Algorithms

A few years ago, I crossed paths with an orthopedic spine surgeon who came to be known as "Dr Algorithm." This guy. The images showed major bony changes, nerve impingement, and various misalignments in the spine of the subject. Packaged with a precipitating injury over a decade old, and multiple rounds of steroid injections and physical therapy already attempted over the intervening years, one might imagine he would have some other answer. Alas, he is, as his well-earned nickname implies, married to The Algorithm. He asserted steroid injections and physical therapy were the miracle cure for 90% of "his" patients, and he would not go to surgery until all those options has been exhausted under his supervision. Somehow he had the magic technique, and no previous attempts at injections and PT could possibly have lived up to his particular and special skill.

I only met this man once. It was enough times. Suffice to say the so afflicted patient has since had surgery. With a different surgeon.

Which brings us to today.

 I had a follow-up appointment with the civilian doctor (well, technically seeing the PA) I got referred to about my knee pain. On my first visit, he declared my knee pain must be the result of muscle imbalance. I suggested the level and type of activity I engage in made this conclusion seem unlikely. But, the x-rays were clean, and there was no changing his mind. He wanted me to do PT.

Now that I've had a few sessions of PT, the knee pain is not better. If anything, it's worse. And I had to go around with the physical therapist about some of those exercises, too. At least he was a nice guy and seemed to recognize there's something more to it than inner thigh muscles being weaker than outer thigh muscles or the other way around.

Anyway. I got in to see the PA. He walked in and his first question was about blood work he'd ordered. I told him I hadn't done it, because I realized all the arthritis I have ever had is secondary to other injuries and I don't have any of the conditions he wanted the test for. He got a little snippy and said he "didn't know that." I told him well, now you do.

Have I ever mentioned I'm not an easy patient?

Next he asked "how many PT sessions we have had."

To which I responded, well, *we* haven't had any, but *I* have done 6.

Yes, I really am that petty.

So after all of that, and not making any friends, he's ordering MRIs. Which should have been done 2 months ago. But of course it was not. Because, although he's not as open about it, this place is just as slave to The Algorithm as the surgeon I detailed above. X-rays are clean, the pain must be due to this other, evidently relatively common muscle imbalance. Don't listen to what the patient does. Don't test strength. Don't contemplate there may be more under the surface. Not until The Algorithm has been satisfied. 

But this post isn't ultimately about knees or spines or the surgeons who treat them. It's not even about the medical algorithms we all encounter.

This is really about that other algorithm we're all subjected to, on the daily basis. The algorithm which oversees social media.

Recently, Facebook has been increasingly unhappy with me. Mostly it is unhappy with me because I have a cat named Ugly and they think I'm bullying him. I have to carefully word any post including Ugly, because Facebook will legit remove it for "bullying or hate speech" if I get it wrong.

This would be amusing if I weren't seeing others posting perfectly innocent content and having it removed. An author I follow, Jim Wright, recently had a picture removed for "violation of community standards; it was a picture of a bee, captioned "a bee." Shadow-banning has been a thing, wherein a poster's content reaches very few people, as it's being hidden. I've demonstrated this on my own page, by having someone else post exactly what I did, words and images, in the same group, and they get responses, while mine is not seen.

Particularly after hearing things like this RadioLab episode I've been increasingly disenchanted by the whole Facebook experience. The algorithm has serious problems.

And y'know what? I'm kinda tired of it. I'm tired of how Facebook and most of social media works. I'm tired of bumping up against the algorithm because of pictures of a happy orange tabby cat. I like to get a little deeper into things. Facebook demands pithy and short content. The pressure to make posts amusing or otherwise entertaining is more than I'm willing to put up with.

So, while I'm not leaving social media, I'm going to spend more effort and energy on blogging. I like this format. I can write out long and (at least to me) interesting pieces. If I end up talking to myself, well, that's fine. More often than not, I seem to be talking to myself on Facebook, too. At least here I find myself more entertaining.

Priorities

 There's a lot to do around here.

The morning broke crisp and clear, and downright cold. With the dogs' insistence upon an open door at all times, the house gets cold, too. The central heating in this place isn't very good under ideal circumstances, let alone with the front door hanging open. 

So, the priority is getting a sliding glass door installed in place of the double French doors, and putting a dog door insert in it. No big deal, really, in the overall scheme of things. Not exactly an arduous process. Won't take more than a day to do the install.

Except....

I have horses up to their ankles in mud. It's so bad, there's standing water. Those pens need a good tearing down and resurfacing. But there's nowhere else to put those horses. Hoss and Nova need to be close to the house. Sere, being open (not pregnant), is a bully to her sisters, and there isn't another pen in the lower turnouts for her.

Upper Pen Pond

I moved Hoss and Nova to the arena, and Sere to a small pen, so they'd all have somewhere decently dry to stand and lay down. I could hear Nova ramming around the arena as I went about getting their breakfast together. Later in the day, I saw Sere taking a nap in the sun. I know Hoss laid down, based on the dirt on him. Nova seems more relaxed in the drier space.

Hoss and Nova

The only solution for this problem is another pen. The only way to make another pen is to buy more corral panels and haul them home. Oh, and clear out the space where we plan to put the pen. Then, once that pen is built, tear down the big pen and use many of those panels to create a 6th pen in the lower turnouts, so Sere can have her own room.

Sere, happy to be sorta dry

Not complicated. Fairly straightforward. Lots of work.

The list of things that need done seems to grow faster than I can tackle it. In order to get a new sliding glass door home, I need to get the truck rack built and on my truck. I'm still waiting on the roofer to give me an estimate on what that's gonna cost me. We need a new refrigerator. A new range would be great. New dishwasher wouldn't be bad. We figured out there's an outlet behind a cabinet in the kitchen, and we'd really like to be able to use it. Certainly would make more sense to have the microwave in the kitchen than in the random little alcove. 

Then, the neighbor let me know the dogs were barking at him and his parents. I'm not clear if they're just standing on their side of the property line and barking, or if they're actually approaching people. Either way, that can't be allowed to stand. I had hoped I'd be able to plow some money into getting the property fenced, but with the roof being in a state of critical disrepair, that has to come first. Some time ago I bought an underground fence system, which I haven't installed, for the very simple reason that I wasn't going to install it only to have to dig it out if we ended up forced to move. Now that we're for sure staying, I'll have to put it in, as well as put up some panels between our property and the immediate neighbor's to break up the energy if the dogs do decide to bark at or charge people. The ultimate goal will, of course, be a fence around the property. 

So much to do. So few hours in the day.

Traveling up Middle Peak

So I went for a ride. Demon and I have an endurance ride (the 3 day Fire Mountain Pioneer) coming up in a couple of weeks. I need to get him out and ride him and make sure we're doing well. I had a mind to go up past Ramona to ride to Eagle Rock. Got as far as the turn to go through Julian and discovered everyone was going to Julian. So I turned back and we rode up Middle Peak instead. It wasn't a long ride, but the smart trot on the ranch road back to the trailer was refreshing. On the way back down, when we passed the turn onto Middle Peak, Demon pointed his nose that way, and I gently turned him back to the trailer. Several times, as we approached the gate, he made efforts to turn back. He'd rather be out there. So would I, really. Keeping the priorities straight is challenging enough.

Above the snow line

Ready to head out