Climate Change Deniers Are Completely Insane

January 28th, 2015

I couldn’t agree more with this guy, Matt Walsh, in the article posted on theBlaze.com, Climate Change Deniers Are Completely Insane.

Here’s an excerpt:

If anyone is a climate change denier — that is, someone who denies that climates change — I’d agree that he is an imbecile and probably mentally unstable.

Yet that view doesn’t exist because we all know the climate changes. Of course the climate changes. It’s a climate. That’s what climates do. They change. It gets colder, it gets hotter, it rains, it snows, it does all kinds of things. I don’t deny that, and although I’m not a Republican and I take great exception to that accusation, I feel safe in speaking for them when I say that they neither deny the fact of the climate, nor the fact that the climate changes. Progressives use labels like “climate denier” or “climate skeptic” (for the people who are willing to believe that there might be a climate, but are still a little iffy on the whole thing) because they are not interested in an honest discussion. You either buy in to their environmental dogma one hundred percent, or you will be painted as an idiot, an infidel, and a maniac.

Now, why might a person be skeptical about the theory that humans are causing dramatic shifts to the climate, and that these shifts will eventually kill us all? Have you ever thought about why someone might have these reservations, JM? Have you really taken the time to consider the reasons for this skepticism? Yeah, they’re morons, right, I get it, but have you determined that they’re morons because the media and people on Twitter told you they’re morons, or because you gave their case a fair hearing and came away with the impression that they have absolutely nothing even slightly coherent to say? I’m guessing it’s more the former, which makes you not necessarily a moron yourself, but an intellectually lazy chump who can be easily herded and exploited.

There’s a lot more to his article; very well written, and very much in line with the way I see the issue. The climate change issue seems to have less to do with science than with politics, and the people making the most noise about it don’t do themselves any favors when they start demonizing anyone who doesn’t agree with them on the subject. Well done, Mr. Walsh; bookmarked.

global-warming

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The Science Is Settled

January 19th, 2015

Yeah, sure it is.

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Intellectual Phase-Locking

January 7th, 2015

Intellectual Phase-Locking: A condition that results when dogmatic assumptions inhibit inquiry.

I could listen to this guy, Dr. Rupert Sheldrake, all day long. His classic British accent & professorial manner make listening to him almost a pleasure. It doesn’t hurt a bit that what he has to say makes so much sense. In this first video he puts to words many of the things about modern science that have bothered me for ages. I think he’s my new hero.

… modern science is based on the principal of ‘Give us one free miracle and we’ll explain the rest.’ The one free miracle is the appearance of all the matter and energy in the universe, and all the laws that govern it from nothing in a single instant.

Sheldrake gave the talk in the video above in January, 2013. TED posted it on its website, but in subsequent months TED received some complaints about some of the things he had to say, and pulled the video off of its main site (or as Dr. Sheldrake put it, “put in the bad little boys section of the TED website.”) It’s still available, not really “banned” as some say, just more difficult to find. Reading through the complaints brought against him and his responses makes it look like he hit some tender nerves, and might be onto something. It’s easy to see why more traditional scientists would have a problem with what he says; if he’s right, then they are very wrong on a lot of fronts. (Makes me wonder what my old buddy TF would think of him… Pretty sure I don’t even have to ask!)

Some of what he talks about, like “morphic resonance” I’ve never heard of before, and I don’t know how much evidence there is behind it, but it sounds interesting. And if there’s any truth to it, the implications it would have on scientific thought would be profound. For many years I’ve questioned the belief that instinctive behaviors in the animal kingdom came about by trial and error with one line that tends to do something a little bit better than another line and passes that tendency on to its offspring. Behaviors seem to be far too complex for that to be plausible, no matter how many billions of years it might have taken.

Even if one dismisses the belief that animal behavior & physical traits came about through evolutionary selection, instead believes that those traits were designed by an outside intelligence (God), it’s still difficult to accept that the behaviors & traits are genetically encoded. A collective consciousness that spans space and time and does not exist at the genetic level starts to make sense.

And the possibility of thought happening somewhere outside of the physical brain lends credence to the idea of a soul living on after the body is dead and decayed. But of course, proving any of that to those who subscribe to a more classical view of science will be more than just a bit difficult, so I predict Sheldrake will continue to be a pariah. I’m not very familiar with Sheldrake’s work and thought, so I’m not sure whether he considers himself a Christian or not, but it wouldn’t surprise me in the least if he is. Read the rest of this entry »

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A Tardis Murphy Bed

January 4th, 2015

What a great idea; a Murphy bed dressed up to look like a Tardis! The Murphy bed has been around for a long time, but this is just a neat adaptation of that concept.

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Although it doesn’t look bigger on the inside than on the outside, it does make the room it’s in feel bigger when it’s tucked away.

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It’s kinda cool reading through her build and seeing the photos; she mentions building it for her “house”, but it looks like she could very well have done the work in an apartment or condo; right there in the living space. No workshop, no garage, just a power saw on a patio (and complaints from her HOA!) and sawhorses in the living room. I often wish for more space in my garage or my workshop to build furniture, but here is someone who brought an idea for a furniture piece to life without even the luxuries of space that I have and complain about being too little. I’ve considered building a Murphy bed in the past, but one of the things that kept me from doing it was thinking I’d need one of the expensive hardware kits to make it work; she did without it, and I’m sure it works just fine. More than a little humbling to see this!

Hat tip to Neatorama

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BMWotD — 1988 M3 with S50B32 Swap

January 1st, 2015

I don’t ordinarily gravitate toward e30s, but this one is quite special, and I would certainly make an exception. If money were no object.

An e30 M3 in Hennarot, with a European S50B32 motor in place of the original 4-cylinder. Don’t get me wrong, a car like this with the original 4-cylinder is no slouch, with 192 hp behind a ~2,800 car. But that S50 engine puts out in the neighborhood of 320 hp, which would make this car a rocket. The purists might will most definitely freak out about the departure from the original configuration, but even the most diehard purist would have a tough time finding fault with the quality of this swap.

88′ Hennarot M3 with a S50B32 Euro motor.
191,0xx miles on the chassis, approx 79k miles on the motor/transmission.

I purchased this car in the spring of 2013 from a gentleman in CA who had done most of the mechanical work on the car, and really made it into the wonderful driving car that it currently is. From my understanding the car was largely stock when he bought it several years before my ownership, from that point he focused on maintenance that the car needed. I have a binder containing some of the documentation from the previous owner.

The motor swap is obviously the biggest change over stock. I’ve been told by two separate and independent shops, that the swap was very well done. The engine is very strong, and runs extremely well, I had a compression/leak down done on the car before my purchase and all cylinders checked out perfectly. In fact, the company that sold him the motor wrote ‘superb engine’ on the valve cover while they were testing it. I’d estimate that engine has been in the car for about 6000 miles. When I took delivery of the car I drove it home 1300 miles, it was a great drive, and the car didn’t miss a beat. About half of the miles that I’ve put on the car since I’ve owned it where driving it home, I just don’t get a chance to drive it much. I never had any intention of selling this car this quickly, but I’ve started a E28/LS1 project, and have an E30 touring project lined up behind that. I’m in no hurry to sell it, but I need it needs to be driven and an enjoyed more than I am able to do.

$26,500

Exterior Modifications:
– OEM Evo2 front splitter with replica Evo3 splitter
– Evo3 rear spoiler and carbon fiber flap
– BMW Motorsport door handles
– Euro smilies

Drivetrain/Engine Modifications:
– Genuine carbon fiber airbox with OETuning tune
– AKG S50/S52 E30 motor mounts (less than 2000 miles old)
– Z3 steering rack
– E28 M5 coding plug (so the stock RPM gauge is accurate)
– Sparco strut bar
– E36 Euro M3 radiator
– ZF 5sp transmission (less than 2500 miles old)
– Autosolution SSK
– Treehouse control arm bushing
– E36 M3 Eisenmann muffler with catless custom exhaust
– Massive Rally BBK (6 pistons front, 4 pistons rear)
– Ground Control S/A coilovers
– Ground Control camber plates
– Ground Control rear shock mounts
– Ground Control 650#/400# springs (less than 1000 miles old)
– E28 3.25 LSD (rebuilt by Diffs Online about 2500 miles ago)
– 17” OZ Superleggera wheels (no curb rash)
– Dunlop Direzza Sport Z1 215/40/17 (less than 5000 miles old)

Recent Maintenance (oil changed every 3000 miles):
– Brake fluid flush (less than 7000 miles old)
– New spark plugs (less than 5000 miles old)
– E36 ’96+ offset front control arm (less than 4000 miles old)
– New front wheel bearings (less than 4000 miles old)
– Various belts and gaskets replaced (less than 4000 miles old)
– New battery (less than 4000 miles old)
– New fuel tank and fuel pump (less than 2000 miles old)
– New thermostat (less than 500 miles old)
– New sway bar end links (less than 500 miles old)

Interior Modifications:
– NRG quick release hub – thin version
– Momo Champion steering wheel
– Recaro SR3 seats (new less than 1000 miles old)
– VDO cluster gauges (oil temp, oil pressure, water temp)
– BMP instrument console (for the VDO gauges)
– Custom ///M floor mats (less than 500 miles old)
– Alpine head unit (note: there are no cracks in the dash)
– ZHP weighted shift knob

Considerations:
– Dot-r front left fender…..parking lot mishap with a previous owner
– The rear bumper was painted at one time
– There is a small amount of rust repaired below the windshield on the driver side (see photo)
– The driver side E-brake shoe assembly is missing (e-brake still works fine)
– No a/c, heater core (note: the lines are still intact)
– Corners of the bumpers stick out slightly (common)
– The spare tire well is riveted shut
– I personally like the patina on the front bumper, others may think it needs a repaint.
– The exhaust is slightly crooked, and if desired could be rehung

There isn’t much to nit pick on this car, you can get in and drive it across the country, or to work everyday. It has major and expensive upgrades that arguably make it a better car. Better in the sense that it has a power train that is more reliable than the S14, it creates more power, brakes harder, and turns faster.

As you can see from the pictures the paint is in fantastic condition for a 25+ year old car. If you have never seen hennarot in person, it’s a gorgeous color, and also quite rare, I believe only about 300 M3’s were produced in this color. I am happy to answer any questions serious buyers have, I’ve tried to be as thorough and forthright with the condition as possible.

The following photos were taken by Brian Lewis of SpeedFreak Detailing after he did a complete paint correction to the car in November. The car has primarily been stored away since.

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Something New In Garage Doors

January 1st, 2015

Here’s something I hadn’t seen before; a garage door without tracks: 

The whole system — doors, lift mechanism, folding mechanism –is pretty ingenious. The biggest difference between this system and a traditional garage door is that you don’t have the track rails extending into the garage space, and that only half the height of the door ends up above the open doorway; very handy if you have storage up above. The doors are built by Amarr and sold by a number of retailers and overhead door installers. I’ve never heard of them before, but it looks like they produce some quality stuff. I’m sure it’s not cheap, but you get what you pay for.

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Reviving My Chamberlain Garage Door Opener

December 29th, 2014

Over the weekend I resurrected my trusty old garage door opener. It’s an older Chamberlain door opener, nothing fancy at all, but it stopped after lifting the door about 8″ on Friday morning as I went to take my wife to work*. When it stopped, I hit the button a couple more times; it moved a little, and I could hear the motor turning, but it obviously wasn’t going up. So I gave the emergency cord a yank, backed out, got her to work on time, then popped the cover off when I got home; this is the sight that greeted me.

Yup, that main gear was shot. There were white shavings all over inside the thing.

My first thought was that it’s time to replace the opener; I had no idea how old it was — it was in the house when we bought the place 15 years ago — plus I had no idea what it took to replace that gear or what else might be worn out. Later in the morning Caleb & I went shopping, and I was ready to plunk down ~$200 for a new one, when I noticed a generic-looking bag on the shelf that had a nylon gear that looked a lot like the worn one in my opener, plus a new worm gear and a bunch of other hardware for about $25. The package said it was for Chamberlain (and a few other brands) door openers, so I rolled the dice & brought it home. I did a Google search for replacing the gears; it turns out this is a pretty common failure mode, and replacing the bad gear is pretty straightforward. Most of the time it’s only the large gear that needs to be replaced; the worm gear is fine, as are all the associated hardware bits. I also found you can buy just the gear for a lot less than the ~$25 I spent, but would probably have to order it; I wanted to get it fixed that day, so I just tore into it.

I followed the steps in one of the videos to pull the gear and its shaft out the top, then pounded out the pin keeping the gear in place. I was planning on just replacing the gear, but then noticed a little wobble in the shaft; the bearing at the top was worn to a bit of an oval; there was a fresh bearing in the kit, so I just replaced it. After reassembling it all I put the shaft with the new gear back in place and bolted it back up. I plugged it back in to test everything and got a loud POP! and a flash. Crap. A closer look showed that one of the screws holding the gear & shaft in place had pinched an orange wire; that was the wire for the light. Crap. It looked like the only thing that had happened was the wire itself had acted like a fuse and burned about 1/4″ of the conductor, so I put a splice in there and tried it again. It worked! Cool!

But… when I put the drive chain back on the sprocket on top I found that it would only spin a few revolutions in either direction before stopping and flash the light bulb a few times like there was something breaking the electric eye at the door. There wasn’t anything in the way, and the sensor showed a green LED, so that wasn’t it. I also noticed a green LED on the back of the unit would flash five times, pause, then flash five more times… Trouble code. I did a Google search on that; others had had the same problem, and had cured it by resoldering some cold joints on the controller board. I pulled the board out, resoldered a half-dozen joints, put it back together, and it worked! I’m not sure if the shorted wire had caused the solder joint problem or was just the straw that broke the camel’s back, but either way I’m glad that fixed it.

Almost like earning $175 for my troubles. 😉

* I don’t always take my wife to work, but was planning on changing the oil in her car that day. She was glad that she wasn’t driving when the garage door failed like that, because she had no idea how to open the door without the opener. She knows now. I wonder how many other wives — or guys — aren’t aware of that…

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The Best Paper Gasket Remover

November 30th, 2014

I tackled the job of replacing the leaky oil filter housing gasket on Emily’s e36 318ti this weekend, and as was expected, ran into a few snags along the way. It’s a fairly involved job, but not terribly difficult, with a couple of exceptions. Removing & replacing the stupid serpentine belt was one struggle that shouldn’t have been — that tensioner is a pain in the rear — but the thing that really caused me some consternation was the old gasket. It just didn’t want to come off.

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The gasket is the green stuff on the mating surface shown above. The car and its engine have about 220,000 miles on them, and from the looks of things down there, I’m guessing that gasket was installed at the factory. And judging by the grunge on the lower side of the engine and everything underneath, that gasket had been leaking for way too long. It was stuck hard. I tried all manner of things to get it loose; the engine block is of course made from aluminum, so scraping with anything made of steel is automatically a bad idea. After a few failed attempts with lesser tools, I did take a stab at it with a wood chisel and a razor blade, but set them aside after seeing a few small gouges in the metal.

Abrasives are likewise a bad idea because any time you use an abrasive, some of the abrasive is lost from the surface, and with this particular spot it wouldn’t take much to get some of that abrasive inside the oil passages. Really bad idea there.

I had some plastic razor blades that fit into a scraper handle, but the plastic they were made from was a little on the soft side, and proved to be pretty useless. So I started scrounging around the garage & workshop for something made of harder plastic that could be used for the job, and found it; a plastic two-gang blank cover plate.

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I’m not sure what kind of plastic it’s made of, but it’s plenty hard. The edge that worked best wasn’t sharp at all, it was more of a 90 degree angle from the back to the top edge with little to no radius to it. I just held the back against the mating surface and pushed against the gasket material, and it literally popped off in chunks. With the other tools I had been trying to get something sharp between the aluminum and the gasket, but that was futile; with the cover plate I had the rest of it completely gone in a matter of a couple of minutes.

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I was so impressed with the job it did that I renamed it and gave it special spot in my toolbox. It may be a while before I’m removing another paper gasket, but it’ll be there when I need it!

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The Best Christmas Present

October 8th, 2014

Since it’s been over ten months since my last post in Medical Adventures, and this post has been in draft mode for nearly that long, I suppose it’s time to actually finish it up and hit that Publish button!

My surgery date was December 16 (where did that time go?!?), and it went smoothly, but I did end up staying an extra night in the hospital; they like to have patients who have had this surgery pass some gas before being discharged, and my gut was a little slow to wake up I guess. But it finally woke up, and I was out the door.

I got a phone call from the surgeon the evening I was released — December 18 — and he told me the pathology report had good news; all the “margins” were clear, which is to say the edges of the excised tumor were clean and showed no evidence that any cancerous tissue had been left behind. I’m now considered “cancer free”! And that’s truly cancer free, after beating the lymphoma in my jaw last summer. Woot!

Of course “cancer free” is a somewhat transient condition, especially for a cancer survivor. Two years ago I would’ve thought myself to be cancer-free, but in actuality the tumor in my jaw had already begun to make itself known, and who knows how long that thing had been growing on my kidney… Plus there is the outside chance that some of the lymphoma in my jaw survived the chemo and radiation therapy, which is why I’ve been back a number of times for blood work and the occasional PET or CAT scan. Statistically, the people most likely to get cancer are those who have had cancer before; a recurrence of the same cancer, and often different types of cancer will hit a survivor later in life. If nothing else, last year’s experience have made me realize that my days are numbered; I will live forever, but this body is just dust.

I just rewrote that last paragraph; what I wrote months ago (but don’t really remember writing it) made me sound like a bit of a pessimist — a the-glass-is-half-empty kind of guy — and I don’t think I typically think that way. I guess that’s one of the things that cancer does to you, makes you think differently about life; I don’t take for granted that I’ll live to 90 any more (in my younger days I joked that 30 was dead, and was surprised when I actually hit 30.) An early demise is a very real possibility, from cancer or from any other cause for that matter, but it’s wrong to dwell on that. God graciously gives us every day of our lives, no more, no less.

Since surgery though I’ve visited with the surgeon once — all is well — the oncologist twice. I had a CAT scan in the spring, which was clear, and Dr. Bleeker said my blood work was “stellar”! The most recent visit with the oncologist only involved blood work, and the only anomaly there was a low Vitamin D level — a normal level is between 30 and 200, but mine was 23. Low Vitamin levels are associated with cancer, but whether it’s a cause or an effect of cancer isn’t clear. Why mine is low at the end of summer is a bit of a puzzle though; I do get outside, but I also tend to stay in the shade. I also take a 1000 unit Vit. D supplement every day. Dr. Bleeker put me on a 50,000 unit megadose once a week for 8 weeks to see if we can boost those numbers a bit. We’ll see. My next appointment is in November, long after the last of the megadoses, and long after the last of summer. This time I meet my old nemesis, the PET scan machine. This time with a happy pill, and more importantly, without the Hannibal mask.

Since surgery I’ve also visited with an oral surgeon about having some bone reconstruction done and having tooth implants installed. I’m still unsure about having that done though. The doctor wasn’t sure if the bone in my jaw would be stable enough for grafting and an implant after the cancer and radiation therapy damaged it, so took some time conferring with colleagues and the radiation oncologist about it. I’m also nervous about having anyone dig around in there again; during the biopsy in April of 2013, the nerve in my jaw suffered some damage, which left my lower lip numb and tingly ever since. I dread the possibility that it might get worse. When I last spoke with the ENT doc who did that biopsy he said it probably won’t get any better, but I should be happy that it’s not worse; some patients end up with the muscles paralyzed as well. I really, really, really don’t want that. The whole reconstruction and implant process would likely take about 9 months and cost roughly $7,000. I got approval from our health insurance carrier though, which was a welcome surprise, so that would help considerably, but I’m still hesitant…

It was really good to be able to do “normal” stuff this summer. I am able to go out in the sun and do normal summer things… Last year I had to minimize my exposure to direct sunlight as much as possible; I was surprised at how much I missed doing that, and how much I’ve enjoyed the feeling of the sun on my skin. And this spring/summer we’ve done some nice normal things, like go on vacations. Yvonne & I flew to California in April for a long weekend, and in May we drove to North Carolina with the whole family. I got to dip my toes in both the Pacific and Atlantic oceans, which I don’t think I’ve ever done before, let alone in the same year.

With all of this cancer business almost a year behind me, I’m thankful for all that’s happened, thankful for all the people that were involved in my cure, and most thankful for the blessing of a great God who watches over us all, and was fully involved in my cure. And it is in Him that I trust the rest of my days, whether they be many or few. Thank you, Lord.

There has been a story in the news the last couple of days about a 29 year old woman with terminal brain cancer who has chosen the path of assisted suicide to end it all before the pain she’s been told she will have becomes unbearable. Brittany’s story is a heartbreaker, and I can understand her desire to avoid what’s likely in store for her, but I still disagree with her choice. I read an open letter to Brittany today that does an excellent job of expressing my thoughts on the subject; I hope she reads it, and I pray with the author of the letter that she will ask “the question that is most important. Who is this Jesus, and what does He have to do with my dying?“ After my ordeal with cancer and its treatment, I’m convinced that God teaches us the best things through the hardest circumstances. Walking the valley of the shadow of death will be a lesson that none of us should miss.

Mundane Faithfulness

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Robotic-Assisted Laparoscopic Partial Nephrectomy

December 15th, 2013

That right there is a load of $20 words, but it’s just a fancy way of saying “cutting a chunk out of the kidney without the doctor having to stick his hands in in your side.” It also describes some pretty cool technology, and it’s what they call the procedure that I’ll be going through tomorrow. But before I get into that, a quick (and belated) update on what’s happened since my last post is in order…

I checked in at the Sanford Surgical Tower (no idea why it’s called a tower; it’s not) on October 22 for the biopsy on my kidney tumor, and the procedure went very smoothly. The results came in two days later; the tumor is just a run-of-the-mill renal cell carcinoma, and can be removed surgically. That was a big relief; the thought of another round of chemo and radiation was more than I wanted to think about. I could handle it, with God’s help and that of great friends & family and an even greater wife, but if I had my druthers… Nope. I did a happy dance when I got the news!

So with that news in my back pocket, we met with the surgeon, Dr. Ahrend, a few weeks ago to discuss the next step; surgery. The urologist I spoke with first, Dr. Hofer, said that I was a good candidate for robotic laparoscopic surgery instead of “open surgery”; open surgery for a nephrectomy, partial or full, involves an incision that follows the bottom of the ribcage from the chest around to the back, half way around the torso. That was the way they did things in the days before laparoscopy, and what they still do with some patients that don’t meet the physical requirements for a laparoscopic procedure. The surgeon needs full access to the kidney, and that just isn’t possible without a huge entry point like that. The beauty of laparoscopy, and robotic laparoscopy in particular, is that the surgeon can get that full access to the organ without having to make an incision big enough to see through and to get a pair of big mitts into. Laparoscopy lets the doc manipulate tools inside the patient while watching what’s going on by way of a video feed a pair of miniature cameras. Adding the robotic angle to it makes it almost like climbing right inside…

Dr. Ahrend is a pretty young guy (as can be seen in this KELO news bit) but he is also the best guy in the business in Sioux Falls. He’s done over 700 robotic procedures since residency, and makes it sound like mine will be somewhat routine. While chatting with him at the end of our appointment, he commented that he likes to tell his mom, “all those video games are finally paying off,” and that is a good (but not great) description of how he does the laparoscopic nephrectomy with the assistance of a pair of robotic “hands.”

The “robotic” part is a little misleading though; that term has connotations of the process happening somewhat autonomously, and this machine is anything but automatic. It’s more of a bionic surgery by remote control. The history of the procedure is pretty cool; I’m told it originated with the military, with the idea that a patient who was wounded on the front line could be operated on without having to be transported far, and the surgeon could work from a safe place far from the front line. So far it hasn’t been used in that capacity, but there has been at least one procedure done over a long distance; the surgeon was in New York and the patient in Strasbourg, Germany. The big problem that can keep something like that is latency, the amount of time it takes for a signal to get from the controller to the robotics and the return trip for whatever kind of feedback signal is used. Apparently it was acceptable in this experiment, and in a normal procedure where the surgeon is in the same room as the patient, it’s seldom a problem, but that’s the sort of thing that would keep a networking guy up all night.

When doing a robotic procedure like this, the surgeon has a stereoscopic view of things through a video feed from a pair of cameras that are inserted into the area being worked on. The console that he works from has a pair of video monitors with a divider down the middle to give the surgeon a 3-dimensional view of what’s going on inside; depth perception in the surgical site is crucial.

The tools that are used are remotely manipulated by the surgeon using specialized controllers in the console; much more sophisticated than any joystick or video game controller, because what’s being controlled is much more sophisticated than anything in any shoot-em-up/crash-em-up video game. And the stakes are much, much higher than any video game.

Notice the scale of the little scissor tool in the hand of the model, then watch the video below; the surgeon’s hand movements are scaled down while his view of the surgical site are magnified so that he has a better view of things and a higher degree of control over the tools he’s using.

This YouTube video is pretty fascinating to watch, as it gives a view of exactly what the surgeon sees through his live video feed, and lets you see the dexterity of the robotic tools. It’s especially interesting because the case is very similar to my own; a male patient in his 50’s with a 2 centimeter mass on the upper quadrant of the right kidney. The video is not for the faint of stomach, as you see all the blood and gore and cutting and yuck, but it’s very informative for the same reasons. You’ve been warned!

Watching the video doesn’t give one a very good idea of how things are arranged for the surgery and where on the body the incisions are made. I’m told they make five incisions for the tools to be inserted, and from the photos & videos I’ve seen they go in from all directions. It would be interesting to attend a robotic surgery while conscious to see exactly how it’s set up and done.
Another pretty cool tool that Dr. Ahrend will be using is Firefly Fluorescence Imaging technology. With Firefly, a dye is injected into the bloodstream during surgery, and when a black light is used to illuminate the surgical site, normal tissue will fluoresce bright green, while cancerous tissue appears dark. Under normal lighting conditions it’s difficult to tell the difference between normal and cancerous tissues; the contrast that results with the Firefly dye and black light helps the surgeon know with a higher degree of certainty that all of the cancerous tissue has been removed. They also use ultrasound to help delineate the boundaries of the tumor, but adding Firefly to the surgeon’s tool belt helps immensely in making sure they get all of the tumor the first time, and don’t remove any more kidney tissue than is absolotely necessary.

Here’s another video from the Shawnee Mission Medical Center that demonstrates the use of Firefly, and gives a great demonstration of what happens before the surgeon starts digging around inside, and a good view of some of the equipment used.

That brings us to today, the day before surgery. All in all, I’m pretty relaxed about the whole thing. It’s a little weird (scary weird) seeing all of that and knowing it’s what they’ll be doing to me tomorrow, but I’m ok with it. After all I’ve learned about the procedure, it’s easy to forget how new this whole robotic thing is, but the doctor’s confidence in it is pretty contagious. And knowing that I don’t have to deal with the aftermath of open surgery is huge!

My biggest comfort in all of this though is knowing how many people are praying for us. It’s really a humbling thing being on the receiving end of all that, but the prayers really do make a difference. I am extremely grateful for each and every person lifting us up, and for their concern for us. God is faithful, and I trust that he will see us through this. As for the recovery, I’m really looking forward to some time off; I’m taking two weeks of medical leave from work. It seems like such a long time since I’ve had any time off from work where I wasn’t busy ahead of time getting ready for going somewhere. This time I’ll just be at home, resting. For now though the waiting is the hardest part. Nothing like a bit of anxiety over the procedure, mixed with fasting from everything but clear liquids for the 24 hours leading up to it, plus an enema waiting for me tomorrow morning. It’s gonna be a Monday like no other.

I’m actually looking forward to getting this surgery done and out of the way. I may be speaking too soon, but I think the surgery and recovery will be a walk in the park compared to chemo and radiation. The thing I’m really looking forward to is hearing the news that I’m cancer-free. That will be worthy of a celebration!

Here are some other links that I found to be of interest when researching this topic. Again, many of them show actual surgical procedures, so click with caution.

Information on kidney cancer
News4 da Vinci partial nephrectomy with Firefly
HD Robotic Partial Nephrectomy using “Firefly” Fluorescence Technology
Firefly Fluorescence Robotic Surgery With da Vinci
Robotic Partial Nephrectomy performed by Vipul Patel, MD

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