Welcome, Earhole!

Another super hot day here in the Bend, and the next couple of days are supposed to be a little bit hotter. We’re pushing 100° the next couple of days, and the dew point is well over 60°. I’ll go into the highly technical and detailed explanation of that...it feels like a frickin’ SAUNA out there! Man, I hope everyone is staying safe and cool. This is really some dangerous heat.

I had a very pleasant afternoon, though, because I met up with my buddy Jim for lunch and lots of talk. Jim SOMEHOW managed to forget his wallet at home. Hmmm! Well played, sir, well played! Haha! It had been far too long since we’d gotten together, which was obvious when we realized that we’d been sitting there gabbing for three and a half hours! It went by so quickly, and it was so much fun. We got to laughing about some stuff, including about how much alike we are. I had a great time, and we definitely need to get together more often. Although Jim is one of those friends where, even if I haven’t seen them for several months or even years, we pick up like we saw each other just last week. I’m fortunate to have several friends like that in my life, and I appreciate them very much!

Since Jim was a former coworker, he got me caught up on things at the Micro lab. The big news lately was a freakin’ BRUCELLA exposure! WHOA! In all my years in Micro, I never saw an actual case of Brucella, and it was the first time for many of my former coworkers with as much as or more experience as I had. Apparently someone came into a local hospital, and our lab worked on his blood culture. Vitek (the main instrument in our lab for identification and susceptibility testing) identified it as Brucella, and some confirmatory testing backed it up. This was a big deal, because it’s a highly transmissable organism, and the most common lab-acquired infection. Basically, anyone working in the department when the culture was being worked on was considered to be exposed, and 16 people had to take prophylactic antibiotics (I believe Jim said it was Rifampin and something else, for three weeks), as well as occupational counseling about watching for symptoms. An additional 14 people were exposed in the hospital where the patient was admitted.

Brucella is a bacteria that most often infects livestock, including cattle and sheep, and can cause spontaneous abortions. Humans usually get it by drinking unpasteurized milk. Why anyone would want to drink unpasteurized milk is beyond me! Brucella, Campylobacter, Mycobacteria...no, thank you! Anyway, it was pretty shocking to hear about it, and it really was a big deal for them—as it would be for any lab worker who was exposed. Sounds like everyone is okay, but being exposed to one of the main organisms that is used in bioterrorism had to be unsettling!

After we gabbed for a few hours, he headed over with me to the nearby Claire’s where I got another earhole. Jim already has a couple, and decided not to get another one, but he came along with me. It was quick and easy (and Jim spied some super cute boots that I think I’m going to have to go back and check out!), and relatively pain-free. My ear was a little bit red afterwards, but that’s not surprising, and it seems to have calmed down now. I shall care for it well and faithfully.

The title of this entry comes from Cousin Shane. A while back, I posted about how after not being able to wear earrings for a while due to sensitivity, I tried again and managed to reclaim my earholes. Shane commented, “Welcome, earholes!” I don’t know why that made me laugh so hard, but it did, and I’ve never forgotten it. So when my ear was getting “punched” today, I thought, “Welcome, earhole!”

Infection Connection: We Are Living in a Bacterial World

And I am a bacterial girl. (Go ahead...sing it! You know you want to!)

This week, I finished the book Good Germs, Bad Germs: Health and Survival in a Bacterial World by Jessica Snyder Sachs. Whether you’re on the job or just have a passing interest, this is a truly fascinating book.

Sachs writes about our long, strange trip with bacteria and other microorganisms. Some might think that it’s a simple matter to realize that bacteria are bad, and the proliferation of antibacterial soaps and hand sanitizers makes it obvious that such a message has caught on. It’s much more complicated than that. Sachs mentions what Nobel prize-winning molecular biologist Joshua Lederberg calls the “microbiome.” Lederberg says, “It would broaden our horizons if we started thinking of a human as more than a single organism. It is a superorganism that includes much more than our human cells.”

Essentially, each of us is a walking, talking ecosystem, carting around millions of bacteria that most often protect us, but sometimes harm us. From the moment we are born, we begin developing our occupying microflora, including Staph epidermidis and coryneform bacteria on our skin, Strep salivarius on our teeth, E coli in our gut, and Lactobacillus in our vagina (if you happen to have one, that is). These organisms create protective biofilms that aid in digestion, keep harmful bacteria from getting a toehold, secrete acids that keep the “bad” bacteria at bay, and even send out chemical signals that help regulate our immune system. I find it an incredibly elegant and fascinating system, and I both adore and fear it.

I adore it because it’s obvious that we have co-evolved over millions of years; our microflora coexist peacefully with us in a mutually beneficial relationship. I fear it because it seems to be such a delicate balance, and changing one small part of it can trigger an unpleasant infection, or even a life-threatening one. (Any woman who has taken antibiotics for an infection knows how easily that balance can be upset; it’s a common occurrence to have the antibiotics wipe out our usual genital flora like Lactobacillus and have yeast set up camp. Usually not life-threatening, but definitely not pleasant.)

I find the connection between our microbiome and our immune system especially fascinating. (If I hadn’t concentrated on Microbiology, I would have gone into Immunology. I find both very interesting, and they are closely connected.) You’ve probably read about the recent explosion in asthma and food allergies in kids; many researchers are looking into whether or not kids’ immune systems are not being challenged the way they used to. I don’t think anyone (not any rational, thinking person, anyway) would dispute that vaccines for life-threatening infectious diseases are a must; but our world has definitely become a little more sanitized these days, and it is not necessarily for our protection.

It might seem to be a paradox, but an unchallenged immune system can go into hyperdrive all too easily. When we’ve been exposed to minimal allergens, the presence of an unexpected one can wreak havoc as the immune system summons the troops and engages in a campaign of shock and awe against all invaders. A veritable monsoon of cytokines, interleukins, and other immune-boosting or immune-suppressing chemicals are loosed upon unsuspecting cells; if the immune system mistakenly attacks our own healthy cells or tissues, auto-immune disorders like rheumatoid arthritis, scleroderma, and Sjögren’s syndrome can result.

My relationship with microorganisms has always been a love/hate one. I loved my job, and I loved the “detective work” aspect of it, but I hated the devastation and mortality I saw. I am fascinated by their mechanisms of resistance (one of them is called an efflux pump, in which the bacteria take in an antibiotic within its cell walls and immediately pump it right back out...I picture a sailor frantically bailing out a leaky boat), but worry about how that resistance is resulting in literally untreatable infections. Sachs quotes Rockefeller University researcher Vincent Fischetti concerning bacterial antibiotic resistance: “Don’t ever underestimate bacteria.” I recognize the relationship for what it is, but each of you also has a love-hate relationship with your own microflora, whether you realize it or not.

When it comes to the “war on bacteria,” it seems that we would benefit the most from an uneasy détente. When it comes to preventing what can be devastating infectious diseases like measles, bacterial meningitis, diphtheria, and so many others, vaccines are good things. But it is pointless—and perhaps even dangerous—to believe that a sterile world is beneficial or even possible. The vast majority of bacteria that we encounter in our daily lives is not going to go after us (except for those who are immunocompromised...that is a very dangerous state to be in), as long as we keep ourselves fairly healthy, with our microbiome in general balance. Maybe it’s wise to not mobilize weapons of mass destruction against the critters we encounter every day; a little soap and water is usually going to be enough to keep our own private ecosystem in balance.

Good luck, and hey...let’s be careful out there.

♪ ♫ Bugs may come and bugs may go, and that’s all right, you see. Experience has made me rich, and now they’re after me...’cause we are living in a bacterial world....♪ ♫

Infection Connection: Foodborne Illness and the Importance of Food Safety

My friend Milwaukee Dan #1 recently posted an article on Facebook from the Chicago Tribune concerning a restaurateur in Chicago that was sending his employees outside to cook. Raw eggs were outside in high temperatures, mixing buckets were rinsed out with garden hoses, and the cooks mixed batter with their ungloved hands. The owner of the restaurant maintained that it was only temporary, but the health department was planning on investigating.

I think most of you are probably as grossed out right now as I was when I read the story. In my years in the laboratory, I witnessed quite a few outbreaks of foodborne illness, including Salmonella, Shigella, Campylobacter, and E coli O157. I saw a case or two of Listeria, as well as a rare Yersinia case. That doesn’t count the toxin screens usually done by the State Board of Health that test for Staph aureus, Bacillus cereus, and botulinum toxins. Those are just the most common ones. Most of us have probably suffered through a bout of food poisoning at some point in our lives; it’s not uncommon, and most of the time it is self-limiting and we can fight it off after a few days of misery.

However, severe outbreaks can tax the resources of local, county, and state labs, as well as resulting in hospitalization for those most affected. The CDC estimates that “each year roughly 1 in 6 Americans (or 48 million people) gets sick, 128,000 are hospitalized, and 3,000 die of foodborne diseases.” Some of the symptoms of food poisoning include nausea, diarrhea, vomiting, fever, and some bacteria (E coli O157) can cause hemolytic uremic syndrome, in which kidney failure occurs and can cause a lifetime dependence on dialysis.

The very young, the elderly, and the immunocompromised can be devastated by such illnesses, and complications can include septicemia (when the organism gets into the bloodstream), endotoxic shock, and massive organ failure.

Although dealing with each of these types of illnesses is too broad of a subject for one blog entry, I want to address a comment that Dan received after posting the Chicago Tribune story. (Yes, this is going to get political, but it is a point that needs to be made.) One of his more conservative friends made a sarcastic comment about how oh dear, someone was cooking good food outdoors for people to eat! When Dan mentioned the dangers of food poisoning, and I mentioned that as a microbiologist, I was appalled by what this restaurant owner was doing and that he either needs to take his operations inside or be shut down, the person wondered if there had been any complaints to the health department about this establishment, and that their own immune system was fine with it.

Suffice it to say that I wouldn’t be surprised to see a picture of this person in a tricorner hat, drinking a big jug o’ tea. I pointed out that for those whose immune systems are compromised—people with cancer or diabetes—a bout of food poisoning can be a life-threatening situation.

I recently read a story about a teabagger gathering in which people were cooking and selling food without a permit. One defender of this practice said that if the vendor gives people food poisoning, he won’t be in business for long...the market will correct itself.

To me, this is every single damn thing that is wrong about these freakin’ teabaggers. I suppose that if a food vendor manages to kill a bunch of people because he sells tainted food, he probably would be put out of business. In the meantime, a whole bunch of people are still dead. If that’s what the market needs to do to correct itself, then I think that market needs a little more regulation. Not everyone is a healthy, hale adult whose immune system can fight off a bout of Salmonella; sometimes people who have underlying disease that leaves them vulnerable to infections ingest these bacteria, viruses, or toxins, and it can be devastating to their health. A pregnant woman who eats ice cream or a hot dog that is tainted with Listeria will often miscarry because Listeria can cross the placental barrier and will often kill the fetus.

What really burns my bacon about those who think the government and the FDA should mind their own business and let the food market regulate itself is that they seem to have no concept or intellectual grasp of just how devastating these infections can be. As long as they’re strong and healthy and can fight off a bout of Shigella (although from talking to friends who have had Shigella, they won’t be quite so strong and healthy after that...one person told me that they were pretty sure they weren’t going to die, but they wanted to), they really don’t seem to give a flying fuck about anyone else, including kids, the elderly, and anyone who might not have the immune system of a superhero or a vampire.

We have an agency that is designed to protect the safety of our food, the FDA. It is not perfect, and there are still things that get by it. But we won’t get healthier by eating Salmonella-tainted eggs and spinach, or E coli-laden beef, or drinking unpasteurized milk contaminated with Campylobacter or Brucella. We’ll just get sick, resulting in lost productivity and in some cases, loss of life. We have the ability and technology to screen our food supply for these organisms, and we are healthier because of it. Challenging our immune systems by allowing all sorts of contaminants to enter our food supply is irresponsible and dangerous.

Anyone who thinks that the open market will correct such contamination problems, or that food vendors will police themselves, should probably take a look at what happened with Wall Street and our economy when regulation was eased. It may right itself eventually, but only after a lot of hurt, pain, and general misery. Perhaps they also might want to think about the greater good; although your portfolio might be robust, or you are in very good health, not everyone is that fortunate. What is so hard about watching out for the other guy, not just for yourself? Isn’t that what we are supposed to do as a society?

Infection Connection: PCR

First of all, thanks to everyone for their kind words of support. Things are definitely rough lately, but we all get by with a little help from our friends. Thank you.

I got a book shipment today, and it’s always fun to open up that box and pull out book after book of fun stuff. (One of the places I order from is Edward R. Hamilton, a place which has overstocks and closeouts. What is really cool is that if you send in your order via snail mail, using a check, it’s a flat-rate $3.50 for shipping. In this shipment I got nine books, at an average of $5 per book. What a deal!) This time I ordered from their Science and Nature catalog, and I found some good ones about Microbiology:

• Emerging Epidemics: The Menace of New Infections
• The Secret Life of Germs
• Good Germs, Bad Germs
• Case Files: Microbiology
• The Life and Death of Smallpox
• Vaccine

They all look pretty good. I skimmed through the Case Files one (I always loved the case studies when doing continuing education at the lab) and I was still able to figure out most of them (or at least be in the ballpark) and answer many of the questions. The first one was a farmer who owned cows and presented with a black eschar on his arm. I said, “Anthrax!” Winnah winnah chicken dinnah! Anyway, it made me think about how much I still love Microbiology, and since I was in need of a good diversion, I decided to write an Infection Connection entry I’ve been wanting to do for a while.

Polymerase Chain Reaction (PCR) is a powerful laboratory tool developed in the past couple of decades. Dr. Kary Mullis is generally credited with the development of the technique (and won the Nobel prize in Chemistry for it in 1993), although his research built upon the work of others, as do all inventions and techniques. Shoulders of giants, and all that. I recommend Mullis’s autobiography, Dancing Naked in the Mind Field. He’s brilliant, but a real character, and has put forth some pretty bizarre and disproven ideas. He credits his usage of LSD with his realization of how PCR could work. [shrugs] Who knows? It really is an amazing development in science, and maybe it took that expanded leap of imagination to get him to that point.

Anyway, it’s a pretty amazing thing, and I think by the time I’m done with you, you’ll think so, too! (haha) The way it works is that you mix up this cocktail that includes the sample to be tested, free nucleotides (Remember ACTG, the building blocks of DNA? Adenine, Cytosine, Thymine, and Guanine. They only fit together one way: Adenine pairs with Thymine, and Cytosine pairs with Guanine.), a DNA primer that will target a specific strand in the organism for which you are testing, and Taq polymerase, an enzyme derived from the bacterium Thermus aquaticus, an organism that thrives in high temperatures. (I’m sure I’m not the only person who always thought of “Tak!” from Stephen King’s book Desperation whenever saying “Taq polymerase.”) A few other things are in there, like a buffer for stability, and some various ions that facilitate the reaction. I’ll explain in a moment why Taq polymerase is so important.

When you get your cocktail together, you place it into a thermal cycler. This is an instrument that can reach high temperatures quickly, and then cool down quickly. At the high temperature (usually around 90° Celsius), the DNA strand in the sample denatures, i.e., the hydrogen bonds in the double helix are broken, and the DNA strand zips apart. Think of running a chainsaw down the rungs of a ladder. The thermal cycler then drops down to a lower temperature, around 60°C, at which point the DNA primers form hydrogen bonds (this is called the annealing phase) with the target strand of DNA. The thermal cycler then goes up to 72°C, which is the temperature where Taq polymerase is most effective, and the enzyme causes the free nucleotides in our cocktail to go to the site where the primers are and they begin to extend the strand of DNA. If the next nucleotide in the sequence is Thymine, an Adenine nucleotide will attach to it, and so on. Are you still with me?

What is essentially happening here is that we are duplicating that original strand of DNA in our patient sample. We split the strand at the high temperature; the primers attach to the target strand at the low temperature; the primers tell the nucleotides where to go at the medium temperature, and a new strand of double helix is formed. We have made an exact copy of that original strand of DNA, all in the matter of minutes (because the thermal cycler is capable of rapid temperature fluctuations). What’s next? We do it all over again. We now have two identical strands of DNA, and we do the process again and are left with four strands; the next cycle gives us eight strands. We let these cycles run for as long as necessary, usually up to 40 cycles. At the end of 25 cycles, there are more than 33 million copies of our original DNA strand. I don’t know about you, but that STILL blows my mind!

Why is this important? There are a couple of important reasons from a microbiological perspective. One, some infections involve a very low number of organisms. And if the organisms are damaged because the patient is already on antibiotics, they may not be able to be cultured. If there are only fragments of the organism available, or very low numbers, the PCR method can still target the specific DNA strand and increase it exponentially so that there are large numbers of DNA strands which we can test for. Second, traditional culture methods can take a while, and PCR can provide much quicker results. The best example I can think of is that in the lab where I worked most recently, we did a PCR test for Group B Streptococcus, an organism that can cause life-threatening infections in newborns if the mother carries the bacteria and delivers vaginally. Culture can take up to three days; PCR can be done in a matter of a couple of hours. If a woman goes into labor and hasn’t already been tested for Group B Strep, the PCR test can mean the difference between a vaginal birth with antibiotic prophylaxis and a C-section with its attendant complications. If a baby picks up Group B Strep from a vaginal birth, it can result in meningitis or septicemia, both of which can kill. Rapid diagnosis is key, and PCR provides that.

I was going to mention why Taq polymerase is so important. Because this enzyme is so heat-tolerant (it doesn’t denature at the 90°C temperatures used in the PCR process), it allows for a closed-system procedure. In other words, you can take it through numerous cycles without “killing” it, so that you don’t have to stop after every cycle and add more polymerase. You just mix up your cocktail, pop it in the cycler, and walk away until it’s done. This allowed for a practical application in the clinical lab; companies can put together systems that are affordable for larger hospital and reference labs.

There are other molecular methods in use in labs, including DNA-RNA hybridization and ligase chain reaction. These have definite differences, but they are all based on the molecular level rather than traditional culture methods. We did one molecular procedure to identify the species of mycobacteria in a culture; those are the organisms that cause TB and other infections, but they can be notoriously slow-growers. We can now identify a case of TB in a matter of several days rather than several weeks, which is hugely important from an epidemiological standpoint.

Twenty years ago, I remember my supervisor at the lab where I worked in Indianapolis telling me, “Eventually we’ll be able to take a sample and test it directly using DNA probes.” He gave the example of testing a sputum sample for TB directly, rather than processing and culture. We had just started doing DNA probe testing (sort of the beginning of molecular testing in the clinical lab) for Chlamydia and gonorrhea. Molecular methods are both more sensitive (able to detect lower numbers of organisms) and more specific (targeting only certain organisms, resulting in fewer false positives). Paul was right. It only took two decades to get to the point where molecular testing is a part of routine diagnostic testing, and the patient is the big winner here. Better, more accurate, and faster tests can mean shorter hospital stays, quicker recovery, and less chance of passing on serious infections like TB to others.

It really is a revolutionary testing method, and I am very glad that I got to see it unfold during the course of my career.

It’s UP!

Nice to see a little positive news. The Dow is up, and has gained 1200 over the past two weeks. (Click on the picture to get a more detailed graphic.) They're saying that confidence is up because of the plan to buy toxic assets in order to get credit moving again, as well as a 5% upswing in housing starts. I'm sure we haven't seen the end of this recession yet, but it really was nice to hear some good news rather than the constant barrage of bad news and scary numbers. I see a glimmer of hope. I really see it! And color me shocked! They're interviewing Ben Stein on CNN, and he has pretty good things to say about the plan, that the assets that Wall Street is going to snap up at these prices are pretty good, and he thinks this will get investments moving. Ben Stein is saying this? [clutching her heart] I'm comin', Elizabeth! (A Silver Squirrel to anyone who gets that reference. I need to make the award first, though!)

I want to thank everyone for their thoughtful comments on my previous entry about healthcare. I think everyone realizes that there is a big problem, and it needs more than a Band-Aid. It needs major surgery. (Not to beat the healthcare metaphor to death. Ha! Death! Get it?) We really do need a major shift in how we think and operate. (Ha! Operate! Get i--oh, never mind.) I believe with all my heart that we must transition to a preventive mentality and provide preventive care for all, rather than ignoring our own health because we can't afford preventive care and waiting for a catastrophic illness to force us into the ER. We can save millions in healthcare costs. Here's just one example: a yearly Pap smear for sexually active women who aren't in a monogamous relationship (every other year for women whose previous Pap was negative and who are in a monogamous relationship). If caught early, cervical cancer is very treatable. But if it progresses too far, the costs of aggressive treatment, chemotherapy, surgery, etc., will become astronomical. We're talking $150 versus $150,000. Minimum. It adds up.

I especially want to thank my British and Canadian friends for weighing in on the issue. It's invaluable to get the perspective of someone looking at our country and saying, "Wait a minute...why doesn't everyone there have care?" We must do better, and we can do better. I know it.

I also got a couple of comments about my profession, Medical Technology, that I want to address. The Wiki page I linked to is very accurate as far as our training and the jobs that we can do. Even though I'm not working now, I still feel that I am an MT and always will be, and I'm very proud of the work that MT's do.

Giovanna wrote: I have a question: How can an internship be done in 3 months? If it used to take 12 months. Are they still learning the same or are they learning less?

And DB wrote: 12 month internship to 3 months is a big leap. Were you prepared after 3 months?

This is the first time Giovanna has commented, so welcome to Nutwood, Giovanna! And D, it's always good to see you, my friend.

Very legitimate questions. My internship started in July after my junior year, and went to July of my senior year. I had to move off campus (Remember the house on Rex Street, Dan? We had at least one big party there.) because I wasn't technically a Ball State student any longer, but I also didn't have to pay tuition! I stayed in Muncie, doing my internship at Ball Memorial Hospital, although there were several sites in the state where I could go. Even though I wasn't done with my internship until July, I got to go through the May commencement, so that was cool. Kind of a strange arrangement, but it all worked out well. (My parents especially loved the no tuition part!)

The internships are much shorter now, and I'm glad that I got to do such a long one. The shorter internships merely mean more classroom instruction. The training and knowledge base is the same, but the hands-on work is curtailed. We have to rotate through all departments in the lab, and my Microbiology rotation was...I think 11 weeks. Chemistry was the longest at 13 weeks. Most students now spend about 4-5 weeks in Micro, and the other departments are obviously shortened as well. I'm not even sure if they spend any time in Histology and Cytology, and I spent about 3 weeks going through those areas. (I'll never forget my first view of an amputated leg in Histology. Whoa.) Students now still receive plenty of classroom instruction, but the hands-on stuff is limited. Part of this is due to legal issues and more stringent regulations about who does testing. In my internship, those of us who showed special aptitude would end up doing the morning Hematology run, for example, and report out those results with the oversight of the tech who was working with us. I don't know about other departments, but in my most recent job, we did not let students report out any patient results.

I think the main difference is that with a year-long internship, I was probably a little more in tune with what is was like to work in a lab. My first job was still an eye-opener, but I'd say it was an easier transition than some experience now. When you actually get in there and find out what a crazy workload it can be, it can be overwhelming. Of course, everyone remembers the really good students who seem to "get it," especially in Microbiology, because not many do. Those are the students that end up getting hired at the lab or hospital where they do their internship.

So rest assured, there are plenty of good people working in the lab, doing your lab work. There are multiple inspections for every lab, continuing education is a requirement, and almost every lab requires that their techs be certified by at least one regulatory agency. Several states also require state licenses.

Have you hugged a Medical Technologist today? [grin]

Saturday Roundup

I think I'm caught up! Six o'freakin' thirty, and I'm finally caught up!

First I got caught up on AOL alerts. Those seem to be way down, which shows that we're all moving along and trying to get comfy in our new digs.

Next was getting caught up on everyone's Blogger entries, and it was great to see that people are starting to write more here and enjoy our new format. I think it's a lot of fun to play with the settings, and although I'm sure I'll be tweaking things for a while, I'm happy with things at the moment.

THEN it was catching up on emails. I had several from friends and I apologized for neglecting them while I dealt with this big mess with moving our blogs. It was great to hear from everyone, and it sounds like all is well. One is working on buying a house, one is planning on an election night party, and all are well!

And a big congratulations to my pal Jim, who successfully passed his Medical Technology registry! I'm an MT, too, and you can read about our profession if you follow the link provided. Did you know that 80% of diagnoses come from laboratory results? Although we're trained in all departments of the lab, many of us focus on one area, and for the last 20 years of my career, I worked in Microbiology, because it was always the most interesting to me. Be sure to hug an MT today if you get a chance, and Jimi, I'm sending you a virtual hug! Jim got his MLT degree (a 2-year degree) several years ago, and he's been working full time and taking online courses to get his Bachelor's degree for the past couple of years. Why does it matter? Well, it gives you a broader depth of knowledge, for one thing. And with a four-year degree, you get more money. Right now, I'd guess that the latter trumps the former!

I've already received one big benefit from this switch to Blogger from AOL. I sent out a mass email telling almost everyone on my email list that my blog was moving. I was thrilled to hear from my friend Bruce in Indianapolis. He wrote back, "Hi Doll!" How can you not love that?! It was wonderful to hear from him. He lost his long-time partner a while back, but has just started to move on, get back into the dating scene, and is trying to rejoin the world in general. Bruce is also a wonderful writer, and I asked him if he's considered writing a blog...? I still remember his column about the infamous Dumpster Dive, and believe me, if he starts posting anything anywhere anytime, you'll find the link here. He's a peach.

Hope you're all having a wonderful Saturday! Notre Dame beat Stanford (and looked good doing it) and Illinois beat Michigan very decisively. Good day for our teams!