Sweet Scent

Image found here

Many people with Sjogren's have a decreased acuity of their sense of smell. I'm one of them. It's a very unpredictable thing. Sometimes I can smell whatever I'm sniffing, sometimes I can't smell anything. Sometimes that's a good thing. Sometimes..... not so much. 

We were visiting some friends today. They had just finished baling hay, and were in the process of moving the new hay bales into the barn. It began to rain, so everyone was busy getting the last of the hay under cover. I was enjoying the commotion and being outdoors and reminiscing about growing up on a farm. When it began to rain more heavily, I ducked into the barn. 

Oh, yeah. The fragrance of new hay hit me like a wall. What a treat! I couldn't help myself but flattened my face against the nearest stack of bales, and thanked my lucky stars that of all days, today my olfactory bulbs were working. 

I'm glad my friends didn't see me snorting a bale of hay. 

You can read more about taste and smell disorders here. 

I'm a Chicken

My friend Terese always manages to get into the darndest situations. With me next to her. 

We were shopping for party decorations, and were splitting the cost. I cruised the store while Terese hopped into line to check out. I joined Terese with my full basket and heard a very irritated "harrummmph" from the lady behind us. 

I could sense a brewing confrontation, and OK, maybe it did look like I was cutting in line. All right, all right, I admit I was cutting in. But Terese told me do it. 

I pretended not to hear more grumpy noises coming from the woman next in line. 

"Excuuuuuse me!" Cranky customer's voice raised an octave or two and about ten decibels. 

Um, yes?

"I was here first!"

Um, well, we're splitting the cost of these things, and my friend was holding my place in line, and..........well, if that's OK.....

"No. It most certainly is not OK!" 

Since I did nothing but gape stupidly at her, she steamed away to another line. She also left the store sooner than we did, I might add, for pete's sake. 

My point for telling this story, aside from pointing out Terese's penchant for getting me into trouble, is that I reacted much differently to confrontation in this instance than I might have five years ago. 

Anyone who works in the medical field, or any other customer service type industry knows that confrontation is an all too frequent part of the job. Whether from clients or other co-workers or vendors or families or........well, you know how it goes. 

I have never looked forward to a confrontation, but I have to say that in years past, in my opinion, I held my own in those discussions. Once, a physician asked me to take used dialysis equipment and reattach it to a patient's dialysis machine. I won't elaborate further but that tubing stayed in the garbage bag. 

I think my kids would think it funny if anyone suggested that I avoid conflict. Especially during their teen years. 

I kept thinking about how I felt when accused in that store. I felt those angry words almost physically strike me. My brain ceased functioning and I couldn't find a word to say. I wonder how I would have felt had I crossed paths with someone in a more serious situation. Terese would have had to scrape me off the floor since I am sure I would have disintegrated into a puddle.

In thinking about why my reactions have changed since Sjogren's, my first thought was that I was simply out of practice in arguing. But...no, this felt different at a much deeper level. Have I become a wimp? What's the matter with me? 

I am so glad to have so many resources at my fingertips when looking for answers like these. When I scout around on the Sjogren's World Forum site, I find many others who have experienced these same changes. I have read story after story in which others shared the same feelings and experiences. We are not wimps. We are changed people because of autoimmune disease. 

It is reassuring to know that I am not alone in this crummy disease. The opportunities to share, vent, and ask each other the questions that no one else would understand is incredibly valuable. I can prop my feet up on the coffee table, laptop under my fingers, and connect with people all over the world. 

Now all I have to do is figure out how to handle a confrontational Terese when she reads this post. 

Pie Victim

It all began in the produce aisle.

I unsuspectingly wheeled my shopping cart past an innocent and delicious looking stack of fruit. I caught a whiff of fresh peach, and I immediately stopped in my tracks. There they were - neatly stacked in a perfect pyramid, all fuzzy and peachy and delectable. 

"Fresh fruit is really good for me," I remember thinking. Before I knew it, six of those juicy beauties were tucked into a brown paper bag and on their way to the checkout. 

The problem began as I was driving home.

Images of those peaches kept appearing in my imagination, and the images were not of simple fruit. No. They had the nerve to appear repeatedly as a fragrant, homemade, warm, flakey-crusted, vanilla ice-cream topped pie. 

I don't want to boast, but I have to say that I make a good pie. A fantastic pie. I learned from my mother when I was barely tall enough to see over the kitchen table as Mom whipped out the only pies that could ever be - and still are - better than mine. 

I piled the peaches in my fruit basket in the kitchen and sternly told them to behave themselves. They were to be eaten in their fresh unadulterated state and that was that. 

But these naughty little peaches just kept tempting me all through the day. By evening, I was helplessly rolling out pastry and slicing fruit. 

I just finished eating my third piece of pie. And it is not my fault. 

I'll Have One To Go, Please

I love this story from Science Daily. 

E-BCP, a chemical found in spices and food plants such as oregano, cinnamon, basil and rosemary, was found to have anti-inflammatory properties by a study completed at Bonn University and ETH Zurich. 

"We have used E-BCP to treat mice with paws swollen due to inflamations", explained Dr. Jürg Gertsch of the ETH Zürich. "In up to 70 per cent of cases the swelling subsequently subsided".

Oregano? Basil?  

No-one had previously realised that it can have a beneficial effect on the body. "Our results have revealed that E-BCP inhibits inflammation", declared Professor Dr. Andreas Zimmer of the Life&Brain-Zentrum in Bonn.

Kids! Eat your pizza - it's good for you. And I don't want to hear any complaints, missy. 

Professional Patient

A very nice comment regarding Reasonably Well can be found today on Professional Patient. Thank you!

This very informative and well-written site is authored by Valerie Reidel, who describes herself as a thirty-something Marfan Syndrome and Sjogren's Syndrome patient. 

The Professional Patient site is a guide to managing illness, insurance, and disability in the U.S. When you visit her site, click on the upper right corner on the site index. 

Prepare to be amazed by the extensive list of posts and resources listed on this blog. 

Green Dogs

Our lawn is freshly mowed and the dogs are romping around in the piles of cut grass. Bart's grey fur looks relatively normal but Maggie's white beard and Sam's white feet are stained neon green. They all have grapefruit sized globs of grass attached somewhere to their furry bodies. I give them a cursory swipe with a towel before letting all three of them in to the house, thinking that at least they all smell fresh and .... grassy. 

This is a change of epic proportions for me. In days past, I would have hauled out the dog shampoo, sloshed a bucket of water outside, and sudsed all canine appendages until I felt they were worthy of touching Couch. 

No more. 

I look around my house, and while I am really good at making light of the dust bunnies that threaten to take over the bedroom, or dishes piled up in the sink growing new forms of life, inside I seethe. 

My poor house just cries out for a good thorough housecleaning, but I just can't do it. The knowledge that I can't physically do it really ticks me off. Sometimes my physical limitations make me furious. 

Not quietly frustrated. Not miffed. No, I mean pitch a fit, throw things, primal scream, roll on the floor kicking and screaming and flailing the fists furious. The realization of what I would feel like if I gave in to those instincts and actually threw myself on the floor only makes things worse. 

At times like these, I think to myself, this isn't living Reasonably Well, Julia. 

No kidding. 

What keeps me from breaking out the confetti and balloons for a pity party? 

Sometimes, nothing does. Nothing stops those feelings of frustration and grief. I flop onto Couch and indulge myself in going through the motions of crying, even though I no longer make enough tears to soak a Kleenex. Which only cues another round of angst. I lie on my back, theatrically dangling arms and legs off Couch, throughly convinced that there is no one else on this entire planet that has as disgusting an existence as I do. 

Eventually, reality puts things into perspective. Doggie Sam, in an effort to comfort, launches himself onto my chest and squeezes the breath out of me. I gasp for air and laugh in spite of myself. My daughter comes home with news of her day. I hear the garage door open and know that John will throw something on the grill for dinner. 

It seems as though Couch decides that the time has come to put an end to the tantrum, and the cushions roll me and Sam to the floor. Bart and Maggie start a slobbering frenzy. 

Life goes on. 

It's That Time Again...

Ahhh.......................Summer is finally here. 

With each change of season, I mark the occasion by changing my knick-knacks on my kitchen windowsill, and my summertime collection always includes a flock of pink flamingoes. As I was unpacking the flamingo box this year, it was fun to examine each bird and think about the friends that have given them to me. 

Those special people that have remained with me through these tough times are precious. When I am asked about strategies for surviving chronic illness, I think that the effort to nurture and cherish friendships is one of the most important strategies of all. 

How Do You Spell Fatigue?

The folks at the Sjogren's World Forum have done it again. This thread, which goes on for four pages, provides for interesting reading as the participants try to think of a synonym for the fatigue that we Sjoggies experience. 

My favorite comment describes how a horse feels after an exhausting race. Check it out!

Taking My Medicine

Picture and "story" found on Cute Overload. See Medicinal Laughter post below. 

OSLO -- Scientists at the Grubermann Institute for Hypnosis have announced that they have successfully hypnotized a subject into believing that he is a bowling pin. "The hard part," notes lead researcher Pyetr Van Fnyrrd, "was getting him to wobble realistically before falling over." The team hopes to apply concepts learned to its next project: Hypnotizing a family of four into thinking it is a set of steel-belted radial tires.

I feel healthier already. 

e-Thanks

The e-Patients website posted a very nice comment about Reasonably Well. You can read it here.

Thank you very much!

Medicinal Laughter

It's been said ad nauseum - laughter is the  best medicine. There is an abundance of research to back up the claim. 

A report issued by the University of Maryland Medical Center provided data to suggest that laughter is linked to healthier cardio-vascular health. 

Miller said that the most significant study finding was that "people with heart disease responded less humorously to everyday life situations." They generally laughed less, even in positive situations, and they displayed more anger and hostility.

"The ability to laugh -- either naturally or as learned behavior -- may have important implications in societies such as the U.S. where heart disease remains the number one killer," says Miller. "We know that exercising, not smoking and eating foods low in saturated fat will reduce the risk of heart disease. Perhaps regular, hearty laughter should be added to the list."

A study completed by Loma Linda University in California showed that laughter activated the immune system in several ways: 

	An increase in the number and activity level of natural killer cells that attack viral infected cells and some types of cancer and tumor cells.
	An increase in activated T cells (T lymphocytes). There are many T cells that await activation. Laughter appears to tell the immune system to "turn it up a notch."
	An increase in the antibody IgA (immunoglobulin A), which fights upper respiratory tract insults and infections.
	An increase in gamma interferon, which tells various components of the immune system to "turn on."
	An increase in IgB, the immunoglobulin produced in the greatest quantity in body, as well as an increase in Complement 3, which helps antibodies to pierce dysfunctional or infected cells. The increase in both substances was not only present while subjects watched a humor video; there also was a lingering effect that continued to show increased levels the next day.

So are those of us who are curmudgeonly, cranky, or just don't get the joke doomed?

Not if you sign up for the nearest laughter yoga class. This Science Daily article from May 2008, describes the University of Michigan Healthcare System's class and it's  benefits: 

“Kids laugh about 400 times a day, and adults only about 15,” notes Barb Fisher, a certified laughter yoga leader and the instructor of this class offered by the U-M Health System’s MFit health promotion division. “Laughter is a gift that has been given to us to make us feel better.”

Fisher teaches her students that not only is it fun to laugh, but that laughter yoga (also known as hasya yoga) can provide many health benefits:

• Help to reduce stress
• Enhance the immune system
• Strengthen cardiovascular functions
• Oxygenate the body by boosting the respiratory system
• Improve circulation
• Tone muscles
• Help with digestion and constipation

I guess we need to take our lightheartedness more seriously. Laughter yoga may be one way to get your daily humor allowance in, but my personal preferences may be different. So may yours.

 Go find your laughs for the day, and share them with me. We'll all be healthier. 

e-Patients

I recently discovered this very thought-provoking site, e-Patients.net, dedicated to empowering patients to become educated and active participants in their own health care, primarily by utilizing the educational and social connections made possible by internet resources. 

These are pretty lofty goals. Especially when some physicians and other health care providers adopt an attitude which can range from indifferent to offended by the well-informed healthcare consumer. The authors of e-Patients, many of which are physicians, look to change those attitudes, and in doing so, improve the quality of medical care. (Thanks to e-Patient Dave deBronkart for sending the link to me.)

The physician responsible for creating the e-Patient concept, Tom Ferguson, was a multiple myeloma patient and utilized his own principles and concepts as an e-Patient in dealing with his disease. This information about Dr. Ferguson was taken from the e-Patients site:

Tom Ferguson coined the term e-patients to describe individuals who are equipped, enabled, empowered and engaged in their health and health care decisions. He envisioned health care as an equal partnership between e-patients and health professionals and systems that support them.

Dr. Ferguson and a group of collaborating authors produced a fascinating white paper, found here, which expands and discusses the e-Patient concept. From the introduction: 

"...When patients participate more actively in the process of medical care, we can create a new healthcare system with higher quality service, better outcomes, lower cost, fewer medical mistakes, and happier, healthier patients. We must make this the new gold standard of healthcare quality and the ultimate goal of all our improvement efforts.....

- Charles Safran"

 The paper goes on to elaborate the authors' concepts:

Patient-Driven Healthcare: Seven Preliminary Conclusions

1. e-Patients have become valuable healthcare resources and should be treated as such.

2. The art of "empowering" patients is trickier than we had thought.

3. We have underestimated patients' ability to provide useful online resources.

4. We have overestimated the hazards of imperfect online health information.

5. Whenever possible, healthcare should take place on the patient's "turf".

6. Clinicians can no longer go it alone.

7. The most effective way to improve healthcare is to make it more collaborative.

As the author of a patient centered blog I am excited and gratified to read of this movement in healthcare. Those patients in the blogsphere and cyberspace have seen this need and have been working on our side of the solution for years. It's good to see healthcare providers step up to to the challenge.

I encourage readers to visit this site and take the time to read the white paper.

Soda Free Summer

I may have found a tool to help me kick my Coca-cola addiction. See previous post here. 

The bay area is promoting a Soda Free Summer campaign. Useful information found here.  Doc Gurley adds additional ammunition to the fight by labeling cola as "liquid obesity". 

Brilliant!

Sjogren's Syndrome and Kidneys

A reader left a comment and question yesterday about kidney disease and Sjogren's Syndrome. It was a very good question and deserved a more thorough answer than my brief reply. 

Her question was: 

I came to this blog because of Sjogren's. I have been diagnosed with it for almost 4 years now. It has affected my kidneys to the point that I have stage IV chronic Kidney Disease. I am scared that I will be put on dialysis in the next couple of years. I am being put on Procrit injections. Have you had to do this or know someone that Sjogrens has affected their kidneys badly?

The impact that Sjogren's has on the entire body should never be underestimated. Too often, medical caregivers are unaware of the existence of this autoimmune disease. Many have only a sketchy understanding of Sjogren's, and assume that the disease affects simply the eyes and the saliva glands. 

The reader's problems with her kidney function as a result of Sjogren's is unfortunately a good example of the possible systemic, meaning body-wide, complications of this disease. Other organs which may be affected include the lungs, liver, organs of the intestinal tract, the nervous system, the skin and connective tissues, and kidneys. 

Kidney involvement as a result of Sjogren's Syndrome is not uncommon, but the percentage of patients with serious and obvious symptoms is small. The most common problem in kidney function occurs when lymphocytes, a specific white blood cell, mistakenly identify kidney tissue as foreign to the body. They then move in to the kidney in large numbers, and attack the kidney. Most frequently, these "broken" lymphocytes move into the tissue around specialized kidney filters, and cause a condition called interstitial nephritis, resulting in the patient passing large amounts of un-concentrated urine. 

Another condition, renal tubular acidosis, occurs when these lymphocytes cause the kidneys to become unable to excrete a highly acid urine. This can result in an imbalance of normal salts and other essential blood chemicals.  

Less commonly seen are problems which lead to progressive kidney failure. 

You can read more about kidney involvement and Sjogren's here in a National Institutes of Health document,  here, in a National Kidney and Urological Disease report, and here, in an excerpt from The New Sjogren's Syndrome Handbook  by Stephen Carson, MD, and Elaine K. Harris. 

Pictures

Maggie

Sammy

Bart

This picture of Mount Hood was taken from my back yard using my birthday present - a zoom lens for my camera. 

New Math

Image found here. 

In one of my earlier posts, I made the observation that my life is directed by an equation:

Tired = Stupid

I used to be one of those people who could walk and chew gum at the same time. I wasn't an Einstein, didn't have a photographic memory, but could remember most daily details. Usually I could identify my kids in a large group of people, remember where I parked the car, get myself to work and back home again, and had some general idea how much money was in the checking account. 

On days when I have a fair amount of energy, these things are still true, to a certain extent. But when my energy levels are low, my mind morphs into mush. Suddenly simple tasks require an enormous amount of concentration. My kids get referred to as "um...you...what's your name again?" I wander around the house looking for my car keys, which are inevitably right in my pocket. Dinner may be plus or minus key ingredients, if it gets made at all. 

While this is still true, I have found that lately I am refining this equation further:

Tired = Stupid + Cranky (squared)

When this equation is in effect, what results is not a pretty scenario. 

It seems that lately my cheerfulness factor (CheerF) is directly proportional to my energy levels (EnergyL), and my crankiness factor (CrankF) and stupidity levels (Stupid) are inversely proportional to my cheerfulness factor and energy levels. Got that? 

So I guess that would create yet another equation which would look something like this:

CheerF/1 =EnergyL/1 = 1/4CrankF = 1/Stupid

Or, maybe it would look like this:

1/CheerF = 1/EnergyL = 4CrankF/1 = Stupid/1

I would also like to add that this is not fair.  I am not sure how to correctly express that mathematically. 

I seem to recall from my math classes that to be correct, both sides of a mathematical equation have to be equal in value. So how can I possibly equate being low in energy with being overwhelmingly crabby and stunningly stupid? Is there anything equal or fair about that?  

No, there isn't.

Overheard

Photo found here

I was sitting in the backyard, Bumpus hounds running amok, looking at the gorgeous sunshine from a generous patch of shade. From somewhere in the neighborhood, I overheard a conversation. I wonder what I would have seen had I peeked over our fence. Here's what I heard:

Two male voices talking.

Guy number one: "What happened? Flat tire?"

Guy number two: "Nah. The kid got sick."

I had to really think about that one. How could you mistake a flat tire for a child being sick? Any ideas? 

Anyone? 

Stages and Changes

As I watched my daughter stride confidently across the stage to receive her college diploma last weekend, I felt a surge of pride, then a wave of nostalgia. The cliche "seems like just yesterday", so trite and overused, yet so true.....

It seems like yesterday that I made that walk before beaming parents and friends to grasp  my diploma. And yesterday that John and I were married, and just five minutes ago that my daughter was born. 

I remember spending hours impatiently dreaming of  my future. 

And now, here we are. 

Isn't life grand?  I just wish it would slow down a little.  

Father's Day

Best wishes to all those wonderful dads out there. 

In honor of Father's Day today, I thought it fitting to repost an earlier submission written back in March. 

A friend has said to me that I mask my disease and it's symptoms really well. I thanked her for the compliment, but in all reality this is not true. The REAL master of this ability is my dad. I am such a wimp compared to him. 

Dad is an eighty something dairy farmer living in the midwest. He is the toughest individual that I have ever met. On first meeting, this isn't immediately evident. He is a little on the short side, moderate build, wears glasses, and recently has started using a cane. 

Dad's toughness isn't apparent until his medical history comes to light.

My favorite Man of Steel story about Dad, and there are too many to write here, happened several years ago. He had been in his tool shed and showed up at the house with a huge bolt hanging out of his cheek. One can only guess how this happened. We suspect it was related to some of the power tools he has in his shed, but Dad wasn't sharing that information. 

Later, in the emergency room, after Dad refused any attempts to numb the area, the ER doctor was mulling over his options for removing the bolt. He told Dad that the best plan of action would be to send him to surgery, where it could be removed with the least amount of pain, and then a plastic surgeon could repair the wound without leaving an enormous scar. 

Naw, Dad said, and patiently explained how threaded bolts work - lefty loosie - righty tightie. Then he told the doctor to start twisting the bolt out, or he would start himself. It took a few minutes for the doctor to realize that Dad was serious. This is exactly how that bolt left Dad's cheek. A few simple sutures later, he was on his way home. 

Last fall, Dad was diagnosed with lung cancer. The diagnostic procedures that led to this diagnosis were difficult and they led to an even more difficult surgery in which one third of his lung was removed.  I flew home to be with him and to help Mom care for Dad after he returned home. 

The day of his discharge, which took place two days before he was advised, Dad was glad to be home. He still had considerable pain, and I was prepared to spend a sleepless night keeping watch over him. But Dad popped a couple pain pills and hobbled to bed. He and Mom said their prayers and cashed in. 

I woke up eight hours later, and sat up in shock. Where was Dad? Did he actually sleep through the night? Then I heard the familiar sound of early morning news drift in from the living room, and I relaxed. He must have gotten up early and was probably sitting in his favorite recliner. I threw on my robe and headed for the living room. Hmm....no Dad. I checked his bedroom, but Mom was sleeping quietly alone in their bed. Not in the kitchen, basement, or bathroom. 

I was beginning to worry. He couldn't have - no, he wouldn't - I made a dash for the garage. Dad's car was gone. I woke up Mom and we both began to throw on clothes, in anticipation of issuing an all points bulletin for my AWOL father. 

Just as I finished lacing up my shoes, we heard the garage door close, and a very pale, very weak Dad came through the door. 

He held up his hand to stop our tirade from beginning. 

"I made it through this surgery. I am home safely. I decided that I needed to go to church to tell the Lord how thankful I am." 

He walked past us and went back to bed. 

Weekend Plans

My daughter is graduating from college this weekend, so the family and I are heading to her school. It's time to reminisce and celebrate!

Sniff....

I may or may not be posting over the weekend. 

I'm feeling verklempt.....

Talk among yourselves. 

Sleep Equals Grades

In the spirit of the weekend's theme, which is my daughter's college graduation - YESSSS! - this article has valuable information for my youngest, who is still in college. Check this out, daughter number two: 

A study completed at University of North Texas concluded that students who considered themselves morning people were more likely to have higher grade point averages than students that called themselves night owls.

They had 824 undergraduate students complete a health survey that included questions about sleep habits and daytime functioning, and found that students who are morning people had higher grade point averages (GPAs) than those who are night people. 

The finding that college students who are evening types have lower GPAs is a very important finding, sure to make its way into undergraduate psychology texts in the near future, along with the research showing that memory is improved by sleep," study co-author Daniel J. Taylor said in a prepared statement.

"Further, these results suggest that it might be possible to improve academic performance by using chronotherapy to help students retrain their biological clock to become more morning types," Taylor said.

I wonder if this same information can be used to understand more about the relationship between sleep and other memory/cognitive issues, such as brain fog in autoimmune disease. The importance of good quality sleep is incredible. 

Technology Help in Troubled Times

Photo found here.

I love reading stories that highlight the good things that we do for each other.  

This article discusses two great websites which provide free web page hosting for those in medical crisis. The following are excerpts:

By STEPHANIE NANO NEW YORK (AP) — When he was diagnosed with kidney cancer last year, Dave deBronkart needed an easy way to keep his far-flung friends and family updated. So did the president of the American Medical Association when he fell ill months ago. And so did the mother of a soldier wounded in Iraq who later suffered brain damage.

They all turned to the Internet, setting up individual Web sites to give progress reports. In return, they get posted notes of encouragement and support — all without having to repeat the details in emotional and exhausting phone calls.

"I had already been burning myself out with phone calls" telling people, said deBronkart, of Nashua, N.H.

DeBronkart, like others, used free online services like CaringBridge and CarePages and their user-friendly formats to quickly set up a Web site to share the news — good and bad. Patients themselves or family members write about treatment and recovery from illnesses, accidents or other medical crises, such as a premature births. 

The mother of Marine Lance Cpl. John Doody uses CaringBridge to keep in touch with his Marine buddies, friends and relatives in the Denver area, where he grew up, and her new husband and friends in Idaho.

Chris Ott has been at her son's side since January when he collapsed while recovering from gunshot wounds from Iraq and suffered brain damage. For a time, she stopped answering her phone because "it was too painful to talk about it."

Her sister set up the Web page and soon Ott was posting updates, writing about each step in her son's recovery, the move from San Diego to a Veterans Affairs rehabilitation center in Tampa, Fla., and outings to the mall and beach. News that her 25-year-old son had begun to talk again brought a flurry of excited replies.

"It helps lift your spirits when you know people are thinking about you and praying for you," said Ott, who was married at her son's bedside in February.

On the Net:

• http://www.CaringBridge.org
• http://www.CarePages.com

Efficiency

Photo found here. 

Aren't gasoline prices outrageous? Here in the Pacific Northwest we hit $4.25 today. 

Excuse me while I hyperventilate. 

As gas prices have skyrocketed, our family's awareness of the efficiency (or inefficiency) of our vehicles has skyrocketed too. It's suddenly very important to be as miserly as possible with that expensive energy resource - gasoline. 

Which gives me yet another opportunity to point out the similarity between efforts to conserve resources of any kind of energy, be it at the fuel pump or in my body's cellular power plants - the mitochondria. You can read more about mitochondria and other cellular innards here. 

My latest favorite mitochondria-type energy saving device is my mini vacuum cleaner. It closely resembles a souped-up Dustbuster on a stick. I won't post the manufacturer here since my intent isn't to plug a particular product, but this thing is great. 

With five critters leaving fur around my house, vacuuming daily is crucial to allergy-prone John's sinuses. Early on in my Sjogren's, I simply couldn't summon enough energy to heft a full size vacuum cleaner around the house. After wading around ankle deep in fur for awhile, it occurred to me that some serious problem solving was in order. 

This little gadget is very lightweight. I don't have to bend or stoop to use it, and it has just enough power to efficiently capture pet hair and other doggie shrapnel from my hard surface flooring. It is emptied easily and goes back in it's battery charger/storage stand in a snap. 

I wonder if there's a gizmo out there that would teach my pack some good manners?