“Hamilton, Tear Down This Wall!”– Bringing Our Construction Up to Date

Walls have always been big news. From Ronald Reagan’s famous 1987 speech imploring Mikhail Gorbachev to tear down the Berlin Wall to our current political situation, walls create a barrier and an image. So it is no surprise that we have been using a very critical eye in assessing where the interior walls are to be located in our new home. A particular sticking point has been the walls for the stairway to the loft space and upstairs bedrooms. Since the new house is predominantly a ranch style home, the second story has been downplayed in importance, with some concessions being made to accommodate roof trusses. But we want to make sure the stairway has sufficient overhead clearance, is wide enough to allow easy transport of furniture, and doesn’t feel claustrophobic. There are building code issues to consider, and a crown moulding question as well.

So the stairway has undergone several revisions on paper to meet all of our requirements. Each do-over has reconsidered how many steps will protrude onto the foyer, where the mid-stairs platform will be, and where the required hand railing will go. The end result included a new interior wall that was constructed last week. Walking through the house with Jefferson-the-Builder the next day we got our first view of the Wall. I could see Barb’s brain churning. This was not looking right at all. But I could also see that she had the answer. Guillotine the top part of the wall, put the hand rail just so, match this to that, and it could all work perfectly.

barb and jeff — Barb and Jeff-the Builder sweat the details.

Jeff didn’t have any reasons why the revised plan couldn’t work, but we still had to present it to Hamilton-the-Architect. “Tear Down This Wall!” Barb proclaimed. And just like Gorby in Berlin, Ham agreed. He even liked the idea. The wall chop has now been done and it looks great. Once again Barb has put her touch on a problem and found a diamond in the rough. Now we just need to convince Ham and Jeff about our crown moulding preference.

Otherwise the construction is progressing, although at times the pace seems a bit too protracted for our taste. Rough plumbing, electrical, HVAC, and low voltage wiring should be completed within the week, to be rapidly followed by inspection, insulation and wall-boarding. If the wall-boarding doesn’t happen soon, it might be time for some water-boarding to get things moving along! In the meantime we are busy working out the shape and materials for the patio, completing lighting and flooring choices, and pushing hard on Stan the Cabinet Man.

Since we plan to close on sale of our Long Grove house right around Labor Day, we have rented interim housing beginning in September. In another of those karmic events that have been inexorably linked with this process since the beginning, I have found a furnished two bedroom apartment in the same housing complex we lived in 26 years ago while waiting to move into Long Grove. Instant Karma’s Gonna Get You!**

One last thought. If Trump could really get the Mexico to pay for his wall, do you think he could also get it to pay for building our house? If he can accomplish that, I might vote for him after all. (Just kidding, folks!)

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** Music Trivia–What other songs have “Karma” in the title? I can think of three more. Email your answers to les.raff@post.com

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It Is What It Is-OY!

The Passover Seder is a time for the joyous retelling of the escape by the Jewish people from slavery in Egypt about 4000 years ago. Unlike the lucky slaves who built the White House, the ancient slaves were not particularly well-fed, and freedom was a definite step up on the social ladder. The retelling can take hours, buffered by ritually prescribed four glasses of wine, a variety of sweet, bitter, and salty symbolic foods, and a visit from Eliyahu, the Man Who Wasn’t There. For our family the highlight of the evening is always a rollicking rendition of the song “Dayenu.” Each verse speaks of another, greater, service that God provided for the Jews on their exodus from bondage, while each chorus is a repetition of the single Hebrew word “Dayenu,” translated as “It would have been enough.”

Why bring up Passover, a holiday celebrated during the spring harvest, now? Because “Dayenu” came to mind while hearing, for the 40th time this week, my least favorite phrase-du-jour, “it is what it is.” The phrase goes back more than 65 years, but it is just in the last year or so that it seems to have spun out of control, replacing “whatever” as the sign of universal acceptance. I hate it! But I did think it would make a catchy chorus. So in the spirit of “Dayenu,” here we go:

Another stormy day in the 90’s-It is what it is
Because of the storm Southwest just cancelled 125 flights out of Midway-It is what it is
I missed my job interview in New York because of the cancelled flight-It is what it is
I’m out of a job because I missed the interview-It is what it is
I can’t get another job because everything is made overseas-It is what it is
Everything is made overseas because of those stupid trade treaties-It is what it is
We have those stupid trade treaties because Democrats are idiots-It is what it is
Because Democrats are idiots I’m voting for Trump-It is what it is??????????????

Please, Dear Lord, make it all stop. Make The Donald and that stupid phrase go away. Then it truly will have been enough-Dayenu!

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Having Fun Re-Examining Flossing, and Seven Other Health Care Rules

Might be movin’ to Montana soon
Just to raise me up a crop of
Dental Floss

Frank Zappa — 1973

I can now admit it. I am a crappy dental flosser. I have carried the excuse that vigorous flossing either inflames mouth sores I already have, or aggravates my tendency towards getting them. While that is true, my bad habit was more because flossing just seemed like one more thing to add to a nighttime ritual that already was too bogged down with minutiae, when all I really want to do is read a few pages of whatever thriller is at my bedside, kiss Barb goodnight, and fall asleep. And each of the multiple dental hygienists my dentist has employed has complemented me on the appearance of my teeth since I stopped getting cola stains all over them. So why bother with flossing? But I did feel guilty.

Guilty no more! As reported in the New York Times, the Departments of Agriculture and Health and Human Services no longer recommends flossing in its dietary guidelines. It seems there aren’t any good studies demonstrating that flossing really does prevent cavities. It may help against gingivitis, but even that evidence isn’t the strongest. I can now read my latest potboiler with a lighter heart. But just so you don’t think I am becoming a total libertarian, here are some current health rules I believe we should all still follow:

Going swimming less than one hour after eating is still a bad idea, especially if you are swimming in a school of very hungry sharks.
Spraying lighter fluid onto a glowing grill fire is verboten UNLESS you want to start global warming on your face.
Texting, either while driving or while sitting in the front row of a ball game still sucks, unless you enjoy getting the imprint of your steering wheel or a Rawlings Major League Baseball on your forehead (Note–an exemption to this rule can be given when White Sox are batting at the Cell.)
Don’t crack your knuckles in the middle of an emotional love scene at the multiplex. It might not cause arthritis, but it will cause dirty looks to be aimed your way, and possibly a punch in the nose if a particularly sensitive soul is in the seat next to you.
Picking your feet in Poughkeepsie–still not recommended. At least as long as Gene Hackman is alive.
Drink lots of coffee. No wait, don’t drink coffee. Or feel free to drink all you want. Who knows? I’ll stick to tea.
Have your men get a PSA blood test. Have your kids and grandkids get immunized. No Joke.

Stay health, stay happy, and keep on the lookout for our next edition. Housing updates to come–I promise.

It’s Her Party and I’ll Cry If I Want To; Bernie Sanders Can’t Crack a Smile

It was a week when I should have been spending every night packing up the house. We have done a lot but there is so much more to do. It was a week when I could have been watching the City Series, a chance to see the White Sox one last time before they throw in the towel. It was a week when I could have binged on all the TV shows I missed while devouring ballpark hotdogs and late night pie alá mode in Milwaukee last weekend. But instead, it was the week I spent glued to convention coverage, watching night after night of key note speakers.

First Lady Michelle Obama, Former President Bill Clinton, President Barack Obama. Different styles, but all on message. Let the Democratic Party come together as one, unite behind Hillary Clinton, send Trump back to his Towers and TV shows. America would NOT be portrayed as part of a post-apocalyptic world that would be my private nightmare. With each speech the house in Philadelphia, the Cradle of Liberty, rocked. I won’t say I was standing up and cheering in my family room, but I did feel a whole lot better than I felt the week before.

Last night was Clintonpalooza. First Chelsea (my God is she really 36 already?) with Dad crying in pride on the sidelines. And then the Main Event, Hillary Clinton, “presumptive” candidate no longer. I concede that she doesn’t have the phrasing, the tonality, the rhythm of the wonderful speakers from earlier in the week. But I loved the way she wasn’t afraid to tackle Trump. Her message was more to the left than I wanted or expected, but it was an acknowledgement of the strength of the Bernie Sanders movement.

And there’s the rub. Bernie, Bernie, Bernie. Half-hearted applause and not a hint of a smile. I know you lost, I know you are disappointed and feel cheated. But come on, you know she needs you, or at least needs your supporters. And you know you really don’t want to open the door to a Trump presidency, once a laughable lunacy, now a poll-able possibility. Would one ear to ear grin, one signal to Bernie Backers that this girl from Park Ridge, Il was alright, really have been that hard? That look on your face is ranked right up there with Clint Eastwood’s chair as one of the worst props in convention history.

So in the musical spirit of this blog, a few suggestions for your play list should you ever be in this situation again:

When You’re Smiling
God Put a Smile on Your Face
Sarah Smile
Can’t Smile Without You.

Or just remember the Beach Boy’s Album Smiley Smile. You can do it Bernie. I know you can!

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The Password is “Intense”

I just got back from my annual baseball guys trip with the usual group of high school friends. As always, we picked a weekend series featuring one of the Chicago ball clubs at an out of town park, said goodbye to our wives and hit the road. This year we set out for Milwaukee and enjoyed two great games. Yes, we saw the Cubs and Brewers split a pair, but those aren’t the great games I am talking about. No, what we will remember long after we have forgotten the close play at the plate Friday night, or the Brewers three bombs on Saturday, are the killer, no-holds-barred, games of Password we played Saturday and Sunday.

“Password?” I can hear you say. Isn’t that the lame TV game show from back in the 60’s? Yup, that’s the one , with Allen Ludden whispering to the audience while a pair of D-list celebrities gave alternating one word clues, each trying to get their civilian partner to figure out a “password.” Everyone sat calmly behind a podium and Mr. Ludden was thoroughly avuncular. You could almost hear the paint drying, right down to Ludden’s giving the audience a closing “Password of the Day.”

But that is not the way WE play Password. For us, this is the NCAA Championship for National Honor Society Students, the Pro Bowl for Dean’s List Pupils. (Yes, a couple of the guys played varsity athletics, but not any of the real jock sports.) Lengthy, thoughtful rumination precedes giving each clue. Strategy is plotted three or four moves ahead. The inflection of your voice as you give your clue is studied and critiqued. A five minute delay between the clue and a potential answer is not unusual. Don’t have a thorough knowledge of music, movies and TV from the 60’s and 70’s? Don’t even think of playing in our game. You’ll whiff on most of the clues.

We eschew the electronic version of the game for a tacky boxed one. We have played on a jet at 35,000 feet, annoying the rest of the passengers in our row. We have played under the blazing sun while the fish were biting in the middle of a placid lake. We have played while driving a minivan at 80 mph through a fierce rain storm on the way home from an Indians-White Sox series. No way was being behind the steering wheel going to release me from my Password obligations.

Classic clues and games from year’s past are long remembered, classic grudges remembered even longer. The perfect clue for “Knicknack?” “Paddywhack” rings the bell. For “Leopard?” The winning clue has got to be “deaf.” Feel free to use “Chicago” as a clue for “blues,” but don’t be tempted to use “St. Louis.” Our judges have permanently declared that the name of the Gateway City is two words. As for body language, there is no use of hands, but gazing skyward when trying to get your partner to say “balcony” is totally legit.

We take this very seriously. There’s no crying in baseball, but lose in Password and tears may flow.

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For those of you dying to try your hands at playing a round, can you figure out the password from the one word clue “pinssa.” If you think you know, send me an email at les.raff@post.com

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“But Doctor, How Do You Know that is MY Biopsy?” — Maintaining Patient Identification.

It ain’t me babe
No, no, no, it ain’t me babe.
Bob Dylan, 1964

Get the right diagnosis to the right patient. That is the mantra of any good laboratory. No institution does it exactly the same way, but linking each specimen received to the patient it came from is an essential part of laboratory management and quality. A laboratory cannot receive accreditation without having the process totally embedded within standard operating procedures. But a lab like ours that handles hundreds of core biopsies of the prostate a week faces a special challenge. To the naked eye, all those biopsies look the same. How do we tell one from another?

Our system actually begins in the urologists office. Prostate biopsies usually consist of between eight and 12 very skinny cores of tissue taken from different areas of the prostate, each placed in a separate jar of formalin preservative. Before the doctor performs the biopsy, an order is placed in the electronic health record. Our system is designed to automatically print labels to be placed on each formalin jar. These labels are required to have the patient’s name, plus at least one other “identifier,” such as birth date or a medical record number, unique to each patient. The label goes on the jar (NEVER on the lid!) the tissue goes in the jar, and then our medical group adds one special documentation. The patient is required to look at each jar and sign a statement indicating that the label on the jar has his name on it. We even want the patient involved in our quality process!

Once the specimen is received by the lab, our team takes control. In every step of the processing protocol which transforms the tissue cores into thin, stained slices on glass slides, we take care to maintain proper identification. We require that only one patient’s specimens are in any working area at a given time so that jars or specimens can’t be mixed. We have rules that require a second technologist review labeling at certain key steps. We also utilize bar coding, though we plan on taking a great leap forward in that area with installation of a new information system this fall. And then we take an added step. All cores from each patient are inked with one of five different colors, and the color noted in the working documents. If at any time we see an outlier such as one blue core mixed with 11 yellow ones, we know we have a potential problem.

bx cropped — A prostate biopsy after formalin fixation

bx ink cropped — The biopsy following inking with black ink.

How would we resolve that problem? I’ll tell you in a minute, but first I want to mention a new step we have taken to ensure that our process has worked as planned. We now have available a system from a company in Indianapolis that compares the DNA from a patient’s cheek, obtained with a cotton tipped swab at time of the procedure, with the DNA in the patient’s biopsy. A match here is a virtual guarantee that the biopsy is from the right patient. The system is not free, and some of our patient’s elect not to utilize it, but we appreciate the certainty it provides. We would also use that system to straighten out the blue/yellow mix up I hypothesized above.

No matter what system we use, we must always be diligent. Good patient identification means never having to say you’re sorry.

When It Hurts to Say I Told You So: Advanced Prostate Cancer Cases on the Rise

Diagnose a patient’s prostate cancer in its earliest stages and you have a great chance of curing it. Starting in the early 1990’s, that was the philosophy behind Prostate Specific Antigen (PSA) blood testing in men. It wasn’t a perfect test, and many men with increased PSA proved not to have cancer when their prostates were biopsies. Some other men underwent heavy duty treatment such as prostatectomy or radiation for prostate cancers that were SO small and bland they probably would never have spread. Despite the drawbacks, the death rates from prostate cancer dropped in men who were being screened.

As I have written about before. some scientific panels, as well as CMS, the federal agency that oversees Medicare, took a dim view of PSA screening, and the number of men being screened decreased. Some men were never tested, others were still getting tested, but maybe a few years later or a little less frequently than they had been in the past. As a busy prostate pathologist this delay in testing worried me, and I never missed an opportunity to tell the men I knew to have PSA testing. I told women to nag the men they love. And I never failed to have my PSA tested as part of my annual physical

My worries soon began to become reality. My colleagues and I, examining biopsies under the microscope, began to see more cases of aggressive looking (higher Gleason Grade) prostate cancer than we had in years past. This was what is called anecdotal findings; it was our impression, but we did not do a statistical study or a publish a peer reviewed scientific paper to state our claim and have it verified (or debunked) by other pathologists around the country. But we wondered, was there a correlation between what we were seeing and the amount of spread of cancer in the men being diagnosed?

We now have the beginning of an answer. A study published this week from my alma mater, Northwestern University, confirms that a higher number of men are once again being diagnosed with advanced prostate cancer. By the time of diagnosis, their cancer has spread to bones or lung, making cure much more unlikely. The window of catching a small, treatable, tumor has passed. The authors do not claim this is entirely due to lack of PSA screening, but to quote the lead author, Dr. Edward Shaeffer, “If I were a patient, I would want to be vigilant. I firmly believe that PSA screening and rectal exams save lives.”

PSA isn’t perfect. We hope someday to have a better test. And, very importantly, any man diagnosed with prostate cancer needs to have a long discussion with his urologist about the best way to manage his disease. But mammas, don’t let your babies grow up to be victims. Tell them PSA’s save lives.

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We Take a Shine to YInMN. It’s the New Blue!

Have you seen her dressed in blue?
See the sky in front of you.
The Rolling Stones-1967

Once again, I have mislead my blog readers. I told you that white was the decorating color of the year. That may be what Sherwin-Williams and Benjamin Moore want us to believe. But they missed the boat on this one. Did you know we have a brand new pigment, one that no one has ever seen before? Named YInMn Blue, it was created by chemists at Oregon State University a few years ago out of the elements Yttrium, Indium and Manganese. It is extremely vivid and lucky for us, is now on the verge of commercialization. That means you (or we) can be the first on the block with the first new color in a million years or so. According to various resources on the web, you can use the pigment in paint, you can use the pigment on roofs (environmentally friendly and reflects infrared light, keeping homes cooler), but you can’t use the pigment in hair dye. No YInMN punk rockers or YInMn-haired grandma’s, at least not yet.

I think a special new color deserves some special new uses. Here are a few.

A rebirth of interest in the Neil Diamond Song Catalogue with the new hits “Forever in YInMn” and “Song Sung YInMn.”
Capture a Pokémon Go character who is wearing a YInMn cloak and collect triple points.
You think “Avatar” was special? Just wait until you see Na’vi creatures in YInMn blue in “Avatar 2-The Sequel We Don’t Really Need.”
Support Prostate Cancer Awareness group SEABlue with a contribution for the September 11th 5K. Or contact me at les.raff@gmail.com to order a YInMn wristband ($5 each.)
An improved Boo Berry Cereal with YInMn colored flakes and a special prize.
Forget that Little Blue Pill–the Viagra Special Edition Little YInMn Pill will keep you going strong for hours.
No World Series Championships for Cubbie Blue in 108 years? Give ’em YInMn baseball caps, and go ahead and schedule the championship parade. Because YInMn doesn’t fade.
If caps works for the Cubs, imagine what full YInMn uniforms can do for the St. Louis Blues. Sorry Blackhawk fans-the St. Louis YInMns are here to stay.
Rename The House of Blues as The House of YInMn, and hear some of the music that made Chicago famous. And I am pleased to inform you that Jim Belushi and Dan Aykroyd have NO plans to film “The YInMn Brothers.” John Belushi can continue to rest in peace.
You love the Red, White, and Blue? How about the Red,White and YInMn to truly make America great again!

Whether you are singing the blues or kicking them, just remember, with YInMn, it’s a whole new ballgame.

10 Things That Have Changed In A Year, and One That Hasn’t

It seems like yesterday, but it has been about a year since I started writing “Down-Size Maybe,” first as an independent blog on Word-Press, and for the last eight months as part of ChicagoNow. It was meant to be a blog about our home building experience, but like the whole failed concept of “Down-sizing,” the blog has just grown and grown. There have been approximately 125 posts, with poems, songs, raps, some satire, and some smiles along the way. Writing has been a great way to keep in touch with old friends and make some new ones. I have even learned a little punctuation and ~~speling~~ spelling. So let’s take a look at what else has changed in year.

Castles in the Air: That’s all we had a year ago. A piece of land next to a pond, nothing on it but a forlorn looking For Sale sign. It is now a beehive of activity, about 2/3’s of the way toward becoming our home. The neighbors can’t wait to have all the construction finished with, we can’t wait to move in.
Isn’t She Lovely: We were grandparents of one lovely lady, now we are grandparents of two. Double our pleasure, double our fun, double our number of bedrooms in the loft space of the “Big.”
Tumbling Dice: A year ago Elizabeth Holmes and Theranos were the darlings of Forbes and Silicon Valley while portraying themselves as the future of laboratory medicine. Since then Forbes has delisted Ms Holmes, and Medicare has delisted Theranos. Sometimes when you fly too high to the sun your wings melt.
We are the Champions: We went from losers to winners. We topped a Halloween Costume Party Contest, one of my blogs made the ChicagoNow “Best Ten Posts of the Month List.” and I sneaked in a win on “3 for Free.” Our total cash compensation? $25, or about 0.00000001% of a decent PowerBall win. But recognition from Jimmy Greenberg and Lin Brehmer? Priceless.
Tears of a Clown: Early in the primary season: Donald Trump was a loud mouthed, bad-haired buffoon. Oh wait, that hasn’t changed, but now he is a Presidential Candidate (presumptive) of a Major Political Party (also presumptive.)
Norwegian Wood (This Bird has Flown): Yes, a year ago I did have Twitter and LinkedIn accounts. I had sent exactly zero tweets, and posted about as many times on LinkedIn. Now I have posts and followers. Some of my links have wound up on Houzz and the New York Times. I have become a citizen of the 21st Century!
The Games People Play: Bulls a mess, Blackhawks trying to fit under salary cap, Cubs on play-off pace, White Sox languishing, Bears have wide receiver issues. Wait, did I write that last sentence this year or last?
King of the World: July 2015 – Jon Snow is dead, Cersei is humbled; July 2016 – Jon Snow is King of the North, Cersei is Queen of the Seven Kingdoms. Is it time for a Ned Stark resurrection?
(I Want to Be) Elected: A year ago no one had heard of Bernie Sanders and he was opposing Hillary. Now everyone know who he is and he is supporting her. Sort of.
Greenback Dollar: Last year he was just a face on the $10 bill. Now it will take you about 50 of those to get a seat when Hamilton comes to Chicago

And one thing that never changes:

Forever and Ever Amen: Barb’s hard work and vision. Thanks, Babe!

Music Trivia as always: Who were the original artists for the 11 songs listed above? Let me know at les.raff@post.com

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Cole Porter and Suburbia–A Great American Weekend

Just slippin on by on LSD

Alliota Haynes and Jeremiah- 1971

Yes, I know. I swore I would not go near the Taste. I documented my reasons, and I swear by every one of them, even though Whitney from SpotHero did give me some parking alternatives. What I had neglected to take into consideration was that we had plans for Saturday evening that DID include our making the trip downtown to the lakefront. Friends had invited us for supper in their Lake Point Tower apartment, followed by the Cole Porter Celebration at the Pritzker Pavillion at Millenium Park. So it was into the city we headed!

The drive from the northwest suburbs to the city on any given Saturday can vary from a breeze (a rarity) to a centipede-like crawl (the normal,) but we anticipated the worst for Taste Saturday, so the long slow drive was no surprise and easily taken in stride. It was our hunt for clearly visible but difficult to approach Lake Point Tower, one of the rare buildings east of Lake Shore Drive, that almost doubled our commuting time. The NAV system in the car sent us flying towards the Field Museum and Adler Planetarium-definitely an overshoot. Finally, after several U-turns, a desperation call to our hosts led to their sighting our car from their high-up apartment, and then guiding us to the building, as calmly as any air traffic controller at O’Hare or the long defunct Meigs Field.

Subsidized parking in the building (sorry, Whitney) was followed by a tasty supper and then a bus ride to Millennium Park. What a lovely evening it was for an outdoor concert! An orchestra, a chorus and four soloists going through the Cole Porter song book. I was especially delighted to see and hear Karen Mason, who we had last seen in concert with Don McLean (yes, THAT Don McLean) in the early 1980’s. Karen looked and sounded great, then and now. After the show we strolled back to the apartment, our way illuminated by the fireworks show at Navy Pier. Final note to suburbanites-you do NOT want to drive west on Ontario to get to the Kennedy on Saturday night. Take Grand to Milwaukee to Ogden. You will save 45 minutes (at least.)

For those of you eagerly awaiting our house progress, well, it looks great. The exterior stone is 95% in place, limestone window ledges mortared in, the roof a fait accompli. Neighbors continue to walk by and compliment the look of the house. Barb’s due diligence is paying off. We also had a productive meeting yesterday with Ham and Jeff, going over some layout details and considering the shape and composition of the backyard deck. Still no decisions there. I am partial to cedar, but know the ongoing maintenance that is required. Any thoughts for us?

A promised shout out to friend and neighbor Barry B for naming the most songs/artists with a year in their title in our little quiz. He bent the rules a bit, but still came up with the most names that met the “Approved” list. Just like “3 for Free” on ‘XRT, no prize for this one.

That’s it for this edition. In the newly learned greeting of our granddaughter, “Have a good day sir!”

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