept him going through the dialysis, it was coaching.
"I fell in love with coaching high school football," he said. "It changed everything I did. I went back to school to get a teaching certificate to teach and coach. I haven't gotten there yet, but I'm working on that end."
Tryon no longer coaches, but he is around Lahser so much it is difficult to know that he is not on the staff.
He watched as Hertle struggled with kidney failure as he waited for a match.
"Whoever's willing to be tested as a donor -- God bless them -- gets tested," Hertle said. "My wife was a match, but at the 11th hour they canceled her out because she had kidney stones and other issues that excluded her from being a donor."
And that is when Tryon stepped forward.
"I was originally planning on getting tested, but I heard Sue matched so I stopped and didn't follow through," he said. "When I found out that fell through I thought it through quickly and started going through the process. It takes a long time."
The process took a year. In the meantime, Tryon checked with his four children, who all gave him to go-ahead. He also mentioned he was getting tested to be a donor to his girlfriend, Claire -- before he married her one year ago today.
"I guess that's why I married him," said Claire, who teaches second grade in Farmington. "That's just the way he is. He told me he wasn't put on this earth for just himself, this was the right thing to do."
A life-altering experience
The May 10 transplant did more than simply make Hertle and Tryon better friends. It merged two families.
"Oh my God," said Sue Hertle, who works at Lahser. "He comes in here to see Dan and I just want to hug him. I didn't know Claire that well, but now we're a big family."
Tryon jokes that the process leading up to the donation was good for him because he now had a clean bill of health.
"I got a bunch of medical tests for free -- colonoscopy, straight cauterization awake!" he said, laughing. "They did all the things I was supposed to have done when I turned 50 but hadn't. I have no issues."
There was a question about an artery that appeared to be wrapped around his kidney and the operation was scratched for a short time, but then rescheduled.
"I called Bill and told him it was on again and Bill was not excited at all," Tryon said. "He was emotionally drained by that point."
By then Hertle had tired of the emotional roller coaster and considered scrapping the entire process.
"I had been pulled out once because of my wife and then they second time with John," he said, shaking his head. "I was rethinking the whole thing at that time. Once I realized that I'd get another 20 years of life I'd go through with it."
Tryon respectfully disputes Hertle's math.
"He's going to get more than that," he said. "He's not a normal kidney patient. Most kidney patients are really sick from other things. Bill's not sick from anything other than this genetic thing, so he should live a normal life."
Throughout the process of being evaluated as donor, Tryon was asked by every doctor he met with if he was being paid to donate the kidney.
Other people simply asked if he was nuts.
His answer to everyone was simple: "With what I believe, it was a no-brainer. I would have to say everything I believed in my life was a lie if I didn't go through with this once I found out that I could help Bill."
Tryon doesn't worry that he would be in a life-threatening situation if anything happened to his only remaining kidney.
"I believe God takes care of me," he said. "Because of that I can focus on other people. This is just the epitome of that belief system."
An unselfish act
While Tryon tries to downplay his donation, what he has done is not lost on Dr. Jason Denny.
"It's awesome," the surgeon said. "A lot of times the lay person doesn't understand the sacrifice they are making. It's easy for them; they're still healthy and can live the same life, possibly a better life because now people have a tendency to take even better care of themselves because now they have one kidney.
"But the guy who is receiving the kidney -- his life is lengthened, so he gets a longer life, so it's life-saving that way and life-extending, and he doesn't have to be hooked to a machine three days a week for four hours at a time and all the complications that came with that. So he's changed Mr. Hertle's life quite a bit. He can go back to doing all of the things he was doing before."
That is why Hertle struggles to find words to voice his appreciation to the person who gave him his life back, the guy he used to coach football with.
"I thought it was the greatest thing in the world," he said. "Words can't ... I told him before; I don't know how a person can thank somebody for what he's doing. I don't know."
Tryon knows Hertle doesn't have to say another word.
"It goes both ways," Tryon said. "It's a privilege to be able to do this for Bill."
But there was one interesting aspect the doctors discovered during the transplant.
"The good part of this is, one of my kidneys had a very small kidney stone in it," Tryon said with a smirk as he pointed to Hertle. "He's got it now."
The transplant also provided Loria with a teachable life lesson he will be able to pass along from one team to the next for years to come.
"I'm real big in the football program about looking outside yourself and being a giver," Loria said. "I tell the kids one thing we're guaranteed in life is the opportunity to make life-long relationships and then this one hits us right in the face."
Actually, it was more like a kidney punch.
"I want to say happy Mother's Day to you," Hertle said.
Tryon was confused.
"What do you mean?" he asked.
"Well," Hertle said, "you're the mother of my kidney."
Mother of his what?
"Mr. Hertle
"I feel sorry for you because you have 0 kidneys. I wish I could come to a football game. I hope you don't die. You are going to have 1 kidney and so is Mr. Tryon. You are very lucky."
-- Andrew, second-grader at Beechview Elementary in Farmington.
Hertle, 50, and Tryon, 53, were sitting near each other a couple of weeks ago, just as they had done for years when they were assistant coaches on Dan Loria's football staff at Bloomfield Hills Lahser.
This time, however, they were in Hertle's room at Henry Ford Hospital in Detroit.
Also present were Tryon's two kidneys, but now his left one had taken up residence in Hertle's body.
On the day before Hertle turned 50, Dr. Jason Denny harvested Tryon's left kidney and placed it inside Hertle, who had lost both kidneys to disease.
And it all happened because of high school football.
"It's very cool and they come off the background of teamwork being football coaches," said Denny, a former all-state quarterback at Holy Trinity High School in New York. "Me playing football myself, you understand that the contribution to the group is often greater what you can get for yourself."
Connected for life
"Dear Mr. Hertle,
"You are very lucky to have a friend like Mr. Tryon."
Jason, second-grader at Beechview Elementary in Farmington.
Bill Hertle was hunting in northern Michigan 19 years ago when he suffered severe stomach pains. He learned he had the same gene that led his father to have polycystic kidney disease, which causes clusters of cysts to develop in the kidneys and leads to kidney failure.
It took Hertle's father's life at age 51.
"My internist told me the time line, how my dad went through the disease, will be the same in terms of when it would fail and all that stuff," Hertle said. "I kind of had an idea that at 50 my kidneys would fail, which came to pass."
Hertle's first kidney was removed in 2008 and weighed 10 pounds, about 40 times the weight of a normal kidney.
"I lost a baby," he said.
Dialysis began two years ago and was anything but a picnic.
"Let me put it this way," Hertle said. "The first time they hooked me up I told them to unhook me, I was getting up and leaving. It's a lifestyle change -- four hours squat in a chair with a fistula in my arm so I had to keep the one arm straight and I had a blood pressure cup on the other. It's uncomfortable and it's a four-hour run.
"I could live another 25 years on dialysis, but I wouldn't want to."
Three months later Hertle was placed on a transplant list and continued dialysis that took a terrible toll on every aspect of his life.
And then John Tryon came along with some amazing news.
From football to friends
Hertle, 50, and Tryon, 53, were hired as assistant football coaches at Bloomfield Hills Lahser in 2001 when Dan Loria was putting together his first staff. Loria quickly realized both were knowledgeable football guys, and he also got a sense that Tryon was cut from a different cloth.
"When John (Tryon) interviewed I was explaining the money thing to him," Loria said. "He said he didn't want any money. He said to give it to someone else. He would be a volunteer coach, but he wanted to be a full-time volunteer."
Neither Hertle nor Tryon, who both played football at Bloomfield Hills Andover, was a teacher. Hertle had a printing business and Tryon was a financial planner, and the two grew closer the longer they coached together.
"At Lahser, the varsity coaches also coach JV," Tryon said. "Bill was the defensive coordinator for the JV and I was the offensive coordinator. Bill was also the head coach JV coach and we really became good friends then."
Tryon left after the 2005 season to begin the football program at Southfield Christian and returned to Lahser for the 2007 season.
Hertle, who became Lahser's varsity defensive coordinator, did his best not to let his kidney problems affect his coaching, but it was not easy, especially in 2008 when the Knights advanced to the Division 3 semifinals.
"In our regional championship against (Warren) Fitzgerald he came up to me sweating," Loria said. "He said: 'Dan, I don't know if I can do this anymore.' I told him it was up to him, I didn't want to take anything away from him. But he did it. I'd look at him on the sidelines and he was just dying."
Coaching is not Hertle's profession, it is his passion. If there was anything that kept him going through the dialysis, it was coaching.
"I fell in love with coaching high school football," he said. "It changed everything I did. I went back to school to get a teaching certificate to teach and coach. I haven't gotten there yet, but I'm working on that end."
Tryon no longer coaches, but he is around Lahser so much it is difficult to know that he is not on the staff.
He watched as Hertle struggled with kidney failure as he waited for a match.
"Whoever's willing to be tested as a donor -- God bless them -- gets tested," Hertle said. "My wife was a match, but at the 11th hour they canceled her out because she had kidney stones and other issues that excluded her from being a donor."
And that is when Tryon stepped forward.
"I was originally planning on getting tested, but I heard Sue matched so I stopped and didn't follow through," he said. "When I found out that fell through I thought it through quickly and started going through the process. It takes a long time."
The process took a year. In the meantime, Tryon checked with his four children, who all gave him to go-ahead. He also mentioned he was getting tested to be a donor to his girlfriend, Claire -- before he married her one year ago today.
"I guess that's why I married him," said Claire, who teaches second grade in Farmington. "That's just the way he is. He told me he wasn't put on this earth for just himself, this was the right thing to do."
A life-altering experience
The May 10 transplant did more than simply make Hertle and Tryon better friends. It merged two families.
"Oh my God," said Sue Hertle, who works at Lahser. "He comes in here to see Dan and I just want to hug him. I didn't know Claire that well, but now we're a big family."
Tryon jokes that the process leading up to the donation was good for him because he now had a clean bill of health.
"I got a bunch of medical tests for free -- colonoscopy, straight cauterization awake!" he said, laughing. "They did all the things I was supposed to have done when I turned 50 but hadn't. I have no issues."
There was a question about an artery that appeared to be wrapped around his kidney and the operation was scratched for a short time, but then rescheduled.
"I called Bill and told him it was on again and Bill was not excited at all," Tryon said. "He was emotionally drained by that point."
By then Hertle had tired of the emotional roller coaster and considered scrapping the entire process.
"I had been pulled out once because of my wife and then they second time with John," he said, shaking his head. "I was rethinking the whole thing at that time. Once I realized that I'd get another 20 years of life I'd go through with it."
Tryon respectfully disputes Hertle's math.
"He's going to get more than that," he said. "He's not a normal kidney patient. Most kidney patients are really sick from other things. Bill's not sick from anything other than this genetic thing, so he should live a normal life."
Throughout the process of being evaluated as donor, Tryon was asked by every doctor he met with if he was being paid to donate the kidney.
Other people simply asked if he was nuts.
His answer to everyone was simple: "With what I believe, it was a no-brainer. I would have to say everything I believed in my life was a lie if I didn't go through with this once I found out that I could help Bill."
Tryon doesn't worry that he would be in a life-threatening situation if anything happened to his only remaining kidney.
"I believe God takes care of me," he said. "Because of that I can focus on other people. This is just the epitome of that belief system."
An unselfish act
While Tryon tries to downplay his donation, what he has done is not lost on Dr. Jason Denny.
"It's awesome," the surgeon said. "A lot of times the lay person doesn't understand the sacrifice they are making. It's easy for them; they're still healthy and can live the same life, possibly a better life because now people have a tendency to take even better care of themselves because now they have one kidney.
"But the guy who is receiving the kidney -- his life is lengthened, so he gets a longer life, so it's life-saving that way and life-extending, and he doesn't have to be hooked to a machine three days a week for four hours at a time and all the complications that came with that. So he's changed Mr. Hertle's life quite a bit. He can go back to doing all of the things he was doing before."
That is why Hertle struggles to find words to voice his appreciation to the person who gave him his life back, the guy he used to coach football with.
"I thought it was the greatest thing in the world," he said. "Words can't ... I told him before; I don't know how a person can thank somebody for what he's doing. I don't know."
Tryon knows Hertle doesn't have to say another word.
"It goes both ways," Tryon said. "It's a privilege to be able to do this for Bill."
But there was one interesting aspect the doctors discovered during the transplant.
"The good part of this is, one of my kidneys had a very small kidney stone in it," Tryon said with a smirk as he pointed to Hertle. "He's got it now."
The transplant also provided Loria with a teachable life lesson he will be able to pass along from one team to the next for years to come.
"I'm real big in the football program about looking outside yourself and being a giver," Loria said. "I tell the kids one thing we're guaranteed in life is the opportunity to make life-long relationships and then this one hits us right in the face."
Actually, it was more like a kidney punch.
2011年5月25日星期三
Cancer patient puts trust in God, alternative medicine
Bryan Harper, 48, of Florence, keeps a quote by former first lady Eleanor Roosevelt on the wall by his desk at Midway Motors in Hillsboro.
“We do not have to become heroes overnight,” Roosevelt said. “Just a step at a time, meeting each thing as it comes up, seeing it is not as dreadful as it appeared, discovering we have the strength to stare it down.”
Harper said that is his approach to cancer.
In mid-February he said he was feeling fine, but one day there was blood in his urine. He thought that perhaps he had passed a kidney stone, but thought it was odd that he hadn’t had any pain. After he drank a glass of water, the problem cleared up.
His urine was bloody again the next day. When he passed a blood clot, he decided it was time to see a doctor. The doctor couldn’t find anything wrong with him, but scheduled an appointment with a kidney specialist three days later.
The next day Harper’s stomach started hurting, and he went to the emergency room when it became too severe. That’s when he got the news. A scan showed two softball-sized masses on his left kidney.
“I couldn’t believe I had kidney cancer,” he said. “I never hurt a day before.”
Doctors removed the affected kidney a couple of days later. He felt fine recovering from the surgery.
“I’m just glad it wasn’t in both of them (kidneys),” Harper said. “It’s one of those things, you can live with one.”
However, about a week later a full-body scan showed the cancer had spread to both of his lungs.
“It’s pretty devastating news,” he said.
His doctor told him modern medicine has no cure for the kind of cancer he has. Radiation and chemotherapy can slow the progression of the cancer, but can’t stop it. Harper said he was grateful the doctor was straightforward with him. Since the news, he has continued to work at the car dealership.
“I’m not going to do chemo and radiation,” Harper said. “It won’t cure it.”
He said he had seen his father wither away while undergoing treatment for incurable cancer, and he didn’t want to follow that path.
“It’d be pretty easy to curl up in a corner, but that’s not me,” Harper said.
Instead, he is following a regimen of spiritual healing and herbal remedies. The healer he is working with has had success with other cancer patients, using diet and herbs intended to strengthen the immune system in conjunction with prayer. The diet he is on precludes pork, wheat and flour products, soda, and refined sugars.
“Cancer survives 100 percent on sugar,” he said.
Meanwhile Harper has been eating more fruits and vegetables. He said sticking to the diet is tough but possible.
“You can do it,” he said. “It’s doable, but I have to bring lunch.”
Harper trusts that with faith and determination, he can defeat the cancer.
“The Lord has given me a temple,” he said, referring to his body.
Harper said that there isn’t anything he could have done differently, except possibly getting expensive full-body scans on a regular basis. He doesn’t smoke, tries to eat healthy, is active, and has had regular physicals.
He said he plans to face the problem head-on.
“I’ve always believed you look fear in the eye,” Harper said. “Fear can be conquered.
“I know a lot of people think I have a death sentence,” he said. “It’s not a death sentence; it’s a reality check.”
Nobody lives forever, he said. He would prefer to live to see old age rather than succumb to cancer now, and he is doing what he can to fight it. But he isn’t afraid of death.
“I have no regrets so far in life,” Harper said. “It’s been good.”
“We do not have to become heroes overnight,” Roosevelt said. “Just a step at a time, meeting each thing as it comes up, seeing it is not as dreadful as it appeared, discovering we have the strength to stare it down.”
Harper said that is his approach to cancer.
In mid-February he said he was feeling fine, but one day there was blood in his urine. He thought that perhaps he had passed a kidney stone, but thought it was odd that he hadn’t had any pain. After he drank a glass of water, the problem cleared up.
His urine was bloody again the next day. When he passed a blood clot, he decided it was time to see a doctor. The doctor couldn’t find anything wrong with him, but scheduled an appointment with a kidney specialist three days later.
The next day Harper’s stomach started hurting, and he went to the emergency room when it became too severe. That’s when he got the news. A scan showed two softball-sized masses on his left kidney.
“I couldn’t believe I had kidney cancer,” he said. “I never hurt a day before.”
Doctors removed the affected kidney a couple of days later. He felt fine recovering from the surgery.
“I’m just glad it wasn’t in both of them (kidneys),” Harper said. “It’s one of those things, you can live with one.”
However, about a week later a full-body scan showed the cancer had spread to both of his lungs.
“It’s pretty devastating news,” he said.
His doctor told him modern medicine has no cure for the kind of cancer he has. Radiation and chemotherapy can slow the progression of the cancer, but can’t stop it. Harper said he was grateful the doctor was straightforward with him. Since the news, he has continued to work at the car dealership.
“I’m not going to do chemo and radiation,” Harper said. “It won’t cure it.”
He said he had seen his father wither away while undergoing treatment for incurable cancer, and he didn’t want to follow that path.
“It’d be pretty easy to curl up in a corner, but that’s not me,” Harper said.
Instead, he is following a regimen of spiritual healing and herbal remedies. The healer he is working with has had success with other cancer patients, using diet and herbs intended to strengthen the immune system in conjunction with prayer. The diet he is on precludes pork, wheat and flour products, soda, and refined sugars.
“Cancer survives 100 percent on sugar,” he said.
Meanwhile Harper has been eating more fruits and vegetables. He said sticking to the diet is tough but possible.
“You can do it,” he said. “It’s doable, but I have to bring lunch.”
Harper trusts that with faith and determination, he can defeat the cancer.
“The Lord has given me a temple,” he said, referring to his body.
Harper said that there isn’t anything he could have done differently, except possibly getting expensive full-body scans on a regular basis. He doesn’t smoke, tries to eat healthy, is active, and has had regular physicals.
He said he plans to face the problem head-on.
“I’ve always believed you look fear in the eye,” Harper said. “Fear can be conquered.
“I know a lot of people think I have a death sentence,” he said. “It’s not a death sentence; it’s a reality check.”
Nobody lives forever, he said. He would prefer to live to see old age rather than succumb to cancer now, and he is doing what he can to fight it. But he isn’t afraid of death.
“I have no regrets so far in life,” Harper said. “It’s been good.”
American Idol Recap: Paul F. Tompkins Makes It to the Final Round Alive!
This is like Christmas Eve, in a way! I’m excited that this is the second-to-last night I will be watching this show. I am excited that tomorrow night will be the last night. I am not excited about actually watching the show either night. I guess it’s like if you referred to the night before you had kidney stones removed as “Kidney Stone Eve.”
The show begins with clips of Idols past Carrie Underwood and David Cook as children. Oh, come on. Are we reeeeeally gonna see clips of all the Idols as kids? Well, no, as it happens. Just those two. But now I'm curious: Is there no footage of any other Idols as kids? Were Carrie and David the only non-ugly children who went on to become American Idol winners? I want to see Kris Allen’s hump! Soon there are clips of Lauren and Scotty as children. Even younger children, that is. In Scotty’s home video, we see the little boy Scotty declaim, “The next American Idol winner … !” The footage then cuts off, as presumably the producers didn’t want to sway the voting or risk a mistrial.
As the camera sweeps over the exultant multitudes gathered in the Nokia Theater, it lingers on season seven Idol runner-up David Archuleta. Seeing him, I instantly flash on the YouTube video of the little girls crying their eyes out and screaming at the world’s injustice when Archuleta lost to David Cook. And I am struck: Did I not react similarly when Haley was eliminated last week? Did I not cry out in shock, and disbelief, and sorrow? If you prick me, do I not bleed? I am shaken from my reverie by the signs behind Daveulata’s head:
Love you Ryan.jpg
There is no way these signs are not sarcastic. Look how hastily made they are. Look at what they say. No one believes that. No one’s motivation was this. These signs amuse me because I know they are fake. Good work, sarcastic teenage girls. Please never turn your sarcasm on me.
The judges enter. Randy is dressed like one of the Borrowers. Steven Tyler is dressed like a depressing hotel bar. There are no words missing in the previous sentence. J.Lo is dressed like a hot Medieval Times waitress. Ryan is wearing a tuxedo, because this is supposed to seem important. I give him credit for wearing an actual bow tie, and not the “formal necktie” that cheaters and slobs wear.
Ryan brings out the kids. Despite everyone else’s fancy finery, Scotty is playing it safe by wearing a generic “country” T-shirt with a “Western” image on it. It very much looks like something you’d get at a truck stop, which I’m sure is not accidental. It absolutely works for his genre. Ryan tells us that there was some drama with Lauren’s voice. At rehearsal that day, she’d blown a vocal chord! Just the one! Then I start wondering how many vocal chords we have (two? Two thousand?) for a fair bit. It’s fun to think about science. Then a doctor comes out (wearing his black formal scrubs, he’s a gentleman) and tells us all Lauren’s going to be okay. This is disappointing news. HEAR ME OUT. I am not going to say that I wish for this young girl’s voice to fail her. I am going to say that if this young girl’s voice should fail her, it would mean something interesting would happen on this hour of television. The needs of the many outweigh the needs of the few. I have been and always shall be your friend.
Scotty won the coin toss that I just learned is part of this process, and being a good little gentleman, he defers to Lauren in the matter of who performs when. Lauren would prefer to go second. Oo, strategy! Maybe!
For the first round, the kids will sing their favorite songs from the season. Scotty opens it up with “Gone” and has been granted the use of the Game of Thrones Fiddler. I have to say, I’m glad Scotty chose this number. I don’t remember him singing it before, but it’s way more dynamic now than his performance of it two weeks ago or four months ago or on The Merv Griffin Show or I don’t know where I am anymore and why is this happening. My point is, it’s an up-tempo song with some energy to it. Scotty is really selling it, stalking all over the stage, at one point leading a mini-parade of the GoT Fiddler and Idol’s own in-house Guitar Strangler (I have a suggestion for this guy, and it’s his to take or leave: get a shirt that reads, “This fascist kills machines.” Where my folk fans at?).
JUDGES: We are just moving on, it seems! Nothing from the judges! I guess they have said all they have to say. Good. Keep quiet. You’ve done enough by doing so little.
ME: I can still talk, though. And yawn. I am already so bored and I am only eight minutes into this show. All I can think is, That was probably the song I am going to end up enjoying the most, and I didn’t really enjoy it, and there’s 52 more minutes of modern country to go.
Lauren’s favorite song from this season is “Flat on the Floor.” She sings it and sasses it and does what she does. I am slightly grateful that it’s not a ballad. So far I’ve enjoyed a two-song ballad reprieve.
ME: Honestly, there isn’t anything to say. Since they’re singing songs they’ve done before, they’re that much more comfortable with them. I don’t like either Scotty’s or Lauren’s performance styles and I don’t enjoy the one genre of music in which they both perform. So. Hello!
For the next round, the idols of the Idols will decide what songs are sung. Oh, well, pardon me, Your Majesties. I’m sorry no one was singing what you wanted to hear before. Let's start the season over with you calling the shots, whoevers you are. It turns out one of the whoevers is George Strait, who is Scotty’s idol. Out of all the songs in the world and from all the long rich history of music, George picks one of his own songs for Scotty to sing. I once heard that Prince only listens to his own music. Perhaps George Strait is the Prince of modern country music, and I just never knew it or didn’t care and still don’t. The George Strait song George Strait would most like to hear is called “Check Yes or No.” It makes a certain sort of sense that Scotty is singing this song about passing notes in school, but why was a grown man ever singing it? Come on, George Strait, live in the here and now! You deserve to be happy! Surely something nice has happened in your life since grammar school! Didn’t you get a new hat? The GoT Fiddler has now played on three songs.
Lauren’s idol is Carrie Underwood. Carrie Underwood, who won American Idol six years ago. It’d be poetic if Lauren started singing a song called “That Dang Ouroboros,” but instead she sings “Maybe It Was Memphis” by Pam Tillis. This is obviously a big hit and a legendary country song and all that, but to me it’s an all-day car trip and there’s a whole long stretch where all you can get on the radio is modern country or religious call-in shows. Hey, pull over here, I’m in a televised singing contest and I need to buy a shirt.
Once the kids are done singing, I expect George Strait and Carrie Underwood to come out and do something. Say hello, at least. But they don’t. We don’t even see any photos of them or anything. Where are they? They just pick these songs from an undisclosed location? Are they watching from their secret modern country lair, under a volcano? Of course, a country volcano. Come on. It’s implied.
Oh, I was wrong. The judges do get to talk. Why now? Four sings in? Fine. Let the babies have their bottles.
JUDGES: Steven likes it! J.Lo thought the performances were amazing and crazy, not as dynamic, strong, and clear and beautiful, in that order. Randy commends America on its choices for the final two. Randy awards round one to Scotty, round two to Lauren. Most important, they’re both IN IT TO WIN IT! STILL, I GUESS! I SHOULD THINK SO, AT THIS LATE DATE!
The show begins with clips of Idols past Carrie Underwood and David Cook as children. Oh, come on. Are we reeeeeally gonna see clips of all the Idols as kids? Well, no, as it happens. Just those two. But now I'm curious: Is there no footage of any other Idols as kids? Were Carrie and David the only non-ugly children who went on to become American Idol winners? I want to see Kris Allen’s hump! Soon there are clips of Lauren and Scotty as children. Even younger children, that is. In Scotty’s home video, we see the little boy Scotty declaim, “The next American Idol winner … !” The footage then cuts off, as presumably the producers didn’t want to sway the voting or risk a mistrial.
As the camera sweeps over the exultant multitudes gathered in the Nokia Theater, it lingers on season seven Idol runner-up David Archuleta. Seeing him, I instantly flash on the YouTube video of the little girls crying their eyes out and screaming at the world’s injustice when Archuleta lost to David Cook. And I am struck: Did I not react similarly when Haley was eliminated last week? Did I not cry out in shock, and disbelief, and sorrow? If you prick me, do I not bleed? I am shaken from my reverie by the signs behind Daveulata’s head:
Love you Ryan.jpg
There is no way these signs are not sarcastic. Look how hastily made they are. Look at what they say. No one believes that. No one’s motivation was this. These signs amuse me because I know they are fake. Good work, sarcastic teenage girls. Please never turn your sarcasm on me.
The judges enter. Randy is dressed like one of the Borrowers. Steven Tyler is dressed like a depressing hotel bar. There are no words missing in the previous sentence. J.Lo is dressed like a hot Medieval Times waitress. Ryan is wearing a tuxedo, because this is supposed to seem important. I give him credit for wearing an actual bow tie, and not the “formal necktie” that cheaters and slobs wear.
Ryan brings out the kids. Despite everyone else’s fancy finery, Scotty is playing it safe by wearing a generic “country” T-shirt with a “Western” image on it. It very much looks like something you’d get at a truck stop, which I’m sure is not accidental. It absolutely works for his genre. Ryan tells us that there was some drama with Lauren’s voice. At rehearsal that day, she’d blown a vocal chord! Just the one! Then I start wondering how many vocal chords we have (two? Two thousand?) for a fair bit. It’s fun to think about science. Then a doctor comes out (wearing his black formal scrubs, he’s a gentleman) and tells us all Lauren’s going to be okay. This is disappointing news. HEAR ME OUT. I am not going to say that I wish for this young girl’s voice to fail her. I am going to say that if this young girl’s voice should fail her, it would mean something interesting would happen on this hour of television. The needs of the many outweigh the needs of the few. I have been and always shall be your friend.
Scotty won the coin toss that I just learned is part of this process, and being a good little gentleman, he defers to Lauren in the matter of who performs when. Lauren would prefer to go second. Oo, strategy! Maybe!
For the first round, the kids will sing their favorite songs from the season. Scotty opens it up with “Gone” and has been granted the use of the Game of Thrones Fiddler. I have to say, I’m glad Scotty chose this number. I don’t remember him singing it before, but it’s way more dynamic now than his performance of it two weeks ago or four months ago or on The Merv Griffin Show or I don’t know where I am anymore and why is this happening. My point is, it’s an up-tempo song with some energy to it. Scotty is really selling it, stalking all over the stage, at one point leading a mini-parade of the GoT Fiddler and Idol’s own in-house Guitar Strangler (I have a suggestion for this guy, and it’s his to take or leave: get a shirt that reads, “This fascist kills machines.” Where my folk fans at?).
JUDGES: We are just moving on, it seems! Nothing from the judges! I guess they have said all they have to say. Good. Keep quiet. You’ve done enough by doing so little.
ME: I can still talk, though. And yawn. I am already so bored and I am only eight minutes into this show. All I can think is, That was probably the song I am going to end up enjoying the most, and I didn’t really enjoy it, and there’s 52 more minutes of modern country to go.
Lauren’s favorite song from this season is “Flat on the Floor.” She sings it and sasses it and does what she does. I am slightly grateful that it’s not a ballad. So far I’ve enjoyed a two-song ballad reprieve.
ME: Honestly, there isn’t anything to say. Since they’re singing songs they’ve done before, they’re that much more comfortable with them. I don’t like either Scotty’s or Lauren’s performance styles and I don’t enjoy the one genre of music in which they both perform. So. Hello!
For the next round, the idols of the Idols will decide what songs are sung. Oh, well, pardon me, Your Majesties. I’m sorry no one was singing what you wanted to hear before. Let's start the season over with you calling the shots, whoevers you are. It turns out one of the whoevers is George Strait, who is Scotty’s idol. Out of all the songs in the world and from all the long rich history of music, George picks one of his own songs for Scotty to sing. I once heard that Prince only listens to his own music. Perhaps George Strait is the Prince of modern country music, and I just never knew it or didn’t care and still don’t. The George Strait song George Strait would most like to hear is called “Check Yes or No.” It makes a certain sort of sense that Scotty is singing this song about passing notes in school, but why was a grown man ever singing it? Come on, George Strait, live in the here and now! You deserve to be happy! Surely something nice has happened in your life since grammar school! Didn’t you get a new hat? The GoT Fiddler has now played on three songs.
Lauren’s idol is Carrie Underwood. Carrie Underwood, who won American Idol six years ago. It’d be poetic if Lauren started singing a song called “That Dang Ouroboros,” but instead she sings “Maybe It Was Memphis” by Pam Tillis. This is obviously a big hit and a legendary country song and all that, but to me it’s an all-day car trip and there’s a whole long stretch where all you can get on the radio is modern country or religious call-in shows. Hey, pull over here, I’m in a televised singing contest and I need to buy a shirt.
Once the kids are done singing, I expect George Strait and Carrie Underwood to come out and do something. Say hello, at least. But they don’t. We don’t even see any photos of them or anything. Where are they? They just pick these songs from an undisclosed location? Are they watching from their secret modern country lair, under a volcano? Of course, a country volcano. Come on. It’s implied.
Oh, I was wrong. The judges do get to talk. Why now? Four sings in? Fine. Let the babies have their bottles.
JUDGES: Steven likes it! J.Lo thought the performances were amazing and crazy, not as dynamic, strong, and clear and beautiful, in that order. Randy commends America on its choices for the final two. Randy awards round one to Scotty, round two to Lauren. Most important, they’re both IN IT TO WIN IT! STILL, I GUESS! I SHOULD THINK SO, AT THIS LATE DATE!
2011年5月22日星期日
BMW 328 Hommage Concept Debuts at Villa d’Este 2011
The BMW 328 is considered the most successful and best-looking sports car of the 1930s. The BMW 328’s success was the result of its design through the use of systematic lightweight construction, aerodynamic lines, opti-mum engine types and outstanding suspension technology. These historical facts have laid the foundation stone for a new vehicle concept following its 75th birthday.
The festivities started near Lake Como at the Mille Miglia. There, the main focus was on the fascination of the BMW 328 racing car. To this day, the award-winning vehicle BMW 328 Touring Coupé still holds the record for the highest average speed on the Mille Miglia circuit and, in 2010, was again able to win the historic revival of the race.
Yesterday at the Concorso d’Eleganza Villa d’Este, the two-seater’s functional aesthetics will be the focus of attention. In this area of conflict between tradition and modernity, BMW is paying tribute to the BMW 328 on the occasion of its anniversary with a special model – the BMW 328 Hommage.
Based on the Vision Connected Drive Concept revealed in Geneva, the 328 Hommage is a modern interpretation of the celebrating classic sports car from the 1930s. The looks of the vehicle combine the distinctive diagonal carbon fiber weave, the 328 Hommage focuses on lightweight construction through carbon fiber reinforced plastic (CFRP). The result is a gross vehicle weight of only 780 kilograms.
Fine leather, matt and high-gloss black polished alu-minium as well as CFRP make up the interior. The vertically positioned double kidney grille imitates the slim, vertical kidney design of the early BMW models. In those days, the BMW 328 was one of the first BMWs to feature it, after which it became further established with later BMW models.
The festivities started near Lake Como at the Mille Miglia. There, the main focus was on the fascination of the BMW 328 racing car. To this day, the award-winning vehicle BMW 328 Touring Coupé still holds the record for the highest average speed on the Mille Miglia circuit and, in 2010, was again able to win the historic revival of the race.
Yesterday at the Concorso d’Eleganza Villa d’Este, the two-seater’s functional aesthetics will be the focus of attention. In this area of conflict between tradition and modernity, BMW is paying tribute to the BMW 328 on the occasion of its anniversary with a special model – the BMW 328 Hommage.
Based on the Vision Connected Drive Concept revealed in Geneva, the 328 Hommage is a modern interpretation of the celebrating classic sports car from the 1930s. The looks of the vehicle combine the distinctive diagonal carbon fiber weave, the 328 Hommage focuses on lightweight construction through carbon fiber reinforced plastic (CFRP). The result is a gross vehicle weight of only 780 kilograms.
Fine leather, matt and high-gloss black polished alu-minium as well as CFRP make up the interior. The vertically positioned double kidney grille imitates the slim, vertical kidney design of the early BMW models. In those days, the BMW 328 was one of the first BMWs to feature it, after which it became further established with later BMW models.
'Our little piece of heaven': Swansea couple's backyard goes with the flow
A visit to a neighbor's pond led Tim and Cindy Hammond to build theirs.
"We were just taking a walk in the neighborhood," said Cindy. "We saw a neighbor who had a pond. He invited us back to look at it. I said, 'That's really pretty. I'd like one of those one day,' and he was off like a shot."
That was about seven years ago.
Their pond -- with waterfall and stream -- is now the focal point of the Swansea yard. From the second-story deck, you can hear water tumbling over rocks and see clumps of yellow irises with their feet stuck in the 18-by-12-by-3-foot pool. Impatiens and hostas dot the landscape.
Mulched paths wind through woods that stretch across the back of the yard. It's kind of like the English woodlands garden at Missouri Botanical Garden, which the Hammonds visited for inspiration.
"I love it," said Cindy, 59, sitting on the deck after work. "It turned out way better than I imagined. I think it's great. We sit out in the evenings. In the morning, we drink coffee. It's very peaceful. We hear the stream. The back reminds me of the Missouri Ozarks. It's just very, very peaceful."
Hostas, fern and wildflowers such as Virginia bluebells, trillium, Solomon's seal and mayapples do well in the shady setting.
"We let nature take its course," Tim said. "It's a lot easier than fighting it."
The wood-chip pathways are lined with fallen limbs. The Hammonds replace the chips every three years because they either sink, wash away or rot.
"It's low maintenance," said Cindy. "There aren't a lot of weeds. We do put mulch out by the pond."
The Hammonds have lived on the partially wooded lot for 30 years. Cindy grew up in Belleville. Tim, born in Toronto, grew up in southern California, and came to the Midwest because of a job. He's a retired civilian contracting officer from Scott Air Force Base. They have three grown daughters, two grandsons and a granddaughter on the way.
Tim built the lower deck during his first year of retirement.
"He's very goal-oriented," said his wife.
The pond project came next.
"The girls' playhouse used to be there," said Tim, 68. "When they grew up, we took the playhouse down."
The spot was just right for the pond project. He started by laying out a hose in a kidney shape.
"I had nothing to do with it," said Cindy. "I have no sense of creativity. He would tell me and talk about it. I was clueless."
"It wouldn't be something for someone not an engineering type," said Cindy.
"I enjoy the challenge," said Tim.
Shortly after, he began digging the 3-foot deep pond, he hired two teen neighbors to help.
"I knew their work ethic," said Tim. "They were happy to have the job. I fed them sandwiches and made them take breaks. The boys did the heavy work and moved stone."
The dirt piled from the hole became the stream bed.
"It grew into something much larger ... When I had to do engineering, I started looking at books, going to pond stores, talking to people to determine the best type of equipment."
For the pond, he purchased an Aquascape system that included a heavy rubber liner, bio falls, the skimmer and filtering system that's rated for 8,000 gallons an hour. The 3,500-gallon pond turns over a couple times an hour, he said.
Costs escalated.
"He told me a certain amount," said Cindy, a information technology business manager for AT&T. "It was three times that amount."
Tim estimates he spent $3,000 initially, not including landscaping and rock, pathways and shrubs.
"I probably have $10,000 to $15,000 in it," he said. "I am in the wrong business. Rock is expensive. I hand-picked boulders and rocks. I was afraid to tell Cindy how much it cost.
"I got a little (rock) at a time so she wouldn't notice, and I pay the bills."
But looking out from the upper-level eck onto the pretty, parklike setting makes it all worthwhile.
"We spend hours out here," said Tim. "It's peaceful. It's our little piece of heaven."
"We had the family over," said Cindy. "Both grandsons are almost 2. They came a month ago and had an absolute ball.
"They played king of the mountain, and had fun throwing rocks into the pond. They never got tired of throwing rocks in the pond."
Critters have discovered the water project, too. Blue heron, raccoons and "something like a weasel" visit and take a swipe at the goldfish. A few frogs moved in to let them know they have a healthy set-up.
In the evening, timers turn on landscape lights around the water. Tiki torches add atmosphere.
"It's kind of like 'Survivor' island," said Cindy, "and we are right behind Schnuck's."
Tim's water feature advice:
-- Don't skimp on the liner. Get the best you can afford. "I bought very heavy, top-of-the-line stuff. At the time, Aquascape was pretty much premiere."
-- Roots can be a problem. Cut them back so they don't pierece the liner. It was hot, heavy work, but worthwhile, said Tim.
-- Cantilever edges of the pond. When the rock rims over the edges, fish can swim underneath. That way, cats and other critters can't get them.
-- Consider upkeep and maintenance. "There is some upkeep work," said Tim. "I think it's a little understated. Ours is in a forest. There are lots of leaves. I spend an hour a week tops, cleaning little things such as the filter basket."
-- Tim recommends emptying and cleaning the falls and pond every two or three years. He uses a powerwasher to clean it.
-- "If I run the pump 24/7, it costs $75 a month," Tim said. "We turn it off in the winter and put in a pond heater so there's oxygen (for the fish). Several go down and hide. It's about three feet deep. They go to sleep and we don't see them at all."
-- Watch your water level and the ground around the waterfall and pond. Theirs settled in places and had to be built up.
"We were just taking a walk in the neighborhood," said Cindy. "We saw a neighbor who had a pond. He invited us back to look at it. I said, 'That's really pretty. I'd like one of those one day,' and he was off like a shot."
That was about seven years ago.
Their pond -- with waterfall and stream -- is now the focal point of the Swansea yard. From the second-story deck, you can hear water tumbling over rocks and see clumps of yellow irises with their feet stuck in the 18-by-12-by-3-foot pool. Impatiens and hostas dot the landscape.
Mulched paths wind through woods that stretch across the back of the yard. It's kind of like the English woodlands garden at Missouri Botanical Garden, which the Hammonds visited for inspiration.
"I love it," said Cindy, 59, sitting on the deck after work. "It turned out way better than I imagined. I think it's great. We sit out in the evenings. In the morning, we drink coffee. It's very peaceful. We hear the stream. The back reminds me of the Missouri Ozarks. It's just very, very peaceful."
Hostas, fern and wildflowers such as Virginia bluebells, trillium, Solomon's seal and mayapples do well in the shady setting.
"We let nature take its course," Tim said. "It's a lot easier than fighting it."
The wood-chip pathways are lined with fallen limbs. The Hammonds replace the chips every three years because they either sink, wash away or rot.
"It's low maintenance," said Cindy. "There aren't a lot of weeds. We do put mulch out by the pond."
The Hammonds have lived on the partially wooded lot for 30 years. Cindy grew up in Belleville. Tim, born in Toronto, grew up in southern California, and came to the Midwest because of a job. He's a retired civilian contracting officer from Scott Air Force Base. They have three grown daughters, two grandsons and a granddaughter on the way.
Tim built the lower deck during his first year of retirement.
"He's very goal-oriented," said his wife.
The pond project came next.
"The girls' playhouse used to be there," said Tim, 68. "When they grew up, we took the playhouse down."
The spot was just right for the pond project. He started by laying out a hose in a kidney shape.
"I had nothing to do with it," said Cindy. "I have no sense of creativity. He would tell me and talk about it. I was clueless."
"It wouldn't be something for someone not an engineering type," said Cindy.
"I enjoy the challenge," said Tim.
Shortly after, he began digging the 3-foot deep pond, he hired two teen neighbors to help.
"I knew their work ethic," said Tim. "They were happy to have the job. I fed them sandwiches and made them take breaks. The boys did the heavy work and moved stone."
The dirt piled from the hole became the stream bed.
"It grew into something much larger ... When I had to do engineering, I started looking at books, going to pond stores, talking to people to determine the best type of equipment."
For the pond, he purchased an Aquascape system that included a heavy rubber liner, bio falls, the skimmer and filtering system that's rated for 8,000 gallons an hour. The 3,500-gallon pond turns over a couple times an hour, he said.
Costs escalated.
"He told me a certain amount," said Cindy, a information technology business manager for AT&T. "It was three times that amount."
Tim estimates he spent $3,000 initially, not including landscaping and rock, pathways and shrubs.
"I probably have $10,000 to $15,000 in it," he said. "I am in the wrong business. Rock is expensive. I hand-picked boulders and rocks. I was afraid to tell Cindy how much it cost.
"I got a little (rock) at a time so she wouldn't notice, and I pay the bills."
But looking out from the upper-level eck onto the pretty, parklike setting makes it all worthwhile.
"We spend hours out here," said Tim. "It's peaceful. It's our little piece of heaven."
"We had the family over," said Cindy. "Both grandsons are almost 2. They came a month ago and had an absolute ball.
"They played king of the mountain, and had fun throwing rocks into the pond. They never got tired of throwing rocks in the pond."
Critters have discovered the water project, too. Blue heron, raccoons and "something like a weasel" visit and take a swipe at the goldfish. A few frogs moved in to let them know they have a healthy set-up.
In the evening, timers turn on landscape lights around the water. Tiki torches add atmosphere.
"It's kind of like 'Survivor' island," said Cindy, "and we are right behind Schnuck's."
Tim's water feature advice:
-- Don't skimp on the liner. Get the best you can afford. "I bought very heavy, top-of-the-line stuff. At the time, Aquascape was pretty much premiere."
-- Roots can be a problem. Cut them back so they don't pierece the liner. It was hot, heavy work, but worthwhile, said Tim.
-- Cantilever edges of the pond. When the rock rims over the edges, fish can swim underneath. That way, cats and other critters can't get them.
-- Consider upkeep and maintenance. "There is some upkeep work," said Tim. "I think it's a little understated. Ours is in a forest. There are lots of leaves. I spend an hour a week tops, cleaning little things such as the filter basket."
-- Tim recommends emptying and cleaning the falls and pond every two or three years. He uses a powerwasher to clean it.
-- "If I run the pump 24/7, it costs $75 a month," Tim said. "We turn it off in the winter and put in a pond heater so there's oxygen (for the fish). Several go down and hide. It's about three feet deep. They go to sleep and we don't see them at all."
-- Watch your water level and the ground around the waterfall and pond. Theirs settled in places and had to be built up.
2011年5月18日星期三
Adjuvant Drugs May Aid Clearance of Some Stones
Adjuvant use of tamsulosin or nifedipine after extracorporeal shock wave lithotripsy (SWL) improves stone free rates in patients treated for non-lower pole renal stones 10-20 mm in diameter, Brazilian researchers reported at the American Urological Association 2011 annual meeting.
In a double-blind study, Fabio Vicentini, MD, and colleagues at the University of São Paulo randomly assigned 136 with radioopaque non-lower pole kidney stones to receive daily treatments of 0.4 mg tamsulosin, 20 mg nifedipine, or placebo for up to 30 days after a single session of SWL. Patients were considered successfully treated if they no radiographic evidence of stones or they were asymptomatic with stone fragments 4 mm or less in size at any time during weekly follow-up.
The success rate was 60.5% in the tamsulosin arm, 48.6% in the nifedipine arm, and 36.8% in the placebo group, according to data in the researchers' poster presentation. The differences among the study arms were not statistically significant.
Among patients with 10-20 mm stones, however, those in the tamsulosin and nifedipine had significantly higher success rates (61.9% and 60%, respectively) than placebo recipients (26.1%). The study revealed no significant differences in stone clearance among patients with stones 5-9 mm in size.
Compared with placebo, adverse events rates were significantly higher with nifedipine than placebo (28.5% vs. 2.6%), but not with tamsulosin.
The three treatment arms were similar with respect to pain intensity and time to clearance.
In a double-blind study, Fabio Vicentini, MD, and colleagues at the University of São Paulo randomly assigned 136 with radioopaque non-lower pole kidney stones to receive daily treatments of 0.4 mg tamsulosin, 20 mg nifedipine, or placebo for up to 30 days after a single session of SWL. Patients were considered successfully treated if they no radiographic evidence of stones or they were asymptomatic with stone fragments 4 mm or less in size at any time during weekly follow-up.
The success rate was 60.5% in the tamsulosin arm, 48.6% in the nifedipine arm, and 36.8% in the placebo group, according to data in the researchers' poster presentation. The differences among the study arms were not statistically significant.
Among patients with 10-20 mm stones, however, those in the tamsulosin and nifedipine had significantly higher success rates (61.9% and 60%, respectively) than placebo recipients (26.1%). The study revealed no significant differences in stone clearance among patients with stones 5-9 mm in size.
Compared with placebo, adverse events rates were significantly higher with nifedipine than placebo (28.5% vs. 2.6%), but not with tamsulosin.
The three treatment arms were similar with respect to pain intensity and time to clearance.
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