Archive for November, 2024

A Pre-Emptive Subtotal Colectomy?

November 27, 2024

3 different doctors told us my wife’s colon needed to be removed. This ongoing ordeal began last spring when she sent a fecal sample to Cologuard, a company that advertises frequently since the medical establishment has become fixated on reducing deaths from colon cancer. The results found genetic markers suggesting my wife might have colon cancer. The doctor ordered a colonoscopy. This procedure entails sticking a camera up a person’s ass. The doctor also removes polyps to be biopsied, while they are looking for possible cancerous tumors. Doctors normally find 1 or 2 polyps in most people, and most polyps are not cancerous. The doctor found hundreds of polyps in my wife’s colon–too many to remove at once because there would be an increased risk of perforating the intestinal wall. None of the polyps they removed or looked at were cancerous, but the gastroenterologist called them “pre-cancerous,” and he told us there was a “100% chance” she would develop colon cancer. He told us her colon should be removed.

My wife has hundreds of pre-cancerous polyps in her colon. Doctors want to remove her colon because they can’t biopsy them all.

I researched the subject before we decided to follow the doctor’s orders. It didn’t make sense to me that doctors would want to perform such a drastic procedure when they didn’t even find cancer. The average age of a person developing colon cancer is 71, and my wife is only 61. Why go through such an invasive operation before she might even get sick? Serious surgery could make her get sick when she wasn’t sick prior to the operation. I could find no studies that show pre-emptive colectomies (the term for colon removal) decreased mortality rates. Her surgeon later explained to me this data didn’t exist because most people get colectomies when their doctors tell them they need it. I also researched colon cancer, and it is scary. Colon cancer can spread to other organs and cause people to sicken and die within a few years. We consulted with our family doctor, and he concurred with the gastroenterologist. He explained the colon is located so near the liver that cancer could easily spread to this organ. My wife decided to have the operation based on our family doctor’s concurrence, and I didn’t object. Though I am skeptical, I’m not a doctor and I defer to their expertise. If I had this issue, I wouldn’t go through all this medical torture and would be content to take a dirt nap when my body naturally failed me, but I can understand why people fear death. Besides, what if I influenced her not to have the procedure, then she developed colon cancer? How would we feel about that decision? The regret might poison our relationship, and I might become wracked with guilt.

We went to meet the gastro-intestinal surgeon, and he agreed with the other 2 doctors, but he wanted to perform a colonoscopy himself, so he could determine what kind of colectomy would be best. If pre-cancerous polyps were found throughout the entire colon, he would remove it completely, and she would have to wear a plastic bag that collected her waste. Fortunately, he found no pre-cancerous polyps in her rectum and the bottom part of her colon, and he determined he would be able to perform a bowel resection–a procedure that involves connecting the small intestine with the remaining part of the colon. Nobody wants to wear a bag of shit, if it can be avoided.

This is the surgery my wife is going to have. The hospital estimates the cost will be $64,000, but our insurance company is going to cover it entirely. The insurance company isn’t going to pay anything close to $64,000, but if we didn’t have insurance, we would receive the bill in its entirety. What a bunch of crooks.

This is what the surgery looks like. I hope I didn’t ruin your appetite for Thanksgiving dinner.

We scheduled the surgery. It is officially called a hand assisted laparoscopic subtotal colectomy. A laparoscope is used, so they don’t have to make a large incision. Instead, the surgeon makes a smaller incision and inserts a camera that allows him to work without opening her up all the way. A urologist will also perform a procedure to prevent her urethra from being damaged during the surgery. The surgeon will remove most of her colon and suture her small intestine to her remaining colon, probably using absorbable sutures made from polyglycolic acid. The surgery will take 3-4 hours, and my wife will have to stay in the hospital for 3-5 days. The suture between the intestines is known as an anastomosis. The most common complication is leakage at the anastomosis. She won’t be allowed to leave the hospital until she has a bowel movement that proves the surgery was successful, but the opiate pain killers they give her will shut down her digestive system. They will administer additional drugs that will counter this side effect.

The first successful bowel resection was performed by Jean Reybard during 1825, but the Paris Academy of Medicine condemned the risky operation. Until the late 19th century, patients with intestinal injuries were left to die (given up to God, as they referred to it), but with the widespread use of anesthesia, medical science advanced. The surgeon rates my wife’s prognosis as good. Without the procedure he rates her prognosis as “unknown.”

We met a pre-op nurse who gave instructions along with a bag of special Ensure drinks to build up my wife’s immune system a week before the surgery. The nurse seemed a little too delighted. She was thorough, but her syrupy attitude struck me as oddly enthusiastic. It made me wonder what she’s really like at home. The crazy nurse from Stephen King’s novel, Misery, maybe? We have to be at the hospital at 6 am the day before the surgery, so the doctor can mark the spot of the anastomosis with a dye. This requires yet another colonoscopy. The day of the surgery we have to be there at 5 am–literally a nightmare. I’m an old man, and I hate driving in the dark. The sugary nurse told us we couldn’t bring a futon for me to sleep upon, but I am going to try to break that rule. If I have to sleep on a chair for 3 nights, I will be furious. I’m putting this blog on hiatus until next year. Going through this ordeal is going to be all consuming, and I don’t feel like working on it.

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Flawed Study Suggests Anthropogenic Fires Caused the Extirpations of Megafauna Near the La Brea Tar Pits

November 20, 2024

A group of scientists think they’ve found the answer to what caused the disappearance of most of the megafauna species that lived near the La Brea Tar Pits. They took sediment cores from several sites near the tar pits and measured the quantities and composition of pollen and the amount of charcoal present–an indicator of fire frequency. They radio-carbon dated the layers of the core. They also used radio-carbon dates from 172 specimens of megafauna species in the region including saber-tooth, giant lion, dire wolf, coyote, bison, camel, horse, and ground sloth. They fed this data into a statistical model and concluded as the climate became warmer and drier, the environment became more susceptible to fires set by increasing populations of humans. The anthropogenic fires transformed the landscape from juniper-oak woodlands into a semi-arid chapparal, and the only surviving megafauna species (that they studied) was coyote. (A chapparal is a dry landscape covered in pine, shrub, flowering herbs, grass, and cactus, and the climate consists of mild winters and hot summers.) These extirpations in Southern California occurred about 1,000 years before the extinctions in the rest of the North American continent, but they occurred at the same time these species were in decline elsewhere. Camels and ground sloths disappeared a few hundred years before the other species in this study, but I should note (which this study does not) that the most recently dated specimen was likely not the last surviving member of the species–there still could have been a considerable population that perchance left no fossil evidence. A serious flaw in the conclusion reached by this study occurred to me.

This illustration is a ridiculous exaggeration, and I think it is based on a seriously flawed assumption. From the below referenced study.

List of species used in the below referenced study and their final extirpation date estimates.

The authors of this study assume the transformation of juniper/oak woodlands to a dry chapparal environment resulted in the local extirpations of megafauna here. The problem with this hypothesis is that at least 3 of the species used in this study thrive in semi-arid chapparal like environments. Lions live in semi-arid environments all across Africa. Wild horses are most common in the American southwest where they roam deserts. And camels, of course, are known to live in arid environments, and today introduced wild camels survive in Australian deserts. I realize the North America Pleistocene versions of these species are not exactly the same as modern species, but they were highly adaptable and lived all across North America, and they endured all kinds of sudden dramatic shifts in climate, including peak Ice Ages which caused widespread arid conditions. I seriously doubt a shift to more open drier conditions negatively affected horses, camels, and lions. I think populations of these species would increase in this type of environment.

Horses thrive in the semi-arid type of environment that the below referenced study erroneously assumed caused their extirpation in southern California.

Camels also can endure semi-arid conditions. I think the authors of this study blundered in their conclusion.

19 scientists put their name on this paper. I find it hard to believe this obvious flaw in their conclusion occurred to none of them. It occurred to me before I finished reading the paper. I contacted the lead author of the paper and pointed out this flaw, but so far, he has not responded. It seems as if scientists want to bridge the gap between climate models of extinction with those who hold humans are solely responsible. Put me in the latter camp. The increase in fire frequency is proxy evidence for the presence of humans. Direct hunting by humans increased megafauna mortality above the ability of these large slow-reproducing animals to maintain their populations. It was overhunting by humans, not a change in fire regime that caused the extinction of these species. It is the simplest explanation, and the only one that makes sense to me.

Reference:

O’Keefe, R. et. al.

“Pre-Younger Dryas Megafaunal Extirpations at Rancho La Brea Linked to Fire-Driven Shift”

Science August 17, 2023

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Posted in Pleistocene Mammals | 2 Comments »

The Ancestors of House Cats (Felis sylvestris) Followed Human Farmers into Europe

November 14, 2024

I’m living the “Trouble with Tribbles” episode of Star Trek. The plot of this episode revolves around cute, little, furry animals introduced on board the star ship Enterprise as pets. A problem arises when they reproduce so rapidly, they clog the engines and foul the food supply. The plot must have been inspired by house cats. Two years ago, animal control (without my knowledge at the time) removed most of the cats living near my house. Years before this, I started feeding just a couple of stray cats, and my neighbors love cats and feed them too. The population exploded. After so many cats were removed it didn’t take long for them to replenish their population. I’m attached to 3 of the cats, but I wish a coyote would come along and get rid of the rest. They swarm the front door, and when I have to take my disabled wife to an appointment, it is a nuisance to try and get her wheelchair out of the house when the cats get in the way. I’m going to research birth control cat food because I don’t have the heart to do anything else about it.

Scene from the “Trouble with Tribbles” episode of Star Trek. It seems as if I am living in the episode.

Cats are cute and entertaining, and I am attached to some of the cats, but they can be a real nuisance when I am trying to roll my wife’s wheelchair in and out of the house.

House cats are a commensal species that thrive near human habitations. They descend from a North African subspecies of wild cat, but scientists have determined it is the same species as the European wild cat. The ancestors of this subspecies of wild cat first started living near man in the Middle East (also known as the Levant) about 9500 years ago when humans transformed forest into farmland, thus increasing populations of the mice that feed upon cereal crops. An isotopic study of 6 cat remains found in caves located in Poland determined this Middle Eastern subspecies of wild cat followed human farmers into central Europe between 6200-4300 years ago. These are the oldest known cat remains (of this subspecies) in Europe. They occupied the same ecological niche as the European subspecies of wild cat and had a similar diet. The specimens found in Polish caves were living wild and their diets were not supplemented by humans. There are no cat remains in this region near human habitations from this time period, so scientists aren’t sure if tame populations occurred here this early.

The transformation of forest into wheat, barley, rye, and fallow fields greatly increased the population of house mice (Mus musculus), a primary food of both subspecies of wild cats. Wild cats also fed upon rabbits, hares, and birds; especially black grouse, migratory thrushes, and woodcocks. The latter species spends much time on the ground and is particularly vulnerable to cat predation.

Image from the below referenced study. The North African subspecies of wild cat followed humans into Europe where a different subspecies of wild cat already occurred. Remains of the former were found in Polish caves and date to about 5,000 years ago. From the below referenced study.

Chart showing species fed upon by wildcats in Europe based on isotopic evidence. These are species of mice and voles that lived in the wilderness rather than near farmland. From the below referenced study.

Both subspecies of wild cats interbreed on occasion, but they have somewhat different behavior patterns. House cats sleep more; European wild cats spend more time scent marking and are more vigilant.

Reference:

Krajcarz, M.; M. Krajcarz, M. Baca, and H. Bocherens

“Ancestors of Domestic Cat in Neolithic Central Europe: Isotopic Evidence of a Synanthropic Diet”

PNAS 117 (30) July 2020

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Some Selected Snail Species Native to Georgia

November 6, 2024

Historically, famines occurred across France, perhaps explaining why the French hold such reverence for good cooking. People subject to starvation may have a greater appreciation for food preparation and gastronomic enjoyment. During the French Revolution for example there was a shortage of bread and people rioted. The hungry populace was reduced to dietary desperation and turned to frogs and snails. The former tastes pretty good, frog meat is clean and white, but snails are completely neutral in flavor. Nevertheless, they are a good source of protein, though they have to be carefully prepared because they often carry parasites. Some species of snails may consume toxic vegetation as well. I have eaten snails–they don’t taste bad; they simply have no flavor. The appeal of the famous French dish of escargot is dunking good bread in the garlic butter sauce the snails are cooked in.

Escargot. Just about any protein tastes good in parsley, garlic, and butter. Snails are very lean meat and need the fat from the butter.

In a recent study scientists estimated there are between 215-282 species of land snails native to the state of Georgia, far more than the known 67 species of aquatic snails that live in the state. There are 214 species of land snails from 28 different families with representative specimens in museums, but the authors of the below referenced study estimate there are 68 more. The list of species in this 2019 study was the first snail species list published since 1964. Snails are understudied (like I have mentioned about spiders previously) because the number of species far outnumbers the scientists interested in studying them. Snails are abundant wherever soils are rich in calcium, an element necessary for them to develop shells. Snails are valuable components of the ecosystem. Their droppings fertilize soil, they reprocess organic material, making nutrients more available for plant roots, and they disperse seeds.

A few interesting species of snails found in Georgia include the bearded mystery snail (Viviparus georgianus), Goniabasis catenaria, and the eastern whitelip (Neohelion albolabris). The bearded mystery snail lives in ponds, lakes, and slow-moving streams. These snails live in shallow water during summer but move to deeper water during winter. They are unusual because they give birth to live young–most snails lay eggs. They feed upon detritus, diatoms, algae, and fish eggs. Although they are currently considered 1 species, scientists suspect populations from 3 different river systems are 3 different species.

Bearded mystery snail.

Goniobasis catenaria. This species doesn’t have a common name.

This species of land snail is abundant in Georgia.

Goniobasis has no common name. It lives on rocky shoals in the piedmont and is accordingly endangered. Many shoals in the piedmont have been inundated by reservoirs or silt from erosion. Eastern whitelips on the other hand are common. They are the largest widespread snails in Georgia. (Apple snails, a larger species, are restricted to 1 county in southwestern Georgia.) They reach 40 mm in size. They are common from Georgia west to Mississippi. During wet weather I often see them in my yard, especially on my compost pile where they feed upon fruit and vegetable refuse. I also seem them foraging on rock, cement, and brick; somehow getting calcium from these sources. I used to grow napa cabbage and bok choy in my garden, and they loved these calcium rich vegetables. I don’t use pesticide on green leafy vegetables, and I was also plagued with tiny black snails that seemed to do just as much damage to the vegetables as the larger snails.

Reference:

Felix, Z; M. Dubue, and H. Rona

“A Tentative List of Land Snails in Georgia”

Georgia Journal of Science 77 (27) 2019

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