Netflix Refund

Netflix gave us a partial refund for receiving three unplayable copies of the same DVD in a row. I'm going to put it towards buying the discs, if Isaac puts up the rest. That's good customer service!

Shingles Scars?

When I had my shingles attack, I didn't pick at the blisters that formed -- I swear! They cleared up, but my forehead still looks scarred. It's an odd kind of scarring, though -- it appears to be in the deeper layers of the skin, and is more or less visible depending on the lighting. It looks like purple staining or bruising.

Very strange. It has been about a month and ten days. I wonder if they really will be permanent? It seems like yet another cruel trick of this nasty little virus.

Meanwhile, the pain has continued to subside. I have another acupuncture treatment on Monday. My eye is still touchy, especially in bright light, but I've been able to drive and able to work. That's a big improvement! Now, I didn't really have so much prettiness in me that I can feel good about getting a little bit uglified. But I'll take some uglification over persistent neuropathy any day...

For the Geek who Has Everything: Bismuth!

Someone on eBay is selling bismuth germanate crystals originally made for scintillation detection (for particle accelerators? Where do people get some of these things?)

It'd be just the thing for my bismuth collection. What bismuth collection, you say? Well, it is really a collection of interesting elements, but I have more bismuth items than items for any other element. I have a very nice lab-grown crystal, as well as a variety of crystals I grew myself, and some castings of different forms. I've got a small cast rod that I can hang by a thread to demonstrate diamagnetism, and a couple of discs that can be set up to levitate a small magnet, although this requires a stabilizing magnet and is tricky to set up.

I'm also looking for a small antique (the older the better) Pepto-Bismol bottle with the pink liquid still in it, but have not found that yet. A package of some kind of makeup that uses bismuth in it would be a neat addition. I've already got an antique jar of bismuth subnitruate in powder form, and a little tin of bismuth formic iodide powder. Bismuth subgallate would round out the collection, although I can't bring myself to buy a bottle of Devrom at the drugstore!

The only thing cooler would be a bismanol magnet, or even a sample of bismuth strontium calcium copper oxide, which is a high-temperature superconductor. There is another one, bismuth telluride, but that is pretty toxic, so I don't want it in my collection. I have a small sample of native bismuth, but most of the naturally occuring minerals aren't much to look at.

At some point I'll order another batch of bismuth metal to melt down and cast some pretty ingots. It's a neat demo!

Netflix Discs

So, we received a DVD in the Stargate: Atlantis season 1 series, and it arrived too scratched to watch (it causes my DVD player to say "disk dirty" and will not eject until I power-cycle it. My attempts at cleaning aren't any help (I have some micro-fiber cleaning cloths which usually do the trick, or if there is something sticky on it the dish soap trick sometimes works, but this one is badly scuffed).

Isaac procrastinated for a while but eventually reported it damaged, so we got a new copy. This one, however, was cracked.

It's really hard to actually break a CD or DVD. I wonder how it happens?

The business model for Netflix is built around their ability to send DVDs through regular U.S. Mail in only a paper envelope and a Tyvek sleeve. It seems to generally work, although we have received at least three or four disks that were broken. I wonder if the DVDs are more vulnerable to cracking during the cold winter months?

I wonder if they have a third copy. I wonder how they manage to replace broken disks that are part of boxed sets. And I wonder how many viewings they get out of a typical DVD. Did they accurately predict the rate at which their inventory would become unusable? It would be an interesting case study.

Followup: a third DVD of the same series (season 1, disc 2 of Stargate: Atlantis) also arrived unplayable due to scratches. I wrote to Netflix:

My son has received three unplayable copies of Stargate: Atlantis season 1 disc 2 in a row. The first was extremely scratched, the second was broken, and the third was a different copy that was also too scratched to play. The problem is not our DVD player -- it is very rare to find a disc that is so scratched it won't play. I cleaned the discs and that did not help.

Can we get a partial refund for our account for this month (for Isaac's queue)? I realize Netflix can't prevent broken DVDs, but they can pull extremely scratched copies out of circulation. Three bad copies of the same movie in a row is getting ridiculous. Thank you.

We'll see what they say!

Acupuncture

Today I had my first acupuncture treatment for the trigeminal nerve pain that is still with me just over a month after the start of my shingles attack. I have also been taking some enzymes that are supposed to have a therapeutic effect. I'm not sold on the enzymes yet, but the acupuncture definitely works, so I am going back next week!

I was not expecting to feel much pain from the very fine needles used, but I felt even less than I expected. My acupuncturist put some in my left leg, one in my right foot, one or two in my left hand, and a couple more in spots around my face. Many of the needles I could not feel at all after the initial slight tap as each was inserted. Some of the spots on my face were more sensitive, and I could feel a mild burning or itching while the needle was in, but I would certainly not call it painful.

After I relaxed with the needles in on my front for a while, my accupuncturist took them out, then had me turn over, and put in a couple of needles at points at the base of my skull. This spot on the right side had been particularly sore and sensitive during the initial shingles attack, so I was rather surprised to find that I could not feel the needle there at all once it was inserted.

While I was face-down, my acupuncturist also did a procedure involving dropping bits of hot incense ash on some points on my upper back. At least, that's what I think he was doing; he told me he was going to do something with incense and heat, and I smelled it and felt it, but I could not see the details. This felt hot, but like the acupuncture it was not actually very painful, as the ash did not seem to be hot enough to produce burns. This technique is called moxibustion. I have to confess that I know almost nothing else about it aside from what Wikipedia could tell me.

During treatment my right eye, which has been very dry, began to water quite a bit, which was a big improvement. A couple of hours later it is still watering more normally. It seems to be focusing more readily. The muscle tension stuck in my forehead and brow is lessened greatly. I'm feeling much less of the various types of pain that have been zinging through my forehead and brow. There is also a slight relaxation/energizing effect which is persisting. Some of that may be attributable to getting the answer to my question "I wonder if this is going to hurt?" It also seems to have revved up my metabolism a bit -- I've been especially hungry and thirsty!

As I told my acupuncturist, "if this happened to you, you'd try whatever treatment modalities you could." I'm glad I tried this one!

Baby Sam Update

Sam has fortunately come through his chicken pox infection (at 3 months!) pretty much unscathed. We were worried -- the risk of complications of chicken pox in a child so young is relatively high. We had a scare late in his illness where he would occasionally wake up and start screaming for no detectable reason. We rushed him to the pediatrician -- they arranged for him to come into a separate exam room via the back door, for reasons of contagion. They found no problems; his lungs were perfectly clear, his sores all healing normally. It seems that he was just getting really, really sick of waking up to find out that he was still covered with itchy sores! But now sores are all healing, and he seems to be in good spirits and gives everyone a big grin! Go, baby Sam!

Followup: this brings up a couple of points. One is that apparently because he is so young and his immune system is not fully developed yet, he may get chicken pox again when he is a little older! That seems so unfair. The other one is the idea that newborn babies receive some immunities from their mothers via nursing. This is often touted as one of the benefits of breastfeeding, but I am not so certain it actually holds up under scrutiny. Can antibodies ingested in breask milk actually survive the digestive process and go on to establish the same antibodies in the newborn? I don't know. Has the idea ever been subject to serious study? How would one study this? Certainly if newborns had no immunities other than those conferred by nursing, bottle-fed babies would drop like flies when compared to nursing babies. I don't think that happens, although nursed babies are statistically healthier. But does the transferred-immunity theory actually hold water?

I'm of the belief that using bad science, even to push for objectively good outcomes, is a misuse of science, and ultimately makes people stupider. So I'd like to know the actual facts on this issue, if they can be clearly determined!

The Regimen

Wow, it adds up. Today I'm taking:

Lotemax (tm) prescription steroid eye drops (last day)
Valtrex (prescription antiviral) 1 gram (last day)
Elavil (prescription tricyclic antidepressant) 10 mg. at bedtime
Vicodin (prescription painkiller) as needed for pain (probably 2 at bedtime)

And the following non-prescription items:

Bion Tears (tm) over-the-counter lubricating eye drops as needed.
1200 mg St. John's Wort
1500 mg niacin (no-flush)
2 g fish oil
800 IU vitamin D
500 mg vitamin C ("Emergen-C" drink with B vitamins)
400 mg vitamin C (esterified)
olive leaf extract
antiviral enzymes (2 caps)
1 g calcium (Tums)
1 glass red wine with dinner

The ester-C, antivirals, and OLE are to take together between meals as part of a regimen recommended by the accupuncturist. Most of the rest (the wine, the fish oil, the vitamin D and niacin) are recommended by my doctor in an effort to improve my cholesterol numbers. The St. John's Wort is in lieu of a prescription antidepressant, and seems to work fairly well, especially during the dark winter months.

Wow! That's a lot of pills! With luck all the prescription meds, at least, will be off the menu soon!

Critics Rave!

Critics rave about the pain of herpes zoster ophthalmicus! "Like fresh ground pepper ground into your eye while you sleep!" raves one. "A hot cheese grater on the forehead!" marvels another. "It would make a marvelous interrogation technique!" adds former Secretary of Defense Donald Rumsfeld.

Yes, it is all that -- and more! It has been almost a month since the first sign of infection. My forehead still looks mottled and purple and I still have a distressing variety of different types of pain. Nerves heal slowly, so this is not an illness for the impatient; the pain can linger for a long time. I am back at work, although I may have to reduce my hours somewhat. My ophthalmologist tells me that my cornea has healed up pretty well, with only minor scarring. I'm off the various antibiotic and steroid gels and drops. That's good news. The bad news is that the pain persists, and with it some hyper-sensitivity to light and difficulty focusing. So I'm wearing my sunglasses in front of the computer (yes, it is true; I wear my sunglasses at night). And I'm gone back to my regular doctor to try to come up with a plan to manage the pain.

On Sunday I tried Zostrix (capsaicin cream). Yes, the pain was bad enough that rubbing what is essentially hot chili sauce on my face seemed like a good idea! Remarkably, this really seemed to help. It works by inducing pain! That seems a little strange. The theory is that if you induce a steady pain, it causes depletion of something called "substance P." When the substance P goes down, the nerve loses some of its capacity to hurt you. It feels to me like I am distracting the nerve: while it is occupied handling a steady pain in my forehead, it stopped bothering me about my eye; the eye became less hyper-sensitive and started watering normally. Unfortunately, after a day of this my skin became raw and began to peel.

It also seemed impossible to prevent small quantities of the capsaicin from working their way into my eye. When this happened I would have to dash into the shower and drench my eye with Cetaphil cleanser. Whether this was because I couldn't keep from touching my face, or because some of the substance vaporizes or flakes off, I could not tell, but it doesn't really matter; it just does not seem quite practical to keep on my face next to my eye all day, and I can't sleep with it on, since I will inevitably rub it onto my pillow or a cover and then into my eye.

The eye does not water normally, so I'm dousing it with over-the-counter lubricating drops as recommended by my ophthamologist. My doctor has put me on a low dose of Elavil (amitryptiline, a tricyclic antidepressant) at night. This is supposed to help settle the damaged nerves. I also have some Vicodin to take as needed, although it does not seem to help very much.

Finally, I have set up an appointment to see an accupuncturist on Monday; he's got me taking some enzymes that are supposed to be helpful when dealing with viral infections. I try to keep an open mind with respect to alternative medicine: open, as they say, enough to let new ideas in, but not so wide open that my brain falls out. I think the accuncture is certainly not snake oil. If rubbing hot chilis into my forehead can help with the pain, sticking in some tiny needles will almost certainly help as well. I'm less confident about the enzymes, but I'll reserve judgement for now. Wish me luck!

Herpes Zoster Ophthalmicus

For those interested, here is an article called "Evaluation and Management of Herpes Zoster Ophthalmicus" from American Family Physician magazine. This is a shingles attack involving the eye.

The list of possible eye complications is long and nasty. The ophthalmologist told me I was having some keratitis, but there are several different kinds, so I'm not sure what that means. At this stage, it is hard to judge how the eye feels and how well I can see out of it, independent of the facial nerve pain, which is ongoing. I'm just enduring the healing process and hoping for the best outcome when it is done.

A Pox on Our Baby Boy

So, despite our best efforts at keeping baby Sam in quarrantine, he has come down with chicken pox. Because he is so young (not yet 3 months) the illness can be hazardous -- it is a respiratory infection, and can cause pneumonia or other problems in babies whose lungs are not yet well-developed.

So far, the news seems to be good -- he does not have a large number of blisters, and they don't seem to be bothering him that much. He is in good spirits, smiling and babbling more-or-less as usual, with only a little bit of fussiness, no more than a low-grade fever, and only minor sniffles. We've been consulting with his pediatrician by phone, and are told that he only needs to go into the office if he gets noticeably worse.

To add insult to injury, he will probably not develop immunity from this infection, which means he will either get the vaccine later or get chicken pox again. Poor Sam!

I thought I had managed to avoid infecting him, since it has been almost three weeks since my first shingles symptoms appeared. But apparently it can incubate for a long period. I'm sorry, baby Sam!

Shingles Followup 1

Things are gradually improving. I saw my opthalmologist yesterday. I am no longer using the antibiotic gel by day, but at night only, and now I have a different medication for daytime. The vision in my right eye is much clearer without the non-water-soluble gel, so I am able to work at the computer more easily. I am not driving yet, although feel like I will be able to drive again soon.The right eye is no longer noticeably swollen, although if you compare it to the left eye you can still see that the lid is purple and thickened (it sometimes itches a lot), and still does not open quite as wide as the other lid. The white of the eye is a bit red still, but not nearly as red as it was. I have another followup scheduled with the ophthalmologist. There is also a high rate of eye complications following shingles infection, so I am trying to be conservative and follow the ophthalmologist's instructions exactly!

I am still experiencing a fair amount of pain across my eyelid, forehead, jawline, and especially in my scalp and at the base of my skull. Sometimes an icepack helps with this; last night i could not sleep until I used an icepack for a while. There is a risk that the pain will be lingering or permanent, a condition caled post-herpetic neuralgia, but I am hoping to avoid that outcome!

It has been about sixteen days since my first symptoms. It might have been helpful to go see a doctor at that stage and get on the anti-viral medication a couple of days earlier, although I think it is quite possible a doctor would not have diagnosed shingles yet. It is possible that the second night, when I was unable to sleep, was actually caused by the onset of general pain symptoms, prior to any visible swelling of the eye or any localized stinging in the forehead or scalp. My doctor suggested that the all-nighter may not have been the primary contributor; I may have been fighting off one or more other viral infections for several days before that, since everyone in the household was sick, seemingly with a different sore throat or cold. That might have distracted my immune system enough to allow the virus to run wild. Stress over work, the run-up to the holidays, and generalized sleeplessness due to a misbehaving two-year-old certainly didn't help.

I am trying to be more aggressive about enforcing an early bedtime for everyone! More sleep and less stress in 2007!

When Shingles Attacks!

So, I am back after a longish hiatus. I have not even looked at my e-mail since 22 Dec 2006. I don't think I've been away from the online world for such a long time in many years. It was not entirely voluntary, though! Just before Christmas I came down with a shingles infection, which started in my right eye.

Shingles is a reactivation of the herpes zoster or "varicella" virus, the same virus that causes chicken pox. I did a near all-nighter the Monday a week before Christmas, which might not have been too bad, but then the following night we had a sick baby and I was also unable to sleep. That was apparently enough stress to cause the virus to reactivate.

By Wednesday my eye was stinging; I thought it must just be the aftermath of too much screen time, which occasionally happens, so I tried using lubricating drops. By Friday the lid was swollen and I was starting to feel prickling in my forehead. I was using compresses, and there was no sign of bacterial infection. I had no idea what was actually happening until Saturday morning, when the rest of the infection started to become visible. I had always thought that shingles generally broke out on the trunk, especially the back, but apparently it also affects the face (and eyes).

Saturday afternoon I managed to get a callback from the backup doctor on call at my doctor's office, who suggested that since my eye was involved I should definitely see someone as soon as possible. After a lot of difficulty finding someone who was still in town and available to cover child care, Grace gave me a ride to an urgent care center. There they confirmed that it was shingles.

My eye was examined with dye and a slit lamp and the doctor on duty noticed that there were spots of viral infection on my right cornea. (Shingles almost aways occurs on one side of the body). She spoke with an ophthalmologist and they put me on a seven-day course of an anti-viral medication called Valtrex. They also prescribed an eyedrop with a steroid for the swelling and an antibiotic to prevent secondary infection from a scratchy, swollen eyelid, and advised me to contact the first available ophthalmologist the day after Christmas.

So, I spent the weekend unable to do much; I couldn't read, or wear my glasses, or watch TV. I was considered contagious (I could spread chicken pox to anyone not already immune, such as our two-month-old baby Sam), so Sam was off-limits. Grace started sleeping in a chair with Sam. Veronica was not off-limits, though, so she kept me company, whether I wanted company or not!

Shingles is painful. I have become intimately familiar with two new types of pain, which I call the blowtorch and the nightstick. The blowtorch is a feeling like my skin is being burned by an open flame and is bubbling. That is the sensation of the blisters forming, although it comes at other random times too. The nightstick is deep pain along the nerves of my face, where they feel like I've been beaten. That produces a tremendous amount of muscle tension in my jaw, and around the base of my skull as well, where large areas are still very hyper-sensitive to touch.

Just to make things more enjoyable, the Valtrex has terrible side effects. I had waves of fever and chills, often back-to-back (asking Grace if it was suddenly incredibly hot, then a few moments later shivering violently). It also caused nausea, diziness, and strange, disturbing visions when i closed my eyes. I'm off the Valtrex now, so thankfully those side effects have gone away.

So for most of my ten days off work I was fairly incapacitated: unable to see, unable to read, lying in bed with fever or chills and wracked with strange pains, very bored and frustrated, covered with blisters and scabs. When I got out of bed, I was dizzy, stumbling around the house looking like a crazed sunburned pirate with an eye-patch on. I have not been able to hold my baby boy for almost two weeks. Grace has been sleeping in a chair.

It did not help that Veronica had a cold and sore throat and was throwing up about once a day (she finally seems to be over it), and that Sam also came down with an ear infection (he is taking amoxicillin). And now Grace seems to be getting sick. She never had chicken pox, although she had the vaccine, so all we can do is hope that she does not get chicken pox, and that she does not pass it to Sam.

After a few days, past the point where I was allegedly no longer infectious, I did manage to get out of the house with the family. That was a godsend for my mood. We had meals out, and on the Friday after Christmas Grace brought me to the office to pick up my paycheck. I said hello to a few co-workers and gave them an update. But aside from those brief errands out, I've been completely home-bound.

Anyway, I am back at work. The scabs are gone, although my face is still visibly splotchy and bruised-looking. I should no longer be contagious, although I will get my doctor's opinion about that this afternoon. My right eye is still swollen and there is still some pain remaining. I had the followup with the ophthalmologist, who confirmed that my cornea was infected with the virus, and changed up my medication from drops to a thicker antibiotic gel. I am still using that, which means my right eye is still hazy, so I am not driving yet. I see my regular doctor today and the ophthalmologist again tomorrow.

I think the likely outcome is that my vision will be undamaged, or at least not damaged significantly. I'm assuming the visible blotches on my forehead will go away. At least, I hope they will. It seems like the pain will persist at reduced level for at least a while longer. Persistent neuropathy is a possibility, but let's hope that doesn't happen. Let's also hope that this does not recur.

We were very fortunate to have assistance from various friends, particularly our friends Pete and Suzy. Pete drove me to the opthalmologist the day after Christmas and then out to the drugstore to get one of my prescriptions filled. And they brought us dinner one night and even cleaned up our kitchen!

Dear reader, I sincerely hope you had a better holiday than mine. And if not, God bless you!