Monday, October 3, 2016

231st post


"The road to any destination is often filled with distractions along the way."

Forrest Caricofe

Google search: About 26,500,000 results (0.87 seconds) 

No results found for "The road to any destination is often filled with distractions 

along the way."


"and then" to the right I could see an old one lane iron bridge. If you turned

off here, crossed the bridge making an immediate dog leg left and a football

field's distance a dog leg's turn to the right, you could drive for about 5 minutes

or walk for an hour, as I have done (2002-2014), and come back into Bridgewater 

just south of the bridge that crosses over the North fork of the Shenandoah River

on State Route 42.

Father made a slight left while driving and the last house on the left while leaving

Mt Crawford was there at the time (about 1954) or not. If we forge ahead to 1999,

the dog kennel in the back of this house is where my Uncle Paul spent the last few

days of his life and we can finish the rest of that story tomorrow....



From Wikipedia, the free encyclopedia

Zachary Taylor

12th U.S. President

Zachary Taylor was the 12th President of the United States, serving from March 1849 

until his death in July 1850. Before his presidency, Taylor was a career officer in the 

United States Army, rising to the rank of major general.

Born: November 24, 1784, Barboursville, VA

Died: July 9, 1850, Washington, D.C.

Nickname: Old Rough and Ready

Political party: Whig Party

Buried: Zachary Taylor National Cemetery, Louisville, KY

Spouse: Margaret Taylor (m. 1810–1850)"


BBC News 

The BBC poll of polls looks at the five most recent national polls and takes the 

median value, ie, the value between the two figures that are higher and two 

figures that are lower.

US election poll tracker: Who is ahead - Clinton or Trump?

updated 3 October 2016             Hillary Clinton 49%      Donald Trump 45% 

updated 2 October 2016             Hillary Clinton 49%      Donald Trump 45%    

updated 1 October 2016             Hillary Clinton 49%      Donald Trump 45%        

         30 September 2016            Hillary Clinton 48%      Donald Trump 46%    



"A narrow win for Colombia's opponents to a government peace deal with FARC 

rebels has thrown the country into disarray, leading one journalist to starkly 

declare, "Nobody really knows what will happen tomorrow."


"Tens of thousands of Polish women are expected to miss work on Monday to 

protest a proposed law that would totally ban abortions in the predominantly 

Catholic country."


Copyright DPC)

By Rick Ansorge   |   Friday, 30 Sep 2016 04:47 PM

 Doctor Shortage: Is It OK to go With a Physician Assistant?

"With doctor shortages in many regions of the US, MDs are increasingly relying on 

physician assistants and nurse practitioners to handle some of their patient loads. But 

should you be worried about seeing someone other than an MD to manage your 

health? Here's what you need to know.

With millions of newly insured patients entering the healthcare system as a result of 

Obamacare, the demand for family practice doctors has increased astronomically.

There aren’t nearly enough general practitioner MDs to go around. By 2025, there will 

be a national shortage of up to 31,100 family physicians and internists, according to the 

Association of American Medical Colleges.

To handle the patient overflow, MDs increasingly rely on physician assistants (PAs) 

and nurse practitioners (NPs). At many clinics, patients rarely see their primary-care 

physician, and many of them aren’t happy about it.

About 72 percent of patients would rather see an MD than a PA, according to a recent 

national survey.

But should you be worried about seeing an MD instead of a PA or NP?

Not necessarily, experts say. But it depends on why you’re seeing a healthcare 


Most PAs or NPs are perfectly able to treat minor conditions. But more serious 

disorders require the attention of an MD.

“The vast majority of medicine is routine,” says Tom Ahern, a certified PA with nearly 

40 years of experience. “I would say that 99 percent of the time it’s OK to see the PA.”

Although both PAs and NPs can diagnose and treat illnesses, prescribe medications, 

and order/interpret tests, there are some differences.

For example, only PAs are allowed to assist during surgery. NPs specialize in disease 

prevention and health management of chronic but stable conditions such as diabetes 

and hypertension.

The role of PAs or NPs varies from practice to practice, and depends on their level of 


At many family practices, PAs and NPs handle routine problems such as coughs, colds, 

rashes, sore throats, cuts, sprains, and urinary tract infections.

They also ensure that patients are checked for blood pressure, blood cholesterol, and 

blood sugar, and that their vaccinations are up to date.

Research shows that the widespread use of PAs and NPs is associated with shorter waits 

for appointments in clinics and quicker treatment in hospital emergency rooms.

According to one study, older patients received higher quality care for dementia, falls, 

and urinary incontinence when they were managed by an NP and an MD than by an 

MD alone....

 Despite these benefits, there are situations that demand the attention of an MD.

“Anybody that has a potentially life-threatening illness really needs to be seen and 

managed by a physician,” Ahern tells Newsmax Health.

“This is particularly true in cancer care, in severe unstable diabetics, and in severe 

unstable cardiac and pulmonary patients.”

Others who should see an MD include the estimated 5-10 percent of patients whoarrive 

in clinics and emergency rooms with conditions that aren’t easily identifiable.

Because MDs have rigorous continuing education requirements, they may be more 

likely to correctly identify conditions that seemingly defy diagnosis.

If your primary-care MD is usually missing in action, and you want to see someone with 

an equivalent level of training and experience, consider a DO (Doctor of Osteopathic 


Nationwide, there are about 87,000 DOs and 60 percent of them work in primary care.

Like MDs, DOs receive training in a four-year medical school. After graduation, they 

must complete a residency program in a specialty ranging from family medicine, 

gastroenterology, dermatology, or neurosurgery.

In every state, a DO can do everything an MD does. This includes diagnosing and 

treating conditions, prescribing medication, ordering tests, and (if qualified) 

performing surgery.

In addition, DOs are trained to use their hands to examine a patient’s musculoskeletal 

system and treat conditions by manipulating joints and muscles."

© 2016 NewsmaxHealth. All rights reserved.

I've had or been associated with a NP or PA in 3 states and all were women. One 

diagnosed my Mother's congestive heart failure in Virginia, another treated me 

with a bad sinus condition in Omaha, Nebraska and the 3rd was my primary care 

physician in Las Vegas. Her name was Tigger Mathis and because she had nothing

to compare my health status to, she set up appointments for about 7 MDs who

specialized in their professions. She could also write prescriptions.

All in all, I can say that NPs or PAs are just as good as MDs and may, after all is said 

and done, they may have the better bed side manner.


"A hurricane, tornado, or other weather of the same may be God's message to

us as to who is still in charge."

Forrest Caricofe

Google search: About 62,300,000 results (1.55 seconds) 

No results found for "A hurricane, tornado, or other weather of the same may 

be God's message to us as who is still in charge."


Tropical Storm Matthew Near Hurricane Strength in the Caribbean Sea; Jamaica, 

Hispañola, Cuba, Bahamas Threats Next Week

Published: Sep 29 2016 11:30 AM EDT

Powerful Hurricane Matthew Now Moving North

"Hurricane Matthew is now moving towards Haiti and the Dominican Republic with 

winds of 145 MPH. 

Matthew is nearing hurricane strength in the eastern Caribbean Sea.

Tropical storm conditions are possible in Aruba, Bonaire and Curaçao.

Jamaica, Hispañola, eastern Cuba and The Bahamas face a hurricane threat early next 


Potential U.S. impact next week remains unclear.

(MORE: Matthew Becomes the Fifth Hurricane of the 2016 Atlantic Hurricane Season; 

Jamaica, Hispaniola, Cuba Threat) 

Tropical Storm Matthew is near hurricane strength in the Caribbean Sea and poses a 

danger to Jamaica, parts of Hispañola, eastern Cuba, and The Bahamas early next 

week. It's potential U.S. impact later next week remains unclear.

Matthew was located just under 300 miles south of San Juan, Puerto Rico, as of late 

Thursday morning.

Current Storm Status

A Hurricane Hunters reconnaissance mission early Thursday measured flight-level 

winds a few thousand feet above the sea of just over 90 mph. So, Matthew is teetering 

with hurricane status, despite the wind shear.

A tropical storm watch continues for Aruba, Bonaire, and Curaçao. Winds of 40 mph or 

greater are possible there beginning later Thursday.

Current Watches/Warnings

Radar from Meteo France shows the heaviest rain has ended, but a few bands of rain 

are still lingering over parts of the Lesser Antilles, but will slowly diminish the 

remainder of Thursday.

George F.L. Charles Airport on St. Lucia picked up 9.21 inches of rain Wednesday. On 

the south side of the island, Hewanorra Int'l Airport picked up 13.19 inches of rain in 

just 12 hours from 8 p.m. Wednesday through 8 a.m. Thursday, according to the 

Antigua Met Service....

For most, total rainfall accumulations of 4 to 8 inches are expected across the 

Windward Islands and the southern Leeward Islands through Thursday. Life-

threatening flash flooding and mudslides are possible.

Rainfall of 1 to 2 inches can be expected farther north across the northern Leeward 

Islands plus the Virgin Islands and Puerto Rico. 

Accumulations will range from 1 to 3 inches across the Leeward Antilles, including 

Aruba, Bonaire and Curaçao through Friday. 

A wind gust to 89 mph was reported in St. Pierre, Martinique, Wednesday evening. 

Some stations are elevated at 50 to 100 feet. Sustained winds of 39 mph were reported 

on the island of Barbados.

Rafael Elliot @rairizarry

#TropicalStormMatthew  sustained winds of about 70 mph 112 km

2:10 PM - 28 Sep 2016
The "Caribbean Right Turn"

Matthew is currently experiencing some wind shear provided by southwest winds 

several thousand feet above the surface, which has blown convection away from its 

center of circulation.

Current Satellite, Wind Shear

Areas of high wind shear are shown in the purple contours. The latest position of the 

center of circulation is also plotted.

This wind shear may temporarily pump the brakes on any significant intensification of 

Matthew the next day or so.

First up, given the southern track, outer bands of rain and winds to trpoical storm-force 

are possible in the typically drier "ABC Islands" – Aruba, Bonaire and Curaçao – as 

well as parts of coastal Venezuela and Colombia Thursday through early Saturday.

Beyond that, uncertainty is still considerable on the critical details of this system.

(MORE: Just Because It's Fall Doesn't Mean We Shouldn't Pay Attention to the Tropics)

Over the next couple of days, Matthew should continue to move west as it rides the 

southern periphery of the Bermuda high.

Sometime this weekend, Matthew should make its long-anticipated northwest or 

northward turn in the Caribbean Sea, as the system reaches the southwestern edge of 

the Bermuda high.

The critical details regarding when exactly that turn is made, how sharp it is, and 

Matthew's intensity at that time will dictate the impacts for Jamaica, Hispañola, and 

eastern Cuba.

Unfortunately, there is still some important forecast uncertainty regarding those 

important details, which is common for a tropical cyclone forecast several days out. 

For now, impacts could begin in Jamaica and Hispañola (particularly Haiti) as soon as 

Sunday night, and in eastern Cuba as soon as Monday.

In addition, there is uncertainty regarding Matthew's intensity as it nears those 

locations. Matthew may be stronger than the current forecast.

Projected Path and Intensity

Beyond that, Matthew is likely to begin impacting parts of the central or southeast 

Bahamas by Tuesday.

U.S. Threat?

Beyond that, it is still too soon to determine which parts of the U.S. may be in danger 

next week.

Ensemble forecast guidance includes scenarios where Matthew moves north, then 

northeast remaining well off the East Coast, but also includes tracks into the Gulf of 

Mexico next week. 

Why Long-Range Model Forecasts For the Tropics Can't Often Be Trusted.

The track will depend, in part, on the steering currents in the atmosphere.

If high pressure aloft is stronger near or over the Eastern U.S., that may steer Matthew 

closer to some part of the U.S.

Conversely, if a southward dip in the jet stream is in play over some part of the Eastern 

U.S., that could help deflect Matthew to the east.

For now, ensemble forecast guidance is lessening the threat of a Gulf of Mexico track, 

but it is still too far out to rule out an East Coast threat later next week.

There is also considerable uncertainty on how fast Matthew moves.

Even if Matthew stays sufficiently off the East Coast, a threat of dangerous swells, 

coastal flooding, and beach erosion is likely to be in play along parts of the Eastern 


Colorado State University tropical scientist, Dr. Phil Klotzbach noted 60 percent of 

landfalling U.S. hurricanes from September 27 and beyond since 1900 have occurred 

in Florida. However, while lower probability, there have been landfalls this late in the 

season as far west as the Texas Gulf Coast.

Typical October named storm origin locations and tracks.

For now, all interests in the Caribbean Sea, Gulf of Mexico, Bahamas and U.S. East 

Coast should continue to monitor the progress of Matthew. Check back with us 

frequently at for any important forecast updates.

Now is a good time to make sure you're prepared before the storm. Are you 



I accomplished nothing yesterday in the flower beds or the yard.

I would like to get my flower bulbs in the ground and maybe today 

I'll get the time to do it.

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