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I'm not ready to say goodbye
kitty hatred
ONCO - Medical Record - Initial Consult
Dec 11, 2013

Technician notes
History: 17y/o MN Domestic Shorthair. Hx of episodic inappetence,
vomiting and constipation dating back to June/July 2013. Owner had been
managing the chronic issues with supportive medications at home due to
Fezzik's extreme stress when going to see a a vet - dyspnea, requiring
oxygen therapy on arrival. Fezzik inappetence and vomiting issues
seemed correlated to constipation episodes for some time. Abdominal
lymphadenopathy and effusion noted on AUS on 12/5/13. Prior abdominal
lymphadenopathy noted on AUS on??? Hx of azotemia.

Prior Blood work: 10/4/13 -- ALB 3.9 (H), Crea 2.4 (H), Amy 1224 (H),
Abs. Lymphs 880 (L)
Biopsy Report: Fluid analysis and cytology - neoplastic effusion r/o
carcinoma v. adenocarcinoma
Date of initial diagnosis: open
3 view thoracic radiograph: not performed at time of ultrasound but
performed in June
Ultrasound: 12/5/13 - abdominal lymphadenopathy and effusion

PHYSICAL EXAM: Fezzik not present for appointment so no PE

Fezzik has a metastatic carcinoma of his intestines and peritoneal
(abdominal) effusion. His recent abdominal ultrasound shows the changes
in his intestines are diffuse as most of his intestines are thicker
than they should be. We do not have a confirmed biopsy of his
intestines, but it is my opinion that the carcinoma effusion on his
abdomen is product of carcinoma in his intestines and lymph nodes. We
discussed this type of cancer and how it can spread to regional lymph
nodes, liver or lungs. We discussed prognosis with no treatment (likely
only a few weeks or as long as we can keep him comfortable (or if we
try chemotherapy (likely less than 6 months, but we are hoping for a
year). We talked about quality of life concerns and how treatment and
traveling would impact his quality of life.

Recommended staging discussed today include: Bloodwork (CBC, Chemistry
panel), Urinalysis, Chest x-rays, Abdominal ultrasound, Fine needle

Results of today's diagnostics: none performed today

Treatment options discussed and to be considered:
· Surgery: to remove the tumor. Recommended if possible to remove
primary tumor or reduce tumor burden. However, due to diffuse changes
in most parts of the intestines (based on ultrasound report) surgical
resection not likely possible.
· Radiation therapy: not recommended due to diffuse intestinal disease
· Systemic chemotherapy. We discussed general side effects of
chemotherapy (bone marrow suppression and gastrointestinal signs), the
frequency of treatment and costs. Recommend following surgery to
address metastatic cancer or in the palliative setting (if not surgery
pursue) to target cancer cells and stop or slow down the progression of
his cancer. We compared injectable treatment with carboplatin or oral
options with Palladia (off label use), but Fezzik would need to come to
our clinic for treatment and monitoring.
· Other options such as palliative care to treat systems and make sure
your pet is comfortable. We discussed how to monitor pain and quality
of life issues such as behavior or appetite changes. We also discussed
end-of-life decisions to prevent suffering if we cannot make him feel

Treatment plan:
You have indicated you would like to consider your options and I have
sent you home with cost estimates to review at home. Our main challenge
with treatment is how the trip to the clinic would upset Fezzik and
without checking him we would not be able to give him chemotherapy
safely (side effect risk). Without treatment his cancer will continue
to develop and will soon affect his quality of life to such a degree
that humane euthanasia should be considered to prevent suffering. You
are considering trying him on general supportive medications to help
with possible intestinal pain, inflammation and appetite to try and
keep him comfortable.

Treatments given: none

Medications to continue at home: no changes, but to consider
buprenorphine and steroid for palliative care

My buddy is dying and there's not a thing I can do.

Your Happy Thought for the Day
When someone enters the bathroom stall next to yours and proclaims, "oh dear!" this can only indicate that either they've encountered the remains of someone else's asshole exploding, or they just shit themselves. Either way at that point their day has nowhere to go but up. Good for them!

Iä! Iä! Cthulhu Fhtagn!
A disturbing discovery while staying in an Embassy Suites this weekend.
Make your SAN rollCollapse )

Not that I'm contributing to the solution here...
...but remember those days when you used to refresh this once an hour, vs. once a day or even once a month? Good times....

Hey, Maryland?
If you're going to be sending drivers through Arlington in the morning could you at least filter out the assholes kthx.

(no subject)


Happy 1978th Anniversary...
...of the first "documented" zombie uprising. From Matthew 27:51-53:
At that moment the curtain of the temple was torn in two from top to bottom. The earth shook, the rocks split and the tombs broke open. The bodies of many holy people who had died were raised to life. They came out of the tombs after Jesus’ resurrection and[a] went into the holy city and appeared to many people.
Perhaps on this day of remembrance you might get a small gift for a loved one from Amazon's Ultimate Zombie Apocalypse Survival Kit

Eternal vigilance.

Jon Kyl was an anal birth
Why is it the only people who don't have to tell the truth to Congress are the elected officials of that body? http://www.newser.com/story/116186/stephen-colbert-jon-stewart-take-down-sen-jon-kyls-planned-parenthood-remarks-daily-show-colbert.html

Ken Ham given the boot
Short version: HA-ha!

Longer version: Ken Ham and Answers in Genesis, who you may know as the carny-hawkers of creationism, inerrant Biblical literalism, and builders of that totem to ignorance known colloquially as the Creation Museum currently squatting in Kentucky, have been un-invited from two Christian homeschooling conferences. Why? AiG rhetorically asks the same question. The posted letter informing them of this decision by the organizers of "Great Homeschool Conventions" makes clear their position; that public statements by Ham attacking other invited presenters crossed a line of comfort for GHC and they felt it better for their cause to disassociate themselves.

It should be needless to say that Ham never met a disagreement he couldn't victimize himself with. If you're curious about the specifics of his defense, see the link above.

Instead, I'm going to cherry pick some phrases from AiG's response to propose an alternative opinion about why Ham and his clan were asked to stay away.

Remember that AiG is guided by Biblical literalism - that every word is divinely inspired, that every event depicted is a historical record, that every decree is an instruction from God that is to be followed to the letter. From AiG's response letter linked above, in addressing perceived deficiencies of another GHC invited speaker:
For the moment, you should be aware that Dr. Enns makes it clear that sin should not be discussed with young children because it will cause problems with their view of God. He also doesn’t believe in a literal Adam and literal Fall.
Or there's AiG's perception of themselves as the last bulwark against compromise in defense of literalism (I lost track of the number of times "compromise" was used as a derogatory):
We at AiG are burdened before the Lord that parents may choose to use the Bible curriculum from Dr. Enns, without being aware of the destructive teachings in it.[...] Someone needs to stand against the compromise that is pouring into the church from many directions.
AiG is very, very big on the "authority" of Scripture, referring to it no less than 7 times in their response:
Because we publicly exposed one of their speakers and his curriculum because his beliefs clearly undermine the authority of Scripture,...
We at Answers in Genesis are on a crusade—a mission. We continue to move ahead to call the church and culture back to the authority of God’s Word....
It is sad that a speaker and ministry, which stand boldly and uncompromisingly on the authority of God’s Word, are eliminated from a homeschool convention...
We have made this point over and over again: we recognize that Christians who believe millions of years, evolution, Adam is a metaphor, etc. are undermining the authority of God’s Word. The issue comes down to one of authority....

That's AiG's position. Uncompromising defense of the supremacy of Scripture and unquestioning practice of it's demands. Just how far does AiG think this defense should go? Not a rhetorical question at all as it turns out; AiG conveniently provides their answer to this via the words of the Book of Mark, specifically Mark 9:42(quote taken from the New International Version, other translations similar):
Our Creator and Savior, the Word, the Lord Jesus, certainly confronted compromisers publicly. He taught, “whoever causes one of these little ones who believe in Me to stumble, it would be better for him if a millstone were hung around his neck, and he were thrown into the sea” (Mark 9:42).
Returning to the question of why AiG was un-invited? Perhaps it's because GHC is worried Ham and his minions plan to step up their game and start drowning other speakers.

Protip: Should Ham succeed in convincing the legislature of Kentucky to force the taxpayers to help fund his latest folly (a biblically themed amusement park named Ark Encounters), you might want to consider avoiding the dunk tank attraction lest you end up accused of negligent homicide.

Sometimes it's a shame failblog only wants images
Guest column: Forefathers fought for religious freedom
by Rick Santorum

http://www.desmoinesregister.com/article/20110306/OPINION01/103060315/Guest-column-Forefathers-fought-for-religious-freedom :
In the heat of the American Revolution in 1777, the Continental Army was struggling to muster shoes and victory. What were two of our most heroic founding fathers, Thomas Jefferson and James Madison, doing? They were arguing in favor of religious liberty, giving us the precursor to what we now know as the Religion Clause of our Constitution's First Amendment - the heartbeat of our Constitution.

Fast forward to recently when President Barack Obama claimed the federal Defense of Marriage Act (DOMA), defining marriage for federal law as one man and one woman, was "legally indefensible."
This may be the biggest historical ellipsis ever. From 1777 to 2011 in one fell handwave of attempted revisionist history.
Intellectually, morally, and constitutionally President Obama's claim is absurd. And it is a dagger aimed at the heart of a core constitutional value: the free exercise of religion.

Schools, the media, and even some politicians often like to remind us of the first part of our First Amendment - that "Congress shall make no law respecting an establishment of religion" - but tend to omit the remainder: "or prohibiting the free exercise thereof."
Rick Santorum want you to rest assured that he will protect and defend your God given right to be a bigoted asshole while still qualifying for handouts and special considerations from the government, but you've got to be the right kind of bigoted asshole...
Last week, ignored it was
['da fuck? Yoda pulling a Kanye West here?]
I believe if two adults of the same sex want to have a relationship that is their business. But when they ask society to give that relationship special recognition and privileges, then we should be able to have a rational debate about whether that is good public policy.

We should also ensure the debate takes cognizance of its constitutional implications. And with the President's decision, the free exercise of religion will be eviscerated.

Just five years ago, Catholic Charities of Boston announced it was getting out of the adoption business as a result of Massachusetts "orientation discrimination laws." Catholic Charities had a terrible choice: continue finding homes for hard to place kids at the expense of their religious principles or stop providing adoption services and keep the faith. It was a choice they should have never had to make.
...and the right kind is the kind that's a bigoted asshole for Jesus.
Make no mistake about it: with this decision, traditional Christian...beliefs about sex...now make those religions "unfit" to work in the fields of foster children and adoption.
Pssst...Rick, do you really want to go there? Do you really want to discuss the fitness of the Catholic religion and children? Really?


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