Category Archives: Personal
After watching the documentary film “The Bleeding Edge” on Netflix I thought I should weigh in as a patient who has had both of my hips resurfaced, meaning my hip joints are metal on metal ball and sockets.
The film is a very well done documentary that examines the $400bn medical device industry that reviews five products that have exhibited significant failures including the broad review of cobalt based hip implants. This is an important documentary that does expose the weakness of our regulation of the medical implant industry and sounds a needed alarm to those patients who may now be at risk.
I am focusing on hip resurfacing which was lumped into the broad exposure of any metal joints made from Cobalt. The greatest concern comes from these devices that actually operate with a metal on metal joint, and hips are probably the most common. My hips are made of a Cobalt-chrome alloy that is used because it creates one of the hardest and strongest metals known to man. These features are critical for a successful and enduring joint replacement. The premise for using a metal on metal hip as in my case is that the body naturally encapsulates and provides lubrication for the joint movement. The Co-Cr alloys show high resistance to corrosion due to the spontaneous formation of a protective passive film composed of mostly Cr2O3. The minor amounts of cobalt and other metal oxides on the surface appear to be contained by the body’s encapsulation. The documentary does not spell this out in sufficient detail, instead it broadly classifies any device made from cobalt as dangerous.
My History: My family has shown a propensity toward the development of an arthritis that creates some bone deposits in our hips. For me this has been accelerated by a life of sports activity, most notably basketball, that allowed this arthritic condition to wear away the natural lining of my hip joint. Once I understood this back in 2006 when I was 52 years old and in constant pain I had to figure out a solution. I had heard that hip replacements were good for 15-20 years which did not seem to match well with my age. I remember hearing about hip resurfacing in a 60 Minutes type segment on Americans traveling to India for this surgery. So I started investigating this alternative procedure. The allure for me was the fact that you could remain active and if needed down the road I could still get a hip replacement. Fortunate for me there was an orthopedic surgeon in Salem, Oregon, who was allowed to perform this surgery probably due to the FDA’s 510(k) pathway for approving medical devices as mentioned in the documentary. My first hip was his 439th hip resurfacing. I do believe that my second hip done in 2010 was from the same design and stock of the Cobalt-chrome implant.
I guess the point of my post is to let it be known that hip resurfacing can be very positive. So why have I not experienced any cobalt poisoning related medical issues? Obviously the surgery can be positive, however, it is true that many have experienced serious problems. Depuy, owned by Johnson & Johnson, was referenced in the documentary, however, there has been recall activity on cobalt based joints from Stryker and Smith Nephew. My theory for my success is based on the fact that the hips that were used for me were created in the early pre FDA approval period. I have asked who made my hips and I never got an real answer. They appear to be similar to the Smith Nephew BHR and the Wright Conserve systems. Maybe those early test hip parts were done with more attention given to the metallurgy involved. Possibly my success has to due with my lifestyle. I have learned that I cannot participate in physical activity that is based on radical lateral movement such as basketball or handball. What I can do is walk or backpack which I have done to the tune of about 2000 miles since my second hip surgery. So overall I am extremely thankful for this medical hip resurfacing technology.
I do hope that the FDA is able to improve the overall approval process for medical device technologies and it is good that documentaries are made to help bring attention to these needs. But we must also caution against blanket assumptions made to help sensationalize a documentary, such as all devices made with cobalt are bad for you.
I changed my primary Uniform Resource Locator, URL, to a name more fitting for the next phase of my life. Of course I am also trying to move past my Higher Education Technology focus. This change is not really worthy of a post, however, the experience surrounding the purchase and implementation of a new URL did capture my interest. I have wanted to switch for a while but I had not been struck by a name that seemed appropriate. But I have been referring to my blog in the sub title as “The Adventure Continues” and I have drifted around that theme with a number of posts. So I took the next step, checked WHOIS and voila, the name I wanted was available and affordable. I have always gravitated to the .org top level domain because I equate .org with non-commercial and I have no interest in monetizing my blog. For the most part, my blog is my archive of my adventures, so the Adventure Continues with a new blog name and URL.
Do you remember when the URL was everything. URL squatters tried to grab up all potentially lucrative names that at that time would typically precede .com or maybe .net. Of course today you can create about any top level domain but us old timers still feel a connection to the early pioneers. The other day I was in a meeting with students reviewing a proposal which had an URL printed in the documentation as a reference. I told the students that they could paste the url into their browser to review the site. One student giggled and said that she could not remember ever hearing someone refer to a web address as an URL. OK, that surprised me a bit. But really that was validation that the URL does not carry that much weight anymore. Content is king because search engines are all powerful.
I reflect upon this because of the emphasis my domain name provider tried to place on the importance of privacy for my domain name registration. They wanted to charge me $8 per year to make my whois registration private. If you have no idea what I am talking about open a terminal session and type “whois adventurecontinues.org”. I have owned URLs from the very early Internet days, back when the URL dictated whether anyone would find your site or not. Public whois registration information was important to validate the integrity of the site and of course let people know who they might need to buy the URL from in case it was highly desired. Unfortunately this is valuable identity information which today is considered an invitation to sell you something, primarily all sorts of help with monetizing your website. Since purchasing my new URL I have received 100+ emails offering me every conceivable service I might ever need to optimize my website. Luckily all of those emails end up in my Spam folder (thank you Google). I suppose I could have avoided those emails ending up in my Spam folder if I had paid GoDaddy an extra $8 per year. Maybe I should pay Google the $8 for making it easy to delete them all “Delete all spam messages now (messages that have been in Spam more than 30 days will be automatically deleted)”.
I can rationalize this decision to brave the dangerous world of public notification but then again, it will create further issues. I have always been good at protecting the distribution of my phone number and to a certain extent my home address, but this information is readily available via the WHOIS lookup. Oh well, I think I will take the risk. After all Life is just one Big Adventure.
At the end of my Timberline to Cascade Locks backpacking segment I was crushed by the news that my beloved dog, Abby, had died unexpectedly. Abby was 12+ and not able to backpack with me any longer, but losing her at a time when I was experiencing a dream that she should have been sharing with me was tough. My wife and I knew we would find a new dog when we felt the time was right. Well this post is dedicated to introducing you to our new dog, Brook, another Australian Shepard who is destined to be my new backpacking buddy.
Brook came from Gearhart Aussies on the Oregon Coast about a month and we have survived puppy training. Plenty of accidents have been cleaned up and not to much chewing damage has occurred.
There is a period of time with the new puppy where your lives are not yours. You have to cater to the needs of the puppy at the expense of your own desires. However, you know it is short-lived especially when dealing with the intelligence that comes with the Australian Shepard breed.
Brook is a Blue Merle Aussie with piecing blue eyes. Her color scheme is beautiful with perfect marking of the reddish fur. She has already shown her commitment to being a Broncos fan during last weekend’s AFC Championship. Now we will prepare for the Super Bowl.
We will also hit the trail soon to expose Brook to the discipline needed for backpacking. I like her disposition of displaying initial caution with strangers or unusual activity, however, she quickly evaluates the situation and reacts appropriately.
My wife works in a hospital and would like for Brook to possibly accompany her as a comfort dog for her patients. I think Brook will be perfect for this duty. But the primary job for Brook will be to provide companionship for us, function as a watchdog and allow us to love her unconditionally for the rest of her life. A Dog’s life is so tough.
Here is a video recap of the Gales Creek Hike in Tillamook State Forest.
I have seen a trend with my STEM connected colleagues over the last 6 months wanting to discuss concepts of adaptive or competency based learning, CBL. These discussions evolved for many reasons such as; lack of classroom space, course scheduling problems or issues surrounding non-tenure track faculty. This discussion is right on target when it occurs with younger faculty, however, now older faculty are asking questions and seem to be contemplating how this could work. Generally there is agreement that it is inevitable that education will move in this direction, but then you start talking about the repercussions of what that might look like to the higher education business model and fear returns to the conversation. I guess what is different is that now there seems to be recognition of the value of the learning model and discussions are tending toward how we might implement it.
I decided to write this post after a number of discussions yesterday, some stimulated by those who viewed CNN’s airing of the “Ivory Tower” documentary. As we talked about implementing adaptive learning to our STEM courses I was drawn to the vision of the old one room schoolhouse. STEM possibly more then any other academic discipline is based on building blocks or competencies. Math and the sciences dominate this with competency based requirements built into courses as well as with interdependencies between courses. So when I thought of the one room schoolhouse I saw it as similar to the students that we receive. In the one room schoolhouse students have to progress through levels of reading, writing and arithmetic, and they had a built in remediation process. The teacher was there to help at all levels.
How did we get to our current college degree attainment path based on taking a selected number of courses that may or may not actually give you all of the competencies that you or your employer desire? I think we used to have a much more standardized entry path to college. Students from high school, mostly Americans, had very similar competencies due to similar curriculums that could not be supplemented by additional information as is now available via the Internet. The over achievers could go to World Book, but for the most part if a student got accepted to college then they pretty much entered at the same level and the progression through a standard set of courses with a few electives worked fine. That world no longer exists. We have screwed up high school believing that standardized testing validates competencies. Combine that with the financial pressure universities are under to maintain enrollment and you end up with a freshman class that is much more in line with the one room schoolhouse.
Change is coming and it will be heavily influenced by competency based learning and I think STEM may be well positioned to adapt to this. We have been working on this concept in our general ed core curriculums of math and science. At first it was about trying to figure out online or hybrid learning but now we are starting to see how we may need to change the academic business model. The emerging CBL providers such as Western Governors are built upon a personalized learning foundation that allows the student to progress at their own pace. Tuition is based on a period of time not on credit hours, which creates the incentive of “the faster you progress, the more you save”. Maybe there is a hybrid version of this that can work for the traditional residential university.
I’m going to take a stab at what this might look like for STEM degrees. I’m looking at this as realist considering what might be acceptable for our entrenched higher education culture, today’s student and the political and financial forces that will inevitably force the change. The first 2 years of most STEM degrees are fairly similar based on the need to build a foundation of math through calculus, basic concepts for the sciences with English and physics typically being foundational as well. This is true for pre-meds through engineering and it is typically fairly challenging to ensure that we are not wasting our time on the students in the upper level of the degree program. So how about a one room schoolhouse for each STEM discipline complete with a set of competency based learning modules designed with assessments that provide adaptive options to complete each step. We have talented non-tenure track faculty always available and still teaching but not on a fixed lecture circuit. The environment would facilitate collaborative learning along with the necessary lab requirements. The student pays the same tuition, and heck we even keep the semester structure. The advanced students finish early or have more time for extra curricular activities such as undergraduate research or experiential learning options. As the student emerges from this general ed core they enter into the more traditional degree completion with the upper level courses and labs taught by tenure track faculty to complete their STEM program.
I’m going to stop here without digging into the obvious questions and details. But what do you think? I think it might be an improvement.
I will blame not posting on my transition between jobs but I find myself in a hotel room in Rock Springs, WY on my way across America with some time for reflections. I am driving my beloved car from Oregon to Missouri via Denver where I will take in the ELI Conference on the 4-6. This Western half of the trip brings back many memories for me.
Leaving the Portland area through the Columbia River Gorge reminded me of the trip I took in the opposite direction in 2004 when I came to Oregon and George Fox University. What a dramatic portal it provides to the Northwest. I was extremely thankful that my trip east on a good highway was so much easier then Lewis & Clark had to deal with. I reference this concern because my entire trip in the heart of winter is a bit precarious in an Acura RSX that looks more like a snow drift to the trucks and snow plows that I have been dodging. Yes the Blue Mountains with snow packed roads kept me a bit tense. As I approached Salt Lake City with a plan to work my way down to I-70 for rendezvous with colleagues in Grand Junction, I had to abort due to a pesky storm hitting the area. Luckily diverting to I-80 worked out well and allowed me to reminisce about my earlier life in Mine Engineering and Electric Power Generating out of NW Colorado.
Rock Spring, WY, an oasis for coal miners in one of the harshest environments in the US. It is about 30 F and the wind is blowing 40 mph as it typically does. But there is coal in these parts and rivers to set power plants next to. Now they have added wind powered generators so there is plenty of electricity flowing out of this desolate place helping to light the cities of the West. Tomorrow I hope to make it to Steamboat Springs, assuming their recent 2 feet of snow does not stop me. There are still good friends and lots of memories there.
Update: I tried to get to Steamboat Springs but turned around at the Continental Divide on the road to Baggs, WY. Glare ice, 40 mph wind and big trucks caused me to reevaluate the risk/reward and decided to drive to Denver via I-80. The next day I did get to go Fly fishing on the head waters of the South Platte near Decker, CO. And yes, I caught a nice trout.
Final update, I did make it to Rolla. Bought a house the first day, love S&T and Rolla, MO.
I have been out of commission for a few days thanks to receiving a new hip Monday by way of the Hip Resurfacing procedure. Amazing technology on all fronts. I was a strong candidate for resurfacing being younger with strong bones. It appears playing way to much basketball along with some arthritis from my mother wore out my natural hips, but these chrome-cobalt ones are actually better. No more basketball but handball and golf work fine.
I will put a plug in for resurfacing, definitely explore it vs. Hip replacement. It was recently FDA approved.
PS – created this post with the iPad, had to revert back to old editor due to Flash incompatibility. Lack of Flash is definitely the biggest problem with the iPad. Have been using the iPad on and off for a day and a half and I’m at 57% charge. This heartrate monitor connector on my left pointer finger is a bit annoying as well.