Tweet the Week in San Diego

Those planning to attend Renal Week, the annual meeting of the American Society of Nephrology, are invited to Tweet the Week. A lot of those signing up for the activity have not tweeted before. Some of the nuts and bolts of the service are obvious after the sign-up process, but there are ins and outs of the Twitterverse that may not be readily apparent.

Basics of Twitter

So you have a screen name (if not, click on the logo below; all you need is a valid email to sign up). Now it is time to create your profile page. Try to come up with a photo or image of some kind to represent you online. Put some information about who you are, but nothing you don’t want strangers to see. For an example, click on the Tweet the Week logo below; it will take you to the RenalWeek profile.

You also have to make a choice about whether or not to protect your updates. If you do not, anyone on Twitter can follow you and see what you put out there. You can go through your list of followers every so often and block anyone you want (like the half-naked women whose profiles list their favorite sex act), but you will also encounter a broader, more interesting swath of people this way. If you protect, then only people who you approve can see your updates; however, this means you will have to manually OK each and every follow.

For Tweet the Week, we have chosen to keep the feed closed. Some of the followers are closed, but most are public. RenalWeek is following all of the participants. Anything tweeted by RenalWeek will be visible only to official followers. 

Specific Tweet the Week Issues

If you are tweeting something general on your public feed, anyone who follows you will see it, including RenalWeek. If you want to send a message to RenalWeek that you only want the Tweet the Week crowd to see, you can direct message it. Do this by placing “D” in front of the screen name: D RenalWeek. If it is something of interest to the RenalWeek crowd, it can then be retweeted. Most twitter clients allow you to repeat someone’s tweet; this is how stuff “goes viral” and spreads quickly.

Mechanics of Twittering On the Go

You can tweet from a computer, and there certainly will be internet access in the San Diego Convention Center. Most stuff worth chatting about does not happen when you are near a screen. Luckily, Twitter was made for the mobile world, with a character limit shorter than a standard text message. You can register your cell phone and have tweets texted to you; this may drive you crazy after a while. You can also set it up so you can send tweets to the service via text message. Your usual text fees apply, so figure out ahead of time what this may cost you.

If you have a smart phone, you are in luck. BlackBerries, iPhones, and Pre’s all have Twitter clients that make participation easy and fun. There are too many to list here, and more popping up every day; a quick Google search will take you to lots of choices.

Even if you decide to limit your tweets to your laptop, you may want to check out a dedicated Twitter client. Many will let you group your followers or work with multiple accounts. I am using TweetDeck, and I have my personal account (PHLane; feed shown on the blog page above) and the RenalWeek account for Tweet the Week. A bunch of these are available; some may be downloaded via the Twitter web site, and there is a Wiki that lists many more.

I hope you decided to attend RenalWeek and to Tweet the Week with us. If you have any specific questions, ask in the comments below so others can share your answer.

Why Not Everyone?

For a while I have considered posting on “the public option” in healthcare that I am most familiar with, the Medicare End-Stage Renal Disease Program. The history of this disease-specific program is fascinating, and I think it provides a good example of what “the public option” could be (and why private insurance companies are scared).

See, you can get public coverage now if:

1. You are employed by the government (like congress)
2. You are or were in the military
3. You are of “retirement age”
4. You are disabled
5. You are poor with dependent children or you are a dependent child
6. You have kidney failure

That’s a whole lot of health care already run by the government. In my experience, it works pretty well with far fewer headaches than many of the private insurers generate.

I was toying with a post about this topic; however, someone has provided a far more compelling story than I could tell as a physician. Jennifer Nix in Salon tells us the history and realities of the Medicare ESRD program through a family saga:

My family's 36-year journey with end-stage renal disease -- the only long-term, chronic disease classification for which the U.S. government provides insurance coverage, regardless of age or income -- offers a telling case study into what once met Congress' standard of an unequivocal, moral imperative to provide public-financed health insurance. My family history mirrors exactly the period from 1973 to 2009, during which this entitlement program has allowed access to life-saving dialysis and kidney transplants, treatments previously denied to all but a very privileged few.

Read the full story: I love my socialist kidney.

We have identified a number of groups for whom we, as a society, feel a moral imperative to provide health coverage. Isn’t it time that a nation with our wealth and spirit extends that opportunity to all of our citizens?

Photo courtesy of PhotoXpress.

It’s ExtraORDinary

I have a confession. A dirty little secret. Nothing that threatens life, my marriage, or the free world. But something that no other traveler in the US is likely to admit:

Yup, O’Hare International Airport in Chicago. I have had my share of really bad days there – 9 hours trying to find a good chair, and several hours of delays with my entire family during a layover on that first day they banned carry-on liquids. It’s a really busy airport, with way too many people running around without apparent direction. Folks are often surly or rude as well. And yet, I still find stuff to love.

I first appreciated the architecture of the B and C concourses in the original Home Alone movie. Ceilings seem to soar and become part of the air above, even when the fog rolls in off of Lake Michigan. The halls look wide and expansive, without the tunnel effect of many older terminals. If you ignore the jostling around you, the concourses are truly beautiful.

On this last trip, I crossed from B to C concourse. These terminals are parallel, unconnected halls of gates. Between them is a giant jet parking lot, under which runs a tunnel. A tunnel can be utilitaritarian or it can be this:

The photo really can’t do this crossing justice. Moving walkways are centered between walls of lit glass bricks. Overhead are wavy neon tubes in the full spectrum of colors, presenting an amazing light show. While you run or stroll through the corridor, a new-age version of Rhapsody in Blue accompanies your journey, a version that sounds as if fairies are tapping it out on tiny chimes. Very Disney-esque.

There are some issues with the airport. The older terminals could use some more updating, and better shops would help during long delays. Overall, it is an amazing building.

And good thing, because I spend many hours there every year.

Food For Thought

How do we get the message out that animals are important in biomedical research? There are so many things about normal cells and organs that we do not understand, and only through observing and testing in mice, rats, and other animals can we learn new things that can drive new treatments. A lot of animal testing could be redundant, and we can learn many things using cell and tissue cultures; however, on the sharp, cutting edge of science, interactions of various systems in a living organism are still necessary.

A while back when I was in medical school, physiologists studying animals could tell that some signal transmitted from the heart caused the kidneys to excrete sodium. My faculty were betting on some sort of neural signal. Instead, some investigators tried injected extract of heart into rodents and found that the atria of the heart produce a hormone that induces sodium excretion (see Experientia. 1982 Sep 15;38(9):1071-3). Eventually the secretory granules were identified, the protein was purified and named (atrial natriuretic peptide), the protein and gene were sequenced, and antibodies were made. We now know that other organs make these proteins (like brain), and we use them for diagnosis of heart problems (by measuring blood levels) and therapeutically (infusion of BNP can improve salt and water output in patients with congestive heart failure). It took about 20 years from initial discovery to clinical use, but this discovery has helped a lot of people and animals.

What other undiscovered systems lie in the living body? Computer models require that we know everything about a system so that we can predict its actions and reactions. I know we aren’t there yet. Culture studies cannot replicate complete living systems where multiple organs, tissues, and cells interact with each other. And we can’t examine some of these systems in humans because we do not have the technology to test them… yet.

Here is a video from the Foundation for Biomedical Research:

This short video tells a compelling story of living with a disease on all levels personal and professional; I am not certain it conveys how essential these rodents are to medical progress.

FBR has other stories planned. We will have to wait and see if the overall effect is what we need.

We, The People

Today passed quickly on the Hill in DC. Advocacy is always an interesting experience. I am amazed that a brief walk through a metal detector and having my bag x-rayed allows me access to my elected officials. So my heels set off the detector the first time through… eventually they went through the x-ray box and we were in!

ANYONE can do this! We had made appointments ahead of time with some key members (and their key-er staffers), while we dropped by other offices with contact information and materials about our issues.

We passed several groups in the halls. Some wear tee or polo shirts displaying their group or cause. Others carried signs or other props. All were there for the same thing that brought us: personally extending our opinions to our elected officials. (Note: my group did not wear matching uniforms of any sort, just nice business clothing).

Will they do what we ask? Some will, some won’t. Some will decline for political reasons, others will frankly disagree with our opinions and information. In the end, we made our voices heard for the American Physiologic Society.

Photo courtesy of PhotoXpress. Yeah, I forgot my real camera, and the phone camera image wasn’t good enough…

Blogging from the Airport

I am seated in Eppley Airfield in Omaha, awaiting my first flight of the day. CNN plays on the television, another story about H1N1 flashing by. The accompanying footage has a bench with a lot of pretty colored liquids being pipetted from flask to flask.

It does not resemble any virology lab I have seen. And no one is masked in the footage…

I guess I am thinking too hard again. Time to traipse through security and wait at the gate.

Photo courtesy of PhotoXpress.

Omaha Fashion Week: Who Knew?

Last night was Girls’ Night Out. Last  year I purchased a wine tasting at a charity auction, and we started the evening there. All agreed that we learned a lot about wine; we also found out that the store has spa nights with pedicures, facials, and wine tastings. We will be back.

My mom, daughter, and I then ate dinner. Then my kid took me to Omaha’s Fashion Week show. Omaha has fashion week? Apparently they do!

They closed off a block in downtown Omaha near some trendy clubs and bars. A giant catwalk and stage dominated the space. Every chair was filled, and the parking decks and overpasses were packed with spectators.

Local designers showed off their stuff on local models. Cameras flashed and telephoto lenses waved. No movie stars, but the event rocked! Of course, nothing on the runway will be in my wardrobe; I don’t think they have 48 year old professional women in  mind, especially the guy who did a goth-inpired collection in red and black patent pleather.

It was a GREAT evening, and I am delighted to see a venue for local artists.

Photo courtesy of PhotoXpress.