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Lynne Leichtfuss
Social climber
valley center, ca
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Feb 26, 2009 - 12:05am PT
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so since i'm new, school me sewelly ..... who or what is barbar...? must be famous, infamous ?
Edit: ron g. will be watching the white stuff, ouch !
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Lynne Leichtfuss
Social climber
valley center, ca
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Feb 26, 2009 - 12:27am PT
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Sewellymon, LOL !!!! Todd hide yo familia. The climber dudettes I have met can take care of theyselves. Barbar better watch his own self ....hehehe. lrl
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mooser
Trad climber
seattle
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Feb 26, 2009 - 04:26pm PT
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Got to change my return flight to a couple days after the event. Yee haw! Looking forward to it.
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Todd Gordon
Trad climber
Joshua Tree, Cal
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Feb 26, 2009 - 08:26pm PT
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Check out the Stonemasters pre-book slideshow peek-a-boo, help out Roy "Beadwagon" McClannahan, have some uncooked dead fish, and sample some of the relaxing, low agle dummy dome breast climbing.....sure to be a weekend to remember...
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Ezra
Social climber
WA, NC, Idaho Falls
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Feb 26, 2009 - 09:42pm PT
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Tar,
I spoke to a very good vascular/Cardiothroacic surgeon today at lunch. He offered some good insights.
1. He said he would want to demonstrate increased pressures in your forearm before he would have the surgery
2. At least in the anterior compartment of the calf you loose 5-10% of your calf strength when you have surgery for compartment syndrome.
3. He said the surgery wasn't that technically difficult.
4. He said that measuring the intra-compartmental pressure is difficult and variable depending on the technician.
In my opinion I would see an orthopaedic or vascular surgeon who is comfortable evaluating and correcting compartment syndrome, maybe even before a rheumatologist.
The surgeon should be open minded, as compartment syndrome of the forearms is extremely rare.
Bring articles on compartment syndrome of the forearms to him (or her).
Best
-e
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Lynne Leichtfuss
Social climber
valley center, ca
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Feb 26, 2009 - 10:16pm PT
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Grate for you mooser ! Todd, dude, keepin' the fun in the thread which is what some of us need. Yes !
Jess got home and watchin' the On Sight dvd by Alastair Lee. Love the screaming, scary parts. :D
Big Respect for those dudes...."that's a whack" ....yeah it sho was. Ouch !
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Tarbuster
climber
right here, right now
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Feb 26, 2009 - 10:33pm PT
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Thank you for running that down Ezra.
Yes from what we’ve been reading, testing the ICP (inter-compartmental pressure) is a must-do in first verifying compartment syndrome or chronic compartment syndrome. I won’t go under the knife without it.
Thanks for highlighting that it’s also a tricky process; testing the compartment pressure.
As it turns out,
I've made an appointment with a rheumatologist for March 31.
This is for a doctor who was in a similar fellowship to that of Dr. Collier, under Sterling West.
Hopefully this will open up the diagnostic avenues a bit and lead to a good vascular/thoracic surgeon if need be.
Did you read up-thread where Healyje recommended I forward a packet with my histories, symptoms and tests prior to my appointment?
I have this packet standing by (plenty of them have gone out in the past).
He also recommended that one of you might prepare a cover letter, in order to summarize and best set the stage.
I just e-mailed him about it.
What is your opinion or inclination towards the cover letter?
Joseph said he was comfortable with drafting one, perhaps it is less appropriate for you to do it since you're an M.D. and I'm not technically your patient.
Thanks again,
Roy
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Ezra
Social climber
WA, NC, Idaho Falls
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Feb 26, 2009 - 10:37pm PT
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Roy,
I'd probably be better if Healy did it, especially if he knows you personally. I'd like to help, but have never met or examined you. Wishing you the best, I know you are an amazing person and fighter, here's to the next crux (I've been drinking Moose Drool beer recently).
-e
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DanaB
climber
Philadelphia
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Feb 26, 2009 - 10:39pm PT
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Compartment syndrome of the upper extremities does seem to be very unusual. I did a Medline search and only found five cases in the medical literature. If it would be helpful, I could retrieve them and send them to you.
Dana
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Tarbuster
climber
right here, right now
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Feb 26, 2009 - 10:43pm PT
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Ezra,
Keep in mind I'm not resisting this growing sense amongst you physicians here on the form that this might be a form of chronic compartment syndrome.
Also recall I just underwent a workup from a very good vascular surgeon; wherein I pressed him on the idea of both a strange variety of exercise-induced TOS, as well as compartment syndrome, and the testing for inter compartmental pressure.
It sounds like I really need to do that ICP test and I'm not averse to it.
Roy
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Mighty Hiker
Social climber
Vancouver, B.C.
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Feb 26, 2009 - 10:45pm PT
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It sounds like it will be quite a large event, given the general location, the site (Gordon ranch), the time of year, the entertainment (Stonemasters, sushi, etc), and most importantly the cause. How many people are likely to attend? Working backward from that, what arrangements will be needed?
It sounds like 100 - 200 might be there.
 Portable toilets? (Dwayne?)
Keg(s), and whatever is needed to dispense them?
City permits?
Sound system, screen and projector, large enough area?
Big cleanup the next day?
Emergencies?
Sushi?
Money?
Bodyguard for Roy, so 200 people don't shake his hand and wear out his arm?
Plus all the other great stuff that Rick, Todd etc are doing to make it happen.
I'd guess that a volunteer or ten will be needed to make this all work well. Not knowing the plans, site, or likely attendance, I can't say more, but some planning and preparation are likely to pay off. That is, to generate more funds for Roy, and make sure everyone has a good time.
Not to mention the stuff people have to figure out themselves - getting there, designated drivers, places to stay, etc.
It may help to have a new thread, just for people to indicate whether they're coming or not, and whether they'd want sushi or not. Doug can decide if he wants people to pay in advance, or will trust them to show up and pay. Maybe a wrist band system will work for that part.
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Tarbuster
climber
right here, right now
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Feb 26, 2009 - 10:49pm PT
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Dana B,
We've been reading some of these accounts of chronic compartment syndrome local to the forearm and the resultant surgeries.
Yes please, do forward what you found, or simply post the links here.
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Tarbuster
climber
right here, right now
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Feb 26, 2009 - 11:09pm PT
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Ezra,
Here's a link to a particularly difficult form of thoracic outlet compression (TOC), resulting in exercise induced ischemia:
http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=1764965
When I described this to the vascular surgeon whom I recently saw, he said we could try a CT angiogram, while holding my arms in different positions.
Perhaps it's inappropriate to second-guess professionals on a forum such as this, but do you think your colleague would pursue a similar diagnostic avenue?
Is it possible you might run this by him?
Roy
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Lynne Leichtfuss
Social climber
valley center, ca
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Feb 26, 2009 - 11:16pm PT
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Good thoughts MH. :D Have a Peace filled eve. lrl
Edit: I'm playing fantasy tonight. Pretending I am Ice Climbing a Waterfall in Iceland. Feeling in the brain what it may be like to place an ice screw or two. Then taking them Ice axes and placing them into the Ice. Whooheee !
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Tarbuster
climber
right here, right now
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Feb 26, 2009 - 11:24pm PT
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Mighty Hiker,
Thanks for broaching the logistical concerns.
Some of those items we've discussed and it has been expressed a few of those items won't need further consideration.
(We being myself, Todd Gordon, Spencer Lennard, and Rick Accomazzo.)
If you wish to help coordinate, or likewise just highlight areas of concern which you think need more attention, I'd suggest copying what you just wrote and please forward it along to Rick and Spencer.
Todd Gordon of course will answer to some of those concerns.
He'll get it right here on the thread for certain.
I'm sure we could use some help.
I think attempting a head count is a really good idea.
And maybe a separate thread for logistics would be a good idea.
Let's get a consensus here before we do it.
(Doug already has his separate thread)
raccomazzo@bmalaw.com
bigwildlife@gmail.com
And thanks for asking earlier about my flight and transportation arrangements.
Lisa made these a few weeks ago, using a voucher she had for my flight.
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Ezra
Social climber
WA, NC, Idaho Falls
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Feb 26, 2009 - 11:39pm PT
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Tar,
Would be happy to run it by Mike. Thanks for the link, must sleep now. Don't know when the next time I'll see Mike at lunch. He trained under Debakey at Baylor, super smart and nice guy. The Throacic outlet compression also seems like a good possibility. We'll all be interested to find out what the answer is. Feel like we have a descent shot (better than 50%) of figuring this problem out.
-e
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Tarbuster
climber
right here, right now
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Feb 26, 2009 - 11:42pm PT
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Thank You Ezra.
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matisse
climber
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Feb 26, 2009 - 11:42pm PT
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Tar,
you said compartment syndrome was ruled out but you didn't say how. perhaps the pain is not in the right place. we can't see/tell that. But if it is someplace even remotely compartmentally , and if you have not had pre-post exercising compartment pressures, then it has not been ruled out.
The TOS is another great thought. If it was me I'd keep going on the vascular side of things. I don't think a rheumatologist will do much for you
good luck
Sue
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Lynne Leichtfuss
Social climber
valley center, ca
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Feb 26, 2009 - 11:44pm PT
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Yah, Ezra .... thank you from all of us for your time and concern for a major mate on the taco. Really ! Peace and Joy to you. Lynne ....Good Life to Ya. :DD
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Tarbuster
climber
right here, right now
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Feb 26, 2009 - 11:58pm PT
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Matisse,
I have known about the ICP for some time, and pressed the vascular surgeon on it.
(It's been ruled out through, history, palpation (physical exam), and Doppler)
I don't know why CS has been ruled out without doing further testing; but he's not the only MD to feel no need to push further in that direction.
Concurring with the vascular surgeon (on CS), are two neurologist's, a physiatrist and a neurosurgeon.
TOS/TOC,
Read the link above.
Regardless of that information, I've had numerous doctors rule this out. The last one, a neurologist, said my thoracic pulse is a bit slow to come on, but fine. Nevertheless, she recommended I see a vascular surgeon which I did and have reported on his findings above.
He suggested a CT angiogram if I felt like I wanted to throw some money at it, but really wasn't thinking himself that this is where we need to go.
If you follow this thread from the top you will see how we arrived at covering the rheumatology base. My primary care physician who specializes in metabolic issues and sees a wide range of patients presenting with all kinds of systemic anomalies, didn't think I needed to go with rheumatology.
Slippery stuff.
Thanks very much for chiming in here.
Roy
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