Anticlimactic End of Days

The past week has been pretty surreal for people on the East Coast.  Last week, we had a moderate size earthquake that was felt up and down the entire eastern seaboard.  I was at work when the earthquake struck, actually in the middle of a teleconference with some people from our Pennsylvania site.  There were a series of small rumbles and the room started to shake slightly, but it was weak enough that I thought it could have just been some construction.  However, when the person on the telecon mentioned that her room was also shaking, we immediately thought it was an earthquake.

In typical fashion, my company over-reacted and we had to evacuate for a couple of hours to make sure things were safe.  Luckily, there really wasn't too much damage up here in northern New Jersey.  Even more luckily, it was a nice, warm summer day and it was nice to sit outside.  Interestingly enough, I've lived for seven years in California---in all seven years, I had only experienced one earthquake and it was weaker than this one on the East Coast.

Only several days later, everyone panicked again when it looked like Hurricane Irene was settling in on a collision course with New York City.  The news media had a field day with it---there was 24-hour coverage on every station and predictions of catastrophe.  Really, what could be better than having a disaster hit the biggest media market in the country?  Particularly a slow moving storm that crawled it's way up the East Coast?

The hurricane bullseye

Due to the coverage, everyone went crazy.  We stopped by the grocery store on Friday and it was a mad house.  Shelves were literally cleared bare.  People were carting out gallons of bottled water.  There was no milk or bread to be had---that always confused me.  If you're worried about being trapped at home, why would you stock up on perishable food like bread or even worse milk?  It doesn't make sense.  People were filling up their bathtubs with water.  We hunkered down at home Saturday and waited for the storm.

And it turned out that we survived with barely a scratch.  By the time Hurricane Irene got up here, it had turned into Tropical Storm Irene and its wind speed had died down.  We got hit with essentially a day long rain storm---not even any thunder or lightning.  We didn't have any flooding and the power might have flickered for a little bit, but otherwise we were unscathed.  We did lose our cable tv and internet, but that's probably not something worth complaining about.  (Remember that Morton's Fork?  I guess that decision became pretty easy...)

To be fair, we were pretty lucky.  There were certainly places that got hit a lot harder than us and there are still some places without power.  And there were a few downed trees around the neighborhood which made getting to work like navigating an obstacle course.  Check out some of the hurricane photos.  And most of the warnings were concerned around overland flooding, which has been an issue.  Still, it does feel pretty anticlimactic after all the dreaded warnings of another Katrina (one tv station was even prediction running out of body bags...)

So, an earthquake and a hurricane...and there were a couple of tornadoes this spring and some crippling blizzards this winter.  What's next?  The end of days?  2012?

At least I can cross off celebrating a birthday in the middle of a hurricane from the list...

In Memoriam

This weekend (yesterday actually) was the one year anniversary of the day our first cat, Marquis, passed away after his battle with chronic renal failure.  He had been diagnosed over a year earlier and his death hit us pretty hard since we had been dedicated to his treatment for a year and he had seemed to be doing well until his health just crashed at the very end.  It was one of the motivations to start this site in the first place.

Last image of our Snowshoe cat Marquis

I had been meaning to write more about our battle with feline chronic renal failure, but it was a subject that I've been avoiding for awhile.  Certain breeds of cats such as Siamese and Snowhoes, of which Marquis was, tend to suffer more from chronic renal failure or CRF.  CRF, as opposed to acute renal failure, is a gradual weakening and deterioration of the kidneys.  Acute renal failure might be due to the cat eating something toxic, but can usually be treated with full recovery.  However, chronic renal failure is more insidious.  Kidneys are strong organs, but unfortunately this has the side effect of not being able to detect the progress of CRF until more than 70% of the kidney function has been irreparably lost.

The kidney has several important functions:

1)  Filters out waste material from the blood (these tend to be nitrogen-containing molecules from the breakdown of proteins from food)
2)  Regulates electrolyte concentration (sodium and potassium ions, which have an effect on ion channels)
3)  Produces EPO (erythropoietin), a hormone involved in producing red blood cells

Once the kidneys become compromised, the body slowly gets weakened, which accelerates the deterioration of the kidney function.  The blood starts to accumulate waste since the kidneys are not as effective at filtering them out.  This can be tracked through blood tests for creatinine and BUN (blood urea nitrogen) levels, which are markers for this waste.  Elevated levels are a key marker of renal failure and are one of the first indicators of CRF.

So how can we treat this?  The standard method is to approach the problem from two directions.  The first is to switch to a low protein "renal" diet.  This is food that has low amounts of protein (which contain phosphorus and nitrogen) so that when the body metabolizes it, there are less nitrogen-containing waste products poisoning the blood.  There are several veterinary diets that you can use, but you can also look up the phosphorus levels of common cat food.

Dry Cat Food Phosphorus Analysis
Wet Cat Food Phosphorus Analysis

The other approach is to dilute the waste products in the blood stream.  This is done by giving the cat water---most CRF cats tend to be more thirsty than normal due to this.  As a result, the cat urinates more frequently which also helps to remove the poisons.  Wet cat food is highly recommended over dry food to the water content.  But to take it one step farther, one standard of care is to give the cat subcutaneous saline injections directly---the saline is then absorbed into the bloodstream.  This is not a pleasant act, but Marquis was actually very good about it---in the morning we would sit him on the couch, pinch up the skin of this neck, and then slowly inject the saline.  He would sit there and wouldn't complain and we would give him a treat afterwards.  He became used to it after a while.

Subcutaneous saline injection therapy for CRF cats

There are other more involved treatments that you can do, such as potassium supplements (to make sure that the cat's electrolytes are balanced), iron supplements (to battle anemia due to low red blood cell count), and EPO injections (highly expensive).  We ended following the diet and saline injection approaches.  We found a low phosphorus wet food and we gave him daily injections of ~50 mL of saline.  This worked well for Marquis---he lasted for over year and basically showed no symptoms of his illness until his kidneys finally started to fail.  At that point, he became too sick to eat regularly and he quickly lost his weight and strength.  At the end, he had lost more than half of his weight and wasn't able to walk or stand.  It was heartbreaking.

CRF is a devastating disease and it is a terminal disease.  However, there are steps that you can take to treat it and give your cat good quality of life.  Some good sites that helped us with it:

Tanya's Comprehensive Guide to Feline Chronic Renal Failure
Feline CRF Information Center
Sub-Q Survey of CRF Cats

And the best community for owners of CRF cats is at The Feline CRF Support Group at Yahoo Groups.  This is an amazingly supportive community of people who have been through CRF.  They gave us very kind messages of support and understanding and helped us get through the situation.  Thank you!

The Cost of Fatigue

It's been a while since I last updated, mostly since I've been putting in a few extra hours at work and have been too tired when I come home.  I've never been a morning person, but now I've been getting up around 6 am to get to work.  And sadly, going to work early never means getting out of work early---I usually end up staying until well after 5 pm.  By the time I get home, I'm exhausted.  Partly it's because there's so much work to do (our group is very lean and stretched out), but I wonder if partly it's because I'm not as efficient as I can be.  As with most of this generation, I can feel my attention span dropping and have trouble focusing.  It would be easy to blame all of the distractions of modern life, but part of it is I think due to simple fatigue.  I'm just not getting enough sleep.

And it's not just me.  According to a study in Journal of Occupational and Environmental Medicine, 38% of surveyed workers reported "low levels of energy, poor sleep, or a feeling of fatigue" during the past two weeks.  It's estimated that fatigue costs an average of 5.6 hours a week in lost productivity.  Interestingly enough, this is one disadvantage is demographically opposite of the standard---fatigue hits white workers harder than black workers.

The National Academies estimate that fatigue costs businesses around $150 billion annually, with another $48 billion lost in vehicle accidents.  I suspect those numbers are actually a little conservative since fatigue is such an undefinable factor.  How do you quantify fatigue?  How do you measure lower efficiency and performance?  It's like a vicious cycle---you're tired at work, so you don't get as much done and you feel more stressed, which makes it harder to get a good night's sleep, rinse and repeat.  On top of that, each night adds to your overall sleep debt so that by the weekend you can hardly move.  And sadly, my body is so trained at waking up early on the weekdays that I have a hard time sleeping in on the weekends.

I think that I'm doing pretty well at work, but I've always wondered how much more productive I could be if I could only get an extra couple of hours of sleep.  Instead of starting the day before 8 am, what if I didn't show up until 10 am?  I'd lose a couple of hours, but I'd feel a lot more refreshed and recharged at the start of the day (which is why I think this is better than having a nap time in the afternoon).  I bet I could recoup those two hours with more energy and efficiency and get even more things done.  Which is better, having a good solid 30 hour work week or a tired, cloudy 40 hour work week?  I guess this is related to that innovative idea that quality of life can improve quality of work...I think the answer is pretty clear, but that's why I'm not in management...