YeshuaAgapao.com Blog

The American Heart Association ‘Natural History of Hypertension Subtypes’ article says that cardiovascular disease risk starts at 115/75, which is probably why the pre-hypertensive category got added and starts at 120/80.

The Medscape site has a new term – Mean blood pressure. It is roughly estimated at Diastolic Blood pressure + 1/3 of pulse pressure. It is the most correlated with stroke. Though the article is focused in telling doctors not to ignore ISH (isolated systolic hypertension) in people over 50, it, by accident, is also telling doctors not to ignore IDH (isolated diastolic hypertension) as it raises the mean blood pressure (DP+1/3*PP). Combining with the AHA Hypertension Subtypes article, risk of cornary artery disease is still present because IDH is likely to turn into SDH (systo-dialstolic hypertension) over time, which is a big risk factor of conary artery disease.

I read these because my mom is paranoid about my blood pressure, but is focusing her paranoia on the bottom (diastolic) number. My mom has 4 stented cornary arteries (over two emergency room visits with chest angina), and 100%/70% occluded carotid arteris (moderate language-area stroke with high-recovery). I have a crusing (at home, low stress, usually night-time) BP of 118/78 to 125/85 that sometimes elevates to 130/80-90 to 135/90-95 (intermittent mornings or moderate stress) and peaks at 140/100 (traveling or high-stress). My absolute highest reading was 142/105, but I’ve had a few (5-10) isolated readings of 135-140 over 95-100. My pulse pressure (difference between the high / systolic and low / diastolic numbers) is usually 40-45, but intermittently it can be as high as 50 or as low as 35.

Overall i am pre-hypertension with intermittant elevation into isolated diastolic stage-1 hypertension (ISH-1 is >=140/<90; IDH-1 is <140/>=90; SDH-1 is >=140/>=90) and uncommon elevations into SDH-1/IDH-2. I do have a high resting heart rate in the low-to-mid 80s which means I don’t get enough excercise. My cholesterol is borderline-high (210-225), slightly higher than my father’s (190-210; My father’s genetic baseline with a worse diet). My mother had (before drugs) cholesterol was over 250 and my sister (smoker+recovering alcoholic) is over 300. My mother’s BP was really high all her life. She is normalized with drugs but is probably very dependant on them now because if she misses more than 1 consecutive dose, it turns 200+/something (<100 i think). I hope I have my father’s genetics in regards to BP (excluding stress sensitivity) in addition to cholesterol. The non-alcholic members of my father’s side of the family all have lived a long time, and even the alchoholics get into their 60s (and still drinking).? My father’s-side grandfather will probably outlive my mother and is is my only currently-living grandparent.

Trade Guevera. Dump Jolley, Meola, Henderson and one other guy. Seems consistant with Red Bull. 3 Guys consume half the salary cap. Most of the guys with medium-high salaries (60-200K) would have to be dumped or they would have to run a major young-player sweatshop to have a productive cog in their marketing engine (Red Bull has marketing EVERYWHERE).

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Lanny is getting married! Second paragraph. He has lived with her for a couple of years now. I think the marriage will stay stable after the sex wears out.

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I learned that video games (Non-frustration, no indulging violence), game boys, books, and kitty cats lower my blood pressure (I bought a Omron from between 130/85 and 140/100 (pulse pressure between 40 and 50) to between 120/80 and 130/90 (pulse pressure between 35 and 45). I tend to have constant upper-130s blood presure when traveling and it goes up also when thinking anxious thoughts (I also have 130s readings when just waking up but I do snore badly and I think I have non-breath-hold sleep apnea, whatever you call – breathing resets from snore-jam).

Quite the opposite in arguement (pro infant-labectomy vs anti-infant-circumcision). Arguing pro for either is on the same reasoning – more hygeine (less bacterial havens) and less sexual desire opportunity. Neither site is christian. Half of the reasoning in the laws of the old testament are hygiene related. The additional disadvantage of labectomy over circumcision is that labectomy damages appearance more than circumcision, and it is in a very visible area! Also penile foreskins are probably way more emulate-able via sex toys than lips are!

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The snorkel goes into the mask (the hand, which also keeps water from going up the nose, hides the snorkel’s mouth-end), wraps around to the back of his neck, down the back of his shirt, through the side of his shorts, and out the back of the leg, and then snaked out over the edge of the foot-end of the bathtub. There is about 2 ft of pressure difference, but breathing is still somewhat reasonable. It is definitely a concealed snorkel and not a pressurized air source within the mask. Rebreathers and other closed circuit systems are too bulky to conceal and other breating systems emit exhaled bubbles. Try putting that snorkel into some deeper water If you must do it in a bathtub, make sure somebody is there to pan the camera and make sure the person is not ceoncealing a snorkel (and to save him if he passes out), and that the person is not wearing a face-mask and is naked or at wearing spandex so that a snorkel hose will be quite visible.

Here is a really good ankle anatomy map to supplement These more detailed, color coded pics. This one has a more 3D look and itemizes the individual bands of the deltoid ligament (Anterior / Posterier Tibiotalar, Tibiocalcaneal, Tibionavicular), though it doesn’t designate which are superfiial layer and which are deep layer. It shows the lateral side (anterior / posterior talofibular, Calcaneofibular) and shows intact and torn versions. I ripped this from a coaching magazine PDF article about basketball injuries.

Click for full size – 518×540 93KB

Edit 2008-11-28: Since this page is receiving a lot of relevant traffic, here is a link to my blog entry on my deltoid ligament injury back in 2003, with scans of the X-Ray and MRI reports: My Ankle Injury in October of 2003 – A no-fracture medial-lateral ankle sprain with a deep-deltoid tear

Drugs……Probably stimulants – Caffein pills (no-doz), Meth, Cocaine, Crack, Aphedra, or other like herbal stimulants. Dieuretic effect not counterbalanced by additional hydration (if possible without pissing it all out).

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Hmm… Asphyxiation…. Probably not from smothering, but from the extreme hyperactivity of the sympathetic nervous system made him lock up in utter tension to the point of stopping breathing. The cops were normal low-intelligence, soldier-like training-wired, power-hungery, ’subdue him now’, intimidator-type cops. They are law-enforcement soldier-drones of police-state america-becoming. There are many of these in Phoenix and Mesa. Add together autistic hyper-sensitivity, autistic temper-tantrum, and adrenaline/panic from the taser hits and pepper spray and you get what is said in the article. I think a lot of Autistic people are tasered (pepper spray probably made it worse) to death because the taser would trigger a tantrum or direct death from greatly amplifying an existing tantrum rather than subdual. Even subdued normal people are tasered excessively because the cop expects them to comply without aid rather than just sit there frozen. Cop tasers a woman’s arm and then expects her to independently put both of her arms (with one half-paralize and in excruciating pain) behind her back without aid and keeps pushing the button while she its locked up in panic until either the battery runs out, she dies, or somebody intervenes. I don’t think normal stunning devices subdue autistic (the lower the functioning level the worse) people as well as normal people, especially if they are already in a tantrum.

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The ‘Blake’ person in this story truly is hopeless. Might as well shoot him. The lovey agencies cost a lot of money and the parents have poor chemistry. The parents only cope out of love but there is limited connection only from brute-force love. Most parents give up with a lot less destructiveness and burden. If this guy ended up in an state-funded institution he’d be in permanent maximum security solitary confinement within months because the doctors don’t do brute-force love. If he ends up in a cheap-private or any private institution that doesn’t comprehend severe autism well, he’d be kicked out and end up in the state hospital’s max-security solitary confinement ward anyway. Most animals that function / behave at this level are quickly shot to put them out of their misery. Only a major media event or something else with the odds of winning grand prize on a scrather-lotto would save this guy.

Once should consider a half-front-zip or no-string back-zip biketard (short sleeve/short legs) rather than a leotard (looks like a woman’s bathing suit – only enough to cover the crotch) for preventing him from eating his feces out of his diaper. I think any type of leotard on a guy looks disgusting. A microfiber/lycra material may be much more comfortable than more typical nylon/lycra or cotten/lycra especially with sweat, urine, or diarrhea. I assume the diaper is being worn over the leotard because of its skin-tight fit, otherwise it would be very uncomfortable (skin-tight outifits such as wetsuits or the lycra-suits worn underneith for comfort are very comfortable if it fits, otherwise it is not comfortable at all), then again, so is the feces that would probably smear up into his back.

I had a fracture-less lateral-medial ankle sprain in October of 2003. Sprained it when side-stepping instead of down-stepping a 6″ sidewalk curb. It rolled laterally. The knee buckled and there was a lot of calf torque (I have huge calves) while the ankle was rolling. I did not fall. Normally my weight would shift to the other leg when the knee buckles, but it was up on the curb. I know my leg muscles (especially quads/calves) are perfectly capable of supporting a slightly flexed knee, which is probably why I didn’t fall. The ankle popped (probably the ATFL tearing out fully) after the knee buckled. I think the proces of injury ceased when my other leg finally (probably a second late) got off from the top of the curb to get the weight off my cocked right ankle.

I think the injury mechanic was inversion + extreme plantar-flexion + some rotation of the foot inward (This pattern is what made the ankle hurt most after the sprain – Hard plantar-flex, roll-out (invert) , rotate foot inward). I bore weight on the bumpy thing on the outside of the ankle (lateral malleous) and my inside (medial) of the knee hurt a little (sensitive but didn’t affect walking) for about a day, so I probably subluxed the hell out of my tibia/fibula (enough to minorly affect the knee) from the weight-bearing on the outside bumpy thing / malleous. The ankle, up until 1-2 hours, was relatively pain-free, as long as lower-leg muscle tension was maintained. I was walking limp-free but slowly. After the swelling started though, it was very painful.

There was bruising on both sides of the ankle at the 3rd-5th day post-injury. After 2 days I was weight-bearing pain-free. After about 5-days, I stopped using the crutches for walking (I never really used two except to help in turning) as they weren’t helping me walk faster (they were slowing me down), but I would still carry one for another week or two to help with step-downs. After 2 weeks, I dumped the crutches altogether. I had to be careful to not have any sideways momentum (left or right) when placing weight on the ankle for about 4 weeks. Another problem at 2-6 weeks is that I couldn’t pronate the foot and had keep the weight on the outside and maintain some minor muscle tension to keep it from hurting (not too bad though). The doctor was surprised at my range of motion 1 1/2 to 2 weeks after the injury but sent me to get an MRI because it was still really swollen on both sides. The MRI revealed the deep deltoid tibio-talar tear. I read the deltoid ligament tears are very rare without a fracture (ankle or leg) and often avulse the bone instead (tear the piece of bone at the attatchment point off). The ankle hurt with any use of the calf muscle at all for about a week. Then I could minorly use it for the 2nd week. After 3-4 weeks I could use my caff pain-free enough to use it to stabilse the ankle on rough ground. It took 2 1/2 weeks for me to be able to ascend stairs at a normal pace. After about 4-6 weeks I was able to descend stairs without trouble but still couldn’t run or jog because of medial pain.

I finally saw a specialist 6-weeks after my injury because there was still swelling and I couldn’t run or put a lot of right-leg torque pedaling a bicycle. He gave me a shot and had me come 2-weeks later. I don’t think the shot helped at all. It made it take more to get it to hurt, but when it did hurt, it hurt more. The doctor said I would normally need surgery, but I have much to loose in terms of strength and range-of-motion and many doctors, including him, have 0-experience at medial-ankle surgery and the remainder have very-limited experience, So I agreed to no-surgery.

I got a ankle constraint after seeing the specialist but I didn’t use it as it didn’t work and was also uncomfortable because it didn’t fit around my bulging calf. I also got a 8-week rehab prescription but I was only able to go 3 weeks because of insurance limitations. STI Physical Therapy and Rehabilitation is a really good rehab place. Great service. Only catch is that they are not subjugated by HMO and PPO networks, so it was ‘classic’ or out-of-network only PPO. The Ultrasound was probably the most helpful part of the rehab specific to my injury. Most of the non-routine therapy was proprioception and balance as my strength and Range of Motion (ROM) was more than adequate (The star-exercise was the most difficult for me). Rehab on aggregate got me able to jog on the ankle, but I, even as of this day can’t run normally. I also have a bit of lateral-ankle instability but it is only an issue if the muscle stabilization is neutralized somehow (un-awareness of terrain or akward position). If I’m aware of the terrain, I can go over rough rocky-terrain without turning the ankle but it often feels like it wants to go unless there is calf or outside-lower leg tension (enough to feel stiffness/contraction but not heavy straining).

Now I can run a few hundred feet at a time strength-shoe style, on my toes. Any pronation while running is met with pain on the inside-front of the ankle after the 2nd-4th impact. But I hardly run in my routine life and my ankle handles hill-climbing torque on my bicycle without pain as long as the weight is not on the inside of my arch, and I walked normally from the 2nd day after my injury and handled stairs normally after 4-6 weeks (1 1/2 – 2 weeks for up, 4-6 weeks for down), so I wouldn’t go get surgery unless I really really wanted to play soccer again or anything else that needs a lot of running. I also cannot trap high-speed balls (20mph+) on the mid-arch to heel as it aggravates the medial ankle (had it happen once) and renders it sensitive for about a week two. Dribbling and passing are no issue. Can take shots too. I can turn and cut on the ankle wihtout pain or failure but there are intermittent proprioceptive / coordination failures if there is insufficient calf support and I let the weight fall on the heel to much. The media ankle sometimes cracks when I turn on the right knee in a casual scenario (weight a little back, some calf tension to lock the foot, turn on the right knoee knee). It doesn’t hurt and there is no feeling of slippage but sometimes it can be fairly audible. In a active scenario my weight is sually more forward with more active msucle support and it hardly ever cracks.

I think the reason that I had no fracture is because of my genetics. My father has never broken a bone in his life, though he has had a number of ‘bone bruises’ (‘occult fracture’ or ‘occult contusion’???) from motorcycle accidents. My father probably has flexible bones. My mother has heavy bones. I seem to have both heavy AND flexible bones (I overheard a doctor commenting on the size of my tibia and achilles tendon from when I sprained my left knee). I think a normal person would’ve broken their leg before tearing their medial ligaments as I had half or more of my weight on my lateral malleous (the ball/bump on the outside of the angle).

Here’s really good Anatomy map of the ankle that makes Gray’s Anatomy look like an obsolete joke (at least for the medial ankle). Applicable figures for my Injury are 8, 9 and 10 with the injury being on Figure 8 : Pin 9 (ATFL Anterior Talo-Fibular Ligament Complete Tear), Figure 8 : Pin 11 (CFL Calcaneo-Fibular ligament Partial Tear, not mentioned in MRI), and Figure 10 : Pin 2 (Anterior TibioTalar Ligament on the Deep fibers of the Deltoid Ligament Badly Torn).Anatomy of the talus and the surrounding bony and articular structures – JOINTS INVOLVING THE TALUS

Here is my X-Ray and MRI reports regarding this injury. Impressions #1-3 are definitely from this injury. #4 probably is as it doesn’t hurt there anymore. #5 is not and I still have it. I license these reports/scans under Creative Commons Attribution Share-Alike License. Feel free to use it in your medical research and case studies, just give credit and let the other people copy and share it.

Click on the image below to get the full-size scan.

A pharmacist’s aide at an Osco’s told me that the main reason there are ‘Pharmacy-only Non-Prescription Drugs’ is that if they were truely over-the-counter, it would render weed, cocaine, ectasy, etc… obsolete as the kids would come to the drugstore to get high. I learned it at Southern/Central when getting some Gel-Kam toothpaste. I think I sort of believe him when you see the rate of ritelin abuse in the middle schools.

I was Autistic at birth (according to my mother) but not officially diagnosed until I was 3 or 4, after moving from AZ to CT. I don’t think any vaccine turned me from normal to autistic. I Never had Ritalin. Ritalin is nothing but kiddie-weed. You take 6 pills instead of the prescribed 1 or 2 pills and you can get high. Kids sell this stuff in middle schools (4th-6th grade usually) for 50 cents a bag. My nephew got prescribed retialin for ADHD and he only likes it to get high.