Relocating

What good are relocation companies if they can't help you find something simple, like short term storage? I thought their job was to help make the transition easy, not tell me to "Call every self storage place in the phonebook.. Oh yeah, you don't have a local phone book do you? Well, look at the yellow pages online".

Yes, that's helpful.

Oh well.

Pack Rats

Moving makes you realize just how much junk a person (or two people in this case) can accumulate. Three trips to the dump in the last week. How depressing is that?

Shortage of Rheumatologists: Feeling the Pinch

According to the Arthritis Foundation, the number or rheumatology patients is increasing while the number of practicing rheumatologists is decreasing. I hadn't really seen any evidence of that until today. Today, I am trying to find a new rheumatologist in my new city. Said city has one of the best rheumatology departments in the country, but only about 15 practicing rheumatologists in the metro area (which has a population of about 1 million).

For arthritis patients, continuity of care is very important to prevent irreversible joint damage or systemic damage. So, when moving to a new area, it is very important to see a new rheumatologist as quickly as possible. It is even more important if you are on an IV drug regimen like Remicade. Lapses in treatment schedule allow the levels of the drug in the body to drop, causing inflammation, swelling, pain and possibly joint damage.

For the reasons above, I was hoping my rheumatologist here in Maryland would know someone in my new city or do some research for me. He did not; so today, I started calling rheumatologists in my new city. The earliest one could see me so far is July. The major rheumatology center at the teaching hospital has a wait of about 6 months. I am due for my next Remicade infusion on 31 May. I need someone to take mercy on me and at least give me my medicine. So now, I need to have my rheumatologist try to talk to another rheumatologist and see if they will budge.

It's just very frustrating. And this is in a city that has choices among rheumatologists. I wonder about the people who have to drive hours to see a rheumatologist. And the ones who only have one rheumatologist near them. What happens if that doctor retires or passes away? It makes me wonder why rheumatology is not chosen as a specialty by medical school graduates.

So, for once, I am feeling the pinch of this shortage. I am frustrated and upset. I'm trying not to take that out on anyone I've spoken to at these clinics, but I need my medicine. Today is the best I've felt in about two years. I don't want to have to suffer needlessly when a simple drug treatment could keep the inflammation, pain, swelling and damage at bay.

Paint

The bad: Paint fumes give me a nasty headache and make it difficult to breathe.

The good: My stairwell now looks presentable.

Also, it is impossible to keep dogs out of paint. Both of my dogs now have splotches of (white and beige) paint on their (black) coats from rubbing up against the walls. At least the walls still look ok!

Government Computer Security: Still Pretty Bad

The annual FISMA grades are to be announced for 2006 sometime today. From the initial reports, the scores are still pretty bad at a C- for the entire government; though, overall, the government did score better than last year's D+ grade. (I'm sure some member of Congress will bill this as a "success story.")

Of the 24 agencies that must file FISMA grades, 7 received grades of A (from this article). Of the remaining agencies, 13 received a grade of D or below.

Some highlights:
Good Scores

• Agency for International Development (USAID) - A+


• Department of Justice - A-


• Social Security Administration - A

Failing Scores

• Department of Commerce


• Department of Defense


• Department of State


• Department of Treasury

And finally, the Department of Veterans Affairs didn't even submit their report. Let's just say, based off of their issues with laptop loss, they probably would have failed anyway.

Of note, for the first time since its inception, the Department of Homeland Security didn't fail (source).

These scores, and the lack of improvement show that FISMA is not succeeding in making government IT security any better. It has ended up being a paper exercise with no repurcussions for failure. As a former government employee, I know that security is considered a high priority in some agencies, but others just don't care. To me, it seems that some agencies that should care (DoD, DHS, State, etc.) have done little to protect their information systems.

So It Goes...

Kurt Vonnegut died yesterday at the age of 84.

I'm a huge Vonnegut fan. I read Slaughterhouse-Five in high school (for my Junior year English class no less). I absolutely loved the sci-fi juxtapositioned against war torn Dresden. During high school I struggled quite a bit (like pretty much every other teenager) with the usual things as well as health issues. Because of everything going on, I often felt as if I were watching myself go through life from another plane, and Vonnegut's writing in Slaughterhouse-Five spoke to that and put words to what I had never been able to describe. I always felt "unstuck in time." Vonnegut, through the Trafalmadorians, likened human life in moments of time to "bugs trapped in the amber of the moment". And that time is unmoving, like a mountain range; each individual point in time at a distinct place on the range that cannot be changed. Life and death are just part of it all.

Vonnegut clearly did not believe in free will. I don't really know where I stand on that; I never have been able to come to a clear decision. But all too often, the refrain "So it goes" seems to sum it all up. Things just happen.

"So it goes," Kurt Vonnegut.

w00t!

No more waiting. Much less uncertainty.

I finally got the job offer in another city. Pay's a little less than what I was hoping for, but it's still good considering the cost of living is so much lower there than here. The company will pay to move my stuff and for a house hunting trip.

So, things are moving quickly. This weekend will be spent getting the house ready to put on the market. I've already done a decent amount of de-cluttering and re-organizing. Nothing like a major move to make you re-think the usefulness of any given item. So, here's hoping our house sells quickly!

Researchers Identify Another TNF Receptor Linked to RA

Researchers at the Kobe University School of Medicine in Japan identified a new TNF receptor and found that it was linked to rheumatoid arthritis. The article is an interesting read, even though it's over this IT geek's head.

The good news is, research like this will lead to new treatments. New treatment options are a good thing for people with inflammatory arthritis.

Bork Bork Bork!

I love the Swedish Chef, especially when he's trying to do something with the chicken.

In Cybersecurity, is a good offense the best approach?

General James Cartwright, commander of the Strategic Command (STRATCOM) thinks so. Last month he gave testimony to the House Armed Services Committee indicating that a "purely defensive posture poses significant risks" (link via a Wired article by Bruce Schneier). Cartwright is of the opinion that the U.S. needs to be able to fight its cyber adversaries "when necessary, to deter actions detrimental to our interests."

I have no problems with offensive strategies for computer systems defense under the right circumstances. However, when a military commander starts discussing offensive strategies, I get a littled worried. STRATCOM is responsible for planning and directing cyber defense strategies for the Department of Defense. When STRATCOM's commander discusses offensive measures as a defense, you have to wonder how measured an offensive response would be.

The Department of Defense is a very large government entity comprising both the military (all branches) and several civilian agencies (or joint agenices, both civilian and military). DoD also has some of the most sensitive government information on its networks. The sensitivity of data as well as the nature of DoD make it a prime target for cyber attacks, but is unilateral offense a good strategy?

Due to the complexity of some sophisticated computer based attacks, it is not always possible to know where an attack originates or the intent of the attack. If offensive tactics are to be taken in some events, what is to say that the processes and procedures for responding will be sufficient for every type of attack? When those processes and procedures are insufficient, who will make the decision to attack or not?

Particularly worrying to me is the prospect that a US citizen's computer will be attacked or that a country with which the US has a shaky relationship will be attacked. What happens if DoD is wrong? Diplomatic relations with an entire country could be compromised because DoD chose to launch an offense against an attacker or who they thought was the attacker. An attacked country could possibly view an offensive attack as an act of war.

While I agree that sometimes offensive strategies are necessary in computer defense, there are far too many gray areas for our government organizations to be making offensive moves. Fighting back is not the only answer to defense. The government is riddled with computer security problems, as evidenced by the FISMA report cards (DoD got a grade of D in 2003 and 2004). It would be prudent for DoD to fix its basic security issues before it goes on the offense.

Scary...

A Nevada judge has called a man's child pornography offense an issue of "impulse control" (via Feministing). The man was sentenced to up to 18 years in prison for posessing more than 800 pornographic images of children and will be eligible for parole in 2 years. But, based off of the judge's comments (see below) before sentencing, it's a wonder the man was given any prison time.

These kinds of offenses are problems with impulse control.
...
When I say that, it's my understanding that most men are sexually attracted to young women. When I say young women I don't just mean women that ... you should be attracted to. I mean women from the time they're 1 all the way up until they're 100.
...
It's likely that most people would find young girls sexually attractive.

The judge's comments are disturbing. Perhaps someone should be investigating if he has child pornography since he seems to think it's perfectly normal to find young girls sexually attractive.

I need a shower now.

And I thought I was weird...

Keith Richards of Rolling Stones fame, and quite possibly the most well-known drug user in the world, admitted that he "snorted [his] father".

He was cremated and I couldn't resist grinding him up with a little bit of blow. My dad wouldn't have cared... It went down pretty well, and I'm still alive.

I know it's Keith Richards and all, but damn. However, the best line in the article:

I was No. 1 on the `who's likely to die' list for 10 years. I mean, I was really disappointed when I fell off the list.

That's one odd man.

Still waiting...

I know patience is a virtue and all that, but I really just want to know what's going on! Maybe today I'll find out.

In other news, I'm absolutely exhausted and hurting. Every time I think that I'm doing better, I end up overdoing it and paying the price the next day.

Update:
Still waiting on word about the job in another state. When someone says the beginning of the week, I think Monday or Tuesday. Now it's Wednesday and I'm debating with myself whether or not it's too early to call and check on the status. I think I'll wait until Thursday. Thursday is definitely not the beginning of the week.

Update #2:
Well, they're still waiting for approval for the relo package. Apparently it has to be signed by 5 people fairly high up on the food chain. This better be one good relo package! HR says I might have something by the end of this week, but most likely, it'll be next week before I get anything.
Waiting sucks.

Arthritis News

Biologics and Pregnancy
Two studies were presented in February seem to indicate that the use of Enbrel or Humira (both Biologic Response Modifiers) during the first trimester of pregnancy poses no risk for adverse outcome. This isn't definitive as sample sizes were small, but it is encouraging.

Arthritis Pain Processed in Same Part of Brain as Emotions and Fear
Research indicates that arthritis pain is processed by the same part of the brain as fear and emotions. It was a small study (12 patients), but the research could lead to a greater understanding of the disease. This also explains why emotions affect arthritis pain.

Merck Seeks FDA Approval for New COX-2 Inhibitor
Merck is seeking FDA approval for a COX-2 inhibitor, Arcoxia. The drug, if approved, would be one of only two COX-2 inhibitors available on the market. Celebrex is currently the only cOX-2 inhibitor available. COX-2 inhibitors are a type of anti-inflammatory drug, but they are less likely to cause stomach upset than traditional nonsteroidal anti-inflammatory drugs (NSAIDs). Although there are cardiovascular risks associated with COX-2 inhibitors, the benefit these drugs give to many living with inflammatory drugs outweighs the risk. I, like many others with arthritis and other inflammatory diseases, cannot take traditional NSAIDs due to stomach issues. Although Celebrex does not provide great relief to me, it is better than not taking anything. I, for one, will welcome an additional COX-2 inhibitor as an option for treatment.

Remicade Could be Good for Cholesterol

On the other side of the spectrum, a study published in the December, 2006 issue of The Journal of Rheumatology, has found that a Remicade side effect may reduce cardiovascular disease risk. The researches report that patients receiving treatment with Remicade experienced a "sustained increase" in HDL cholesterol.

HDL cholesterol is known as the "good" cholesterol because a high level of it seems to protect against heart attack.