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I really don’t know how to say this any other way. My dog decided to talk to me the other night and he had a lot to say.
It initially played like any other night really. Once again, I was tossing and turning, in and out of sleep. I was half awake, mulling over my job situation: I want to make money writing but I need an income more. Then the most bizarre thing happened.
“Hey human Bob! This is your best friend speaking! Wake up!”
Who the hell was that? It was a deep, low voice; strong and certain with a hint of a bourbon induced slur. Sounded like Dean Martin actually. I immediately sat up. It was pitch black. The radio clock blurred 3:53 in a dull crimson light. All I could make out was the shadowy outline of Parker, my trusty beagle, sitting upright at my feet.
“Hey boy, did you hear that?” I whispered instinctively. “Someone’s in the house.”
My vision was starting to warm up to the darkness. Parker just stared back at me, his head tilted, his long ears hanging to the side of his head like hand towels on a wall. He turned his head to the bedroom doorway, lifted his nose to the night and sniffed. He turned back to face me.
“Don’t think so.”
I swore Parker spoke but it couldn’t be. I mean his hound drawn lips seemed to move to the words I heard but that was impossible.
“Who’s there?” I yelled into the night. “Whoever it is, I am warning you that I am at this moment retrieving my loaded double-barrel twelve gauge from under the bed. I will shoot you. So leave now and I want to hear the door slam behind you.”
I made some dumb noises in a lame attempt to fool the intruder into believing what I had just proclaimed. I took the ruse to the next level.
“Okay. I’m fully armed and about to call 911 from my fully powered cell phone. Oh yeah, strong signal, four bars. Oh yeah, this is going to be a very clear 911 call.”
“You’re breaking me up. Put the phone down human Bob.”
It was Parker talking. I was certain of it. Nah, it had to be a sick trick.
“Okay, good one Steve. You wired up the dog with a little speaker. Very funny.”
My brother Steve was known to go to great lengths to pull off pranks. But I was pretty sure he was at his apartment in the city, sixty miles away, God knows doing what, and at 48 years old, unlikely to suddenly bother me with a prank—it had been 25 years since his last one. But the mind scrambles to the most implausible scenarios when so duly challenged.
“Don’t think so. Nope it’s me, Parker,” the dog mumbled.
I was positive he spoke again. By now I was sitting straight up, leaning towards him. He just sat there and looked at me with those big dark eyes. His poker face was on.
“Parker? Are you talking to me?”
“Well I’m not talking to myself.”
I leaned back against the headboard. He yawned.
“This can’t be. I’ve got to stop watching Animal Planet.”
“Listen, I’ve got something to say and I’m not sure how long this talking stuff is going to work so …”
“You are talking!” I interrupted incredulously.
“Should you want I bow wow?”
“Holy cow! Parker you are talking.”
“Yup. But I’m not sure for how long. So can I say a few things before …”
“I can’t believe this.”
“Yeah I know. Either can I but if you don’t mind.”
I looked at him with a giant smile plastered across my face. Parker can talk. The dog was talking. Who was I kidding? It had to be a prank. He continued.
“I’ve been listening to a lot of that talk radio and that C-SPAN channel you watch while you write. I’m here to tell ya I don’t like what I’m hearing.”
“You’re kidding me right?”
“Afraid not.”
Oh this was good. I was really hallucinating. Talk-shmalk, I had a few nagging questions of my own.
“Hey, can I ask you something before you get to your stuff?”
“Make it quick. I haven’t got all night.”
“You like smell things a hundred times more than we do, right?”
“Four hundred.”
“Okay, four hundred. Wow! Then I really wonder about this.”
“Yeah I know. Why do we like to sniff every morsel of excrement or yellow patch of urine we encounter on our walks?”
“Now that you bring it up, yeah, why? It must smell like the inside of Dick Cheney’s or Ted Kennedy’s septic tank? And you know how much crap they’re filled with.”
“That was a funny one human Bob. But it isn’t like what you smell. We pick up a lot more notes. It’s a broader pallet if you will. We don’t smell stink. We smell identity, mood, and illness. For instance, you know that crazy cairn terrier down the street?”
“Yeah.”
“She has stomach cancer and her humans don’t have a clue.”
“You are kidding me?”
“She probably has less than six months if they don’t get her to a vet soon.” He paused to lick his right front paw. “Yeah, and another thing. Don’t take me out at nights for awhile.”
“Why?”
“Cause there is a rabid possum living under the porch. That’s why.”
“You know this from the smell of possum poop?”
“Excrement.”
“Whatever.”
“Yup.” Parker yawned as if bored. “So is that it? Can I say what I need to say?”
“Well there is that thing you do with that licking your, you know, your …”
“Penis?”
“Well, yeah.”
“Jealous are we?”
“Well, it’s just that …”
“It’s all about keeping clean. Nothing pleasurable if that’s what you’re driving at. Nothing like what you do with your hand. By the way, I’d appreciate it if you wouldn’t pet me afterwards. Nope, no pleasure; it’s all business. You made sure of that when you had me “fixed”, remember. Thank you very much.”
“Oh yeah, sorry about that. I had no idea you knew any different.”
“No idea my butt. I’ll ‘no idea’ ya.” He paused again to lick his right paw again and then continued. “But I don’t hold it against you. We don’t hold grudges. Heck, if we did, we would have mauled most humans dead by now. Which brings me to why I am talking to you.”
“No grudges. Really? I mean that “fixing” stuff is pretty serious. That’s pretty good if that doesn’t bother you.”
“You done? Can I get to my concern?”
“Sure. Sorry. Go ahead.”
“How can humans be so smart supposedly, while they single handedly are destroying the Earth?”
“You mean global warming?”
“It’s more than that. It’s the air. It’s the water. It’s the dirt. It’s the forests. It’s the killing. It’s the anger. It’s the hate. It’s the grudges. It’s the fear. It’s everything.”
“Oh come on. You’re being a little dramatic.”
“We don’t know dramatic.”
“Well give me examples of what you mean.”
“First of all, the air is filled with danger. Dogs, cats, birds, animals of all kinds can smell it. It is our biggest topic when we get together.”
“I don’t smell a thing.”
“Yeah, that’s part of the problem. And you can’t taste the troubled water either.”
“Scientists don’t seem to be complaining. So I should be listening to a dog?”
“We have no agenda. Dogs call it as they smell it.”
“ ‘call it as they smell it’; I’m suppose to just accept that?”
“Yeah, there is a lot you should just accept.”
“Oh yeah, like what else?”
“Well, and here is what I think is the crux of the problem, you keep choosing the wrong alpha humans.”
“What?”
“You’ve got this alpha thing all wrong. Just because animals order their packs based on physical size and strength doesn’t make it so for humans. We do it because we are simple. You do it because you are thoughtless. That’s what we, and I think it is fair to say I am speaking for all animals, don’t get. Humans are able to think things through. But they never do. Well, that’s not completely true; some have but they are mocked or marginalized.
An alpha dog barks and gets all puffy, like that wacky shepherd Sarge from around the block. The worst he can do is break out of his electronic fence and charge one of us. But you humans take it up a notch.”
“Can you give me a for instance?”
“God there are so many. Let me see. Okay, you’ve elected a president who pounds his chest and walks around like a gorilla with its arms all out to the side, all tough and all, carrying on with ‘bring it on’. When he jumps the fence, he brings tanks and bombs and humans loaded down in weapons and in body armor. Meanwhile, you have alpha males all over the place, flexing their muscle in their packs, threatening to obtain nuclear weapons, the great equalizer, giving the president one excuse after another to hop the fence. It’s nuts. And I for one am telling you, you’ve got it all wrong.”
“Well, I don’t know what to say.”
“You don’t need to say anything. Just start picking the right alpha humans; humans whose visions see beyond fighting, whose hearts hold no grudges, whose thoughts and reasons are not the products of testosterone, whose collective knowledge is rooted in the concept that true peace is never the consequence of war but the outcome of constant learning, negotiating and adjusting.”
“This is what you want to tell me? Nothin’ for nothin’ but it’s a little heavy for a little chat with a dog at 3:30 in the morning.”
“In a nut shell, yeah.”
It was hard to accept this from my beagle. I mean, he’s a dog; a sleeping, eating, sniffing, crapping dog. I was chalking this whole episode up to stress. I was apparently snapping.
“That’s it. I’m pretty much done. Just one last thing while I have the chance.”
“What? World hunger? String theory?” I asked sarcastically.
“You get the right alpha humans and the world hunger thing will take care of itself, smart ass. As far as string theory, who do you think I am, Hawking? I’m just a dog. No it’s more pedestrian than that, something I think you can manage.”
“Then what, already?” I asked impatiently.
“You know that thing you do occasionally where you empty the dish washer in the buff.”
“Ummm … yeah I guess.”
“Put some clothes on. It’s disturbing. I’m beggin’ ya, please!”
“All right, but only if you lick your privates in private.”
“I’ll see what I can do. No promises.”
“So this is it? No more talking? You know we could make a fortune on Letterman with his stupid pet tricks.”
“It’ll never happen. You see, this is a one time deal. Not sure why or how this is happening. Maybe that God guy is involved somehow. All I know is that when it is done, it is …” He abruptly stopped talking.
“Parker?”
Not a grunt. He yawned and as he did he stretched his front legs out and spread across the foot of the bed, his ears resting flat on the blanket.
“Parker … are you done? Is that it?”
He slowly closed his eyes and floated off to sleep.
“Parker … just like that?”
He began to twitch; in hot pursuit of a fox I imagined.
“Holy smokes. I must be dreaming myself.”
I curled back down under the safety of my covers, scratched my butt and thought about the conversation I had just had with Parker or myself or both. I sniffed the air. It smelled fine to me. What the heck was he talking about, ‘danger in the air’? It had to be a dream.
As I drifted off to sleep, I thought about getting a real job real soon, apparently this writing stuff was getting the best of me. I also made a point to remember to talk to the owners of that crazy cairn terrier. I thought it was the least I could do. One can’t be too dismissive of the unexplainable these days.
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Cancer can attack any part of the body; lungs, stomach, reproductory organs and many other parts. A common form of cancer in men is testicular cancer. This is a cancer that occurs in the male sex glands in the scrotum. Testicles produce and store sperms while producing male hormones.
Testicular cancer is also known as germ cell tumor and is of two kinds - seminoma or nonseminoma. About 40% of testicular cancer are seminoma type and the other are divided into four sub-types; choriocarcinoma, teratoma, embryonal carcinoma and yolk sac tumors. The cancer can sometimes also be a combination of both cancers, and are called mixed germ-cell tumors.
Testicular cancer is prevalent in men aged between 15 and 35 and is more common in white men than Asians and blacks. The exact causes are still unknown, but there are various risk factors that can induce testicular cancer. Underdevelopment of testicles, Klinefelter’s syndrome where the man experiences sterility, small testes, breast enlargement and lesser male hormones and those who have had testicular cancer are all prone developing cancer on the other testicle in the 25 years after the attack.
There is nothing that can be done to prevent testicular cancer; the most that could be done is its early detection. Testicular self-exam is a great means of diagnosing testicular cancer; it is always better to test testicles immediately after bathing as this is when the scrotal sac is relaxed. The testicles have to be rolled between the forefinger and thumb for any signs of lumps.
Besides a lump, swelling in the testicles or some changes in the feel of the testicle are symptoms for testicular cancer. Accumulation of fluid in the scrotum or pain in the scrotum is also considered as symptoms of testicular cancer. Though these symptoms may signify other conditions, it is always better to have a physician evaluate the condition. Testicular cancer can also be diagnosed through ultrasound of the scrotum or a biopsy. Once testicular cancer is detected, treatment is rendered according to the extent of the condition.
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The choice between the various available treatment options involve treatment with a proper medicine. Response to an oral agent such as Levitra can be very effective in this context. Studies show that erectile dysfunction is mainly due to insufficient flow of blood to the penis’ veins and lack of stimulation as well. Practising oral therapy of Levitra increases the rate of blood flow that gradually stimulates the penis resulting in a hard erection, adequate for an intercourse.
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It can be surprising to realize that an organ as high-powered and sophisticated as the brain also has a plumbing system. And, as the case with a house's plumbing, the drainage side of the system can get gummed up. But the symptoms are different. When a home's drainage backs up, well...I won't go there. When the brain's drainage system backs up, the brain's owner can become confused, incontinent of urine and unsteady on his or her feet.
The plumbing system in question is that which produces and drains the cerebrospinal fluid (CSF). Normal CSF looks the same as water from a faucet, but is created from the bloodstream in the choroid plexus tissue within three of the brain's four inner chambers -- the right and left "lateral" ventricles and the midline "fourth" ventricle, but not the interposed, midline "third" ventricle. The CSF percolates through passageways from one ventricle to another, finally emerging through openings at the base of the brain to bathe the outer surfaces of the brain and spinal cord before getting reabsorbed into the bloodstream again. This re-absorption occurs in special collection-nodes in the membranes surrounding the brain. The entire CSF volume of about 150 milliliters or five ounces (about as much as a glass of wine) is produced and reabsorbed four times a day, so the fluid is constantly turning over.
But blockages along the way can interfere with the normal flow of the CSF. For example, when the passageway between the third and fourth ventricles becomes narrowed or choked with sludge, the CSF backs into the lateral and third ventricles. Those ventricles react to the increased pressure by becoming physically dilated or enlarged. In this case, a CT or MRI scan could reveal the location of the blockage by showing expansion of the two lateral and the single third ventricles, but a normal-sized fourth ventricle. Another example of a blockage and its consequences is when the collection-nodes responsible for CSF re-absorption in the brain's overlying membranes (meninges) become clogged. In this case, all four ventricles are upstream from the blockage, and all four of them expand. This, too, is visible on brain scans.
Both cases are examples of hydrocephalus, or water on the brain. The first case is one of "internal" or high-pressure hydrocephalus. The second is called "external" or normal-pressure hydrocephalus (NPH). In NPH the pressure is inexplicably normal much of the time, but the term is somewhat misleading because prolonged recordings with pressure-monitors do show intermittent periods of increased pressure.
Hydrocephalus of one kind or another is especially prevalent at the two extremes of the life cycle -- in the very young and the very old -- but can occur at any age. In infancy, hydrocephalus can be caused by malformed brain-tissue. In contrast, adults with hydrocephalus were usually born with normal brain anatomy, but acquired a blockage due to a tumor, injury, bleed or infection. However, many cases of hydrocephalus in adults occur without a history of these preceding illnesses.
CT and MRI scans are sensitive tools in detecting hydrocephalus, particularly when it's striking enough not be confused with ventricular enlargement due to gradual loss of surrounding brain tissue from aging. The main treatment of hydrocephalus is for a surgeon to insert a tube (shunt) into one of the swollen lateral ventricles and provide an alternative pathway for the backed-up CSF to drain. Once the shunt equipment is in place, a piece of hardware about the size of a large button sits outside the hole made in the skull (but inside the skin of the scalp) and redirects the excess CSF through another tube into either a jugular vein in the neck or into the abdominal cavity (peritoneum). Thus, the patient can receive either a "VJ" shunt or a "VP" shunt, with the letters designating the locations of the two ends of the shunt.
The success or failure of shunting depends not just on the skill of the surgeon, but also on the selection of appropriate patients. Sometimes hydrocephalus turns up unexpectedly on scans when doctors are looking for something else entirely. Although an unexpected finding like this should always cause the doctors to re-think the case, the point is that hydrocephalus doesn't always cause problems. Sometimes the hydrocephalus has been there for years and the brain has adjusted to it in a way that produces no symptoms. This is an example of a case that should not be shunted, though it would still be appropriate to monitor the patient and his or her scans over subsequent months and years.
Who, then, should receive a shunt? The answer, in short, is people for whom the benefits of the operation exceed its risks. Identifying them, however, is the tough part. And the task is made even more difficult by the lack of randomized, controlled trials in which a group of patients receiving treatment is compared to an equivalent group of patients not receiving treatment. Although similar reasoning applies to adults thought to have internal (high-pressure) hydrocephalus, I'll lay out the decision-tree as it applies to external (normal-pressure) hydrocephalus. Published observations imply that shunts are most likely to help NPH patients who have the following features:substantial enlargement of all four ventricles a full "triad" of symptoms, including confusion, urinary incontinence and altered walking poor walking as the first of the three symptoms temporary improvement of symptoms after drainage of 50-60 milliliters (2 ounces) of CSF by lumbar puncture (spinal tap) The elderly patients most at risk for NPH are also at increased risk for other diseases, and the shunting operation doesn't help symptoms produced by other causes. For example, confusion can be caused by Alzheimer's disease and strokes. Urinary incontinence can be due to prostate disease in men and sagging pelvic tissue in women. Walking can be disrupted by arthritis, fractured bones, low vision, inner-ear disease, Parkinson's disease and many other unrelated processes.
So it's important for the doctor to determine if other diseases might be to blame for the very symptoms that seem, at first glance, to be from NPH. Assuming that NPH still seems likely, the next round of decision-making concerns the possibility that an operation will cause harm. Even a patient whose brain scan and symptoms are classic for NPH can develop serious complications from the operation. A particularly feared complication is bleeding into the space outside the brain, called a subdural hematoma. Older patients are also more likely to have other medical conditions that could compromise the safety of an operation, like coronary artery disease or emphysema.
Cases in which expected benefits of the operation are much greater than risks, or in which the risks are much greater than the expected benefits, are easy to make decisions about. But many other cases are in the gray zone in which potential benefits and risks are more evenly matched and the chances of doing harm with an operation come close to canceling out the chances of doing good.
(C) 2006 by Gary Cordingley
