Leikkaus / Surgery

Olin 4.­–7.10.2015 Päijät-Hämeen keskussairaalassa kirurgian osastolla 5.10.2015 toteutetun mahalaukun ohitusleikkauksen vuoksi.
I was hospitalized between 4th and 7th of October in Päijänne Tavastia Central Hospital due to a Roux-en-Y gastric bypass surgery performed on the 5th of October.

Tänään olen vielä sairauslomalla toipumassa leikkauksesta, mutta piakkon pääsen varmaankin töihin.
Today I am still on leave recovering from the surgery, but I expect to be back to work in a couple of days.

Omakuva 21.10.2015
Omakuva 21.10.2015

Leikkausta edeltävä päivä osastolla oli huomattavan tylsistyttävä, mutta onneksi sain erinomaista ENED-ruokaa.
The preoperative day at the hospital was very boring, but fortunately the VLCD food was excellent.

ENED-lounas PHKS:ssa 4.10.2015
ENED-lounas PHKS:ssa 4.10.2015

Leikkaus tehtiin tähystämällä, ja minulla on nyt viisi hyvin paranevaa pientä leikkaushaavaa vatsan iholla.
The operation was laparascopic, and now I have five well healing small incisions on the skin of my abdomen.

Leikkaushaavat 16 päivää postop
Leikkaushaavat 16 päivää postop

Sairaalassa piti opetella taas syömään ja juomaan. Varsinkin jälkimmäinen oli hankalaa ja kuivuinkin aluksi aika pahasti.
In the hospital, I had to relearn eating and drinking. Particularly the latter was problematic, and I suffered from noticeable dehydration at first.

Aamupala 6.10.2015
Aamupala 6.10.2015

Kotiuduin toisena leikkausta seuraavana päivänä, ja olen hiljalleen toipunut leikkauksesta ongelmitta, mitä nyt kävin kerran päivystyksessä tarkistuttamassa vatsakipuja.
I was discharged from the hospital on the second postoperative day, and I have been slowly healing from the operation. I did go have abdominal pain checked out once at the local ER, though.

Olen vielä toistaiseksi soseutetulla tai pehmeällä ruokavaliolla, mutta parin viikon sisään saanen ryhtyä hiljalleen syömään normaalia ruokaa. Tehosekoitin ja erilaiset maitotuotteet ovat olleet kovin hyödyllisiä. Päivittäinen energiansaantini on ollut nyt noin 1200 kcal. Proteiininsaantiin on pitänyt kiinnittää huomiota (maitotuotteet ovat tässäkin hyödyllisiä).
I am currently on a pureed or soft foods diet, but I will probably be allowed to start introducing normal foods within two weeks. A blender and various milk products have been very useful. My daily energy intake has been around 1200 kcal. I have had to take extra care to eat enough protein (milk products are useful here as well).

Painoa on pudonnut nyt 7 kiloa, josta suurin osa tippui ensimmäisellä viikolla. Paino putoaa edelleen mutta hitaammin.
My total postoperative weight loss is 7 kg, most of which came off in the first week. Weight loss is still ongoing but slower.

On vielä liian aikaista sanoa, oliko leikkaus onnistunut mutta nykytiedolla en sitä kadu.
It is too early to tell if the surgery was a success, but I do not currently regret it.

Leikkaus lähestyy / Surgery imminent

Lihavuusleikkaukseni, josta kerroin aiemmin, on maanantaina. Huomenna aamulla aloitan matkani kohti Lahtea ja Päijät-Hämeen keskussairaalaa.

Tiedotan kunnostani ensisijaisesti Facebookissa (valitettavasti osa tiedotuksesta näkyy vain FB-kavereille) mutta koetan laittaa tietoa myös Twitteriin. Tänne blogiin en välttämättä sairaalasta pääse. Kotiutuminen tapahtunee muutamassa päivässä.

Ja sananen leikkauksen riskeistä. Lihavuusleikkauksessa on pieni komplikaatioriski ja erittäin pieni mutta olemassa oleva kuoleman riski. Kerron tässä ja nyt, että menen leikkaukseen niistä tietoisena ja hyväksyn ne. Jos riskit sattuisivat kohdallani toteutumaan, minua ei saa käyttää varoittavana esimerkkinä leikkauksen suhteen. Minä en ole uhri, kävi miten tahansa.

My bariatric surgery, which I discussed earlier, will take place on Monday. Early tomorrow morning I’ll hop on a bus and go to the hospital.

I will be reporting my status mostly on Facebook (partially friends-only), but I will try to get some info onto Twitter as well. I will probably not be able to write here on my blog at the hospital. I expect to be released from the hospital within a couple of days from the surgery.

Now, a word about surgical risks. There is a small risk of complications in bariatric surgery and a very small but nonzero chance of death. I hereby announce that I am undergoing this procedure informed of them and I accept the risks. If something bad should happen to me, I forbid anyone to use me as a cautionary example with respect to the operation. I am not a victim, whatever happens.

Bariatric surgery approaching

Update: Due to the surgeon being ill, the surgery has been moved back to October 5, 2015. The original blog post follows:

I will be checking in to a hospital for bariatric surgery on August 31, 2015. The surgery is scheduled for September 1.

The plan is to perform the roux-en-y gastric bypass (RYGB), in which the stomach is cut into two pieces. A small pouch is left connected to the esophagus, and the rest of the stomach is cut off from the food flow. A Y-connection is created in the small intestine, allowing both parts of the stomach to connect to it. The main result is a reduction in meal sizes, accompanied with a faster fullness signal and apparently some hormonal changes; some people have reported a change in their taste sense after the surgery. It is not a miracle cure, and I will weigh about as much when I leave the hospital compared to when I enter it.

Studies [e. g. 1, 2] show a significant reduction in overall mortality and improvement in several relevant outcome measures (such as weight loss, diabetes status) in favor of surgery compared to nonsurgical weight management techniques. This is my main motivation for undertaking this surgery.

The operation will be laparascopic and will require several weeks of recuperation time off work.

Comments and questions welcome, but please, be gentle. This is a touchy subject.

How a wrong model can lead you astray

The other day I got on a bus at the downtown main bus terminal. Behind me, a woman started to interrogate the driver.

“Do you go to Pohjantie?”

When the bus driver did not respond (likely, he does not remember all the names of the roads on his route), she changed tactics:

“Your sign says Kuokkala. Which route do you take?”

There are three roads to Kuokkala, which is on the other side of Lake Jyväsjärvi: two drive around the like on opposite sides, and one takes a bridge over the lake. One of the drivearounds in fact goes through Pohjantie (as well as a neighbourhood called Tikka), and several buses take that route. Buses also use the bridge; to my knowledge, no bus uses the other driveraound route.

“On the way back I’ll go through Tikka.”

“So you end up at Viherlandia?” Viherlandia is the terminus of one of the bus routes that drives through Pohjantie.


“But Kuokkala, how do you get there?”

“I’ll take the bridge, then drive around the Kuokkala centre and then turn right …”

“… toward Nenäinniemi. You’re not my bus, thanks.”

In fact, she was wrong; it would have been her bus had she waited to hear the bus driver’s reaction to Nenäinniemi; he wasn’t going there, instead, he would have just turned to Tikka and from there through Pohjantie back to downtown.

But I suspect she had a mental model: all buses in Jyväskylä run (so she probably thought) pendulum routes, going back the same route they take. So, once she had established that the bus took the bridge, she had all the information she thought she needed.

In fact, that particular line runs a mixed pendulum and ring model: going Northeast from the downtown terminal, it runs to a particular suburb and retraces its steps back to downtown; however, southbound, it goes over the bridge to Kuokkala and drives a semiring route in Kuokkala, existing through the Pohjantie drivearound and making its way back to the downtown terminal.

Route of Bus 20
Route of Bus 20 (Map © OpenStreetMap contributors)

People sometimes say that science is objective and empicial, and that the data speak for themselves. This sort of a statement forgets that data mean nothing by themselves, and your conclusions are no better than your model.

The Imitation Game

Viewed on its own terms, The Imitation Game is a good enough entertaining film among many such. It has suspense, romance, and triumph in all the right proportions, all according to the formula. Breaking the pattern, it also tackles the treatment of gays in the 1950s, as well as the kind of social awkwardness very common among geeks and highly intellectual people. Although the film does push some of my triggers (one scene in particular I was only able to watch about three seconds at a time, pausing the film in between), that’s not the film’s fault.

But the film is not just any other film. It depicts Alan Turing’s life, and in large part dramatizes the codebreaking activities at Bletchley Park during the Second World War. Viewed in this light, the film disappoints. Certainly, a film needs drama, and while codebreaking at wartime is crucial, the suspense involved is too abstract to sustain a film alone; thus, the filmmakers were justified in adding interpersonal conflict to the mix, to inflate the role of Turing at Bletchley Park, and to emphasize Turing’s attachment to coworker Joan Clarke. But where they come up short is that they did it in such a formulaic manner. I am not very good at guessing plots, and I was able to guess large parts of this film (beyond what I knew of Turing’s life). Clarke, who was a capable mathematician in her own right, was cast (based on the historical record, true) in this movie in the role which in any other movie I would call the token love interest, but in this movie that label seems off.

Benedict Cumberbatch gave a suberb performance as a very eccentric Alan Turing; I have nothing negative to say about his work in this film. But that’s to be expected; he is, after all, one of the great stars of my generation. I was more impressed with Alex Lawther’s interpretation of the young Alan Turing. Keira Knightley brought Joan Clarke to life in an unforgettable manner, though I do wonder how much that is due to her and how much is due to Clarke being the only significant female character in the movie. The other actors, however, were rather forgettable.

Alan Turing certainly deserved to be given his own film. Although the movie is wrong to state that we call Turing machines computers nowadays, Turing’s work certainly is foundational and fundamental to all of computing. And, true enough, he is a war hero. In the end, I enjoyed the film, and it certainly deserved to be made. Therefore, ★★★☆☆.

[Edited to add words about Knightley’s performance and about Clarke’s formulaic role.]

Sharon Lee & Steve Miller: Dragon in Exile

I will not bow to ignorance

In this brand new Liaden novel, Clan Korval deals with the consequences of its actions. Not everybody on Surebleak want them there, and not all Liadens are willing to treat with them honorably now that the Council of Clans on Liad no longer counts Korval as a member. The Department of Interior still poses a threat, and Korval must figure out what to do with the agents they captured. In the most part, however, Dragon in Exile is a tapestry woven from many small threads, most following the mundane (and sometimes not so mundane) lives of one or two characters each.

There’s the story of the exquisite rug that a Liaden clan had been meaning to buy and now adorns a whorehouse. And there’s the baker who says no to an insurance salesman. Oh, and what happens when a busful of tourists attempt to use the tickets they bought offworld to actually get to visit Korval’s Tree? There’s several arsons; an attempted armed revolution; and, oh, I almost forgot, a wizard who becomes addicted to his own magical powers.

Dragon in Exile includes a prologue of the “previously in this series” variety, though it is framed as a bona fide scene in the book. Likely the prologue will be useful for the new reader of the series, and I think a new reader will catch on quite well with this book. Readers already familiar with the series will get added richness and texture, of course.

Audible calls Dragon in Exile Book 1 of the Arc of the Covenants. The arc title is nowhere to be seen in the print and ebook editions, but it does make a certain amount of sense given certain scenes in the book and it does point to an interesting direction for the rest of the five-book dash that this book starts.

Kevin T. Collins narrates here his first “modern” Liaden book. I still like him a lot as a narrator, but his pronunciation is in places jarring, as it differs markedly from that used by other narrators.

I enjoyed this book immensely. And with this, my re-listen of this series is complete. It was fun, and I will do it again at some point. And I will re-read the books myself occasionally ­– my inner voice is unlike all the narrators.

Dragon in Exile is available as a hardcover paper book, an ebook, and as an audiobook.

Sharon Lee & Steve Miller: Fledgling

The major export of planet Delgado is higher education and scholarship. Not everybody on the planet likes this, and an significant minority of the nonacademic population are “simples”, who abhor complexity and look for ways to return to simplicity. The eradication of the University of Delgado is one such way.

A professor of Delgado is discovered to have falsified her data. More alarmingly, it is discovered that the certified copies of the original archives she used, which are held by the university, have been tampered with. Sub-Chair Kamele Waitley of the History of Education Department must act decisively to discover the full extent of this sabotage.

Her daughter, Theo Waitley, is used to living in the off-campus house of her mother’s onagrata (registered lover), Gallowglass Chair Professor of Cultural Genetics Jen Sar Kiladi (who we have already met in earlier books in the series). Suddenly, Kamele moves back to a traditional scholar’s apartment at the campus, taking Theo with her and to all appearances ends her relationship with the man Theo calls Father. Theo does not like it at all, but she has no real choice. But when Kamele takes her offworld, to an expedition where Kamele and her team intend to find out exactly how bad the sabotage is, everything changes.

Fledgling has a curious history. Back in 2007 or so, the then-publisher of the well-established Liaden series went bankrupt, taking with it the near-term rights to the existing books and the royalties the authors had recently earned on them. The authors had to scramble. One of the ways of making money they came up with was to publish a first-draft novel, straight from the word processor, so to speak, a chapter a week, so long as the readers kept donating a reasonable sum per week (300 dollars, if I recall correctly). They expected, I understand, to have weeks off due to the slowness of the donations’ flow, but were surprised: the full book was funded very early on. So they kept their promise, and posted a brand-new hot-off-the-word-processor chapter each week. I had just finished my first read of the series as it then existed, and followed the web serial as it unfolded. A couple of years later, when the Liaden rights had been released from the old publisher’s bankruptcy, Baen picked up the series and published Fledgling (with significant edits ­– recall, the web serial was a first draft by intent) as its first Liaden offering.

I have a love-hate relationship with this book. I really hate the young Theo who is the narrator for most of the book (she does eventually grow up, and becomes much more fun a character in the later parts of the series). The kinds of problems she has early on are really cringeworthy. Well written, mind you, but I sure don’t like to be reminded what the teens were like. However, I really love the second plot involving Sub-Chair Waitley, Gallowglass Chair Kiladi and others who essentially become self-appointed detectives in order to solve a mystery that potentially could ruin the whole planet. I also love the introduction to pilot-lore we get through Theo when she gets off planet and starts encountering non-Delgado people and mores.

I should probably write a whole separate post comparing and contrasting the academic environments depicted in this series. Fledgling certainly has one of the most detailed (and realistic) academic environments of the series, but I think a deeper discussion will have to wait for that other post. However, I will mention the rather curious female chauvinism of Delgado, which is perhaps a bit too blatant for my taste but certainly is an effective commentary on the traditional male privilege in our present-day culture.

Fledgling is the first Liaden audiobook narrated by Eileen Stevens. She is really well suited for this book; her voice works very well with a young woman as the lead narrator and it also deals quite adequately with the elderly professors on display.

Fledgling is in print and also available as an legal free ebook. There is also an audiobook.

Sharon Lee & Steve Miller: Conflict of Honors

He raised his glass to his lips. “And what brings you to apply for work on the Passage?”
“I don’t have any choice.”
The slanted brows pulled together. “Has Mr. Saunderson still got that impressment operation going? I did ask him to stop, Ms. Mendoza, I give you my word.”
For the third time in an hour Priscilla felt laughter rising. She drowned it in a swallow of wine. “I’m sorry—that was rude. What I meant to say was that I’ve been—dismissed—from my post on Daxflan. Yours is the only ship in at Jankalim now, so I’m applying here.”

There is this problem with the reading order of the Liaden series if you want to start with the original 1980s books. Agent of Change was the first, and its direct sequel is Carpe Diem, which was the third. The second book, Conflict of Honors, is a prequel to the two others and introduces characters that play a supporting role in Carpe Diem. The first time I read these books, I read them in publication order, leaving the cliffhanger at the end of Agent of Change unresolved for the duration of Conflict of Honors; it distracted me from this book and made it less enjoyable for me. Some people advise reading Conflict of Honors before Agent of Change, which certainly is a logical reading order, but I personally prefer to start with Agent. Therefore, I now skip Conflict of Honors entirely and come back to it at some later point in a rereading sequence. Like now.

Conflict of Honors is a good, leisurely introduction to the universe; I can easily see why some people recommend it as the book to start with. The principal character is Priscilla Delacroix y Mendoza, a Terran citizen. She being Terran, her attitudes and expectations are fairly familiar to the typical reader, that is, not particularly alien. She gets herself involved with Liadens, and particularly becomes entangled with Liaden balancing of accounts (a form of honor feuding), and thus, as she is educated about the Liaden culuture, we are, as well.

The book is, from another angle, a healing book. Priscilla starts as a young woman who has survived much abuse and is quite scarred because of it. She joins a ship whose crew is considerate and loving people, who show her the path to healing and to realizing her full potential.

A detail that I find adorable: big ships in the Liaden universe appear to carry pet libraries. That is, they carry animals which crew and passengers may lend out for a period of time. That is a concept one might want to see introduced into the real world.

“Do you really need a pet librarian?”
“Well, we didn’t have one,” he said, spinning the screen toward her. “So I guess we do. Palmprint here, please.”

Another joy of the book is the character of Shan yos’Galan. He is quite ridiculous but also sharp as a knife. And I find that I enjoy the portrayal of him given by narrator Andy Caploe, who I otherwise find unsatisfactory.

Conflict of Honors is in print as part of the Dragon Variation omnibus, which is also available as an ebook. There is a standalone audiobook.

Sharon Lee & Steve Miller: Scout’s Progress / Mouse and Dragon

This pair of books tell one story, another space regency romance.

Aelliana Caylon Clan Mizel is terrorized by her older brother the nadelm. For example, her mandatory contract marriage that produced her heir was arranged by that same brother to a man who raped and brutalized her. At one point, years later, she comments: “of course marriage is—extremely—distasteful”. She is safe, for some values of safe, by the word of the current Delm. But nadelms become delms, in the fullness of time.

Aelliana Caylon is also known to all pilots as the mathematics scholar who revised the ven’Tura tables used by pilots to determine safe jumps from star-system to star system, and is credited with having thereby saved countless of lives. Her research area is chance event – that is, card games and things like that. She teaches, among other things, a course in practical mathematics to scouts – a course the scouts call “math for survival”. However, due to her family history, she is utterly fearful of other people outside of the classroom.

One night, she happens to end up at the opening of a new casino at her home port. Goaded by some of her students, she observes the play and notices that one high-stakes player is playing a faulty system. She remarks upon it, and finds herself playing against him. She stakes her quarter-share, he stakes her ship. It is no spoiler to let you know that Aelliana wins the ship, for that is only where the story really starts. She now has a plan: learn to pilot, learn Terran, and leave Liad before the nadelm becomes the delm and kills her.

This shall be Korval’s Balance: As of this hour, the ships of Korval and of Korval’s allies do not stop at Ganjir. Korval goods do not go there; Korval cantra finds no investment there. And these conditions shall remain in force, though Ganjir starves for want of us.

…I note that my mother is still dead.

Daav yos’Phelium
Eighty-Fifth Delm of Korval
Entry in the Delm’s Diary for Finyal Eighthday in the first Relumma of the Year Named Saro

Daav yos’Phelium is Korval Himself. The duty weighs on him, and he from time to time hides his ring of office and becomes just plain Daav, casual labor at Binjali Repair Shop at Solcintra Port. He happens to be there when a woman comes to ask for a copilot, she being so new to her license as to need certified flight time on her record; to his astonishment, he learns her to be Aelliana Caylon, the reviser of the ven’Tura tables. But he is, of course, happy to sit her second board.

To tell much more of the two books surely would be a spoiler. I will merely note that they tell a remarkable growth story with Aelliana Caylon as the protagonist, and that everyone who had read the rest of the series – and the authors, I understand! – were really afraid of the second book, which was written more than a decade later, because everyone knew what event that book would have to cover.

As I noted in my previous blog post, these space regencies are emotionally hard for me, but these two are much easier despite having much more cruelty in them.

Bernadette Dunne’s narration continues to be a joy. I particularly enjoy her Aelliana Caylon.

There is perhaps a lot more that I would like to say about these books, but some of them are spoilers and I am too tired anyway, so I am stopping here.

Scout’s Progress is in print as part of the Dragon Variation omnibus, which is also available as an ebook. There is a standalone audiobook.

Mouse and Dragon is available on paper, as an ebook and as an audiobook.

Sharon Lee & Steve Miller: Local Custom

We jump 250 years into the future from the last book, to the time of the generation preceding Shan, Val Con and all the others the whole series started with.

Er Thom yos’Galan is a son of Korval who is required to marry a particular young woman. As is customary on Liad, the marriage is a contract between clans, one clan paying the other for providing a partner for child-making, the marriage to terminate after the child is born. Er Thom must marry, as he does not yet have the heir the law requires of him – simply put, Korval requires another yos’Galan – but he cannot forget a woman he had a brief affair with years ago. To clear the deck, he goes look up that old flame, to say good bye all over again.

Anne Davis is a Terran untenured professor of comparative linguistics based on the planet University. She remembers her brief affair with a Liaden trader fondly. She had even gotten a child out of him, though she never told him. It is customary to name the child with the father’s surname. Shan yos’Galan is a sharp little kid, who never met a stranger and who sees sparkles around people.

When Er Thom and Anne meet again after years of separation, the game changes. When Er Thom yos’Galan meets Shan yos’Galan, the game changes.

Local Custom is one of several space regencies as the authors call them: old-fashioned how-will-boy-and-girl-get-each-other romances. The principals are adults, capable and thoughtful people. Each wants to do the right thing, but their cultural backgrounds are so different that a lot of messages get mixed; both know enough of the other’s culture to think they know enough, but each only knows enough to be a danger. Along the way, we learn a lot about Liaden cultural dynamics and get glimpses of history that was later filled by the Crystal books; and I believe it to be the only book where delm Korval and thodelm yos’Galan, the head of the clan and of the line, respectively, actually command a clanmember to do something they strongly oppose.

One really lovely part of these space regencies is the quotations in the beginning of each chapter, mosly from fictional in-universe sources like Cantra yos’Phelium’s log book:

Here we stand: An old woman, a halfling boy, two babes; a contract, a ship and a Tree.

Clan Korval.

How Jela would laugh.

I have always liked all the Liaden regencies, though I open each of them with some trepidation, because they all touch my heart, in as much pain as in joy.

This is the first book in this series narrated by Bernadette Dunne. I like her; she does everything competently and brings some spirit to the whole affair. That she is not my favourite is not due to any fault of hers.

Local Custom is in print as part of the Dragon Variation omnibus, which is also available as an ebook. There is a standalone audiobook.