Monday, December 8, 2008

Saturday, December 6, 2008

gay blood donors exist

Gay blood ban
It's my belief that the ban on gay blood donations should be overturned.
The ban is patently discriminatory, based on stereotypes, but justified under the mantle of medical science. It's just one example of how rank prejudice is remade as scientific, sanitized, made to appear ethical.
Technically, the ban is on a man who has "had sex with another man, even once, since 1978". There is no ban on women who have had sex with a man, although there are specific categories of male sexual partners that trigger excluding a potential donor from giving, if she has had sex with them in the last 12 months.

Does the ban "work"?
Does the ban in fact keep gay men from giving blood? The simple answer: no.
The more complicated answer: in the General Social Survey, respondents were asked (in 2002 and 2004) whether they had donated blood in the past year, and also several questions about the sex of their sexual partners. Here are the results, using three different definitions of sexual partners...

Among 36 men who reported at least one male sexual partner in the last year, 6 (17%) said they gave blood in the last year. This is somewhat lower than the 22% of 826 men with exclusively female partner(s) who said they gave blood.

Among 43 men who reported at least one male sexual partner in the last five years, 6 (14%) said they gave blood in the last year, while 21% of 884 men who had sex only with female partner(s) said they gave blood.

Among 58 men who reported sex with at least one male sexual partner since their 18th birthday, 4 (7%) reported giving blood in the last year, while 21% of the 942 men who reported no male sexual partners since turning 18 reported giving blood.

There are good reasons for being a bit skeptical about these data, but more on that later...

Adverse consequences
If the ban on gay blood donors doesn't "work", then is it worth maintaining? What are the consequences of maintaining a patently discriminatory policy?

1) An unjust ban on gay blood donors encourages lying. Anyone (straight or gay) who sees the exclusion of gay men as discriminatory will begin to question the validity of the other screening questions, perhaps taking liberties with answering screening questions that have a valid basis for protecting the blood supply.

2) It justifies discrimination in other areas. The fact that most people believe the screening questions on the blood donation form have some scientific or medical basis makes it appear as though this form of discrimination is beyond questioning. Justification of discrimination in one setting encourages people to justify for discrimination in other areas (even on a different basis).

3) The ban makes it unclear how a gay man should approach donating blood. By having an outlandishly discriminatory donor exclusion policy, blood banks are in effect encouraging each gay blood donor to make up, in his own opinion, when it is safe enough for him to give blood. Whereas a policy in line with the other donor exclusion policies would set a more realistic set of limits that gay blood donors would be more likely to honor.
A consequence of this is that the ban on gay blood donors may in fact make the blood supply less safe.

4) The ban reduces the potential pool of donors, in more ways than is immediately apparent.
4a) It is well documented that gay men are more likely to give altruistically in a variety of ways, thus the ban cuts out a segment of the population that would otherwise be eager to give. Although gay men represent a small proportion of all potential donors, and even though many gay men would be excluded for medically justified reasons (such as having unprotected anal sex in the last six months), the exclusion of a motivated group of potential donors may not be a great idea.
4b) The blatantly discriminatory nature of the ban on gay blood donors has already started to lead to a wider backlash. Some straight men, and women of all sexual orientations, get a bitter taste in their mouth from the obvious discrimination of banning men who've had sex with even one man, even once, since 1978. This bitter taste shrinks the pool of potential donors, probably in much larger numbers than the gay men excluded from giving currently.
4c) College campuses, settings where many people initiate a lifetime habit of giving blood, are also settings where action is likely to be taken against discriminatory policies, and in fact blood drives have been canceled on several college campuses already, with the promise for such action to expand in the future. Can the blood supply afford to lose all these potential future donors?

who are the gay blood donors?
I don't know. I'd love to talk to a few to get a better sense of what motivates a gay man to give blood. How does giving blood relate to a man's sense of well-being? How does being refused the opportunity to do so without lying relate to a man's health? Are gay blood donors much more scrupulous about the other screening questions to compensate for lying on one question? Or are they more likely to overlook the other questions?

data limitations
the number of men who report male sexual partners is already pretty small in the GSS (36-58, depending on which question), and the number of these men who report giving blood is even smaller, 4-6. So, it is possible (if unlikely) that these are all data errors. That is, it is at least theoretically possible that 6 respondents weren't paying close attention when asked either about giving blood, their sexual history, or both questions, and gave answers at variance with their actual experience. Or, the telephone interviewer may have slipped when entering the number corresponding to the person's answer.
In addition, there are good reasons to think that the proportion of people saying that they gave blood is considerably higher than the number who actually did give blood. For one thing, a small handful said that they gave blood monthly, even weekly. Blood centers generally ask donors to wait at least two months between donations, so these answers are highly suspect. The other thing is that over 20% of the GSS respondents reported donating blood, but probably no more than 10% of the population actually does donate blood.
However, my point was merely to document that gay blood donors exist, not to give a precise estimate of how many gay men are blood donors. Better data would be needed to make that estimate.

Wednesday, December 3, 2008

more healthy gay men

I just looked at the data in the MIDUS-2 study, and the sample is just too small to say, but it looks like gay men and straight men are just about equally likely to be in 'excellent' health. As in CHIS, bisexual men may be somewhat less likely to report excellent health.
On to the next dataset...

Monday, December 1, 2008

gay men in excellent health

Just had an idea for a research project.

I was chatting with Rachel about why my research seems so alone in the world - nobody in the Public Health world seems to have picked up on the utility of looking at empirically measured changes in societal heteronormativity as having the potential to affect health impacts - and I don't know why. Gay & lesbian people 'get it' instantly. Public health types seem to get confused by not knowing precisely which biochemical pathway a change in law would need to activate.

Anyway, I was working last week on data from the CHIS, and noticed that gay men (in the aggregate) are more likely to report being in 'excellent' health than straight men. My public health training told me to ignore it - 'excellent' health is not a disease, after all. It's a squishy endpoint, who knows what it means?

But something sparked in me during the conversation with Rachel.
Why are gay men more likely to be healthy than str8 men? Maybe it's not a strange question. Maybe it's an endpoint that's worth a little more investigation.

I know that nobody in the epidemiology world will believe it if it's a single finding. As large as CHIS is, it is only one dataset. So now I need to go poking around in other datasets which ask similar questions - and fortunately there's a lot of them.

I'll keep you posted...

Thursday, November 27, 2008

BoneHenge!


This is a shout-out for my aunt and uncle who are involved in a project to recover the bones of a sperm whale that washed up near Cape Lookout, North Carolina.
They are having a shed built on their land in Carteret County to house the bones until they can be re-articulated and put up for display in the nearby maritime museum.

Thursday, November 20, 2008

HPV vaccines for all!

Saw this bit on Jim Pickett's LifeLube about a study showing that one of the HPV vaccines is efficacious in preventing genital warts in boys.
Hopefully, approval will be coming soon, and our backwards policy of vaccinating only girls will be expanded to include boys as well.

Why is vaccinating only girls a backwards policy? Because girls usually get HPV from boys (and men), not other girls. Think of boys like mosquitos. Seriously. If you do nothing to keep the mosquitos from getting infected, they're going to keep poking their noses in, and passing the infection along to anyone who's not protected.
If you reduce the infection rate in the mosquitos too, then the probability you'll get infected drops dramatically, even if the vaccine didn't quite work for you.

So the whole vaccination policy in the US (for girls and boys) is exclusively oriented towards self-interest, which isn't at all efficient or cost-effective.

Implications for the coming HIV vaccine
Imagine, if you will, an HIV vaccine comes along. If our vaccination policy then is oriented exclusively to self-interest (and I'm pretty sure it will be), then vaccines will be 'targeted' towards 'high risk' groups. This targeting will result in extremely inefficient vaccination rates (as we have already seen from the experience with the HBV vaccine).

First, most people not at 'high risk' won't be protected.

Second, a large proportion of 'high risk' people won't get the vaccine because nobody likes to think of themselves as 'high risk'. And it's easy to justify why I'm not nearly as high risk as other people I know. Also, insurance companies will set up a screen for who is high risk enough to get the vaccine paid for, which worked against the interests of getting HBV vaccine out there.

Third, targeting HIV vaccine to 'high risk' people will further the stigmatization of these groups, even if they do get the vaccine. "Why did you need it?" is a question that not only insurers will ask, but also others in a person's life, and most distressingly, each individual themselves. Each shot will be literally a stigmata of risk identity.

So, is there any way we can turn vaccination policy around in this country, returning to the more successful strategies of universal vaccination that we saw with smallpox and polio?

Wednesday, November 19, 2008

graphics showing PM2.5 levels on my commute

So, I've been carrying this dust monitor on my commute.

You can blow up the pictures to the right to see what the exposure levels were at various waypoints.

The EPA limit is 0.035 milligrams per cubic meter (35 micrograms per cubic meter), but the fact that many of these measurements are above that doesn't necessarily mean that they are hazardous. Transient exposures to high levels of dust make one sneeze and not much more than that. EPA only gets excited when someone's daylong exposure is above that level.

It's pretty early to draw any conclusions, but it seems pretty clear that dust levels are higher on the station platforms, particularly the underground ones, than they are on the trains themselves.

Monday, November 17, 2008

Jim Jones - Scary stuff

The Sunday edition of the SF Chronicle had a front page story about the Jim Jones massacre and Harvey Milk's slaying, which happened within 10 days of each other 30 years ago.
Turns out, I just moved into the neighborhood where a lot of Jim Jones' followers came from, and another odd coincidence: one of my roommates played a bit part in a made-for-TV movie about Jim Jones. Guess I should read up on that some more. So grisly, though. I'll probably get nightmares.

Particulate matter on my commute

I got to borrow a portable air monitor from work today - it measures PM2.5, or tiny little bits of dust.
So, I figured I'd see how much particulate matter I get exposed to on my commute.

The EPA has set the air quality standard for an average day's exposure at 35 micrograms per cubic meter.

In my office, the levels were about 55, which is pretty high. The other day, they were about 5-8, and I don't know why today was particularly bad.

At the Berkeley BART station, the levels were up at 65, and spiked to 78 or so when the trains came rolling into the station.

The highest levels on my commute, 85-90, were in the Civic Center BART station, and interestingly enough the lowest levels, 25, were right outside the station at UN Plaza.

The level was about 30 in my house, and jumped up to 40 when Tuna came up to say "Hi".

Its a lot more interesting when you're biking along and watching the numbers....

Saturday, November 8, 2008

No on 8, strategy & the origins of modern biostatistics

Last night when I got home, I was delighted to see a bunch of young queers blocking Market Street at Ninth street, right outside my building.
I grabbed Tuna and went out to join the fray.
It became clear that this was a side-show to the main event, and so we walked towards Dolores Park, but by the time we got there, things were winding down quickly, so I headed up Church Street, and by chance caught the tail end of a re-march headed down to City Hall.
It put a spring in my step.

I want to start out making it clear that I'm thrilled to see street activism directed against the homophobia inherent to the Proposition 8 campaign, but I wanted to comment on some tactics that I felt might be counter-productive.

counter-productive?
I saw a bunch of signs making explicit ties to the Black civil rights movement (such as "I have a dream, too!") that made me a bit uncomfortable. For one thing, these signs were always wielded by White marchers, which should be a tip-off right there that the elision of the Black civil rights movement and the current struggle over marriage equality is not without complications.
I understand the parallels that these marchers were trying to make, but in making these parallels, they are inviting other comparisons that are not necessarily apt.
I've often heard people make arguments paralleling the bans on similar gender marriage with bans on inter-racial marriages that existed formally in this country (and still persist informally), and while I do get the similarities, I think that there is an important consideration that is often not recognized by the (usually White) commentators making these comparisons.

The main issue in the current debate on recognizing similar gender marriages seems to be about recognition first and foremost, equality in the recognition, legally and socially, of similar gender unions.
And that in itself, it seems to me, is sufficient cause to be entirely in support of legal recognition of similar gender marriages.

But, when we start making comparisons to legal bans on inter-racial marriages, there is another key element that is often overlooked: that anti-miscegenation laws were not so much intended to block recognition of inter-racial unions, but had an explicitly eugenic basis, not necessarily geared towards the elimination of racial minority populations (although that was presumably also a desired end), but primarily to prevent the "dilution" of the White race. That's why they were called "anti-miscegenation" laws.
So I think there's a strong potential for being counter-productive when making parallels that (unintentionally) primarily invoke a eugenic element that is largely missing from the current debate on recognition of similar gender marriage.

Origins of Modern Biostatistics
At the risk of making an incongruous jump, the whole topic of anti-miscegenation brings me to one of my favorite subjects, the origins of modern biostatistics.

Ever wonder where the term linear regression came from?

If you go back to the papers describing its original development, the technique was originally used to describe the physical characteristics of the offspring of Englishmen and racial degenerates (their term, not mine), such as Chinese women. The term linear reflects the fact that various physiognomic characteristics of these "racially degenerate" children were, on average, linearly half-way between similar measurements made on their parents. The term regression refers to the fact that these charateristics were racially "regressed" from "English" in the direction of the "racially degenerate" form of the child's mother.
Scary stuff, eh?
I don't mean to say that linear regression and various other methods of modern biostatistics that have been developed should be thrown out as morally indefensible, but I think it is helpful to carry forward the history of where they originated.
Myself, I try to use the term "linear modeling" rather than "linear regression", but I think that's still only papering over the truth.

Sythensis
I don't really see a way of tying these two topics together in some nice pithy conclusion, except to say that history is important, even when one isn't aware of it.

Thursday, November 6, 2008

Premature blame on 8

Wednesday morning, I awoke fresh and ready to tackle the day. "The occupation is over!" I regaled anyone who would listen. Barack Obama's victory left me feeling like I was once again in America, a country that had been stolen out from under our feet.

I could hardly wait to get on the internet and find out how much Proposition 8 had been defeated by, and was surprised to find that the race hadn't been yet called. My concerns grew as I got deeper into the numbers, looking for hope amongst the county-level returns. Often the larger cities are slower in getting their voting returns together, so it seemed reasonable to hope that the margin would shift once the more densely populated precincts finished reporting.

But, after an hour of sifting through the partial returns, it became clear that the only likely outcome was that Proposition 8 would pass.

My day was ruined!

I was honestly shocked. In 2000, a similar measure passed in California handily, but by 2006, an anti-gay amendment was shot down in Arizona, and passed in South Dakota by only the slimmest of margins. I assumed that history was on our side, and that despite the polling data in California, we had passed a tipping point. I figured that any talk about similar gender marriage rights, even the most rabid ravings about it, would by now have made most voters immune to the shock of the idea.

In the wake of Proposition 8's passage, there has been a rush to "explain" why it happened. The most common explanation I've heard, from gays and straights, friends and radio pundits, is that the high turnout for Barack Obama energized racial/ethnic minority voters, who as church-going folk, tipped the balance in favor of 8.

This explanation just rubs me the wrong way, and I don't buy it. The conventional wisdom is that Black, Asian & Hispanic voters are against gay marriage, but I'm not convinced. My recollection from going over data for my thesis showed that rural people are by far the least likely to support gay marriage, and rural people are overwhelmingly White.
My recollection is that in several public opinion polls, racial minority groups were less likely to oppose similar gender marriage than Whites, but I'll need to dig those up if I want to bolster that point.

I spent much of the day today poring over results from Los Angeles, which is the only large county in California to break down results by congressional districts. After excluding the 30th congressional district (which contains West Hollywood, a bit of an outlier), the racial/ethnic makeup only explains about 0.4% to 3% of the variation between how people voted across the districts, depending on how you crank the numbers.

So, I remain unconvinced of the "explanation" that somehow racial/ethnic minority voters did the gays in.

So who does it serve to pitch these constituencies against one another? And why were so many people ready, with the barest shred of evidence, to believe it? This rush to blame seems entirely counter-productive. Who are the ones vehemently behind the anti-gay agenda? Get clear on who our real opponents are: White fundamentalist Christians.

Another potential explanation is about voter turnout. Here again, the conventional wisdom is likely to be misguided. Usually people assume that the anti-gay agenda has been used to whip up enthusiasm among the religious right, and that their increased turnout is what contributed to the passage of so many anti-gay measures.
While I suspect that whipping up anti-gay frenzy probably does raise money and enthusiasm for the Christian right in this country, if you take a good hard look at the numbers, it does not seem to increase voter turnout. In several of the past elections, high turnout has correlated fairly well with not supporting the anti-gay agenda of the Christian right.

In the recent California election, another suspect was the low voter turnout in San Francisco, so I took a look at how voter turnout correlated with support for Prop8, and again there's just not a lot going on there.

I suspect that the story is a lot more complicated, and I'm looking forward to delving in to try to figure it out.

Wednesday, October 22, 2008

Dear Governor King

There is an obvious starting point for my activist lifestyle.
Starting in 1973, a battle between Massachusetts Governor Edward King and sensible people was waged over whether a 5 cent surcharge on beverages sold in bottles and cans should be enacted, redeemable when those bottles and cans were returned for recycling. The legislature passed the bottle bill three times before finally over-riding the Governor's veto in 1981.
I remember the fierce arguments over the issue now some thirty years later.
After one of Governor King's successful vetoes in the late 1970's, I wrote the Governor with an impassioned argument comparing the relative beauty of Vermont's highway shoulders to those of Massachusetts.
Apparently, my argument did not win him over, a crushing blow to a tween who thinks he knows all the answers.
In fact, his letter in response indicated that he hadn't even heard my argument at all. His reply thanked me for supporting his veto of the bottle bill. I was upset, thinking that my letter was somewhere in his office, sitting in the wrong stack on the scales of justice.

At the beginning of this post, I said that there was an obvious starting point for my activist lifestyle. But honestly I'm not sure. Why did I choose to act at that moment in my life, in history, on that issue? What, in the subsequent years, kept that activist streak alive?
Or maybe, my activist life didn't start then at all, and writing Governor King was just a one-off thing that any kid might have done, foretelling nothing.

If you had asked 18 year old Bill, several years later, if he was an activist, he would have said "certainly not!" In my college essay, I went to great lengths to make it clear I was interested in the pursuit of knowledge, of truth, and that I had no interest in politics at all.

People had tried to explain the differences between Democrat and Republican to me, but since everyone seemed to describe a different set of differences, nothing stuck in my head. It was all too nebulous for me to make sense of.
I thought science was inherently good, math even better, and that the only troubles arose when politics was used to interpret science.
Boy did I have that backwards!

My Life as an Activist

Well, this blog started out because I wanted to document my cross-country move, so that friends could follow along with me as I journeyed from Providence to Ann Arbor to White Sulfur Springs to San Francisco, and many points in between.
In the year that I've lived in San Francisco, what the purpose of the blog is has been less clear to me, but I did use it to help develop some thoughts on ITBLG health issues, such as thinking about national vaccine strategy as it relates to HBV/HPV/HIV, and the remifications, personal and political, of routinizing HIV testing...
I'm going to move it to a new phase now, documenting my own life as an activist, and reflecting on it from my current vantage point.
Below I've listed some of the groups, activities, etc. I've been involved with over the years.
Any feedback on what you'd like to hear more about? Let me know...

The early years

  • letter to Governor King about the Massachusetts Bottle Bill
  • letter to the editor about seatbelts in school buses

The high school years

  • Don't shut down the press
  • Energy conservation
The college years
  • 1987 March on Washington
  • Not Guilty
  • Brown's anti-discrimination policy
  • Yale Queer Studies Conference
  • Report for RI Department of Health on Needle Exchange efficacy

The ActUp years

  • Bill's News Headlines
  • Health Department mandatory testing demo - my first (and only) arrest
  • AZT demo at CVS
  • Network/RI
  • Ed Diprete's campaign for governor
  • Jesse Helms = Philip Morris = Bill of Rights = trouble
  • Pat Buchanan visits TF Green Airport
  • Dan Quayle visits the Biltmore
  • Providence Journal editorial policy
  • so many more...

The transition years

  • Needle exchange
  • CPG planning process
  • RI gay rights law
  • Hate crimes & anti-violence
  • Warwick sex sting
  • River Road public cruising sting

The thesis

  • Measuring heteronormative context

ITBLG Health Movement

  • The summits & academies
  • HBV vaccines at the baths
  • Men's health action committee

Reputation

I just got back from the Seattle Gay Men's Health Summit, and I've got a lot on my mind. I think this is a turning point for me.
I've reached a level of prominence in the gay men's health movement that has taken me utterly by surprise. A bunch of people who don't know me personally have heard or read something about me. I have, if you will, a reputation.
Up to this point, my participation in the movement has been based on a series of individual relationships, so this is new and strange territory for me. The fact that there are people who know something about me before meeting me is both thrilling and disconcerting. Thrilling because I don't need to go through as much background with each new person, and disconcerting because I really have no idea whether what they've heard and the impression they have of it is, so I feel a bit exposed.
I think that generally the reputation I've developed is a good one, but of course a reputation is not a singular thing. I guess I never really thought much about having a reputation before. In a naive sense, I thought of it as a cloud around a person, but more or less an entity with shared meaning. But this weekend has made starkly clear to me that a reputation is not a thing, despite the use of the singular, that is we speak of a person's reputation, not a person's reputations.
It is, rather, a series of individual relationships, each its own thing between me and each individual I have yet to meet, mediated through mutual friends, a chain of friends, or my writing.
It's not that I've never had a reputation, or been concerned with what my reputation 'is'. It's just that I didn't come prepared to think about having a reputation within the gay men's health movement. As a college professor, albeit a recent one, I'm very interested in what my students think of me. Of course I want all of them to love me, but I also walk into class on the first day expecting that some won't. We are after all strangers with no expectation of shared ideals or values, and I'm asking them to work hard, and my evaluation of their work may well not match their aspirations or expectations.
One day, when I was googling myself (I guess maybe I'm more concerned with my reputation than I was conciously aware of), I saw that there was a page at RateMyProfessor.com about me. Everyone had warned me not to bother looking at RMP, but I was too curious, and had to check it out. I braced myself for some bad reviews, but was pleasantly surprised to find one relatively positive review. Later (after the grades went out), there were more... and braced as one might be, being called "the worst professor ever" carries a bit of a sting.
So, I'm not new to having a reputation, and not new to the idea of it being highly variable from one person to another. And not new to learning what I can from criticism, but not dwelling on the emotional weight of it. But walking into a classroom, you know you're a public persona, not a private person.
But at the health summits, I had gotten used to being a fairly private person. At the first summits, I went to some sessions, flirted on the sidelines, and nobody 'important' payed attention to me, and I was fine with that. If somebody came up to me and said "aren't you the guy who..." it would have been about my runner-up performance in the pool party kissing contest. I have to say, I'm still proud of the stagecraft K_____ and I employed for that.
Even at the Philly LGBTI summit, where I was on the opening plenary panel, helped design that panel, and helped develop the program, thereby having at least an email relationship with all the presenters. I had a couple of sessions myself, "Queer Blood" was one of them... the other is escaping my little brain at the moment, but I'm sure it had something to do with risk narratives in public health. More people knew me, or knew of me, but I didn't have any sense of people talking about me without also talking with me. It felt like my series of individual relationships was just getting bigger.
So in the wake of this summit, there are things that went on that made me aware of having a reputation, and it's taking me a little time to get used to that.
In the end, I think I like having a reputation. Even if someone hyperbolically believes that I am out to destroy the way they individually practice public health.
Because I am, after all, interested in fundamental change in how public health research is conducted, and how public health interventions are undertaken, by pretty much everyone in the field, especially me.

Friday, August 15, 2008

One Year in SF

Well, here it is, one year since I moved here.
Just finished teaching a summer class on "The Development of Sex and Gender" and I think it went pretty well. I'm up to my eyeballs in grading at the moment, so hopefully I'll have more time to ruminate on the year anniversary soon.
Turning 41 went smoothly. A few friends in Providence had a little celebration for me last time I was back there, which made me miss it terribly (Providence, not 40, that is).
Tuna continues to be an amazing companion, she is far too tolerant of my bouts of fatigue that prevent her from getting the full walks she deserves.
Hopefully, we will be moving in with Paul and his fiancee soon, at Haight & Divisadero. That will be a lot more affordable, and Tuna will have the nearly constant company of Sascha, which will be quite a blessing for the both of them. Given the location, it will be a lot easier to get them out to the park for a romp, as well. The house is conveniently located smack-dab between Alamo Square (our current haunt, about 8-9 blocks from the Fox Plaza tower), Buena Vista Park, and the Panhandle. And Duboce is nearby too. So she'll be sitting pretty.

Weddings.
I had fun taking pictures of the resumption of similar gender weddings in San Francisco. Took the morning off work and wandered around City Hall, took extensive pictures of two couples. I was able to get ahold of these two later, it felt nice to be able to give them a little momento of their moment in the limelight.


Went to a lovely wedding in San Diego, and took the opportunity to walk over the Mexican border and back. It was very smooth in both directions. Definitely a huge transition over such a line in the sand.

Saturday, January 19, 2008

Risk

Last night, I had a lovely dinned with Lisa, talking about my future as a professor. She has good advice. And she's super funny. Before dinner, we went up into the Berkeley hills to watch the sunset.


Tonight, I'm going to a party. Yay! It's funny, here I am, living in the center of one of the hippest metropolises on the planet (here's a shot looking south from my apartment), and I almost never get out.


RISK
Anyway, something exciting is coming up this week. I'm getting together with my friend Chris from Philly to do a little presentation for the SexPol group on "risk" and queer public health on Thursday.
Many luminaries from the field will be there, which is more invigorating than it is intimidating.
The picture to the right is of an ad I saw in O'Hare airport on the way back from Providence, which seemed very apt.
As gay men, we are constantly told to reduce our risks. Actually, as people living in America, we are constantly told to reduce our risks, from smoking, from eating, drinking, and sex.
But in business, it is all about taking risks. "No risk, no reward" is a mantra. That's what this ad is playing on. Risk as thrilling, vital and essential to life itself.
Which makes for an interesting contrast, doesn't it? On the one hand we are supposed to avoid risks and feel bad about them, on the other, we are supposed to seek them out.
No wonder public health is in such a state of confusion. I'm hoping to help find ways out of that mess. More on that later.

Sunday, January 13, 2008

DVT scare

Friday I flew back from Providence, and fell asleep for most of the Chicago->SFO leg of the journey. After walking off the plane, I felt groggy for sure, but there was something more. My right leg didn't seem to want to move the way my brain was telling it to.
It's a hard sensation to describe. It wasn't painful, neither was it like when your leg falls asleep, the best I can say was that every once in a while, there was a twinge, like it just didn't want to move.
Anyway, after I awoke more fully, I realized that my leg wasn't waking up with me. Since my mother had a DVT (blood clot in her leg) last year and spent weeks in the hospital recovering, I was a little worried, so I sat myself down on a bench to take a look at it.
My right calf and foot were blown up like a balloon, presumably filled with fluid. Wish I'd taken a picture, but I had other things on my mind.


So, I called my health insurance company, to see if they would authorize me to go to the emergency room, which they wouldn't do over the phone (so what am I supposed to do, go to their office in Sacramento or wherever?). Being midnight on a Friday night, my doctor's office was closed, and the on-call physician wouldn't call back, so I figured I'd better just go the ER and take my chances with getting re-imbursed for it. I went home first and packed all the medicines I could think of into my bag (I'm not paying $20 for a tylenol!), and a novel to help pass the time. I took two aspirins, figuring that it would be best to get going on blood thinning as soon as possible at any rate.

Well, the folks at the ER were very nice, a bunch of people came by to look at my swollen leg. "Would you look at that?" and so on. And they ordered a blood test to see if there were clotting breakdown products (d-dimers) in my blood. There weren't, apparently (<110 ng/mL, whatever that means), so they just said to go home, which I did. The swelling has slowly come down, but it's still noticeable two days later, but that strange twinging sensation is still there. It might be all in my head at this point, though. It's hard to say.

I don't know what happened, but it wasn't pleasant. So, to all my flying friends, do yourself a favor and:
1) Take an aspirin before/during the flight.
2) Avoid caffeine and alcohol before/during flight, but do drink water.
3) Get up and walk around, and/or flex your calves frequently.
4) Think about wearing one of those compression stockings during the flight.

I thought I just turned 40, not 70!

Home Renovations

Just got back from Providence, where I undertook serious home renovations for a week and a few days.

Started out with demolition...

Hello gorgeous, mind if I come in?

In the process, uncovering a variety of beautiful wallpapers,

and one particularly un-beautiful one.

Peeling back the floors was "interesting"

After the dust settled,

The ceiling joists were revealed,

and the process of re-construction began by building a closet.

Dealing with the old electrical system (reminds me of the Matrix)

Installing a new circuit

Insulating

And putting up wallboard.

Heater before....

and after.

Also made a little time for eating with friends and family.