If you have read my previous article, you know that I’ve been Barefootin’ about this summer in San Diego.  And if you have not read the 12+ comments to this post, you have not read the rest of this story.  But now summer is coming to a close and the June bugs are winding down their wild mating rituals.

And our pond water is now warm enough for Tasha’s first swim test.

Autumn is approaching, which means that it is time to prepare our 2007 Safari Airstream for our fall and winter camping season.  Last June I washed the trailer after our beach outing and noticed a few drops of water had entered the trailer near the forward Fan-Tastic Fan.  It’s possible that I had manually not closed the cover all the way, but I also noticed that there seemed to be a gap in some of the exterior caulking around the fan and other places on the roof.

I have used Acryl-R for a small leak from a seam on one of the Vista View windows and Parbond on the top seam of the stove exterior exhaust vent, but I had not caulked anything on the roof before, so I searched and found abundant information on this Airforums.com thread, Caulking and Sealants.  For caulking Airstream roof seams, Vulkem (now called TremPro) and Sikaflex seem to be recommended the most (both are polyurethane sealants).  Sikaflex is now used by Airstream, Inc. on most exterior large seams and is available from the Airstream Store.  I decided to try TremPro (Vulkem) 635 in white for the roof and ordered this, along with a tube of TremPro 636 in aluminum color, from C & G Trailer Service (Airstream Certified Service Center in Bellflower, California).  TremPro is also available from Vintage Trailer Supply.

TremPro is made by Tremco, a company first started by William C. Treuhaft in 1928 in Cleveland, Ohio.  TremPro 635 is faster curing than 636.  Note that I used a standard, manual caulking gun (unlike the air-powered one used by John, resulting in an exploding tube of caulk, as reported by Lug in his “I Am Vulkem Man” posting).

I followed the directions and made sure the caulking surfaces were clean and dry.  (Our 2007 trailer’s caulking is still pliant, intact and did not have to be removed.)  I cut the tip of the tube at an angle and punctured the inner foil several times with a wire hanger.  Larry held the ladder while I went topside and applied the product, smoothing it with my dry finger.  Paint thinner (mineral spirits) easily removed the product from my hands.  While I was up there, I also applied 303 Aerospace Protectant to the rubber seal around the Fan-Tastic Fan, which I apply annually here and on the window seals to protect them and keep them from sticking.

I repeated this process around the rear Fan-Tastic Fan and bathroom air vent.

Success… now our trailer is as happy as a dancing robot under the Harvest Moon (Caravan Palace)!

Deep in the hot Sonoran desert, the city of Hermosillo, nicknamed “The Sun City“, capital of the Mexican state of Sonora, is considered the legendary birthplace of the Sonoran-style Mexican hot dog.  Some trace the history of the hot dog back to Frankfurt, Germany, where pork sausages (frankfurters) were served in a bun.  Vienna, Austria, is the home of the wiener, a sausage made of a mixture of pork and beef.  Around 1870, German immigrant Charles Feltman began selling pork sausages in rolls on Coney Island.  In 1900 Oscar Mayer and his brothers built a thriving sausage business in Chicago.

Sometime after WWII, the American hot dog made its way to Hermosillo, where it was wrapped in bacon, placed in a bolillo, and topped with Mexican and traditional American condiments.  See the informative and entertaining YouTube video, “Hot Dogs Hermosillo Sonora“.  The Sonoran-style hot dog, also known as the estilo Sonora or estilo Hermosillo hot dog, eventually traveled 217 miles north to “The Old Pueblo”, Tucson, Arizona.  Hear or read the NPR story, “The Sonoran Hotdog Crosses The Border“.  Some say the Sonoran hot dog is the quintessential food of Tucson, which possibly has over 250 hot dog stands.  In summer locals especially enjoy street food at night.

I got excited about this story while recently watching the Travel Channel’s Man v. Food program segment, “The Sonoran Dog in Tucson“, which follows Adam Richman on his culinary quest for the authentic taste of Tucson, while visiting El Güero Canelo, an authentic Mexican restaurant started by the Contreras family in 1993 and listed as one of the “Top 10 New Places for Hot Dogs” by Bon Appétit.  Some say that Philadelphia has its cheese steak, Chicago has its deep-dish pizza, and Tucson has the Sonoran hot dog.

Earlier this year the Travel Channel returned to Tucson to cover the epic Sonoran hot dog battle that has been raging on 12th Avenue on the south side since the 1990’s.  See the Food Wars video of Travel Channel’s visit to the contenders: El Güero Canelo and BK Carne Asada & Hot Dogs.  Some people become quite passionate about the Sonoran hot dog.  This war sometimes pits siblings against siblings, which is covered here in the Circle of Food Blog.

Here in San Diego, the Sonoran Dog is sometimes called the Tijuana Dog or TJ style hot dog.  Since all of the ingredients for the Sonoran-style hot dog are readily available in San Diego, I thought it would be fun making my own, based, in part, on this recipe.  Fresh, whole-wheat bolillos and hot dogs were purchased at Pancho Villa Farmer’s Market.  I then prepared the toppings, including chopped onions, tomatoes, avocado and grated Cheddar cheese.

I mixed the mayonnaise with a small amount of lemon juice and hot sauce and placed it into a squeeze bottle.  I brought out the mustard and put Larry’s homemade sausa verde (tomatillo sauce) into a small bowl.  I wrapped the main ingredient, hot dogs, with bacon and carefully placed them in a frying pan…

and cooked them until the bacon was crispy (about 7 minutes).

We then spooned home-cooked Mayocoba/Canary Beans (Peruvian beans) and chopped avocado inside a pocket cut into the steamed or grilled bolillo.  The bacon-wrapped hot dog is inserted into the pocket and covered with our favorite toppings and hot sauce.

This top dog is truly a Sonoran fiesta in a bun!

Two years ago my “Sun safety” article discussed the importance of protecting our skin from the harmful effects of the sun by using protective clothing, sunglasses, and sunscreen.  I thought I had made a good choice in using a broad-spectrum UVA-UVB sunscreen, with a Sun Protection Factor (SPF) of 30 or higher.  But now I am learning that there are many conflicting reports about the effectiveness and safety of sunscreen products.

The Environmental Working Group (EWG) released its fourth annual “Sunscreen Guide” last month, which recommends only 39 out of 500 beach and sport sunscreens for this season.  According to EWG, many sunscreen products contain red-flag ingredients, like vitamin A (retinyl palmitate) and oxybenzone.  The sunscreen that I had been using contained oxybenzone 6% as an active ingredient, so I now use one of EWG’s top rated sunscreens.

Of course, the best sunscreen is a hat, shirt and a good pair of sunglasses, which I wore while doing our annual big wash and wax job on our trailer, upon our return from the beach last month.

The hat is Tilley’s broadest brim hat, the LTM2 Tilly Airflo Nylamtium Hat.  It is comfortable, lightweight, and comes with a tuck-away Wind Cord.  The white shirt is Silver Ridge II by Columbia Sportswear Company.  It is lightweight, comfortable and super-ventilated.  My extra-large SolarShield sunglasses are comfortable while providing Advanced UV Protection (and can fit over Rx glasses).  These items always travel with me when camping.

EWG points out that their “sunscreen database is dynamic, which means that the sunscreen ranking numbers may change based on evolving science, new information on UVA, UVB radiation and sunscreen ingredients, marketing conditions, or other factors.”  Light might be shed on the sunscreen controversy over the effectiveness and safety of sunscreen products if, and when the Food and Drug Administration (FDA) issues sunscreen industry regulations, which they began drafting 32 years ago, according to The Huffington Post.  Congresswoman Nita Lowey (D-NY) has called upon the FDA to finalize sunscreen regulations.

One of the latest health concerns is the use of nanoparticles of zinc oxide and titanium dioxide in sunscreen products, as discussed in the AOL News article, “More Bad News About Sunscreens: Nanoparticles“.  This further underscores the importance and need for the FDA to develop and publish new sunscreen guidelines and regulations.

In the meantime, here are some tips for smart sunscreen shopping.  Also, see this excellent YouTube video, “Go Green with Sunscreen“, for tips on staying safe in the sun.

Now I think I’m ready for those bright, sunshiny days!

Wildflowers are beginning to make their appearance in Anza-Borrego Desert State Park and this year promises to be a great one because of the heavier then usual rainfall.  With a little luck, warmth and sun, the wildflower displays should be spectacular.  Although we did have one day of full sun last week in the desert, most days were partly sunny and cool breezes prevailed.

Our annual return for this event was even more special for us this time because we brought along a new member of the family, Tasha (short for Rosewood Montage), a Pembroke Welsh Corgi.  We also brought along a new element for our setup, a dog pen (click on the above image for larger view).  Advantages of using a dog pen are noted below.

Tasha’s happy now, but when we returned home from our previous outing our local Corgi breeder, Liisa, told us that Tasha had just lost her first litter (via emergency C-section) and was depressed.  Liisa had to be out of town for a few days and asked us if we could house her, and if it worked out, we would also have an option to buy her, which we did upon Liisa’s return.  Tasha now brightens our days as we cope with the pending loss of our 15 year old Pug, Pau Hoa, who was diagnosed with a malignant mast cell tumor  (She can be seen in the upper right corner of the above photo).

We all had a happy time walking in and around the wildflower displays in Palm Canyon Campground.

On Friday we loaded the Corgis into their carriers strapped to the back folded down seat of our F-250 truck (see Traveling and Pet Safety), positioned the Pug on a floor cushion under Larry’s legs and took off to visit the Farmers’ Market at the Borrego Springs Christmas Circle and enjoyed delicious tacos from Jilberto’s Taco Shop.  We then drove north on Borrego Springs Road exploring various parcels of the Galleta Meadows Estate displaying free-standing welded iron sculptures created by Ricardo Breceda.

One such sculpture is a depiction of Father Hermenegildo Tomás Garcés (April 13,1738 - July 19, 1781) accompanied by his dog holding a bone.

In 1768 Spanish Franciscan Garcés was assigned to Mission San Xavier del Bac near present day Tucson, Arizona.

He conducted extensive explorations of the Southwest and assisted Juan Bautista de Anza in establishing an overland connection with New Spain through the region of the lower Colorado River.

A sprinkling of wildflowers can be seen in the foreground, while snow is seen on the distant mountains in the background.

After visiting and photographing other sculptures (which will appear in my next article), we returned to camp.  Below is a photo of our dog pen.  We have discovered the benefits of dog pens in that they can provide a safe, secure, and shady place for our dogs and help us manage them during meal time.  In this photo Tasha is on a runner and has chosen to enter the pen to relax.  The pen is held in place with bungee cords attached to the table.

Bob and his wife, Theresa, joined us for a Chinese fire pot dinner.  Bob is our veterinarian and has a 30′ Classic Airstream.  Charcoal burns in the chimney of the fire pot/hot pot heating the soup and cooking the ingredients that guests place into the soup with a small wire basket.  Noodles can be added to the soup as a last course.

Tom Yum, a Thai kaffir lime chicken broth, was used as the soup and the following ingredients were provided: raw shrimp, sliced boneless skinless chicken thighs, cooked pork meat balls, bok choy, chopped cilantro, shredded Nori seaweed, and roasted peanuts.  Guests chose from a variety of condiment sauces.

A happy time was had by all…

But there’s no place like home.

I arrived early for my colonoscopy so I looked around the waiting area for something interesting to read and spotted the February 1, 2010 issue of Time magazine.  I thought it would be interesting to take a closer look at a magazine that has a website that was featured in Steve Jobs’ Apple iPad keynote presentation.  What caught my attention while browsing this magazine was the image of what the author, Bryan Walsh, called foot gloves.¹  Bryan’s article on page 45, “Toe Huggers“, tells how going barefoot (or close to it) might be better for your body.

I have enjoyed going barefoot in the Airstream (and in the house for many years) and was fascinated to learn of the benefits of going barefoot.  The human foot is an anatomical marvel of evolution with 26 bones, 33 joints, and more than a hundred muscles, tendons, ligaments, and sensory receptors.

According to Vibram (maker of FiveFingers), to keep our feet healthy, they need to be stimulated and exercised.  Stimulating the muscles in our feet and lower legs makes us stronger and healthier, while improving our balance, agility and proprioception. The wearing of shoes can impede proper alignment and movement within the ankle and foot.  “Shoes are bad”, says Adam Sternbergh in his article, “You Walk Wrong“, in the New York magazine.  He discusses the benefits of barefoot walking and presents a three-part guide on how to walk better.  He mentions that there are groups, such as the Society for Barefoot Living, which help people learn about barefoot walking and the “barefoot lifestyle.”

See the You Tube video, “The Barefoot Professor: by Nature Video“.  Harvard professor and runner, Daniel Lieberman, shows that barefoot runners tend to land on their fore-foot and generate less impact shock than runners in sports shoes who land heel first.  Barefoot running can be more comfortable and could minimize running-related injuries.  Interest in barefoot running jumped recently with Christopher McDougall’s 2009 best seller, Born to Run, which follows Mexico’s Tarahumara Indians, who run long distances wearing thin rubber sandals or no shoes at all.  See Tarahumara: Pillars of the World.

But running and walking barefoot outside can lead to infections and injuries.  We routinely check every campsite for glass, nails, screws, and anything else that could puncture a tire before we back in the trailer.  So I became very interested in Vibram’s FiveFingers.  See Bryan Walsh demonstrate wearing and running in FiveFingers in the Time video, “Is Running Barefoot Better for You?“.  All of this made sense to me so I found Vibram FiveFingers KSO in my size locally.²  They can be ordered online, but, if this is your first time trying these, it is better to try them on in the store to insure a proper fit.

Read the review in Seattle pi Lifestyle article “FiveFingers foot gloves a runaway hit“.

See Wired Science article, “To Run Better…” by Dylan Tweeney, which includes sidebar tips on “How to Run Barefoot”.

NPR’s Weekend All Things Considered host Guy Raz tried on and reported on FiveFingers in NPR’s story, “A Shoe for Barefoot Runners“.

Even poet, author, and artist Marshal South preferred to go barefoot at Yaquitepec during his experiment in primitive living from 1930 to 1947.  He wrote in is article, “Desert Diary 11″, “Ordinarily, bare feet are the rule at Yaquitepec.  Wood gathering however calls often for the navigation of savage sections of rock and thorn where barefoot caution would consume too much time.  So we dig out our Yaqui sandals for the job.  Probably the oldest and simplest human device for foot protection, the sandal is still the most comfortable and healthiest thing man has ever fashioned in the way of footwear… Generations of abuse in ‘thoroughly scientific’ shoes have spoiled civilized feet to such an extent that they have to be entirely re-educated.  But once the sandal technique is learned the foot enters upon a new and better life of freedom.”³

However, there are times when going barefoot or in foot gloves or sandals just won’t do.  So I recently bought what may be the most comfortable shoes that I have ever worn: Merrell’s Encore Groove.  Merrell began in the Green Hills in Vermont and has been providing outdoor enthusiasts with quality performance footwear for over 26 years.⁴

I am now looking forward to taking my FiveFingers and ten toes out on our next camping trip and enjoying what should be a spectacular wildflower blooming season due to our recent rains.⁵  In the meantime, Larry and I have begun taking our FiveFingers (and two corgis) on walk/runs around our local Chollas Lake three times a week and are already experiencing the fun and health benefits.  See Ultra Marathon Running Movie - Indulgence and Copper Canyon Ultra Marathon in Born to Run.

Footnotes to Footnotes:

1.  Also known as shoe gloves, foot socks and barefoot shoes.

2.  REI in San Diego was temporarily out of stock in this model, so I found mine at Adventure 16. Model KSO, “Keep Stuff Out”.

3.  All 102 articles and poems written by Marshal South for Desert Magazine from 1939 to 1948 can be read in Marshal South and the Ghost Mountain Chronicles: An Experiment in Primitive Living, 2005, Edited and with a Foreword by Diana Lindsay and Introduction by Rider and Lucile South, Sunbelt Publications, San Diego, CA.

4.  History of Merrell

5.  See DesrtUSA’s Desert Wildflower Reports 2010 - Southern California

Fall is one of our favorite seasons and, now that temperatures are within our comfort range, it’s time for us to return to the desert and continue to celebrate the colorful fall harvest season.  For the occasion, Larry made pumpkin cheesecake with a rich, buttery graham cracker walnut crust.  It is seen below in its springform pan, just out of our home oven.  Next to the cheesecake is pumpkin pudding made from pumpkin pie filling and baked in a handmade stoneware pie pan made by Barbara Flynn at Renaissance Pleasure Faire.

The refrigerated pumpkin cheesecake came with us to this oasis in the southwestern Anza-Borrego desert region, once inhabited by Kumeyaay Native Americans from 1000 A.D to 1906.  We nestled our Safari between Mesquite trees and Creosote bushes.

The Creosote bush, Larrea tridentata, has waxy resinous leaves and yellow flowers that turn into white fuzzy fruit capsules.  This plant has an aromatic fragrance, especially noticeable after a desert rain.

The Safari’s windows are seen closed on this chilly morning at sunrise, while Larry was inside icing cinnamon buns in a muffin top pan just out of the oven.  Upon opening the trailer door, I was greeted by the spicy aroma of the buns and freshly brewed coffee.

By mid-morning it was time to open up all of the windows, and by afternoon turn on the Endless Breeze fan as temperatures outside approached 80 degrees.

We are very happy with our new lightweight Dim Sum Clock that hangs on a “L” hook screwed in on the end of the galley overhead cabinet.  Dim Sum is one of our favorite foods and this “must have” item for us goes well in the Safari.

The hour pieces represent varieties of dim sum, are handmade by San Francisco artist, Noriko Kuwabara, and mounted on a bamboo steamer.  Starting at the one o’clock position, the pieces include a potsticker, pearl ball (shrimp ball covered with rice), custard tart, crab claw, bell pepper stuffed with shrimp, spring roll, har gow (shrimp dumpling), fried wonton, siu mai (pork dumpling), fortune cookie (invented in San Francisco), wu gok (fried taro root filled with pork), and cha siu bao (roasted pork bun) in the twelve o’clock position.

Also seen in our galley is a replica ad poster (on tin) from the 1930’s Shanghai era.

Larry found this piece while browsing our local Goodwill store.

It features a woman in a traditional Chinese dress (cheongsam) sitting on a low Chinese stool and promoting Lactogen for infants and nursing mothers.

We renamed her “Yum cha“, which is a Cantonese term meaning “drinking tea” and now refers to the dim sum dining experience.  Yum cha has its roots in travelers on the ancient Silk Road needing a place to rest.

Our fall harvest celebration includes setting the Thanksgiving table early…

and enjoying that pumpkin cheesecake (displayed with Pygmy Date Palm seeds)…

and enjoying sunsets and dreaming of gardens in the desert sand.

Our camping season is just beginning and we are about to return to the desert.  I mentioned in my last article specifics of getting our Safari ready to roll and blithely mentioned that we topped off the fresh water tank.  Rich caught this and quickly reminded me of the importance of sanitizing the water system periodically with a bleach and water solution as recommended by Airstream.  I had wanted to do this last spring but I postponed it when I found that the fresh water petcock drain would not budge with normal hand pressure.

We have no need to winterize the trailer in San Diego and have never completely drained the fresh water tank before, but now I was motivated to do so.  I posed this issue on the Airforums and got a helpful reply suggesting that Dow Corning 316 Silicone Release Spray may help and alerting me to the importance of not turning the petcock too far open or closed (so that a finger won’t fit behind it).  My next challenge was to find this product, which is now called Molykote 316.  After numerous telephone calls and online research, I was able to order it from our local San Diego distributor for Kaman Industrial Technologies.

Two cans arrived via UPS and I was eager to use it but found no “How to use” directions included or on the label.  I finally found the product information along with “How to use” instructions here at wolcott-park.com.  So now I went out to the Safari.

I sprayed a light film of Molykote 316 on the petcock and let it be overnight.  (Directions say to allow approximately three minutes drying time.)  The next morning I still found the spigot difficult to turn by hand so I used pliers with plastic tubing over the teeth to turn the spigot.  This worked and I sprayed the petcock again and was able to move it now by hand (but due to my big hand and some arthritis, I found I still relied on the pliers).

Molykote 316 Silicone Release Spray is made by Dow Corning and is a release agent for many food and industrial applications.

The product information says that it helps prevent seizing and jam-ups of conveyor guide rails and reduces sticking of pulleys and valves.

It also says that this product complies with FDA21 CFR 175.300 and FDA 21 CFR 178.3570 regulations for incidental food contact.

This product has a H-1 designation meaning that the lubricated part may have incidental food contact not to exceed 10 parts per million.

Handling precautions indicate that this product contains a flammable solvent, so do not spray in a confined space where the possibility of spark ignition exists.

So now that I was confident that the petcock could open and close, I proceeded with the sanitizing of the Safari’s water systems.

I followed my Airstream Owners Manual for the Safari and computed the required amount of bleach to add to a water solution for my size tank (multiply “gallons of tank capacity” by 0.13 to get ounces needed).  For my 30-gallon tank I used 4 ounces of household bleach (Clorox).  The solution was added and I topped off the tank, and opened all faucets (hot and cold), including the outside shower hose, allowing the water to run until the distinct odor of chlorine is detected (not so easy with my nose).  I then let this sit overnight (the manual says that this standard solution needs to have four hours of contact time to disinfect completely).

The next morning I opened the petcock and the water streamed out (and took two hours to completely drain).  I refilled the tank (with the white fresh water hose with a new TastePure RV Water Filter attached).  Again, I opened all of the faucets and purged the plumbing of all sanitizing solution.

I once again opened the petcock and drained the fresh water tank and, after another two hours, I closed the petcock and filled the tank for the final time and flushed the faucets once more.  (I then drained the gray tank.)

We did not want to water our plants with bleach-water so we allowed it to drain down the driveway.

But in this age of needing to conserve our precious water…

There must be a better way…

Perhaps an alternative technique or active agent…

Such as Purogene Fresh Water Treatment.

Or the use of the Drinking Water Freshener?

The second draining of the fresh water tank may not have been entirely needed.

But for now at least the fresh water system has been sanitized and the petcock works…

So we’re ready to hit the trail…

and enjoy cool clear water.

The summer heat is over and the seasons are changing quickly now, so for us it means the beginning of our fall and winter camping season.  Although it is still too hot for us in the desert, we traditionally enjoy experiencing the fall harvest season in our local Cuyamaca Mountains.

At the end of last season our trailer got its annual major washing, which was followed with a thorough washing of all trailer awnings.  Just prior to starting our new season, I applied 303 Aerospace Protectant to the seals of our Fan-Tastic Vents, windows and doors to protect them and keep them from sticking.  Then we refilled our propane tanks and checked the operation of all equipment, including the hot water heater, water pump, stove, oven, furnace and refrigerator.  Vent screens were cleaned and the trailer was vacuumed.  Tire lug nut torque checks were done along with checking air pressure and installing tire pressure sensors.  The fresh water tank was topped off and our solar panels were cleaned in anticipation of camping without hookups in the Cuyamacas.

Larry prepared the menus and food, including the baking of the buttery, rich and very delicious French apple tart seen below in its tart pan just out of our home oven to tie in with the seasonal apple harvest festival celebrated in nearby Julian, Ca.

Indian summer is an expression indicating sunny and warm weather in autumn when the leaves are turning color, often after the first frost, and before the first snowfall.  Days before our outing, Julian’s morning low was 31 degrees and we departed in the midst of a hazardous weather outlook for all of extreme southwestern California.  But within two days we experienced Indian summer in the mountains.

Besides the periodic California Santa Ana fires, another drama is being played out here and other areas of San Diego’s East County.  Thousands of oak trees are dying from infestations of the gold-spotted oak borer, which may have spread under bark of firewood.  The public has been urged not to transport firewood in or out of the county until more is know about this problem.  Even as we were camping, we could hear dead and/or hazardous trees and undergrowth being cut and turned into chips for mulching areas of the park.

Some of these oak trees were quite large, such as the one below seen on my morning walk.

Also seen during my morning walk were a Rio Grande Turkey hen and her two fledglings emerging into a clearing.

The fledglings foraged while the hen kept a sharp eye on me.

It had been chilly when I left the trailer for my walk, but when I returned, freshly baked Pillsbury Buttermilk Biscuits greeted me, along with a very warm trailer (we found no need to turn on the furnace on chilly mornings when anticipating baking with the oven).

One of a set of small, battery operated LED flickering tea lights (seasonal item Larry found at Costco) is seen in the votive holder above.

By the afternoon we experienced the Indian summer temperature of 80 degrees.  We used our new Endless Breeze 12-volt fan for the first time and Larry reports that it worked beautifully.

This fan is made by Fan-Tastic Vent and is available at Camping World (we ordered ours online from Fan-Tastic Vent).

It plugs into our trailer’s interior DC outlet.  Maximum current draw is reported to be 3 amps (easily supplied by our solar panels).  It also comes with clips for attaching to pet crates.

Our fall harvest/Halloween dinner table setting included pumpkins, Indian corn (also called maize), a turkey-shaped wicker basket containing Pineapple Guava, and a floral display of Plumeria (guava and Plumeria are from our yard).  The Pineapple Guava is sweet and juicy and is especially enjoyed by our pug, Pau Hoa.

And so during this golden fall harvest season, we are thankful to be able to return to and experience our beautiful parks with our loved ones, whether we are vividly awake… or enjoying Golden Slumbers.  

“Nose surgery?” I asked as the secretary was scheduling me for Head & Neck surgery.  “No, Mohs surgery,” she said, and she had to spell it several times before I got it right.  I jotted down the check-in appointment time of 4:30 p.m. for surgery at 5:00 p.m. and without delay I proceeded to Google “Mohs surgery“.  Google presented 162,000 hits (links) and of course, my reliable friend, Wikipedia, was on top.

Mohs Micrographic Surgery (MMS) was developed by Dr. Frederic E. Mohs (1910-2002) in 1936 to precisely remove skin cancer lesions while sparing healthy tissue and is the procedure of choice used by physicians today for anatomically important areas (eyelids, nose, ears, lips, etc.) where tissue sparing and low recurrence is important.

In my case about a year ago I started to notice a small, pin-point tenderness on the left side of the upper bridge of my nose near where the pads of my reading glasses rest and I noticed this most when I slipped on my sunglasses.  I could feel a dry raised tiny spot there that I attributed to wearing reading glasses.  Last spring my dermatologist finally got to see it and he treated it like my other precancerous skin lesions, called solar or actinic keratoses, with cryotherapy.  This initially worked, but after a few weeks I felt the tenderness again and I scheduled a return visit to my dermatologist, which had to be rescheduled after the completion of my summer jury duty on a murder case.  When I finally saw the dermatologist, he offered to freeze it again… or just cut it out.  “Well,” I said, “freezing didn’t work last time… maybe it would be better to just cut it out.”  And he did and sent it to the lab and I got the report back the next week that it was indeed squamous cell carcinoma, the second most common cancer of the skin, with more than 250,000 new cases diagnosed every year in the United States.  (Basal cell carcinoma is the most common.)

The image below shows the healed biopsy spot just before surgery.  The spot is the light circular area on the anatomically left side of the bridge of my nose, horizontally across from my pupils.

So last Thursday, Larry drove me to the hospital where I checked into the fourth floor Head and Neck Surgery Department for this outpatient procedure, which I was told usually takes one to three hours.  (See the excellent You Tube video overview: Mohs Skin Cancer Surgery.)  It is performed using local anesthesia and the patient guidebook said it would be okay to listen to an iPod during the procedure, and to bring a companion to drive me home afterward.

Being a “writer”, I thought I ought to avail all of my senses to savor the full experience, so I left my iPod at home.  I felt the smooth coolness of the rectangular cauterizing grounding pad applied by the friendly nurse to my upper left arm.  I was draped and felt the wet coolness of liquid and smelled the chemical odor of antiseptic solution as it was applied over my closed eyes, forehead, nose and upper cheeks.  I felt the sharp skin-prick and brief pain as the surgeon injected anesthetic into the bridge of my nose.  The surgeon and nurse then left me alone with my thoughts for about fifteen minutes while the anesthetic took hold.  I could barely hear questions and answers of the patient having a similar procedure in the next room, which helped me know what to expect.  I also heard the high pitched sound of what sounded like cauterizing equipment.

The surgeon returned and applied a drape with a small opening over my head.  We chatted and I told him that I was a retired RN.  I was pleasantly surprised when he informed me that his wife works as an administrative RN in the medical center where I had worked for 28 years.  As he mentioned names of people whom I had known and worked with, I drifted down memory lane while he scraped, cut, snipped, sliced and cauterized away.

The removed tissue was sent to the pathologist on duty and Larry was invited in to chat with me (he read to me an article in the latest Camping World magazine) while we waited for the surgeon to return with the pathologist’s report.  Meanwhile, the pathologist flattened, dyed, froze and cut thin horizontal sections (see You Tube frozen section technique) of the tissue using a microtome-cryostat.  The sections were placed on microscope slides, fixed, stained and examined to determine if the tissue margins were clear of tumor cells.  After about thirty minutes, the surgeon returned with good news (no more tissue needed to be removed) and closed the wound with ten small sutures and applied steri-strips.  I was given postoperative instructions, prophylactic antibiotic, narcotic pain reliever, a return date for suture removal and an instant cold pack to apply to prevent swelling during the return trip home.

One year ago in my “Sun safety” post, I documented my actinic keratosis on my left cheek and how it was treated with the antimetabolite Fluoroucil.  Development of actinic keratoses are associated with exposure to the sun.  As noted in this AOCD article on Actinic keratosis, sun damage to the skin accumulates over time and up to 80% of skin damage is thought to occur before the age of 18.  Left untreated, actinic keratoses can progress to squamous cell carcinomas.  Properly treated, the cure rate is 95% to 97%.

Having one squamous cell carcinoma is an indication that others may arise over time and it is important to be watchful and have dermatological examinations at least once a year.  Fortunately, my health care is provided by one of the largest and most respected health maintenance organizations (HMOs) in the United States.  I have affordable health care insurance, but some people are not so fortunate, which is one reason some believe that health care reform is the most important issue of our times.  It is also currently one of the most hotly debated national issues, as evidenced in this New York Times article of Sepember 18, 2009, “The Baucus Plan: A Winner’s Curse for Insurance Companies“, by Uwe E. Reinhardt.

“Every day is a gift…”

The recent death of Senator Edward M. Kennedy, whose passion in life was noted to be health care reform, has sharpened this debate, as evidenced in the August 26, 2009 New York Times article, “Kennedy Death Adds Volatile Element to Health Fight“, by Carl Hulse and Katharine Q. Seelye.  Mr. Kennedy wrote that health care was the great cause of his life and that he hoped that his words would inspire readers to take up the cause (page 506 of his recently released memoir, True Compass, Edward M. Kennedy, Twelve, Hachette Book Group, September, 2009, which is one of my fall reading books).  “Every day is a gift,” he was quoted as saying in the August 26, 2009 New York Times article, “After Diagnosis, Determined to Make a ‘Good Ending’“, by Mark Leibovich.

Although we are faced with increasing health concerns as we age, we are also determined to make each day count and enjoy celebrating life.  For example, last Friday Larry made (from scratch, his first, and so delicious) honey-raisin round challah and I learned how to blow the shofar to celebrate Rosh Hashanah (see the You Tube videos) , one of three annual new year celebrations that we observe.

Also seen on our table above are chopped Chinese roast duck and plum sauce, stir-fried Chinese broccoli (Gai lan) with oyster sauce, one fig (freshly picked from our Brown Turkey Fig tree) on a plate with three apples and nearby honey, peanuts, butter and baklava.

We continue to celebrate life and look forward to our fall and winter camping outings to the nearby mountains and desert.  So for us, and the “Snow Birds” beginning their seasonal migration to warmer, sunnier climes, this is a good time to review Sun Safety Action Steps…

And contemplate autumn sounds and sights.

Up in the trees, the male cicadas seem to relish the increasing summer heat this time of year and quickly contract and relax their internal timbal muscles causing their timbals to emit a sustained, resonating clicking sound that attracts female cicadas.  Most cicadas have a life-cycle of two to five years, but some, such as the Magicicada, have a 17-year cycle and, with a combination of a long-life cycle and periodicity, are sometimes called 17-year cicadas.  Cicadas live underground most of their lives, but eventually tunnel to the surface and molt (see one shedding its skin here).  The Golden Cicada in the Chinese classic, Journey to the West, illustrates the belief that transformations in life can lead to enlightenment and immortality.So we are now in the dog days of summer, the hottest, most sultry days of summer, usually between early July and early September.  The ancient Romans called these days Caniculares dies (days of the dogs) after the “Dog Star”, Sirius, which is in the constellation Canis Major and is the brightest star in the sky besides our Sun.  The ancient Romans noticed that in their summers Sirius rose just before or at the same time as the sun and they thought that their combined heat caused this stretch of hot, humid weather.  The ancient Egyptians noted the peak of their seasonal flooding of the Nile River occurred after the heliacal rising of Sirius, which became their “watchdog” for this event. Some people believe that this is an evil time when dogs become mad and men hysterical.  Politics fray and town hall meetings become raucous.  This is the season when hurricanes churn, wildfires rage, dragonflies swarm, and spiders grow and proliferate.  Others see it as a time when dogs lie lazily about and ants accelerate their march in search of food and water.Indeed, while I was researching this and more on my MacBook Pro laptop computer, I noticed an Argentine ant walking across the beach scene of my computer’s wallpaper. (See CNN News article, “Are ant invaders taking over San Diego?“)  While unsuccessfully brushing it off with my hand, I noticed that this ant was actually inside my computer’s display panel.  I tried to ignore its random explorations back and forth on the beach in hopes that it would just find its way out for some water, food or fresh air.  But when it became apparent that the ant preferred to stay on my beach, I became concerned that it would eventually die there, and become an eyesore and a permanent distraction.I then noticed that the ant became very interested in my computer’s cursor (in the form of an arrow) which I moved about with the computer’s mouse.  The ant must have thought that the image of the cursor arrow looked like another ant and when I brought the arrow near the ant it followed the cursor as if it were following a brother ant and I was able to use my mouse to lead this ant safely off the beach onto my dock where I put my finger down on the subject.  Better to stabilize it on the dock at the bottom of the screen than risk having it litter the beach, I thought. Everyone was amused during my next Apple one-to-one session and they suggested that I show it to the Apple Genius Bar.  They laughed and took pictures of it with their iPod camera and, to head off any long-term consequences of an ant deteriorating in the computer, they authorized a replacement of the display panel under warranty (Apple lived up to its great customer service!)Most of my dog days of summer, however, were spent as the third alternate juror in a gang-related murder case.  I was never actually called upon to deliberate the defender’s fate, but I did find the case fascinating and probably equivalent to a Gangs 101 college level course.  I learned what criminal gangs do (criminal acts), how they recruit (give marijuana-laced cigars [”blunts“] to young teenagers), and how gang members increase their gang-standing (commit more criminal acts).  I learned about gang culture, clothing, colors, symbols, tattoos, graffiti, hand signs, and music (Gangsta rap).I learned how police fight gang-related crime (document gang members using field interview reports, arrest gang members, interview witnesses, and collect and process evidence).  Forensic evidence, such as DNA, GSR (gunshot residue), fingerprints, and ballistics, is playing an increasingly important role in criminal justice.  A career in forensic science offers an exciting combination of science and law studies.  Forensic science is now playing a major role in helping jurors decide on a guilty-beyond-reasonable-doubt verdict or a not guilty verdict.  The Deputy District Attorney (see him prepare and present another San Diego case) instructed us jurors about the felony-murder theory (besides the actual perpetrator, all conspirators present in aiding and abetting a murder may be prosecuted for murder).The trial ended earlier this month and the defendant was found guilty of first-degree murder. It was delayed by another prisoner in the county jail contracting Swine Flu, which resulted in a 10-day medical lockdown of prisoners (who could then not meet with their lawyers or attend court).  (As of August 12, 2009, there have been 1,005 confirmed cases of H1N1 influenza in San Diego County, including 16 deaths.)  During the many trial breaks, I was able to finish one of the books, True at First Light, written by Ernest Hemingway when he returned from Kenya in 1953, seen on our patio table in my “Stepping into summer” article.The Nightblooming cereus seen above and below were blooming on a full moon night earlier this summer.Recent cool breezes in San Diego have made these dog days of summer more tolerable, at least for the moment.  So now that my ant problem has been resolved and the jury case concluded, things are looking up…and I can relax and listen to “Dog Gone Day’s 2009” music, while contemplating our next Airstream trip.