Friday, May 28, 2010

My Experience With Modern Outpatient Surgery

Thursday morning I walked into the surgery suite of Tucson Northwest Surgery Center to have my torn rotator cuff tendon repaired. I have previously described how I hurt my shoulder. The check-in was very easy and quick; sign in at the front desk, show my insurance card and pay my share of the surgery center fee not covered by insurance. My wife, Linda, was with me.

My name was called quickly and I was led to Pre-Op, where I stripped off my clothes and changed into a surgical gown. Everybody was nice. The prep nurse started an IV after making Swiss cheese out of one vein in my hand. It kept rolling and she was not happy with initial stick. It hurt like hell, to be honest. She eventually took that one out and found a second, vein. This was easier but still painful.

What followed was a dizzying array of nurses and doctors, all with questions and explaining what they were there to do. I didn’t see my surgeon until the end. The prep nurse returned with Vicodin and Celibrex, which the surgeon wanted I my system first. The anesthesiologists (yes there were two) explained that this surgery required a pain block; the injection of a drug into a neck nerve that would deaden my arm for 18-24 hours. The used an ultrasound to find the nerve, and then they administered “happy juice”, self-described by the senior doctor. I cared less as they inserted a big needle in my neck. I never felt it.

I was aware of things as I was wheeled into surgery but only vaguely. I do remember them putting me onto the operating table and reading the manufacturer label on the oxygen mask. Last thing I remembered was the senior anesthesiologist, a rocker type in a Phillies surgical headdress, said “nite-nite” and I was gone.

Seconds later I awoke in the recovery room, Linda sitting by the bedside and talking to a doctor that she knew. I was there an hour until my head cleared and the line removed from my arm. I was trussed an elaborate sling and I could not move my right arm. It didn’t even feel like it was a part of my body. But I was in no pain. Rather stiffly I was dressed and helped off the bed. They wheeled me out to our waiting car and off we went. In at 9:00 and out at 2:30. And that’s modern outpatient surgery!

Today, 24 hours later, the pain block is gone and I do feel stiff and sore, but it’s manageable. I do have a sore throat from intubation, but I always get that. This was my forth surgery. I look forward to a very speedy recovery. Today was better than yesterday, and tomorrow will be even better.

Wednesday, May 26, 2010

Reagan And The Politics Of Cynicism

The Presidency of Ronald Reagan gives pause to reflect on America in the 1980’s as a time of triumph over the evil of the Soviet empire but also as an era of missed opportunity for some Americans here at home.

Ronald Reagan, the conservative populist, rode into the White House in a stirring campaign against “Big Government”. Most Americans listened enthusiastically to the man and not the message. Indeed, Reagan was one of the most charismatic presidents of our time – one has to go all the way back to JFK to find his rival. He was affable, likable and hard to be mad at for very long, even if you disagreed with him in the most fundamental way. His winning personality and good-natured social skills had a way of disarming even the most vocal critic.

Yet we as minorities living in the big cities knew instantly what Reagan meant by “Big Government”. He meant to disable the social and economic programs that had been in place since the Great Society to help minority Americans climb out of poverty. The record I believe bears this out – government spending certainly did not decline (and neither did the size of the government) during the Reagan years. Instead, we ran up horrific deficits on defense spending and passed those enormous tax credits to the wealthiest Americans and businesses. Sure, the economy jumpstarted and the Soviet Union collapsed (it was going to anyway), but at what cost to the cities, unions and farmers? And was the recovery enduring?

It was the beginning of the politics of cynicism, a Republican playbook that is still being run today – say one thing and do something else, all the while hoping that voters won’t catch on. It’s been a winning formula for Republicans. Today’s brand of cynicism has reached new lows, with talk radio and talking heads continually engaging in closet racist code-word gamesmanship. Purveyors of such political trash talk are raking in fortunes as they continue to mislead easily misled non-thinking Americans down a disastrous path for our country.

I would argue that blacks and Latinos have never really recovered from Reagan’s onslaught. Take a look at the unemployment rates in urban black communities across America today and my point is proven. Better still, walk through the west side of Chicago or Detroit during any normal business day and see how many jobless men and women are out on the street corners. It is a staggering waste of potential and we ought to be ashamed of ourselves for permitting this to continue in the greatest nation on earth.

I grew up in the 1970’s in a poor family in the Chicago area. We didn’t have much money but my family placed a high value on education. Fortunately, there was a government in existence at the time that was willing and able to lend a helping hand to families like us with reference to college financing and I was able to earn scholarships because of my hard work, grades and financial needs. I turned those advantages into a master’s degree in education at a good school and have been able to rise out of that poverty to help others. I can’t honestly say that students coming up in the 1980’s during the Reagan years and after had the same kind of help from the government, because those doors were being closed to finance the Reagan Administration’s other goals. It is much harder today for a poor person to finance a four-year college degree today and that is wrong, yet, it is a legacy of Ronald Reagan that few will want to acknowledge.

Reagan was truly a “Teflon” President in many ways. His popularity was so great that I doubt that a Clintonesque scandal like the Lewinsky affair would have hardly been front page news. Yet, his administration’s Iran-Contra scandal was a complete disgrace that should have had far more repercussions than it did politically. I am convinced that the sad irony of the situation is that the weapons Reagan’s people peddled to the Middle East are killing American soldiers today in Iraq and Afghanistan. No one will talk about that either and that is yet another national disgrace.

So now we have an African-American president and the playing field has been leveled, right? Far from it, I am afraid. President Obama was assailed by the right even before he took office, demanding that he repair overnight a morass they themselves designed and perpetrated on the American People and the National Treasury. The Politics of Cynicism elevated to the level of art form.

To obfuscate, delay and derail Obama’s earnest attempt at fixing eight plus years of Republican refuse, including a war in Iraq that should never have been fought, the right has thrown one road block after another in his path; financial reform, jobs, bailouts, healthcare, and immigration. The whole Tea Party movement is built on a mountain of lies and cloaked racism about Democratic government spending. Who threw open the doors of the National Treasury and allowed trillions of dollars to be poured into an illegal, unwarranted and unjust war in Iraq? Let’ see, repairing US infrastructure or nation-building in Iraq; which is a better idea? Yes, Saddam Hussein was an evil man; yes he killed hundreds of thousands of innocent people (so have we). Even George H.W. Bush understood that removing him would create a huge power vacuum that Iran only happily was willing to step into. Like they have!

The politics of this nation was built on the premise that political parties would come together to debate issues, compromise when necessary and construct laws and policies based upon a consensus. The politics of cynicism, introduced by the Reaganites, have subverted that idea into an all or nothing political debate ruled by the threat of filibuster, a concept the Founding Fathers did not even choose to embrace when they wrote the Constitution. It’s a senate rule! Yes, Washington is broken, and it has been such a state since 1981. President Obama is waging a brave fight against this busted play of a political game. He’ll make mistakes, but I support him and will do what I can as a private citizen to work for his success. Enough people in our country are still open-minded enough for him to succeed.

Parmesan Biscuits (From Scott Hargrove)

These biscuits are an awesome treat, but they are sinfully rich, so only on special occasions!

Yield: 8 2-inch biscuits

2 cups unbleached all-purpose flour
2 tsp baking powder
1/2 tsp salt
1/2 cup unsalted butter, cut into eight pieces, chilled
1/4 cup grated Parmesan cheese
3/4 cup milk

Whisk together the flour, baking powder and salt in a large bowl to blend. Using fingertips, rub the chilled butter into the dry ingredients until the mixture resembles course meal. Stir in the cheese.

Add the milk and stir until the mixture is evenly moistened and forms dough.

Sprinkle a clean work surface with flour. Scrape the dough out onto the floured surface. Gently pat the dough out until it is about 1 inch thick. Cut rounds out of the dough using a 2-inch biscuit cutter. Evenly distribute the biscuits on a non-stick baking sheet or a sheet covered with parchement paper and bake in a 375 degree oven for 12-15 minutes, or until risen and well-browned.

You may also distribute the dough over your favorite pot-pie filling and bake as directed above.

"Mutha" Sauce (Another Marilyn Davison Favorite)

1/4 cup vegetable oil
1 cup minced onion
1/2 cup minced green pepper
1 jalapeno pepper, seeded and minced
Pinch Kosher salt $ freshly ground black pepper
2 tbsp minced garlic
1 can (28 oz.) tomato paste
2 cups Hunt's ketchup
1 cup water
3/4 cup Worcestershire sauce
1/2 cup cider vinegar
1/4 cup fresh lemon juice
1/4 cup molasses
1/4 cup cayenne pepper or Tabasco
1/4 cup spicy brown mustard
3/4 cup dark brown sugar, packed
1 tbsp chili powder
2 tsp freshly ground black pepper
1/2 tsp ground allspice
1 tbsp Liquid Smoke flavoring (optional)

In a large saucepan, pour in the oil. Set over medium-high heat. Toss in the onions, green peppers and jalapenos and stir. Season with salt and pepper and cook til soft but do not burn. add the garlic and cook one more minute. Add the rest of the ingredients except the Liquid Smoke.

Bring to a boil, then simmer for 10 minutes. Swirl in the Liquid Smoke if desired and let the sauce cool. Pour it into a glass container, cover and store in the refrigerator til ready to use. makes 6-7 cups.

Use on ribs and other ork cuts, chicken or shrimp. Best used in the oven as the sugars will burn over open fire.

Good Times BBQ Sauce (A Favorite)

From Marilyn Davison (Dinosaur Bar B Que Cookbook)

1 bottle (24 ounces) Hunt's ketchup
1 bottle (12 ounces) Hunt's chili sauce
1/2 cup firmly packed dark brown sugar
1/4 cup water
1/2 cup cider vinegar
1/2 cup honey
1/2 cup molasses
1/2 cup Coleman's dry mustard
2 tbsp red pepper flakes
1 tbsp celery seeds
1 tsp garlic powder
1 tbsp Worcestershire sauce
1 tbsp liquid smoke flavoring
1 tsp onion salt
1/2 tsp Tabasco
1 chipotle chile in adobo sauce, minced

Combine all ingredients in a heavy saucepan Add 1/4 cup water to the ketchup and chili sauce bottles and shake well to get as much of the liquid out as possible.

Place over medium heat and bring to a boil. Reduce heat and simmer gently 45-60 minutes.

Use immediately or store the sauce in the two empty bottles. Keeps in the refrigerator for several months.

Thoughts Before a Surgery

Back in August 2009 I was rear-ended at a stop light on a bright Saturday morning. I drive a truck so I hardly felt anything, although there was a jolt. I didn't feel any pain at the time, but a few days later I was moving furniture and I felt a sharp twinge in my shoulder. I knew right then that something was wrong.

A subsequent MRI revealed a partial tear in my rotator cuff tendon, probably caused by the seatbelt in my truck. The orthopdedic surgeon that I saw prescribed a conservative approach. He ordered six weeks PT and then another evaluation. Tendons don't heal on their own but with strengthening of the muscle around it we hoped that the work of the torn tendon could be reduced.

I followed the program faithfully and the arm did improve, but in the end there was still pain. I had a second MRI done, with dye injected into the shoulder (that was painful). This time the images revealed a 90% tear. That was enough for the surgeon to recommend arthroscopic surgery.

So that is were I am right now. Being a trombone player, it has been tough to practice because of the pain. I took leave from the Civic Orchestra of Tucson after the injury was diagnosed and could only play one concert this season with them. I took other assignments but in the end knew that I needed to get this done.

Tomorrow at 9am I go into surgery, for what has been described as an hour procedure. I have had surgeries in the past and I am never at ease with them. I don't usually do well with anesthesia and of course I'll be without my right arm for six weeks. Linda will be with me the whole time so I feel comforted in that fact.

But it's also an opportunity. I can't play trombone of course, but I should be okay with guitar. That will help keep me musically active. At least I hope so. We'll see how it goes.

Tuesday, May 25, 2010

Johnny Carino's Spicy Shrimp and Chicken

For The Spicy Romano Sauce:

1 pint heavy cream
4 tbsp butter
1 tbsp salt
1 tbsp pepper
1/4 c Romano Cheese
1/4 c Parmesan Cheese
2 tsp cayenne pepper

Spice Shrimp and Chicken:

1 1/2 oz. melted butter
3 oz. slice cooked chicken
2 oz. black tiger shrimp
1/2 cup sun dried tomatoes
1/2 cup green onions
1/2 cup sliced mushrooms
10 oz. cooked penne pasta
1 pinch of salt, pepper, and garlic salt
1 oz. heavy cream
6 oz. Romano sauce

To Prepare the Spicy Romano Sauce

Melt butter in a hot saute pan. Add cream, salt, and pepper, and heat to a boil. Take off flame and fold cheeses and cayenne pepper into sauce. Allow to sit for 2 to 3 minutes after the cheeses have melted. Set aside.

To Prepare the Spicy Chicken and Shrimp

Combine melted butter, chicken, shrimp, oinions, sun dried mushrooms, salt, pepper, and garlic salt in a hot saute pan. Saute for 2 to 3 minutes to ensure the shrimp are fully cooked.

Add heavy cream and Romano sauce to saute pan and allow to thicken.

Once sauce begins to boil, add cooked penne pasta. Toss and serve Immediately.

Linda's Killer Sangria

4 c red wine (Merlot is fine)
3/4 c good brandy
1/2 c Cointreau or Grand Marnier
1/2 c sugar (to taste; you can reduce this amt)
8 tblsp fresh lemon juice, squeezed
1 orange, slice thinly
1 slices (yellow cling) drained
1/4 cup coctail cherries

Combine all the liquids in a pitcher and add sugar, stirring until dissolved. Combine with fruits, stir, cover and refrigerate at least an hour, but best overnight. Serve with chilled glasses and ice.

Dirt or Mud Cake

INGREDIENTS

16 oz Oreo cookies, ground
8 oz cream cheese
1/4 c margarine
1 c powdered sugar
8 oz tub Cool Whip
2 sm pkgs vanilla instant pudding
3 1/2 cup milk
1 boxed cake, any flavor

DIRECTIONS

Cream together the cream cheese, margarine and sugar. Fold in Cool Whip. In another bowl prepare pudding with the milk and fold the pudding into the cheese mixture and chill.

Follow cake mix directions and bake, let cool and cut into cubes.

ASSEMBLY

Using a flower pot, large bowl or large tall sided baking pan line the bottom of each with foil and alternate with layers of cake, pudding and cookie mixture. Finish with cookies on top. Chill and serve!

Random Thoughts On A Tuesday Afternoon

So I've just had a light lunch and contemplating getting on the recumbent bike after this settles to run some of this off. I want to use much of this summer to get back into a fitness routine after I recover from shoulder surgery this week. That's a arthroscope but frankly all surgery scares me.

I've had to let my exercise routine go in recent months due to the pain that I have been in and my busy teaching and concert schedule. That's gotta change because I want to lose 30-40 pounds. before the end of the year. That's a doable target for me. But in order to accomplish that I've got to cut out sweets, breads and most of all my precious mixed drinks. One or two a week maybe, but not every day. We'll see.

Blogging is new for me for sure. I want to create an e-book exchange for new authors but I don't know where to begin. Of course I have my own e-books to sell.