ordinary… mostly

"We have nothing to offer each other, except a haven." — K. Nafziger



No more rat poison for me!

(At least for now.)

First, the brief background – I’ve had two DVTs in my left leg: one in 2003 and one in 2010. My various physicians don’t have an explanation, but since it has happened twice, I’m now on a blood-thinning regimen for the rest of my life.

Up until now, that blood thinner has been coumadin – a drug that was originally developed as a rodenticide. The nice thing about this drug is that is well understood. It is true that it caused the demise of some unfortunate cattle (sort of), but it has now been on the market for sixty years. And my grandmother always liked to get a rise out of people by telling them that she needed to ingest her daily dose of rat poison.

The problem, however, is that coumadin requires constant monitoring and dosage adjustments. Eating too much or too little of certain foods (specifically, things with vitamin K) will counteract the drug. Would you like a fresh arugula salad on a warm, sunny day in mid-May? I would, but until now it would require a blood test and an increase in my coumadin intake. (In practice, I could get by with blood tests every month or so.)

xarelto_logoEnter Xarelto, the wonder drug!!! Well – almost. Like coumadin, Xarelto* is an anticoagulant. Unlike coumadin…

Rivaroxaban has predictable pharmacokinetics across a wide spectrum of patients (age, gender, weight, race) and has a flat dose response across an eightfold dose range (5–40 mg). Clinical trial data have shown that it allows predictable anticoagulation with no need for dose adjustments and routine coagulation monitoring.


Rivaroxaban is well absorbed from the gut and maximum inhibition of factor Xa occurs four hours after a dose. The effects last 8–12 hours, but factor Xa activity does not return to normal within 24 hours so once-daily dosing is possible.

(Rivaroxaban from Wikipedia)

* Or ‘rivaroxaban’, if you prefer the generic name. Except that you can’t get Xarelto as a generic yet.

The FDA just approved Xarelto for the prevention of the recurrence of DVTs in November, and at my doctor’s appointment in January, my physician suggested I switch from coumadin.

So there you have it. I can eat my salad and not worry about it, since Xarelto works on a different part of the coagulation cascade. No problems! No worries!

Well… maybe one little one. Or two.

It turns out that there isn’t any way to stop the bleeding in an emergency. With coumadin, you can give a dose of vitamin K. With Xarelto, you can only wait until the effect wears off. Which means that if I’m ever in an accident, it would be better if it occurred in the late afternoon (right before my daily dose) and not during the night (when the anticoagulation is greatest).

The other little concern is the price. Brand-name drug with a legal monopoly status, since it’s under patent?

$10 per pill.

But I have insurance and a big-pharma subsidy for at least a year, so I’m paying $10 per month instead of $10 per day. We’ll see what happens after that.

I might just be back on rat poison.


The practice of getting lost (“An Altar in the World”, chapter 5)

"An Altar in the World" by Barbara Brown TaylorThroughout this year, I’ve been reflecting on how I experience the practices Barbara Brown Taylor outlines in her book, An Altar in the World. Since my family moved to Laurelville in May, this has felt very natural to me. It’s easy to forget that I chose the book for my family’s book club before our new life at Laurelville was even on the radar screen.

In chapter five, Taylor describes the practice of being disoriented or getting lost… or (if one takes the idea to the extreme) failing. She asserts…

Popular religion focuses so hard on spiritual success that most of us do not know the first thing about the spiritual fruits of failure.

There were a quite a few points of connection for me in this chapter. I immediately recalled how my father and I enjoy hopping in his truck and trying to get lost. We grab a Gazetteer and set off to explore new roads…

Somewhere in Garrett County

We still tell the story of the wrong turn – the downhill gravel road, that turned to a dirt road, that gradually became too washed out and narrow to continue on. We didn’t have room to turn around, so we had to back up. But in the process, we managed to poke a stick into the side of one of the tires. Luckily, we had a spare. Too bad one of the bolts was rusted tight. Luckily, we were able to shear it off. Too bad we were out of gas. Luckily we could make it to the nearest station on fumes. Too bad the owner only accepted cash. Luckily Dad had $2. We eventually made it home.

Taylor also relates how a medical emergency can be a type of “getting lost” – a time when you have to rely on someone else to provide your care. In that regard, I recall my two DVT hospitalizations. Like Taylor, I always felt safe and loved. Maybe it was divine; maybe it was youthful delusions of invulnerability. Whatever it was, it continues to shape me.

Perhaps the most tangible example of “lost” in my mind now is our move to Laurelville. It is not entirely clear to me: Was I lost in Chicago suburbs, trying to fit into a life that didn’t quite work out for me? Or is this new life in the Laurel Highlands an attempt to get lost, to break out of an area of comfort? I don’t know the answer to this, but I value the sense of being “vulnerable to this moment”, as the book describes it.

Sometimes I get so wrapped up in Taylor’s stories that I have trouble explaining the bigger picture. While I might agree that a certain practice is valuable, I’ll have trouble saying why. So I’ve been reflecting a bit on “getting lost”…

I’ve already mentioned the idea of being “vulnerable to [the] moment”. While it isn’t quite the same as valuing the moment, it is a step in that direction. Learning to value time and place is an (the?) underlying theme of the entire book.

“Getting lost” also reminds us that we aren’t in charge here. We aren’t God. A healthy dose of humility is a good thing.

And “getting lost” helps orient us throughout life. Hebrews 11 talks about lost people in this way…

They confessed that they were strangers and foreigners on the earth, for people who speak in this way make it clear that they are seeking a homeland. If they had been thinking of the land that they had left behind, they would have had opportunity to return. But as it is, they desire a better country, that is, a heavenly one. Therefore God is not ashamed to be called their God; indeed, he has prepared a city for them.

We can (and will) debate what a “heavenly country” might look like, but it is clear that there is searching to be done. The practice of getting lost reminds us of this.

One final thought: “lost” may be a matter of perspective. A recent post by Trevor Scott Barton in the God’s Politics blog touched on this:

Human eccentrics move in a seemingly aimless way… Their movements make them seem like wanderers to other human beings with finite views. They don’t wander aimlessly, though. They revolve around a different center.

And in the Beatitudes, Jesus demonstrates that things in the Kingdom of Heaven are not judged in the usual way:

Blessed are you who are poor,
for yours is the kingdom of God.
Blessed are you who are hungry now,
for you will be filled.
Blessed are you who weep now,
for you will laugh.

Go get yourself lost.

The practice of walking on the earth (“An Altar in the World”, chapter 4)

Thanksgiving has passed for the year; Christmas and New Year’s are a month away. Do you know what this means?

It means that my family only has one month to finish reading our book of the year! The annual discussion is just around the corner!

This year, it was my turn to choose the book, and I’ve been trying to blog through it. I’m not sure that I’ll make it before Christmas arrives, but let’s continue on…

“Solviture ambulando,” wrote Augustine of Hippo, one of the early theologians of the Christian church. “It is solved by walking.” What is “it”? If you want to find out, then you will have to do your own walking…

So says Barbara Brown Taylor in the fourth chapter of An Altar in the World. It’s a pretty bold statement, and I confess to be seduced by it. But what does she actually mean? How does walking help? Or any other spiritual discipline, for that matter? Taylor says…

The only promise [spiritual practices] make is to teach those  who engage in them what those practitioners need to know — about being human, about being human with other people, about being human in creation, about being human before God.

I’m not a disciplined walker. I’m not disciplined at much of anything – at least not anything that you might call a “spiritual” discipline. But walking is important to me, and has been especially so for the last decade…

In 2003, I experienced a DVT. In 2010, it returned. The DVTs were painful – more painful than anything else I’ve experienced. At their worst, I could hardly move. And they resulted in some permanent damage to my leg. Because of poor circulation in my leg, I now get tired more easily than before.

As a result of this of all this, walking has become something of a motivating challenge for me. I love strenuous hikes, not because I’m a good hiker, but because when I’m hiking I feel especially in touch with life. I’m keenly aware of my own limits and my mortality, and so I also am thankful to be alive.

At Laurelville, I get many chances to walk. My morning walk from home to the main part of camp helps to ground the rest of my day. I joke frequently about how the “commute” is awful. The traffic crawls along at about two miles per hour. Sometimes it even comes to a complete stop as the commuters gawk at everything going on around them. (It is really an incredible blessing.)

We also have a labyrinth on Sunset Hill, but I don’t actually use it too frequently – which is a testament to my lack of discipline. On the other hand, we have lots of trails, and I love to get out onto those. Sometimes, we follow unmarked trails, which is an exercise in getting lost (coming up in Chapter 5 of An Altar…!).

The most challenging of these trails – the one we call the Silver Trail – is the one I like most. For about half a mile, the trail goes up at a 25% grade. When I hiked it this fall, I had to stop multiple times on the way up, but along the way I reflected on how I have seldom felt more alive than I did in the midst of that hike. At the top, I was rewarded with a view of Pittsburgh, 35 miles away…

The view from the top of LaurelvilleWithout a tidy way of wrapping up these thoughts, I’ll simply give thanks for walking – for the opportunity to walk frequently where I live and work, for the groundedness of a day begun by walking, and for the awareness of life that comes with walking. Amen.

A tale of two blog posts

Earlier this month, I had a new blog post take over the top spot for “total hits”. Here is a plot of the hits for the top two over time…

Top blog posts

The long-time front-runner was published back in November of 2010. You can see that it shot up to about 300 hits through the end of the year. Then it leveled off through most of 2011, before recording another 200 hits or so at the end of that year. Now in 2012, it has leveled off again.

The other post was published just over a year ago in May 2011. It had a modest showing through the summer before picking up the pace and consistently gaining ground on the front-runner. Finally on May 4th, it had accumulated enough views to put it into the #1 spot.

So what were these posts, and why such different behavior?

Well – the former leader (in red) is easy enough to explain. It’s a post with images that I created for Advent. When that time of the Church liturgical calendar arrives, people start searching for things to put on their bulletin covers. Voila! Hits on that post.

The new leader (in blue) is a post about my DVT. It gets hits mostly because there seems to be a constant stream of people interested in both the causes of DVTs and the picture of the human circulatory system (which is borrowed from Wikipedia). It’s popularity still surprises me, but it is fairly consistent in receiving two or three hits per day.

At this point, there doesn’t appear to be any other post that could overtake the current leader. Maybe I should start getting controversial!

Late nights

One day ago at this time, I was beginning one of my unpleasant late-night experiences at the synchrotron. I worked way past my bedtime, left at 3 a.m. this morning, and didn’t get much sleep. It could be worse, I suppose. I occasionally have to work all-nighters.

One year and one day ago at this time, I was also beginning an unpleasant late-night experience… in the emergency room. I was up way past my bedtime, finally got admitted into a hospital room after midnight, and didn’t get much sleep. That also could have been worse. I’m thankful that it wasn’t.

Suddenly, late nights at work aren’t quite as bad.


Luxurious accomodations

I just came across this picture from my hospital stay last October. It was taken by my webcam. I forgot that I had it.

Doesn’t look like a real inviting place, does it? I see that I’m dressed in the latest fashion. And apparently, I have a heart beat (note the monitor behind me). Also, you may notice my heparin cart in the background.

(But to be perfectly honest, I have nothing but good things to say about Edward Hospital.)

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