I finally got around to putting up pictures from my trip to Dubai last month. I gave four original talks in four days with the invitation of my friends and colleagues, Humeira & Cathy, in Dubai. What a trip!

I arrived at 7pm on Monday night and had dinner on the beach just outside Burj Al Arab (the “7-star” hotel that’s the 2nd tallest in the world, on it’s own island, and looks like sails). Gorgeous colors light it up at night. You can still make out the helicopter landing pods near the top, too.

Day 2 Humeira took Claire & I to see the inside of the Burj Al Arab (you need special pass to go there). Truly gorgeous! Then we went to the Atlantis resort, had lunch, talks for the Emirates Arthritis Foundation and I gave talk#1 about the cost-effectiveness of RA drugs to patients, insurance providers, and a few doctors. That evening a small group of us went to a restaurant/resort out in the desert where we ate well and I did some dancing with the belly dancer and went up on stage with Claire for more public embarrassment/entertainment. I also rode a camel... in my jacket and tie!

Day 3 the conference, Arab Health: Rheumatology, got into full swing. I was taken to the local market - so much amazing fresh produce and seafood! Did some shopping at the souks. Still have a bit to learn about haggling. Saw a local art exhibit, attended several talks and went back to Atlantis where I gave talk #2 on safety of biological drugs and had a late dinner/bbq outside overlooking the palm and part of the southwestern city skyline.

I’ve skipped over a few important details. First, Atlantis. This $1.5 billion resort just opened in Sept at the top of The Palm Jumeirah, these large chain of islands in the shape of a palm. See Google Maps/Earth for more details - it’s amazing! I took pictures inside the vehicle with GPS to prove where I was on the palm. Second, there are cranes and construction all throughout Dubai! Over 50% of the world’s cranes are there and I can believe it! Skyscraper after skyscraper filled my views. My hotel, the Dusit Thani, a Thai hotel in the shape of bowing palms (hands), is along a line of skyscrapers that are next to the Burj Dubai, the world’s tallest building at 170 stories! It truly dwarfs everything within sight. Below it is the world’s largest mall. And you can see the construction of a metro rail line along the 16 lane highway outside my hotel window. All of the city is within a few miles of the coast - the desert is all too present. The temperature was in the 80s most days until the final weekend when it was near 100 and we had a wind/dust storm. Bus stops are air conditioned. This is the nicer season - the summer is much more unbearable. But since it was dry, seemed more tolerable.

Day 4. By now I’ve had serious jet lag, unable to sleep well and every day was tough to function, but the thrill of so much new kept me going. Another full day at the conference where I gave talk#3 on quality of life, work disability and non-clinical outcomes in RA. That night I went to a special art exhibit (Kids from around the world) and “hobnobbed” with the locals (which were almost all ex-pats). Then I had dinner with many of the rheumatologists from the region at Raffles, a well-known British hotel/casino brand with a pyramid hotel.

Day 5. Friday is the beginning of the weekend, but many docs still showed up for my 9am talk#4 on how to create a rheumatic disease database. It went well over an hour, but that was good as the next speaker didn’t show. That afternoon I went on a desert safari with Humeira, the guest statistician, Kok, & wife from Singapore, . I thought this would entail a simple drive through the desert to see the few animals and sights... I was so wrong. This was a 2.5 hour rollercoaster of a drive through the tremendous dunes! Our driver/caravan was crazy! Yet, so much fun! If I didn’t get car sick, I would want to go again (as it is, I’d like to make such a drive myself). Sliding down giant dunes, going sideways, getting stuck, near collisions with other trucks (all with roll bars) - great fun! The ride ended with dinner and more belly dancing out in the desert (yay!). I held back on dancing this time, though I befriended a newly-wed couple from Pakistan.

Day 6. This was a full day trip to Oman - the tip of the Arabia peninsula at the Straight of Hormuz. It’s a near-uninhabitable collection of giant rocks with a bit of a bay inside that we toured on a dhow. I swam in the water - I was the first one in and the last one out both times we stopped. There was red tide that we avoided, the fish that I avoided, the dolphins we couldn’t get enough of, and the reef sharks we smiled at (and avoided). Considering I have a fear of heights and sharks/water, I was definitely enjoying the thrills! The drive was long - 4 hours there, but the driver was different on the way back and drove our bus like a madman, making it in 3 hours! In time for a home-made meal among friends/family.

Day 7. Cathy & I went shopping at one of the big three malls - the one with the indoor ski slopes. Very impressive place, though it could have just as easily been a fancy mail in another big city. I did pick up a new large luggage bag to replace the current one with broken handle. Picked up some postcards, got a Chinese massage, and then one last dinner in an amazing looking skyscraper (I forget the name, but part of twin towers) with a new local friend. The flight back to DC was 15 hours long (12 hours to get there).

In summary, was wonderful to spend time with great friends, make new ones and future work colleagues, to see such futuristic architecture/engineering marvels, and to learn so much of the native and local cultures (not just the capitalistic side). I’ve said I could live in Singapore, and now I feel that Dubai is livable as well - much yet to be done there, but was great to see a piece of it during the boom (and bust).

As many of you know, I work with Fred Wolfe in running the National Data Bank for Rheumatic Diseases (we go by NDB and not NDBRD). He appeared in the AP news today in this story about Fibromyalgia (FMS).

While it does cover a few of the issues of the problem, it’s weird that there’s only two quotes from Fred, yet says “"I think the purpose of most pharmaceutical company efforts is to do a little disease-mongering and to have people use their drugs," said Dr. Frederick Wolfe, who was lead author of the guidelines defining fibromyalgia in 1990 but has since become one of its leading skeptics.” He wrote a wonderful chapter about FMS in Kelley’s book of Rheumatology that came out last year that covers the topic in greater detail. Plus we’re working with the top FMS doctors in the country in devising a new and updated criteria for diagnosing FMS. Not sure what the AP means by “leading skeptics” and I’m concerned that this will hurt the NDB in our patient participation as FMS patients have zero tolerance for anything that may make them think they aren’t being taken seriously (which is far from the truth - if anything, we’ve done a lot more FMS outcomes research than anyone at UNMC wants us to).

It’s a thorny issue. The pain and problems faced by these patients is real, but the recognition of FMS as a disease by the FDA & ACR hasn’t led to the solution of the problem, but rather to a lot of drugs first approved for other less common problems and then major marketing of them in FMS. There’s the very real concern that the number of patients diagnosed with FMS will increase dramatically after this push by Pharma just like the number increased dramatically after FMS was first named in the 80s (this isn’t coming from Fred, just my own thoughts). Fred was invited to speak at a FMS conference recently, but was uninvited when he said he wanted to talk about medicalization & disease mongering (a talk that he gave to a packed house at UBC in Vancouver last fall - you have less pharma money for such things outside the US).

A fellow rheumatologist and noted opinion-writer, Nortin Hadler, was also quoted in the above AP article. He makes some good points in general, but is often considered to be on the further end of the spectrum on these debates (always interesting, though - his books are thought provoking). Here’s one of his articles now sponsored by abc on heart disease.

Can't believe it's been 3 weeks since my "crappy day". Now that it's no longer freezing (and for the most part, absolutely gorgeous outside), time just flies!

Carpet was installed and I've been using the new home theater for a few local events. I now have a public Google Calendar (permanent link in my K... tab above) showing past and future events so friends can either plan ahead or check it when they want. Everyone who helped me with the basement gets to choose a movie/show of their choice in the new theater. Parents are coming back in mid June to help me finish it up - install 10 more lights, trim, curtains+. Should be a full weekend again!

I have two and a half students "working" for/with me this summer. Overall I'm fortunate as the two full-time students are hard working and good to work with, but it does change my work schedule some and adds to the responsibility list. Spent a few days working in Wichita - drove through a flash-flood storm along the way (and, just like the dislocation - which is still a major pain - I got pulled over for speeding along the way as I suspected would happen after I read about what to do when pulled over (see previous list of links), though only a warning (it's good to be so damn sexy )). Having to get a lot done before I leave for Paris - I'm actually typing this in the airport as my flight is slightly delayed. I've done nothing to prepare for what I'll be doing in Paris (besides the usual meetings, sessions, etc). Guess I'll just wing it!

While the yard looks great - new flowers popping up all the time (currently I have a pink rose bush in bloom, plus some peaneise ?sp) while others fade, we've had night after night of incredile thunder storms. Last Sat night was the worst - sirens from 2:30-3am, tornado hit a few miles away and we lost limbs, trees and power lines around the neighborhood. The worst is that I now have water collecting on the unfinished part of the basement - scared of what may be happening on the theater side! Got a new dehumidifier to help out (the kitties were taking too much time in walking through the water puddles, drying off upstairs, rinse, repeat).

Speaking of the kittehs, QBert hurt herself 10 days ago during the first marathon Heroes showing. After several days of guilt-by-others and watching her limp around (I suspected nothing was broken, but there was the uncertainty that it broke and was healing wrong), I took her to the vet, only to be told (after many xrays) that nothing was broken and that I should just let her limp and heal. Still not used to the expense of city vets.

Yesterday was my annual clothing purchase day. It's nothing official, but I rarely go shopping for clothes, and when I do, I get a lot - often to last me for the year. The bad thing is that these stores don't have carts (and the extra sad thing is that I usually need one!). Needless to say, I'll be sporting the latest in US fashion while walking and being rained on in Paris this week. As for the credit card debacle from last month - still finding new fraudulent purchases. Items that didn't reach me until I got the paper statement (don't know why they weren't listed online) - the crook easily charged over $1K in online purchases, but nothing over $100 (maybe that triggers a flag?). Also makes me question the online places I made purchases this spring - maybe that good deal on the surround speakers made this possible?

Ok, they're herding us up for boarding - off for now!

Seemed like your usual day of "recover from the weekend" - especially when that weekend was being busy working on the basement the whole time (parents drove up to help again - not yet done, but we have a few lights and electricity at last!). Also had a short get-together with some family for my cousin's HS graduation in Lincoln, had a good trip for a talk I gave in Atlanta last Friday, but got lousy sleep (arrived there after midnight and the meeting started at 7am, arrived home at 3am on Sat since my flight was delayed 3+ hours).

But today may beat all. First, was told one of my coworkers in NDB in Wichita died (she had been fighting cancer for a while), then was told that the fellow I helped recruit last year and who was to be our new "research star" now has little interest in research (a big blow), then after returning from an hour of more basement shopping at Menards, I find my car has been dented and scratched along two doors from a parking lot hit and run (easily $1K+ damage), and tonight while doing my finances I discover 8+ purchases of $600+ made fraudulently on my credit card from the past two weeks.

I'm ready for tomorrow!

What a difference a week makes! Last Monday I was playing ultimate (the frisbee football game), going for a long catch in the endzone, tripped hard on the long grass and fell with all my weight on my left shoulder. I heard and felt it snap. I was stunned for a bit on the ground (and I think I swore some, too). Shortly I opened my eyes to find myself surrounded by all of the players (~13 others) - felt like I should be giving orders in a football game or something. I said that it was dislocated and when asked if I could move my arm (ouch, hell no!), I told them to slowly move it up and over my head to pop it back in (which caused several to turn their heads away). What's funny is that only 3 days earlier I was on a flight to Dallas and read a short blurb in Wired magazine about what to do if you dislocate your shoulder - good timing!

*POP* Back it went. It hurt, but felt like I could use it. So I got up, walked off the field and sat and whimpered. My friend Michelle took me to the ER, did X-rays and confirmed the dislocation. Was told that most folks don't pop it back themselves, but they come to ER, get tons of pain pills and get a team of people to pop it back. Made me feel like a tough guy. Sent me home and I've been semi-useless for a lot of the week. First night I awoke after 3 hours screaming in my sleep and then couldn't sleep for 3 more hours. Pain was too much. Discovered later that I fractured my coracoid process - just means it will take longer to heal. I see an orthopod on Wednesday (happens to be a research collaborator). Still very uncomfortable, but we'll see. I've gotten behind with work again due to it. Can't type for long. Was told by doc that I can't play ultimate for many weeks and am at high risk for new dislocation.

In good news, I got my first grant this week! It's from the Arthritis Foundation - a career development award for two years. I'm very pleased. I'm also off to Atlanta to give a high-profile talk (which I haven't started due to April abstracts and the shoulder injury). Had a few folks over for games/food last night - good way to cheer myself up and enjoy the coming of spring. Absolutely gorgeous outside! So many flowers and my house is surrounded by lilies - the entire neighborhood is awash in colors. Truly can appreciate the entire city during this time of year.

The ceiling of the basement is almost finished, but I'm unable to do much on it for a while. Electrical work is next, then carpet, then almost done! Very behind on email - hard to type for a while - still a bit slow. Appreciative of the kitties cuddling...

I've been uber negligent again, but this is usually the busiest month of the year for - the ACR abstracts were due tonight and they're done for another year! Unfortunately I didn't create any at the last minute as I needed, but I did help with 27 other ones (yes, a new record!). Just means I'll be busy helping with them again next Sept/Oct preparing them for the meeting in SF, but maybe I'll have more time to enjoy SF since I won't be presenting any of them.

So I'm still on the nasal sinus rinse and liquid prednisolone for my sinuses. I'm curious as to how much of an effect this will for the long-term use (my research often looks at steroid-induced osteoporosis) though it's been worth it to breath easily and be able to work without headaches.

I finished painting the last of the 2x2' ceiling tiles last night and tonight I began on round 2 with them - going with 2 coats. Woot! Also made headway on basement - done painting the walls (April 5-7), insulation in ceiling (April 22), speaker cables all wired in walls (April 20-tonight), and started on the ceiling grid panels (April 29-next week). Carpet comes in on May 12th or so, which means all should be operating in time for the weekend of the 17th! It's exciting as it gets closer, but damn it's been a lot more work than I thought it would be! (now I understand why people hire out)

Stacie & Mike visited the weekend of April 12 (yes, they win for flying out to visit me more than anyone else!) and we had a quiet 2 days of conversation, food and fun. Always memorable and appreciated. It was miserably cold then and off and on all month. Seemed like The Longest Winter that was 2008 didn't want to end in March like a lamb after all.

Last weekend was our annual RAIN meeting - I gave a 50 min talk on the RAIN database that I and Kate, my talented grad student, had been working on. It's not finally live, but is now publicly viewable here. Also spent a full day learning how to write better grants last Tuesday. Likely will work on another "new investigator" award this summer as well as a 5-year NIH K-award. One could spend so much time writing these... and probably should, though I'd rather write papers and do new research. Who needs money?

QBert got the plastic cone of silence placed on her head for the past 10 days. Had an ear infection again and had scraped her head up rotten (see camera-phone pic in Cats section - my camera broke 2 months ago so apologies for no nice new pics in a while!). She's much better, but not sure she's forgiven TB for hissing and attacking the cone-head so often (though it was sad and funny to watch her bump into things with it). I still have to give her meds every morning and night. I'm thinking of putting the cone-head on TB so she can be teased/tortured and may lose some weight.

Still much to do with and at work. Trying to sleep earlier - nice when I have more of a nice day to get things done. Wrapped up season 3 of Battlestar Galactica and wondering about catching up with 4 (the last). Still my fav show on TV, even if I don't watch TV. Have had active de ja vu of late, too, with bizarre and wonderful dreams. And speaking of bizarre, check out Southland Tales, the movie. Definitely enjoyed it, even if overly ambitious (just like the same director's Donnie Darko, but very different).

Still doing the weekly game night (we had 14 this week!) and finally started weekly ultimate games, though only made 2 so far (too many Mondays were freezing!). When the basement is done, will host regular showings. About time I had something nice for the multitude of flicks at home - though the next question, how many bean-bag chairs to get?

There's a lot more I'm leaving out (my private life stays private it seems), but it was a full and exciting month. The flowers I planted last Nov are blooming and I had crocuses, tulips, daisies and now roses blooming. I love my yard!

Next up, trips to Dallas, Atlanta, parents visit, graduations, more work work - then only 1 trip per month for the rest of the year (so far). Also, I had lunch with coworkers and Warren Buffett sat next to us again. Twice in one year - such nice neighbors! He says that the recession will be long and deep... what a perfect time to go to Europe while the dollar is down. ugh. (Paris in June)

Thanks for not giving up on me - I'm baack!

Spent last weekend in Dallas so this blog post is a week behind. Sheetrock was put up in the basement last Monday and every morning for a few hours additional work (putty'ing, smoothing and then sanding) was done with it finished on Friday morning - Yeah! Unfortunately none of the guys who did the walls ever cleaned up any part of their messes (very annoying). So first thing this morning, with the help of Uncle Brian, Aunt Terri & Tim (later Lizzy) we cleaned up the basement, then put up primer and then painted one coat on the wall and did ~30 2x2' tiles in the garage. It was a gorgeous and productive day! (but that's just the basement - I'm going back late tonight to do coat #2)

One of the better friends I've made here in NE drove off to Virginia this morning. We got a lot of fun time in this week and I hosted a goodbye party for him last night with food, games and then cheering him on in a 11pm hockey game (the highlight of which was him pursuing the puck, the defender and him flying into the wall, Dennis turning and in one motion launching the puck 30' into the air and goal net while the ref blows his whistle and gives him 5 mins in penalty box for checking even though the defender hit the wall on his own accord). Dennis will return in June, but means that our band, Frash, may be on hiatus for a bit.

In work I had my annual review (actually, it was to my surprise since I continued to have phone problems and had no up-to-date calendar - got new phone and fixed the software problem (as of yesterday!)). While it was probably mostly positive, it was easy to focus on the criticisms. Because I don't see patients, it becomes easy for others who do to think that I have lots of free time at work and add more to my workload. It got a bit over the top this winter with this combined with being sick too often. I also was asked to chair a university committee and our first meeting was this week. I didn't know anyone on the committee, and only being here a year, I knew very little about the system we were being asked to provide new regulations/designs for. I wasn't overly worried as a couple higher-ups were to start this meeting, give us our charge and provide early leadership... neither of them showed up! I did a decent job on the fly, but it was very frustrating since I was asking more questions than I was able to answer and probably did little to establish confidence in the committee's goals. (and while I was determined to say no to jobs like this, this one will apply directly to my research in getting data for my local database plus give me some needed cool points with the university).

Kansas just won - what an exciting and krazy game! Gonna use this energy to do some more painting. Still feel like I have a ways to go on the basement, but it's nice to see the transformation in action. One step at a time...

In good news, my grandfather had his gallbladder taken out last week (right after Easter) and is doing much better. Yeah!

I'm skipping over a lot of other important events from this past week including some major ups and downs, but I'm off to paint!

Giving Him The Business - great college game referee detail though apparently first used by a ref in an NFL game 15+ years ago.

Decent plan for establishing a playoff in college IA football, though we'd have to decrease total games or make it ok to have possible 16 games for a couple of teams! I'm a big football fan, but still find this aspect frustrating. The lower division playoff games have been more exciting than the bowl setup.

Disturbingly funny motion picture of a guy and a kitten...

Interesting direction NIH could take on future funding - I've been discovering the pain and "system" young faculty must go through in order to compete for grants. Got my first (of many) rejection letter this past week and what I got out of it was: don't apply for money for anything new and exciting, just do simple things that you've already done all of the work for. Seriously, damn frustrating.

I've made reference to how much I enjoyed playing Portal previously even for a 4 hour game, well here are a few articles that touch on different aspects of it. Very short, Why Portal is perfect; overstuffed but entertaining, Portal is the most subversive game ever; and while I love the end-song for the game, apparently it was written by Jonathan Coulton (I know him from his many songs including "Code Monkey" (an important namesake) and "Re Your Brains") and here is a live acoustic performance of it with scenes from Portal. Portal did pick up the Video Game Awards "Best Breakthrough Technology" award today and yes, I did notice that 3 of the big VGA winners were stolen from me (Bioshock - game of the year, Halo3 - best multiplayer & most addictive & Portal).

Some older science news about a huge body of water discovered underneath East Asia.

Here's something cute that you can go to everyday - the Human Calendar. Fun how it works! Let me know when you see this as a widgit or maybe put it in someone's digital photo frame.

Been a crazy, busy summer. So many violent storms have hit while the temps stay in the 90s. It wasn't your usual July/August. In work I said goodbye to a coworker and friend, Connie, as she moved to Madison.

We had a ribbon-cutting publicity event to announce the formal opening of the Nebraska Arthritis Outcomes Research Center where I got to meet the chancellor and the donors, Bill & Ruth Scott (without whom I wouldn't be here!). That same week I was the guest on the local weekly Community Health Line radio show (here's the site where you can listen to it from July 25 - I can't stand that they only use RealPlayer files!).
That same night my house was host to a rheumatology section party where everyone brought their fams, catered great food, and Renee did some juggling (I tried, too, to much lesser effect). Fun time!







Work hasn't let up - flew to Dallas last week to work with the VA, this week I'm off to Chicago for an all-day meeting, and I've got conferences in Pittsburgh, DC and Boston this fall. Bringing on the miles again!

Gave an invited talk last night (arthritis foundation) about a couple papers that Fred and I had done on lymphoma, RA and RA drugs (new one just came out in A&R). It was nice food and good company though a little awkward as everyone in the restaurant could see (and hear if they tried) what I was showing the group rather than having our own private room.

Got to meet with a visiting professor from the Brigham yesterday and today we had lunch together. What surprised me was Warren Buffett, the 2nd wealthiest man in US and my neighbor of sorts, came in and had lunch with another guy right next to our table. Seemed so ordinary - no body guards, nothing else fancy outside of having a tie and business jacket on. Quite a different life he's living here in Omaha especially compared to what one rich man is now doing in India.

One more link - a fellow rheumatologist and friend of Fred's, Norton Hadler, just posted a thought provoking OpEd about drugs that possibly don't do much for us at abcnews.

Sounds like the name of a planet in a sci fi story, but no, it's a Cox-2 inhibiting NSAID that was rejected by the FDA today. Definitely of note for what I do. Arthritis patients in Europe have been taking it for some time already. Definitely a strong reaction from post-vioxx days. Not to say it didn't deserve this vote, just was surprised as to the vote tally and how still little we truly know the full effects of our pain medications.

Don't know how I forgot this one, but everyone at UNMC got this in their email inbox ~10 days ago. Now folks know who I am and part of what I do research on, but not the other way around. It's a start. Oh, there's another pic of me on this same link, too - from early Feb.

A little name dropping in a rheumatology news press site. It wasn't my paper, but funny how they can fill up such space.

Also, in non-work news, it's the end of the zefrank show. I highly recommend it for amusing regularly videos from the past year.

Today was a big day at work - I got my business cards!


It's unbelievable the entrenched machines that are institutions. I spent a few days trying to modify this card. I ended up arguing with the printer directly in trying to get "email" and "mailing address" removed from the card (redundant!), but they are required by the public relations of the university (or something to that effect). I also couldn't put my NDB affiliation on the other side (I'll do it manually myself later on) to make it a dual-use card (it's annoying to have 2 cards for one person!). My only success was in getting the two top lines of the lower left there instead of them being large in the middle below my name (these small victories!).

Did I mention that my huge institution doesn't recycle plastic? I'm doing it on my own for now (as they do recycle it at my home).

I got my diplomas put on the wall in my office - they had to put in a work order for it. Also, apparently Coke Zero isn't on the allowed drinks available through the university (not to worry, I bring in my own). Yes, I'm on a roll. These aren't all complaints, more observations. I know I'll probably pick on something important to me at some point to rise up and change, but for now I'm learning and only slightly resisting. My wonderful "boss" gave me a book called "Orbiting the Giant Hairball" last spring and it seems so relevant here (and back at Stanford, etc).

I got a pneumonia vaccine injection yesterday. My arm is killing me and the numbness/pain woke me a few times in the night and kept me wide awake all day today. Funny how pain can stimulate the mind. Even a headache, but then it's harder to think. Still have some symptoms, but it's a different kind of pain. Maybe this is what institutional pain is about? The logical expanse from this is that various pain can be very beneficial in doses. (so, yes I have no need to start my own Fight Club any time soon)

Oh, and it seems everyone in the midwest is on eastern time - ie. they go to bed and get up at the exact same time they do in NY. This is unfortunate as back on west coast time not only did we get up later and leave work later, we were already 3 hrs behind eastern time zone! Needless to say, I'm finding it difficult to transition. Still working late... though starting a new wake up system - getting the heater to change to let me know when I should be out of the house (it gets cold!).

Last Friday I got to introduce myself to the UNMC community by giving grand rounds for the department of internal medicine in their large auditorium (with free lunch!). They apparently recorded the whole thing and have it online to view/listen to here (likely requires Real player, which I abhor - so I haven't tried it).

Finally got some office furniture, though I'm still using my laptop as my work computer - waiting for a new machine. Guess it's part of the new faculty life - work while you wait. Speaking of which - back to work!