RA and PRA diagnosis

RA and PRA diagnosis This blog is mainly about low carb eating and living what I consider to be a truly healthful lifestyle. I also (since it's mine and I make the decisions) posted a few times on political issues and other topics unrelated (seemingly at least) to low carb. This is one of those posts. I'm posting thing for several reasons. First off, I feel like have almost have an obligation to my readers (there aren't many of you, but you seem to be faithful) to explain what's been going on in my life and preventing me from posting as much as I'd like. There are many other reasons for this post, including wanting to get some links out there for people that may stumble on this. I have found online support extremely important for me since I started following a lob carb lifestyle. I only have 1 close friend and no family near me as I live in NC and they all live in New England, about 700 miles away. Finding the online support I have found with low carb makes me believe that this can be helpful for all kinds of issues. About two to two and a half years ago I started having trouble with joints being very painful. There were times my ring finder on my left hand would ache, then a day later that was fine and my right shoulder would hurt. A few days later it would be my right ankle, or my left knee, or my left ankle....or my toes, or shoulders, hips, etc. Each time the pain would be moderate to severe, but only last for a day, maybe a day and a half. There were times when the pain seemed to travel from one joint to the next, other times it would go away and I'd be fine for weeks. At this point there was never any redness, swelling, or signs of inflammation, just pain (5-8 on a scale of 10). One day my right foot started bothering me....the outer ankle area. It rapidly progressed to the point where I had trouble walking. I slept little that night and had a lot of trouble just getting to the bathroom. I had a Percocette, so I took it and was able to sleep, but the pain was constant. The next day I went to Urgent care (didn't have a Primary Care doctor, PCP, at that time) and when I got there, discovered the ankle was now red, hot and swollen, very swollen. The first doc told me it was gout, then the second doc (his supervisor) decided it was just inflammation from an injury I didn't realize I'd had and it should be fine in a few days. That night the pain went away almost as quickly as it came on. The next day I was able to finally get an appointment with a new PCP, but still had to wait a couple of months. During that time, the joint pains continued to come and go. The worst is the shoulders....did you know it's tough to move without moving your shoulders? The wrist and hand isn't good either....cooking, typing, getting dressed is difficult when every movement hurts. Eventually I started seeing more and more signs of obvious inflammation. I'd wake up and my right index finger would be swollen to almost twice it's size. I'd be fine and out of the blue my shoulder would start hurting, eventually getting to the point of tears. I had no idea what was going on, but of course started to look up symptoms online, having Rheumatoid in the back of my mind, but finding what I could to "prove" that I didn't have RA! RA hits joints on both sides of the body....some of my joints hurt on both sides, but hardly ever at the same time....and often only the joint on one side would hurt. Well, eventually I had my appointment with my PC, but of course had no symptoms that day. I told him about it and he sounded concerned, but didn't know what it was. He told me to call and try to come back if I had any obvious signs of inflammation. I did, about 2 weeks later. When I went in with symptoms, he immediately told me I needed to see a specialist, had a bunch of blood drawn and set up an appointment with a Rheumatologist. I went to see the Rheumatologist, who had my blood work and was told I had an autoimmune disease, Palindromic Rheumatoid Arthritis. The "rheumy" explained that PRA moves from joint to joint, sometimes shows signs of inflammation but sometimes doesn't, and comes and goes erratically. Wow! That was exactly what I had! He also explained that, like RA, they really didn't know the cause, so they treat it like RA and sometimes get good results. He also ordered more blood work, including a second RA factor, and added a few more tests. When I went back to see him a couple of months later, he ordered Plaquenil for me, but I was unable to tolerate it. In January I finally called and got an early appointment and when I saw the doc I asked for something else, as well as some pain medication. I was prescribed Doxycycline and Oxycodone. I filled both prescriptions January 18th and started taking the Doxy that night. Over the next few weeks, things didn't change, pains came and went, sometimes swelling, but mostly not. Then the pain got more severe, more frequent, and lasting longer in each joint. And then after a few weeks the....um..."intestinal side effects" kicked in. Oh man, I felt like I'd been on a bender....and I don't even drink very often (um, like 2-3 times a year!). Eventually I figured out it was the Doxy and stopped taking it. Apparently this stuff destroys a good amount of the "good" bacteria that live in our guts and you need to take probiotics on a regular basis to keep from having side effects. Right around this time I found a couple of sites about RA and PRA that have information about autoimmune diseases as well as support forums. The sites aren't "official" sites, but are set up by people that are themselves living with one of more of these diseases. All of the "official" sites have the same info. If you go to Web MD or Prevention, or any of the RA organization sites you basically see the same information. There is almost no information about natural, nutritional, or alternative treatments. Antibiotic treatment is apparently not widely accepted, but being found to have excellent results in some people. Eventually, with the help of probiotics, and the wonderful people on the support boards, I was able to tolerate the antibiotic....somewhat. I still have to stop it from time to time, but all in all I'm doing well with it. Now, I don't know if it's working or not....it can take 3-6 months or more before you know if it's working or not. The beginning of March I gave in and asked (begged) my doc for steroids and that has helped a lot.....but it's also now wearing off and the symptoms are coming back. The good thing about having PR is that there usually isn't any joint damage like you see with RA. The bad thing is the degree of pain! I'm told that PR pain is worse than any other....and I sure won't argue with that. I cannot believe how much this can hurt!! So...that's where I am now, and what I've been going through the past few months. Right now I have sore joints and occasionally one will flare up to the point where I want to take a pain med. I am trying to not take them unless I have no choice.....but that's not always possible. I'm still taking the antibiotic, and still hoping it is helping. I imagine when I see my doc this week he'll order more blood work, and hopefully that will show an improvement. I want to post a couple of sites for those with RA, PR and other auto-immune (AI) diseases: International Palindromic Rheumatism Society: An excellent site that has been created by a man with PR. There is a ton of info on there and even a support forum. Tender joints R.A.I.S.E.D. (Rheumatoid Arthritis Information, Support, & Educated Determination): a forum for those with various AI diseases.

Kimkins survivors

I've been on a few forums lately with a high number of new members that are former Kimkins members.

Now, anyone who's been following the chatter in the low carb community knows that there's a lot of controversy about the Kimkins plans, and that it looks like the whole scam is about to blow wide open. Many members have been banned from the site and have looked for an found other sites to get the support and help they need.

You know....this whole thing turns my stomach and makes me want to cry for the victims.

Here's the story, from what I can gather on the net.

Back several years ago a poster on a forum said she had lost close to 200 pounds in a relatively short period of time. This poster went by the name of Kimmer. Over the course of many postings over many months, Kimmer said she was a woman who lived in California with her son. She also said she had foster children, specifically male teens. Apparently there was also a claim of being on permanent disability and having defaulted on college loans. Apparently there have been several confirmations that this Kimmer is actually a woman named Heidi Diaz, who lives in Corona, CA. (I encourage you to look up and at the evidence and make your own conclusions, but the sources I've seen look pretty convincing)

People on the forum were impressed by Kimmer's before and after pictures and started asking her questions about her plan. Eventually they started asking for advice in following her plan, and she more firmly defined it. Apparently there were several plans. After a while Kimmer was apparently approached by someone who suggested setting up a website of her own where she could post her plans and set up a forum for members. There would be a fee for membership. That fee started around $15 and is currently around $60. The fee was supposed to be for the support forums, a personal page, email, etc. The plans were readily available all over the net! (And there are a few!
I never joined Kimkins as the first time I looked into it I found it was a low fat plan. At that point I just dismissed it as one I wasn't interested in. I did notice there was a lot of chatter on the forums about Kimkins, but never really paid much attention. I noticed more and more ads for Kimkins on all the diet sites....and noticed that even links that looked like they were for different things also lead to the Kimkins site. Women's World did an article about Kimkins and boy did the Internet light up with activity to the Kimkins site as well as various weight loss forums!

While this was going on, there began to be a few in the low carb community that were questioning the wisdom of these plans. There were also bloggers that were trying and openly promoting Kimkins, even some of the lower calorie plans.

Now, generally there are 2 groups that use low carb as a diet, and of course there are subgroups. The first group is mainly interested in weight loss....and the faster the better. The second group is more concerned with the health aspects of low carb while working at loosing weight. Within each group you're going to find differences of opinion on whether calories "count" or not, if high fat or low fat is better, if you should eat high protein or high fat, etc. Personally I am of the health group and believe both fat and protein are good in any amounts (as long as they're as natural as possible) and that carbs should be avoided unless they are veggies, fruit and some dairy. I also believe that calories do count, but low carb calories are generally better tolerated than high carb calories.

So anyway....while Kimmer was building her site and more and more people were joining and talking about the plans on other sites, there started to be seen people who had personally been harmed by the diet or were concerned about things that were being said on the Kimkins site forums. And I guess it was right about here that Jimmy Moore publicly joined Kimkins and began to heavily advertise for the plan. (Jimmy has since quit the plan and publicly apologised to his readers)

Jimmy Moore's enthusiastic approval of Kimkins really upset the low carb community. Jimmy's is a very heavily read site and many of his readers are people looking into low carb. By Jimmy approving the Kimkins plans, he was saying that these plans were low carb and safe. (There is also controversy as to whether these plans are to be considered "low carb" or "low calorie". Personally I say they are "very low calorie" diets that happen to be VERY low in carbohydrates and fats) Jimmy's endorsement upset many in the low carb community, myself included.

Now you are seeing blogs reporting fantastic results of following Kimkins as well as blogs explaining the dangers of a very low calorie diet. There are blogs with before and after pictures and blogs talking about the hair loss, weakness, inability to exercise and even loss of menses related to the effects of the diets. There were blogs praising Kimmer and the Kimkins plans and there were now blogs questioning the very existence of Kimmer, aka Heidi Diaz. The pro-Kimmer postings were definitely being overshadowed by the anti-Kimkins postings.

The charges that people are saying about Kimmer and Kimkins?
1. Kimmer is in fact Heidi Diaz, a woman that lives in Corona, California. This woman appears to be morbidly obese. No one knows if she ever lost the weight she claimed to have lost, but even if she did, she apparently was unable to sustain the loss.
2. That Kimmer is posting advice to severely limit the intake of calories to the point of starvation levels.
3. That Kimmer is posting advice to use laxatives on a daily basis.
4. That Kimmer is allowing and even advising at least 1 teenager on her site.
5. That posts on the Kimkins support forum have been edited or deleted. These posts are posts questioning the wisdom of the advice given by Kimmer.
6. That Private Messages have been accessed by the administration staff on the Kimkins site.
7. That members have been banned from the site,, but given no refund and in many cases any explanation.
8. That some of the before and after pictures on the site are fake.
9. That Kimmer accepted money for non-existent foster children as a result of posts about money problems on the site.

To me, there are 2 disturbing things about this whole thing. One is that this woman has been pushing and promoting a very dangerous diet plan without any training in the field. And the other is the way she preyed on a group of people that were vulnerable and, in many cases, desperate.

The plans that many are upset about are the plans that encourage very low calories. Some of these plans are said to have a high of 800 calories!! Fat is restricted as much as possible and vegetables are severely limited. Some argue that these plans are only for short-term use, while others note that there is no time limit stated with the plans and Kimmer is advising people to stay on them for the long-term. Even in the short-term, diets that call for calories as low as these promote should only be undertaken with close medical supervision. I have known several people who have been put on very low calorie diets by their physicians and they were all very closely monitored. They were also told to watch for certain signs of starvation like hair loss and loss of menses.

Kimmer preyed on people, mainly women it seems, who are desperate to loose weight at almost any cost. Some only had a small amount to loose, but desperately wanted to get back to their "goal" weight, and many others had 100 pounds and more to loose. The one thing in common that these people had is that they'd tried other plans and weren't successful....or weren't as successful as they wanted to be. These people were willing to do something dramatic if that something worked....and by all reports, Kimkins did work!

Apparently the support forums on the Kimkins site were great. Many wonderful people posted there and many friendships were formed as a result of belonging to Kimkins. Good thing, as now many of these disillusioned members are finding each other on other sites, including Jimmy Moore's new forum. Many refer to themselves as Kimkins survivors, and survivors they are!! They are now starting to figure out how to eat healthy and loose weight. Many are going to different low carb plans, but are still reluctant to increase their fat or calories too much. They are upset, and rightly so, that not only were they used by Kimmer, but they are also now being used by anti-Kimkins bloggers who are using their words without permission. They are afraid to trust again. The damage done by Kimkins is not only physical.

Luckily there are plenty of support groups on the Internet. I follow several low carb/diet support sites and I'm seeing threads and posts from new members who are former or still current Kimkins members. And the other members on these forums are doing what they can to help. Many of these sites have tools to help track your intake and progress and members that are more than willing to answer questions and provide information and support for those that are asking for it. If you aren't already a member of a support group, I highly recommend joining one. Here are links to some of the favorites on the net:
Active Low Carbers Forum
Jimmy Moore's site
Spark People
Low Carb Friends

My plan:

Protein: minimum 100g/day. Ideal 130+g/day
Carbohydrate: Beginning Jan 1, minimum 15g/day, less than 50g/day. Subtract fiber grams only.
Fat: as desired of the following:

• Coconut oil (and other tropical oils)
  
• Butter
• olive oil (not for high heat cooking)
  
• Nut oils (avoid for high heat cooking)
• Bacon fat (minimal unless bacon nitrate free)
• animal fat (fresh)
  

Total calories: 1200+ per day
Intermittent fasting: 24h Jan 1, 2007, as desired.
Exercise: minimum 3X/week

• Cardio: walking daily, starting minimum of 20 minutes.
• Strengthening/toning: Body For Life program

Processed foods: minimal use
Grains: minimal.
Corn, canola, soy and other "industrial" oils: do not use.
HFCS and trans-fats: check all labels and avoid whenever possible.
Artificial sweeteners: minimal use. Mainly use oligofructose (Sweet Perfection brand)

I base my plan primarily from Protein Power Life Plan (2000 edition) with strong influence of Dr Atkins New Diet Revolution (?1992 edition).

Note, this document is in progress, and may be updated at any time.

Updated 9/16/2007

Millions face risk from drug-coated stents

This is just too important to ignore!!! All of us depend on our doctors to do the right thing. And we depend on the FDA to make sure that drugs and devices are properly tested prior to being introduced for use in the general public. Apparently, the FDA is not doing there job!!

This is from MSN, quoted verbatim:

Potentially lethal heart devices a frightening problem for patients, doctors

Millions of Americans could be walking around with tiny time bombs in their hearts.

The concern centers on devices called drug-eluting stents. Doctors implant them in the hearts of about a million Americans a year to treat coronary artery disease. They generate some $5 billion a year in sales for the two companies that make them. But they may be doing more harm than good.

Next month a panel of experts will try to advise the Food and Drug Administration on what to do about it. But many top doctors and scientists admit they are in uncharted waters with a frightening problem that was largely unanticipated. By one estimate the devices already kill 2,000 Americans a year — and no one knows what the long-term danger will be.

To understand the potential hazard, it helps to look at the history of efforts to open the arteries to the heart when they get clogged with cholesterol-containing plaque. That blockage leads to shortness of breath and the chest pains called angina. If the artery closes completely the result is a heart attack with destruction of heart muscle and often death.

Beginning around 1980, doctors started using tiny balloons inserted on wires through the veins and guided by X-rays to push open the clogged arteries. This procedure, called angioplasty, often worked — but with a problem. In about half the cases the artery would close up again within a few weeks or months, an outcome called restenosis. The re-shutting of the arteries occurs because the blood vessels respond to the treatment as if they suffered a slight wound. They try to heal by growing more cells which can clog the artery again.

Thwarting the body's own healing process
To solve the problem, starting in 1994, cardiologists put tiny pieces of wire mesh called stents around the balloons. These stay in place as a piece of scaffolding to try to keep the arteries open.

These helped, but not enough.

Cells still grew over the wire, and in 20 percent to 30 percent of the cases, the vessel clogged again.

Drug-eluting stents (DES) appeared as the next solution. These give off a drug that prevents cell growth, and for that, they work well. The restenosis rate fell to about 5 percent. In 2003, soon after the FDA approved them, drug-eluting stents captured most of the market, even though they cost about $2,000 compared to $800 for the bare metal version.

Then a new hazard started to appear.

Doctors began seeing patients suffer from heart attacks that seemed to be triggered by the new stents. Because the drug-eluting stents are so effective at stopping the cell proliferation inside the arteries, the DES's end up as a piece of metal sticking out in the artery. That creates a perfect place for a blood clot to form and instantly block the artery. The result? A potentially fatal heart attack.

Dr. Jeffrey Moses of Columbia University, who conducted some of the original studies of the DES's, estimates the danger of a blood clot at 1 in 500 patients a year. For every million of the devices implanted, that would add up to 2,000 clots a year — although not all of them would be fatal.

But an estimate from Drs. Sanjay Kaul and George Diamond from Cedars Sinai in Los Angeles, published on the Web site of the American College of Cardiology, estimates that deaths from the new devices exceed 2,000 a year. Studies from Europe regard the danger to be many times higher. Because the devices are so new no one knows how long the hazard persists.

Already, many cardiologists are cutting back from using the devices. Sales are dropping dramatically. The FDA panel may well recommend they not be used at all.

Companies are searching for alternatives, including balloons that give off the drugs and would be removed at the time of the procedure, as well as stents that dissolve a few weeks after they are implanted.

What's next?
The big question now facing the FDA is: What should the estimated 4 million patients who already have a DES do?

The devices cannot be removed safely or easily. One preventive measure is to keep the patient on the blood-clotting medication Plavix for months or even indefinitely. But that medicine can cause severe bleeding, including a type of deadly stroke, and it costs more than $1,200 a year.

DES manufacturers Boston Scientific and Johnson & Johnson could end up rivaling Vioxx maker Merck as targets of lawsuits from people who suffer heart attacks.

The origin of this terrifying problem is that medical devices, like drugs, get tested for a few months in a few hundred or at most a few thousand of people before the FDA approves them.

Many experts are clamoring for better methods of assuring safety before devices like these go into millions of people for a lifetime.

http://www.msnbc.msn.com/id/15816251/

Please note the lines about the Europe saying failure rates are much higher than US estimates!!!

Also, note that these "complication" didn't show up until after approval? Why is that? Is it because the manufacturer gave incomplete or incorrect data to the FDA? It certainly wouldn't be the first time!!!

What ever happened to "First, do no harm"? I guess that should be removed from they Hippocratic oath?

It's been a very good day!!!

WHOO HOO!!!!

The Dems have won the House, and just a little while ago, it was reported that they also won the Senate!!!

The system of checks and balances has finally been restored!!!

For all that voted yesterday, thank you very much!

For all that voted for the Democrats....You're awesome!!!!

We did it!!!

Vote!!!

I am praying that by the end of the say this Tuesday, November 7 we will see a glimmer of hope. I am praying that people smarten up and stop voting the party and start voting with a bit of thought behind their vote. I am praying that people get out and vote!!!

We must get out and vote!!! It is our civic duty. It is the only way to make ourselves heard. It is the only way to guarantee the will of the people....the majority of the people. If the majority votes, then the majority will be heard. If the majority doesn't vote, well, then only the minority is heard!!!

Get out and vote!!!

If you live in NC, here is a link to the state Board of Elections.

Here are the requirements to vote in NC:

Qualifications to register to vote in North Carolina

To register to vote in this State, a person must sign a voter declaration attesting that:

• I am a U.S. citizen.
  

• I will have been a resident of North Carolina and this county for 30 days before the election.
  

• I will be at least 18 years old by the next general election.
  

• I am not registered nor will I vote in any other county or state.
  

• If I have been convicted of a felony, my rights of citizenship have been restored.
  

If you've not registered yet, it's too late. But if you're not registered, please get registered as soon as possible so you'll be ready the next election!!

If you are unable to get yourself to your polling place, you can contact your local Democratic or Republican Part Headquarters.

Here are the numbers for Durham County:
Democrat: 919-544-1994
Republican: 919-403-7183

Bush owes troops an apology, not Kerry

SPECIAL COMMENT

By Keith Olbermann

Anchor, 'Countdown'

Countdown

Updated: 4:55 p.m. ET Nov 2, 2006

On the 22^nd of May, 1856, as the deteriorating American political system veered toward the edge of the cliff, U.S. Rep. Preston Brooks of South Carolina shuffled into the Senate of this nation, his leg stiff from an old dueling injury, supported by a cane. And he looked for the familiar figure of the prominent senator from Massachusetts, Charles Sumner.

Brooks found Sumner at his desk, mailing out copies of a speech he had delivered three days earlier — a speech against slavery.

The congressman matter-of-factly raised his walking stick in midair and smashed its metal point across the senator’s head.

Congressman Brooks hit his victim repeatedly. Sen. Sumner somehow got to his feet and tried to flee. Brooks chased him and delivered untold blows to Sumner’s head. Even though Sumner lay unconscious and bleeding on the Senate floor, Brooks finally stopped beating him only because his cane finally broke.

Others will cite John Brown’s attack on the arsenal at Harper’s Ferry as the exact point after which the Civil War became inevitable.

n point of fact, it might have been the moment, not when Brooks broke his cane over the prostrate body of Sen. Sumner — but when voters in Brooks’ district started sending him new canes.

Tonight, we almost wonder to whom President Bush will send the next new cane.

There is tonight no political division in this country that he and his party will not exploit, nor have not exploited; no anxiety that he and his party will not inflame.

There is no line this president has not crossed — nor will not cross — to keep one political party in power.

He has spread any and every fear among us in a desperate effort to avoid that which he most fears — some check, some balance against what has become not an imperial, but a unilateral presidency.

And now it is evident that it no longer matters to him whether that effort to avoid the judgment of the people is subtle and nuanced or laughably transparent.

Sen. John Kerry called him out Monday.

He did it two years too late.

He had been too cordial — just as Vice President Gore had been too cordial in 2000, just as millions of us have been too cordial ever since.

Sen. Kerry, as you well know, spoke at a college in Southern California. With bitter humor he told the students that he had been in Texas the day before, that President Bush used to live in that state, but that now he lives in the state of denial.

He said the trip had reminded him about the value of education — that “if you make the most of it, you study hard, you do your homework, and you make an effort to be smart, you can do well. If you don’t, you get stuck in Iraq.”

The senator, in essence, called Mr. Bush stupid.

The context was unmistakable: Texas; the state of denial; stuck in Iraq. No interpretation required.

And Mr. Bush and his minions responded by appearing to be too stupid to realize that they had been called stupid.

They demanded Kerry apologize to the troops in Iraq.

And so he now has.

That phrase — “appearing to be too stupid” — is used deliberately, Mr. Bush.

Because there are only three possibilities here.

One, sir, is that you are far more stupid than the worst of your critics have suggested; that you could not follow the construction of a simple sentence; that you could not recognize your own life story when it was deftly summarized; that you could not perceive it was the sad ledger of your presidency that was being recounted.

This, of course, compliments you, Mr. Bush, because even those who do not “make the most of it,” who do not “study hard,” who do not “do their homework,” and who do not “make an effort to be smart” might still just be stupid, but honest.

No, the first option, sir, is, at best, improbable. You are not honest.

The second option is that you and those who work for you deliberately twisted what Sen. Kerry said to fit your political template; that you decided to take advantage of it, to once again pretend that the attacks, solely about your own incompetence, were in fact attacks on the troops or even on the nation itself.

The third possibility is, obviously, the nightmare scenario: that the first two options are in some way conflated.

That it is both politically convenient for you and personally satisfying to you, to confuse yourself with the country for which, sir, you work.

A brief reminder, Mr. Bush: You are not the United States of America.

You are merely a politician whose entire legacy will have been a willingness to make anything political; to have, in this case, refused to acknowledge that the insult wasn’t about the troops, and that the insult was not even truly about you either, that the insult, in fact, is you.

So now John Kerry has apologized to the troops; apologized for the Republicans’ deliberate distortions.

Thus, the president will now begin the apologies he owes our troops, right?

This president must apologize to the troops for having suggested, six weeks ago, that the chaos in Iraq, the death and the carnage, the slaughtered Iraqi civilians and the dead American service personnel, will, to history, “look like just a comma.”

This president must apologize to the troops because the intelligence he claims led us into Iraq proved to be undeniably and irredeemably wrong.

This president must apologize to the troops for having laughed about the failure of that intelligence at a banquet while our troops were in harm’s way.

This president must apologize to the troops because the streets of Iraq were not strewn with flowers and its residents did not greet them as liberators.

This president must apologize to the troops because his administration ran out of “plan” after barely two months.

This president must apologize to the troops for getting 2,815 of them killed.

This president must apologize to the troops for getting this country into a war without a clue.

And Mr. Bush owes us an apology for this destructive and omnivorous presidency.

We will not receive them, of course.

This president never apologizes.

Not to the troops.

Not to the people.

Nor will those henchmen who have echoed him.

In calling him a “stuffed suit,” Sen. Kerry was wrong about the press secretary.

Mr. Snow’s words and conduct, falsely earnest and earnestly false, suggest he is not “stuffed,” he is inflated.

And in leaving him out of the equation, Sen. Kerry gave an unwarranted pass to his old friend Sen. John McCain, who should be ashamed of himself tonight.

He rolled over and pretended Kerry had said what he obviously had not.

Only, the symbolic stick he broke over Kerry’s head came in a context even more disturbing.

Mr. McCain demanded the apology while electioneering for a Republican congressional candidate in Illinois.

He was speaking of how often he had been to Walter Reed Hospital to see the wounded Iraq veterans, of how “many of them have lost limbs.”

He said all this while demanding that the voters of Illinois reject a candidate who is not only a wounded Iraq veteran, but who lost two limbs there, Tammy Duckworth.

Support some of the wounded veterans. But bad-mouth the Democratic one.

And exploit all the veterans and all the still-serving personnel in a cheap and tawdry political trick to try to bury the truth: that John Kerry said the president had been stupid.

And to continue this slander as late as this morning — as biased or gullible or lazy newscasters nodded in sleep-walking assent.

Sen. McCain became a front man in a collective lie to break sticks over the heads of Democrats — one of them his friend, another his fellow veteran, legless, for whom he should weep and applaud or at minimum about whom he should stay quiet.

That was beneath the senator from Arizona.

And it was all because of an imaginary insult to the troops that his party cynically manufactured out of a desperation and a futility as deep as that of Congressman Brooks, when he went hunting for Sen. Sumner.

This is our beloved country now as you have redefined it, Mr. Bush.

Get a tortured Vietnam veteran to attack a decorated Vietnam veteran in defense of military personnel whom that decorated veteran did not insult.

Or, get your henchmen to take advantage of the evil lingering dregs of the fear of miscegenation in Tennessee, in your party’s advertisements against Harold Ford.

Or, get the satellites who orbit around you, like Rush Limbaugh, to exploit the illness — and the bipartisanship — of Michael J. Fox. Yes, get someone to make fun of the cripple.

Oh, and sir, don’t forget to drag your own wife into it.

“It’s always easy,” she said of Mr. Fox’s commercials — and she used this phrase twice — “to manipulate people’s feelings.”

Where on earth might the first lady have gotten that idea, Mr. President?

From your endless manipulation of people’s feelings about terrorism?

“However they put it,” you said Monday of the Democrats, on the subject of Iraq, “their approach comes down to this: The terrorists win, and America loses.”

No manipulation of feelings there.

No manipulation of the charlatans of your administration into the only truth-tellers.

No shocked outrage at the Kerry insult that wasn’t; no subtle smile as the first lady silently sticks the knife in Michael J. Fox’s back; no attempt on the campaign trail to bury the reality that you have already assured that the terrorists are winning.

Winning in Iraq, sir.

Winning in America, sir.

There we have chaos — joint U.S.-Iraqi checkpoints at Sadr City, the base of the radical Shiite militias, and the Americans have been ordered out by the prime minister of Iraq … and our secretary of defense doesn’t even know about it!

And here we have deliberate, systematic, institutionalized lying and smearing and terrorizing — a code of deceit that somehow permits a president to say, “If you listen carefully for a Democrat plan for success, they don’t have one.”

Permits him to say this while his plan in Iraq has amounted to a twisted version of the advice once offered to Lyndon Johnson about his Iraq, called Vietnam.

Instead of “declare victory and get out” we now have “declare victory and stay indefinitely.”

And also here — we have institutionalized the terrorizing of the opposition.

True domestic terror:

Critics of your administration in the media receive letters filled with fake anthrax.

Braying newspapers applaud or laugh or reveal details the FBI wished kept quiet, and thus impede or ruin the investigation.

A series of reactionary columnists encourages treason charges against a newspaper that published “national security information” that was openly available on the Internet.

One radio critic receives a letter threatening the revelation of as much personal information about her as can be obtained and expressing the hope that someone will then shoot her with an AK-47 machine gun.

And finally, a critic of an incumbent Republican senator, a critic armed with nothing but words, is attacked by the senator’s supporters and thrown to the floor in full view of television cameras as if someone really did want to re-enact the intent — and the rage — of the day Preston Brooks found Sen. Charles Sumner.

Of course, Mr. President, you did none of these things.

You instructed no one to mail the fake anthrax, nor undermine the FBI’s case, nor call for the execution of the editors of the New York Times, nor threaten to assassinate Stephanie Miller, nor beat up a man yelling at Sen. George Allen, nor have the first lady knife Michael J. Fox, nor tell John McCain to lie about John Kerry.

No, you did not.

And the genius of the thing is the same as in King Henry’s rhetorical question about Archbishop Thomas Becket: “Who will rid me of this meddlesome priest?”

All you have to do, sir, is hand out enough new canes.

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I watch Keith Olbermann's show every night, or almost every night. He ends each show with a small tribute to Edward R Murrow saying "Good night, and good luck."

I think Mr Murrow would be pleased.