Sunday, August 31, 2014

Vinyl: The record of who we were (or weren't)

Larry Cornies is a former editor with The London Free Press who now writes a weekly opinion piece for the paper. The weekend column, it runs every Saturday, is a window into media groupthink. A column that ran a few weeks ago, Vinyl the record of who we were, ties a number of common media myths into one tidy package.

Cornies tells us "The children of the ’60s are easing their way toward retirement now, like an old hippie easing himself into a warm bath. . . . for many of us, the dusty, slightly warped and invariably scratched LPs and 45s, still wrapped in their fading and musty jackets . . . are the most revealing parts of the archives of our early lives."

Larry's core premise in this piece is dead on: The record collections of those of us who grew up in the '60s do contain clues as to who we once were. In reading Larry's piece one thing is clear: I don't remember the world like Larry Cornies does. My world is not and never has been the world of Larry Cornies.

My friends and I never had a "stack of vinyl" as Cornies apparently did. Records were kept in their jackets and stored on their edges. They stood upright on a shelf in an area of the room that did not get direct sunlight and was removed from hot air vents. Heat could warp vinyl LPs.

We played our records on either a Dual or Garrard turntable. No one used a record player as most were too wearing on the record's grooves. Record player tone arms were heavy and the automatic ones, which dropped 45s and LPs into the play position, were not trusted. I recall having an Empire cartridge on a low mass tonearm with the pressure set to less than two grams. Minimal wear was the goal.

It's funny but I am not surprised that Larry Cornies found the presets on the AM car radio so important. Most teens I knew found a way to upgrade their car radio, even if it was in the family car, to an AM/FM model. Not that AM wasn't important. It was but it was under attack from FM stations like WABX out of Detroit. AM DJs in the style of Juicy Brucey Bradley and Dick Summers of Boston's WBZ were going out of favour. (The skip enjoyed at night by powerful AM band stations gave DJs like Bradley and Summers tens of thousands of fans over an immense listening area.)

As for Cornies claim that the Beatles’ Sgt. Pepper’s Lonely Hearts Club Band broke the mould when it came to cover art -- maybe. I'd argue the Velvet Undergound album cover designed by Andy Warhol and featuring a peel-able banana deserves the mould breaker honours. Peel the banana and discover a flesh-coloured fruit. Shocking! The difficult to produce album cover was a big reason for the album's late release.

Cornies may have dumped his record collection but I haven't. My albums are not warped and scratched. I still like to listen occasionally to Cat Mother and the All Night News Boys, Savoy Brown, Spirit, Kennsington Market . . . When Don Van Vliet died in 2010, I played my old Safe As Milk album by Captain Beefheart and his Magic Band. Ah, the memories.

I hate to burst Cornies' balloon but I doubt the oh-so-conservative, oh-so-religious journalist knows anything about hippies. True hippies, not the hangers-on so loved by the media, were dedicated. Some of the hippie types I knew are still fighting for the big issues. Maude, of Harold and Maude fame, would understand.

16 hours in the ER; 16 hours well spent

Long wait times in hospital emergency departments is a global problem going back many years. The American College of Emergency Physicians in a paper on ER overcrowding reported:

"The news media have given great attention to the crowding “crisis” in emergency departments as if this were a recent development. However, as far back as 1987, after sustained and unsolvable problems with crowding, the first statewide conference on crowding was held in New York City. . ."

Recently, The London Free Press ran a story reporting ER wait times at London Health Sciences Centre (LHSC) University Hospital (UH) have hit 19 hours. The story went on to bemoan the fact that patients with serious conditions were "spending hours in the ER." Although this is all true, I don't believe this is the whole story.

Less than two weeks ago I spent 16 hours in emergency at UH. Those 16 hours may well have been the most import block of time in my entire life. Those 16 hours led directly to my undergoing life-saving emergency surgery for a serious bowel obstruction.

The day before, Monday, I awoke with a severe pain in my gut. By mid-afternoon I was at the St. Joseph Urgent Care Centre. The service was fast but that is all I can say for it. The centre closed that day at six o'clock. When nothing could be found to explain my pain, an unnamed virus was blamed, I was given a shot of morphine for pain and sent home. I asked if I could stay overnight for observation but was told St. Joe's has no rooms for that.

An interesting aside: This lack of rooms is a main reason St. Joe's fared so well in the CBC Rate Your Hospital report. Patients appearing on St. Joe's doorstep who appear exceedingly ill, possibly dying, are shipped off to University Hospital. UH takes the patients, the responsibility and the risks while St. Joe's accepts the accolades for its lower than usual mortality rates.

Now, back to my story. As soon as the morphine wore off, the pain returned. I suffered all night. My difficulty with keeping stuff down, a problem dismissed by the doctor at St. Joe's, was now a constant. As I take meds for my heart and other meds to prevent stroke, I feared I was losing these all-important pills when I got violently ill. By late afternoon I called the doctor at UH who monitors my pills. I was told to get to the UH emergency department immediately. This was serious.

I arrived by ambulance at the ER shortly before five in the afternoon. I was parked in a hallway but I was not parked and forgotten. An EKG was done and I believe blood was taken for testing. I'm not sure how long I was in the hallway. I really didn't care. The pain had been so severe that I was just grateful to be in the hospital where I was receiving something for the pain.

At some point in the early evening an ER cubicle became free and I was moved to a small bed in ER. I met with an ER doctor who immediately ordered x-rays. He was concerned I might have a bowel obstruction. I did.

It seems a tight band had formed around part of my small intestine. Why it formed was not clear but what was clear was that it had to be removed and soon. The tight band was shutting off blood flow and if not removed soon would irreparably damage the trapped intestine. Surgical removal of the damaged section of intestine would be necessary.

But the doctors in ER faced another complication. I take Pradaxa. This is an anti-coagulant or a blood-thinner in common parlance. Unlike coumadin, there is no easy way to reverse the affect of Pradaxa. Major surgery can result in life-threatening bleeding in patients taking Pradaxa. Discontinuing Pradaxa a few days before surgery is the usual answer but my doctors did not have that luxury.

A CT scan was ordered. A couple of hours before the procedure I was given a litre of a contrast-enhancing fluid to drink. The surgeons needed to know exactly what it was that they were up against. A CT scan was the answer. An MRI might have been another option but not in my case. I have an ICD/pacemaker in my chest. For me, MRIs are no longer possible.

The contrast fluid was not all that difficult to drink when cold. The nurse divided my dose into two 500ml portions. I slowly consumed the first 500ml during the first hour. The nurse put the second dose on ice -- a very thoughtful move.

Normally, I was told, I would have been given close to two litres of the contrast-enhancing fluid but as I was slated for surgery first thing in the morning the volume of the dose was kept to a minimum. One never has anything by mouth before surgery and here I was drinking a full litre of liquid. As soon as the CT scan was complete, a young doctor threaded a tube through my nose and down my throat and into my stomach. He was going to pump what remained of the contast-enhancing fluid out of my stomach.

By 9 a.m. I was in the operating room. The surgical team had determined the exact location of the offending intestinal band thanks to the CT scan. The lead surgeon, an expert in laparoscopic surgery, a minimally invasive surgical approach that does not require splitting the abdomen open, would lead the team down a surgical path that would skirt the Pradaxa bleeding risk. Brilliant.

About three and a half hours later I was wheeled into the intensive care recovery room. When I was asked if I needed another shot of painkiller, I said, "No. The pain is gone."

I had spent 16 hours in emergency. A reporter searching ER records would learn a patient at LHSC University Hospital spent 16 hours in the ER but what they would not learn is that those 16 hours were possibly the most important block of hours in the patient's entire life.

I send my heartfelt thanks to the young doctors, the team-leading surgeon and to the nurses in the ER, the recovery room and on the eighth floor where I eventually found a room. What a fine team! They saved my life.

Thank you!

Tuesday, July 29, 2014

Lathenia: inspired by good blog on Greek cuisine

My quick version of lathenia: A pizza like Greek dish.

As many of you already know, the heart and stroke specialists in London, Ontario, have put me on a cholesterol reduced diet. If it has a face, I can have it only every other day. And if it is red meat, once a month is often enough. Ice cream? I can have it on my birthday.

This diet may sound restrictive, and it is, but it doesn't feel that way. My wife, Judy, is going to Weight Watchers and she is bringing home oodles of good, low fat, vegetable-centric recipes. We have both lost a lot of weight. I am about to drop below 180 pounds and my doctors are very happy with the weight loss. If my heart could smile, it would be sporting a grin.

In searching the Internet for recipes and just inspiration, I have found a good blog on Greek cuisine: OliveTomato posted by Greek-American Nutritionist and writer Elena Paravantes. She discusses the Greek-Mediterranean diet, Greek food, and supplies a constant flow of recipes while touching on the latest research on one of the healthiest "diets" on the globe. I believe my doctors would approve.

I made my quick version of lathenia by using a low-fat pizza crust purchased ready-made at the grocery store. I used just a smidgen of tomato sauce as instructed by Paravantes. I covered the crust with tomato and onion slices and brushed the surface with a little good olive oil. I baked this in the oven at 350-degrees until the simple topping began to caramelize. Five minutes before it was done, I sprinkled a very light dusting of grated Parmesan cheese over the top. I returned the lathenia to the oven just long enough to melt the Parmesan.

My wife said this was delicious and it was only about 4-points per quarter. Today my wife was weighed. She was down and this means my version of lathenia gets a thumbs-up.

If you are trying to keep your weight in check, or trying to develop a heart healthy diet, check out Elena Paravantes' site, OliveTomato. She has posted some good, easy and oh-so-healthy recipes with a Mediterranean/Greek cuisine slant.

You will notice that Paravantes was very generous in her use of olive oil when making her version of lathenia. I may try this again and make her flaky crust but I will restrict my use of olive oil in the topping. I cannot bring myself to use a third of a cup of olive oil. I'll simply brush the surface. For me, that will be sufficient.

Monday, July 28, 2014

Subconjunctival hemorrhage: Nasty looking but harmless

My eye was well on its way to be healed when I took this picture.

My granddaughter noticed it first. The white of my right eye appeared to be filling with blood. It looked nasty.

As I take the anticoagulant Pradaxa, bleeding in my eye was concerning. I headed off to the the ER at University Hospital in London, ON.

Moments after entering the ER I was interviewed, my OHIP information was taken and I was asked to sit down and await triage. A few short minutes later I was being interviewed by the triage nurse. She seemed remarkably calm about my bleeding eye. A good sign. She asked me to take a seat in the waiting room.

A notice in the waiting room warned the wait for a doctor was running anywhere from four to six hours. I took a seat, picked up a magazine and scanned it for something to read. Interesting, I thought, my right eye is filling with blood and yet my vision seems unaffected. Another good sign.

I hadn't waited even two hours when I my name was called and I was taken from the waiting room to a small examining room where I noted there was what appeared to be a slit lamp instrument. These have a support for the chin and a brace for the forehead. With the patient's head held steady, an optometrist or doctor can shine a bright light into the eye to conduct a careful examination.

Soon a nurse arrived and had me read an eye chart. This tests visual acuity. I did fairly well. There was certainly no big difference between my two eyes. Whatever was occurring in my right eye was not affecting the vision.

The nurse left and an ER doctor entered. He carefully noted the meds I take and seemed especially interested in the Pradaxa, the anticoagulant I take to lessen my risk of suffering a stroke. He looked at the results of my visual acuity test and then examined my eye using the slit lamp unit. He put drops in my eye and left to help someone else while the freezing took effect.

When he returned, he used a computerized pen-type instrument to gently touch the surface of my eye to get an accurate eye pressure reading. All was normal.

He had a diagnosis: Subconjunctival hemorrhage. According to the Mayo Clinic this is caused by a tiny blood vessel breaking just underneath the clear surface, the conjunctiva, of the eye. There is usually no pain and no visual problems associated with this despite the frightening appearance. The blood trapped below the transparent layer will usually disappear in a week or two. There is no specific treatment.

The ER doctor made it quite clear that if pain should develop or my vision become blurry, I should return to the emerg. I believe the Pradaxa was a bit of question mark hanging over this whole incident. When one is on a powerful anticoagulant, any bleeding is cause for immediate concern. That said, it did not appear my eye was bleeding all that profusely and the Pradaxa did not appear to be the cause of my problem nor did it appear to be making the event worse.

The doctor sent me home. I had been in the ER a total of four hours.

In the last few months, the ER department at our local hospital has come in for criticism in the local paper. With my own personal defibrillator in my chest, an ICD, with a pacemaker in charge of my heart rate about 93 percent of the time, with a rather rare genetic-based heart condition, I have made more than my share of visits to the ER in recent years. I have no complaints.

The medical staff in the ER have tough jobs. In my experience, they are an amazing group doing damn fine work. Part of the reason I am alive today is because of the fine work done by the doctors and nurses in hospital emergency departments.

Sunday, July 27, 2014

Sun Media: nattering nabobs of negativism

Jonathan Sher, of The London Free Press, reported on the treatment received by patients suspected of suffering a certain type of heart attack in Ontario. The news report was well written, was medically accurate and I believe, was overly negative in tone.

I believe it was this negative tone that resulted in a great many oh-so-critical online comments attacking the health care system in Ontario. "For 1 in 5, fast care isn't there," read the headline. According to the article, nearly one in five Ontarians with a specific type of heart attack, known as a STEMI,  are not getting the fast access to treatment required. All true. The reader is also told Canadian experts look to American counterparts for benchmarks against which to judge treatment times. In Ontario 18 percent fall short of the American/Canadian benchmark.

An online comment warned, "Be afraid. Be very afraid. Do not get sick or old in Ontario." This comment attracted the most support from the paper's Web-based readers with the warning sitting at the top of the comment heap. Another reader laid the blame on Deb Matthews, a London MPP and former Minister of Health.

Let's take another look at the situation in the States. We find articles where the Yanks are downright proud of the their health care system and the rapid advances being made in this area. A recent American study looked at 96,738 patients in the heart attack group under discussion and found only 17 percent had treatment times that fell short of the benchmark.

In Canada, Sun Media bemoans the fact that our health care system fails 1 out of 5 patients suffering this type of heart attack. In the States, the Yanks are proud to report that 4 out of 5 patient suffering these attacks are treated within the benchmark time. The numbers from the two counties are separated by about one percent.

Two of my uncles died from heart problems. My father died from a heart attack. I take powerful meds while watching my diet to keep atherosclerosis (hardening of the arteries) at bay. For these reasons, I carefully follow the ever improving treatment for heart attack patients. 

I see the Canadian health care glass as half full and continuing to fill as medical breakthroughs are made around the world. A lot of medical research is done in Canada and our medical community is aware of not only what is being done in the States but around the globe. 

Recently, when I had an ablation procedure to cure my heart rhythm problems, one of my heart surgeons was a doctor from the south of France. When I was wheeled into recovery after the procedure was done, I felt very lucky to be living in Canada and especially lucky to be living in London, Ontario. 

My health care has been world class.

Monday, July 14, 2014

Weight Watchers for those seeking heart healthy diet

With a failing heart and arteries showing signs of plugging up, I've been put on a Mediterranean diet. The hope is that a low cholesterol diet will help keep my blood cholesterol in check. But my doctors are not taking any chances; I'm also taking 10 mg of Ezetrol, a cholesterol absorption inhibitor.

I take Ezetrol in addition to 40 mg of Lipitor daily as the Ezetrol takes a different approach to cholesterol lowering than statins, which lower cholesterol by cutting cholesterol production in the liver.

By happy happenstance, my wife decided to start attending Weight Watchers at the very same time I was being placed on a low fat, low meat, diet. My diet and my wife's diet fit together like two pieces of good-health-diet puzzle. My wife has lost more than forty pounds and I have dropped about twenty-five pounds in the last few months. My doctors will be pleased when I next see them for a consultation.

Tonight we had spanakopita for dinner with a cucumber and tomato salad topped with slices of bocconcini cheese. On the side we had some broccoli florets lightly "buttered" with Becal margarine. My wife made a Weight Watchers' version of spanakopita -- a savoury mix of spinach and feta and low-fat ricotta cheeses wrapped with layers of flaky phyllo pastry. Each serving of the spanakopita was just four points. I enjoyed two pieces as I have a daily goal of 37 points.

I'd post the recipe but my wife adhered fairly closely to the Weight Watchers recipe. If you want the recipe, you'll have to join Weight Watchers. She did stray a little, she added a few roasted pine nuts to the spanakopita and a few slices of bocconcini cheese to the salad. I should note that this recipe did not call for eggs, not even yolkless egg substitutes, and parmesan cheese was also missing.

I admit, cheese is a bit of a no-no to those of us on low cholesterol diets. That said, I figure my daily intake of cholesterol today was well under 100 mg -- my personal cholesterol ceiling. My intake of saturated fat and total fat was also held in check. At the same time, I had lots of fibre while keeping my salt intake low.

Now to head out for a gentle walk about the neighbourhood. Light exercise is the final important ingredient in my heart healthy regimen.

ReThinking Heritage Districts

The City Hotel as it appeared in about 1895.
Considering how much of  historic London, Ontario, has been torn down and relegated to the history books, The London Plan devotes a lot of space to historic London

I've only lived here since the mid 1970s and yet I've watched a lot of historic London disappear. And I've been amazed at what passes for saving our architectural heritage. Think of the City Hotel, the Capitol Theatre and the Bowles Lunch building.

Today the City Hotel, later the Talbot Inn, is a facade with opaqued windows.

The City Hotel goes back to 1865. In 1886 it was extensively remodeled and enlarged. When I moved to London the name had been changed to the Talbot Inn. If memory serves me right, one could get a good Mexican dinner there along with a cold draft. At night one could catch some of the best blues musicians on the bar circuit playing next door. The inn barely escaped demolition when the other buildings making up the Talbot Block fell to the wrecker's ball. The streetscape disappeared to make way for a new downtown mall and hotel complex. (In the end, the mall/hotel complex failed to materialize despite the hasty demolition.)

The Talbot Block was a wonderfully intact row of historic buildings. It was possibly the most historically important block in the city. At one point, more than a thousand Londoners held hands to circle the block and loudly protest the proposed destruction. It was all to no avail. Everything was taken down. Only a poor imitation of the old hotel's facade remains as the exterior wall of the north-east corner of Budweiser Gardens, a sports and entertainment centre.

The London Plan proposes to protect our built heritage and revitalize London's downtown. The distinctive historical elements on our oldest buildings will be conserved according to The Plan. I say it is a little late to take the save-our-built-history approach. If there was ever a topic in need of rethinking, it's what to do with London's core and the remaining historic buildings.

Large chunks of the downtown have been demolished and rebuilt.

I propose a three pronged approach to creating an historic looking downtown core.

  1. Restore remaining historic buildings.
  2. Rebuild some of the easily duplicated missing historic brick structures.
  3. ReThink the core by finding historic buildings facing demolition in other communities, buying the facades, or at least the most important and difficult to duplicate elements, and bringing them to London for reuse.

I know the last two suggestions sound absurd but they really aren't. In fact, both have being done successfully in many places around the world. Think Williamsburg in the States or Old Quebec in Canada.

 Ada Louise Huxtable points out in her book The Unreal America: Architecture and Illusion that "approximately 730 buildings were removed at Williamsburg; 81 were renovated and 413 were rebuilt . . . The next step replaces the "wrong" buildings with the "right" buildings, moved, in turn, from somewhere else." Huxtable calls the result a stage set.

Old Quebec City, despite its fame, has a lot of faux heritage buildings. According to the Encyclopedia of French Cultural Heritage in North America, GĂ©rard Morisset, the art historian behind the reclaiming of the old city's past, believed "restoring a building does not mean maintaining it, repairing it, or rebuilding it; it means restoring it to a state of completeness that may never have existed." I personally saw some of the last Old Quebec heritage buildings under construction in the mid 1970s. The reclamation had been going on for about twenty years at that point.

The Capitol Theatre facade above left. The faux Bowles Building on its right.

London already has one handsome, faux heritage building: The Bowles Building. Originally one of the Bowles Lunch chain of diners, the building had a rich architectural heritage. It's clean, white terra cotta facade sported two large, ornate capital Bs on both sides of the second floor window. The terra cotta is gone, replaced by stone. The fancy Bs, difficult to replicate in stone, are also missing.

Deconstruction and skimming could repair London's core.
Detroit has a lot of once fine structures that are suitable for architectural salvage, both deconstruction and skimming. Deconstruction is the disassembly of buildings to their foundation to preserve up to 85% of the materials. Skimming, a less intensive method, salvages the easy-to-remove materials. The Architectural Salvage Warehouse in Detroit specializes in both deconstruction and skimming.

Cities are for people. At one time London's core was for people. The sidewalks were crowded day and night. If our city planners want to create a downtown heritage district, they are going to have to get busy creating. Otherwise, many of the remaining heritage buildings will disappear and the feeling The London Plan envisions will never materialize.

Heritage streetscapes are popular around the world.

Since writing this, the downtown core has lost another bit of heritage. Kingsmill's department store is closing and being bought and converted to use by Fanshawe College. One more reason to visit the downtown will have vanished. (My wife and I bought a lot at Kingsmill's.)