Chapter 5: Strikes, Cancer, Retirement.

This week's copy of New Scientist just landed on my doormat. There is an article extolling the biological virtues of fat, describing it "Fat is an organ. You should probably think of it a bit like the liver." It is headed by the following paragraph which I thought you might like.
"I am one of the largest organs in your body. A thrifty caretaker, I carefully husband your body's precious reserves, investing in the good times to tide you over the bad. I influence your behaviour, manage your fertility and shore up your defences against microscopic invaders. Soft and snug I blanket you in a warm intimate embrace, cradling your internal organs, cushioning your footsteps, shielding you from the insults of a mad, bad world. Yet despite all I do, you despise me. And all because I'm Fat."
Yes, and it also absorbs a lot of toxins and keeps them out of your other systems.

Hug Natasha for me.

I don't know how much we make the news in the US, not much I guess. The UK and other parts of Europe are slowly grinding to a halt. We have had fuel blockades stopping virtually all supplies of petrol and diesel, apparently in protest at the level of fuel tax. So now all the petrol stations are closed, buses are running Sunday schedules, supermarkets are rationing bread etc, and so on. This morning the blockades began to be lifted, but it will be some time before fuel gets through to the filling stations, and things like food supplies are going to get worse before they get better, and no-one is yet saying how long it will be before I can resume my business. I have been hearing about it on NPR and BBC Worldwide, but not on other U.S. news. Oh, you poor things. Quelle pain in the pratt.

It is not clear exactly who is causing the obstruction. Hauliers, farmers and taxis are staging 'peaceful' protests at the refineries, and the tanker drivers will not pass their lines. There are different reports as to whether this is because the tanker drivers are supporting the cause, and so are effectively on strike, or because the pickets are intimidating them, which they claim not to be. However the net result is the tankers stay in the refineries. Of course the gov. points its finger at the 'usual suspects', such as "This was unexpected, we have never had a protest like this, the organisers used the INTERNET and MOBILE PHONES!" No shit!. Headless chicken if you ask me. On the one hand, pundits point out the oil price rise has netted the gov. around £3bn in unanticipated taxes, but the gov.s response to suggestions of a tax cut is "we would have to cut spending on health and education." Bullshit!
It all seems to have started when the French decided to blockade England as a protest about French fuel prices. (Why us? We don't supply their fuel. We are just a convenient victim they can hurt easily to embarrass their gov.) Anyway the French gov. promptly gave in (the protesters had obviously studied Hitler's track record), and the next week we had our own protest. Our fuel taxes are higher anyway. The real problem is that taxes are a multiplier (about 5!), so small-ish changes in the world oil price get badly leveraged into high-street fuel prices. Why can't they levy taxes per litre instead of per pound (or dollar)? Oh, far too difficult and expensive to implement.
Maybe we could use fat to store some fuel in for when delivery drivers go on strike.

It reminds me so much of when dockworkers go on strike in Hawaii. That's why you can always tell a true Hawaiian, because we have three gross of toilet paper at all times. It's not hoarding if you'll eventually use it... :)

At all times is OK, the trouble is people here suddenly decide to become Hawaiian only when the news breaks, so the big problem is not that there were no tankers, but that everyone rushed to fill their tanks and larders, so that there is a quite artificial shortage of bread, sugar and so on.
The tankers have been running normally for a few days now, but some filling stations are still closed, and there are still fuel queues.

:

The fuel crisis is over (for now) but it has made us think a bit about what we are doing. Just-in-time production has been the fashion for a while now, which made the blockade particularly effective. The absence of input and output stocks throughout the supply chain meant that things came to a halt VERY quickly. I dream of a situation where cheap fuel (relative to manpower) does not destroy the advantages of energy-efficient transport systems. Non-perishable goods transported in a slow and leisurely manner on canals mean a buffer stock is held in transit, without the need for warehouses at either end. Long-distance rail networks for both passengers and freight with a workable system for getting the loads to and from the stations. Airships, now that the ghost of the Hindenberg has been laid. Teleworking. To achieve all this I reckon fuel prices need to be about five times what they are now, even here. Of course it won't happen because it would make exports unsaleable. We just have to sit and wait for the oil to run out and force majeur to take over.

Oh, we have all those things now, but can we use them? People want things so rush-rush chop-chop wiki wiki that I don't think they'd be able to handle the changeover phase.

Just to add insult to injury we had a local electrical power failure last night, so I put Natasha to bed by candlelight. It really begins to feel Victorian around here.
How old is your house?

1865. It is a stone built mid-victorian house which was originally built for the manager of a brewery just uphill, which used the local spring water (which comes up everywhere). A pub was built adjoining. When the owner died his widow divided the house into two. The original house was three rooms wide and two deep, and was divided into two equal l-shaped parts. We have the part with two front rooms, including the original main entrance. Next door has former servant's entrance, which is at the front because the house backs on to a cliff face, as I have previously mentioned. Now the two halves of the house and the pub make a terrace of three. The brewery is long gone, and the pub is currently without occupant, although that is a recent occurrence.
I remember being totally thrilled the first time I was in the U.K. because the house in which I was staying was built in 1794. Did you see "The 1900 House"? It thoroughly disabused any romantic notions I have had about living in the past. I like living now.
Yes I saw some of it. I thought the family's reaction to their situation was disappointing. They did volunteeer after all, and obviously hadn't done much homework, or communicating. There could have been a bit less whinging about how bad it was, and what hard work. In reality the teenage girls would have been in service, doing someone else's dirty work. And at least they didn't have to deal with the horses.
Lyudmila was fascinated by it and recorded most of the series. I just gave Natasha the tape to record Pokemon on. So much for history.
Even the girls of what looked like a solidly lower-middle-class family?
I believe so, yes. There weren't that many options open to girls who had to earn a living. The alternative was an early marriage. Possibly by 1900 things were a bit different, I don't know. After all that is barely Victorian.

Privately, Tim, I'd like to thank you for your frank words when I posted my bone scan results. As you can see, everyone else is giving me the same happy horseshit, and I want to KNOW if I'm dying or not. My MRI results were even more thrilling, by the way. My doctor wants me in a wheelchair. I'm bummed.
Thank you for the appreciation. It is emotionally difficult to say the right thing. I do understand why most people shy away from facing the facts. They tell themselves they are protecting you but really they are protecting themselves. I think that doctors are often the worst offenders. That's why I felt I should stay with this group. Its easier to say hard words to people you don't really know, at a distance. It wasn't easy to say them to you, I care too much.
We had a lovely district nurse, 40ish, very experienced, very matter of fact and very supportive. She had near-infinite patience, and spent ages with us when necessary, well beyond the call of duty. She knew just what was going on, just from watching and accumulating evidence. "Yes, its in her liver now, you can see her eyes have gone a bit yellow." I would have fallen in love with her but she already has a young PhD scientist husband.
Tell me about the MRI. That is obviously going to be the basis of whatever prognosis you get/got. Wheelchairs get a bad press, they are wonderful because they mean freedom when otherwise you are completely grounded.
Today's post from Carolyn Herring is supportive, she is evidence that all is not lost, although she doesn't say how old she is, which is probably a crucial factor.
Technique
Coronal spin echo T1 weighted, coronal STIR heavily T2 weighted, axial spin echo T1 weighted, sagittal spin echo T1 weighted.
Findings
There is a metastatic focus involving the entirety of the intertrochanteric region at the right hip. It extends into the greater and lesser trochanters, as well. No involvement of the right femoral head or femoral shaft can be seen.
The left femoral head, neck and intertrochanteric region are intact. A small focus of metastatic disease is seen at the proximal femoral metaphysis.
Several small foci of high signal on T2 weighted sequence are seen distributed throughout the pelvis. One measuring 1 cm in diameter is seen at the right sacroila just at the sacroiliac joint, two others measuring 5 mm in diameter seen nearby. An 8 mm diameter metastactic focus is seen at the left sacromila, also near the sacroiliac joint. Several metastatic foci are seen at the S1 level. The largest of these measures up to 2 cm x 3 cm in diameter to the right of midline. A 2 cm diameter focus is seen to the left of midline.
Imaged portions of the soft tissues of the pelvis demonstrate no evidence for metastitic disease.
Impression
1. Metastatic disease to the right introchanteric region extending into the greater and lesser trochanter, also into the femoral neck. There is, however, no evidence for acute fracture.
2. Diffuse metastatic disease to the pelvis, mostly at the iliac bones, but also at the sacrum, as described. The ischia are relatively preserved. No significant metastases can be identified at the pubic bones.
This is as good as it gets. It really tells nothing that isotope scan and a diagnostic X-ray would not have shown. It shows mets confined to bones, with no significant structural failures. Certainly should be very vulnerable to X-ray therapy (radiotherapy).
So there you go. Is this bad, bad mets, or dealable-with-mets? And this is just the MRI of my hip. I expect more glory in tomorrow's head and spine MRI.
Well good luck. Good is small mets in intact bones. Bad is mets in soft tissue (inoperable), mets cutting through moving surfaces or significant fractures. The last two are the main sources of pain, and also of further spread of the disease. Irradiating the tumours while the bones are intact will prevent them destroying the bones and also prevent them metastasising further.

That would be good, I guess. I'm a little nervous about the radiation; I've heard it makes one extremely tired, and I'm alread so TIRED all the time I wonder if I'll ever be able to get vertical.
For the first time in my life I'm drinking a (small) cup of coffee in the morning. Hmm. Might have to increase the dosage.

Side effects are short-lived. The alternative is higher doses of permanent pain medications to enable you to get any part of you vertical, ( the analgesic will make you much more tired), and of course structural failures. I'd be more worried about the risk of collateral damage - inflammation of nearby soft tissues, nerve damage etc..
It takes about a month for the radiotherapy to take effect, then the pain from that source slowly fades away as the bone stabilises. It becomes a bit of a juggling act, finding new foci, getting them zapped and waiting for the bone to settle down before the next focus becomes a problem. It's best to only hit the ones that actually cause pain because that way you get the longest period of relief, the most bang for your radiation buck.
We got to the point of asking if we could book the x-ray therapy machine on a regular basis say once a month rather than wait until we had a target, then make an appointment and wait a couple of weeks for treatment. They wouldn't do that, but once we got the target list extended on the day of treatment, fortunately the new target was visible on the edge of an old diagnostic x-ray.

Queen Languidere

Dammit. I was hoping to be feeling like lifting large heavy boxes by Saturday.
So you now have the Grand Unified Theory of Catharine, and a new direction is taking shape.
Queen Languidere is now a lady of leisure. I'll miss the image of the lady of the pallet truck.

Now I have a sturdy black cane, which I am decorating with stick-on jewels. I wave it about imperiously. Does that help?

Lovely!

I need to whinge for a minute.
The surgeon was scheduled to implant a Port-A-Cath. I discovered, the morning of, that Port-A-Cath implantations are done under general anesthesia here in Washington, and I had to go home because I had driven myself and eaten breakfast. Okay, so we rescheduled it. I got sent home yesterday without it because I came in a taxi, and I needed to have a "real person" responsible for me. I'm furious. So poor David needs to come home early from work on Monday so he can pick me up. And none of this would be necessary if the doctors weren't wusses and didn't like having conscious patients! Argh.
Here you can't have a general at all as a day patient, at least you couldn't last time I had one. You have to be admitted overnight. I'd hate to see someone driving in the aftermath of a general anesthetic. Oh, I agree. Last time I had one it was hours before my blood pressure would pick itself up off the floor. I must say it seems a bit over the top doing a general for catheterisation. It's not as if it hurts much. It doesn't! Well, I mean, I'm sure it does, but a local anesthetic takes complete care of it for me AND I get to be charming and witty to the surgeon. That may be what he is afraid of. ;-}

Then again I don't have locals to have my teeth drilled either, I'm just an insensitive sort of bastard.

I'm a smug, dental-obsessed American. I don't need to have my teeth drilled. :)

They don't rot, they break. Although there are some problems remaining from childhood cavities and 1950s dental care. Most of those have long since fallen appart and been crowned. Last problem was I broke a crown off - the first one I had done, by a rather unsatisfactory dentist who I only had for a year. I quit eating muesli type breakfast cereals because they damaged my teeth (mixing chewy bits and hard bits means a high bite pressure coming down on something hard). I think I just eat too enthusiastically, although the dentist says most adults get more damage from chipping etc. than from decay, and that I also have a rather deep bite which means a lot of side forces on the tooth cusps.

My problem is I grind my teeth in my sleep. But I certainly do eat enthusiastically, too.

I'll ask my surgeon friend what the practice is here these days next time I see him.

Thanks. My surgeon friend in Honolulu is distantly outraged. But does that do me any good? No.
I talked to the surgeon this morning. He agrees that we would not use a general for this sort of procedure, indeed would discourage it unless the patient was very anxious etc.
He says we do sometimes do generals on day patients, for elective procedures anyway. I guess an implantation like this counts as an elective. Perhaps the problem is a general unwillingness of the doctors to communicate - they don't send out procedure information and they don't like having to talk to patients in theatre.

However they should have f...ing told you. Don't they send out a pre-treatment letter listing the dos and don'ts?

You know, "You are scheduled for treatment by Mr.A.Consultant (who you never actually meet, its always turns out to be Dr.Z.Registrar) at 13:30; report to the outpatients reception; do not eat or drink anything for eight hours before; If you are taking any medication please bring the packet; woffle woffle drone drone etc."

All I got was a card saying NPO from midnight on, which is actually not going to happen as my surgery is scheduled for 14:30. If I can't drink several large glasses of water upon waking I go mad, I tell you, mad. I think eight hours NPO is enough.

Is NPO the same as Nil-by-Mouth? If so, why turn up stuffed? Didn't take it seriously, thought you knew better maybe and that it was just an unecessary routine note sent to everyone regardless of procedure? It still shows they didn;t communicate their intentions very well.

Oh, I don't plan to. I understand why one must be empty perfectly well. However, I don't think that sixty or so ounces of water taken at 6:00 a.m. when I go under anesthesia at 2:30 p.m. will be a problem. It's not as though I'm going to eat anything.

I guess they think you're an old hand who doesn't need telling. It's probably worth raising a complaint about that - it must affect a lot of people and play havoc with the schedules.

I called all over the place and found out that this appears to be a regional variation; if it involves the heart, it's general anesthesia. When I had one placed in Honolulu, it took five minutes with local anesthesia. Then I got up and shopped the rest of the day. That's not gonna happen on Monday... Oh, man, I hate general anesthesia. Ick.

Yuk

I'm a little scatty today. First Taxotere treatment this afternoon. I've had a little infection somewhere deep in my port and have been feeling pretty crummy, and that crumminess has increased my fear of another chemo treatment by a factor of about 27. Though the oncology nurse SWEARS that weekly Taxotere will be NOTHING like every-three-weeks Adriamycin/Cytoxan. We will see. Please, please, please don't let me be nauseated.

I don't think it will be if its anything like Taxol, which I think is supposed to be harder. Lyudmila really had no nausea from it at all, allowing that she got a dose of Zofran with each infusion.
My oncologist gave me the most fucking patronizing talk I have ever had from a human being, pardon my Pidgin. He reminded me of the great oncologist whose name I have forgotten, who says, "I can tell who's going to survive the minute I walk into the office. Some people present with a 'don't hurt me' face. They're not gonna make it. Others present with a 'do whatever it takes' face. They will."

What an arse. What's survive anyway? Were all going to die, that's the only thing that is sure. Lyudmila presented as a hard bitch but she still died in 12 months. She was tough, and she always asked if she could have a higher dose to improve her chances. She didn't want to fuck around with it but hit it as hard as possible as soon as possible. But even a Tatar constitution conditioned by Siberian winters wasn't enough.
I said that it was likely that the first group had already been through chemo one time, and that in my view oncology would be well served by having each oncologist go through one round of something nasty just for grins and chuckles. Then we'll see who can put on a "do whatever it takes" face. Then I swept out rather grandly, an effect spoiled by stopping at the reception desk to share some birthday cake.

They're not all as bad as that one. I don't think I'd condemn them all to a shot of Adriamycin/Cytoxan out of hand. Some definitely though.
I guess it's better to be going into chemo slightly more angry than scared.
Sure. Best is to go in as healthy as you can get, the rest probably isn't important, but scared isn't going to help.

Nope. So I came home from radiation and cooked and ate a fried steak the size of my head, and now I'm going to go iron a dress so I look all purty.

The boy-wonder has finally departed for University again yesterday, only two days late, not bad (for him). He gave up trying to get back into Hull University. Hull is considered a rather pedestrian establishment, but as I have said he did not have good enough grades to actually enter a degree course there. So now he has transferred to a positively troglodytic college - Thames Valley University - which will allow him to start a course on his existing qualifications. He is doing Business with Finance, not because he is interested but because the entrance requirements are low. It is more likely Laziness without Finance, but we'll see. Can't you tell I don't approve? I admit this is better than retaking the 'foundation' year, but I fear he will come home with catastrophic debts again and little result. He has much less to live on this year, so the temptation to borrow beyond his means is even greater.
I remain optimistic. Maybe the opportunity to be Big Man On (troglodytic) Campus will be the making of him.
I wish. More likely he will find his level. It has achieved one thing, he phones my parents.

He was forced to, to borrow enough money to be able to pay the deposit on his digs. It took him three days to summon up the courage, but eventually he realised that I couldn't pay it (except by credit card borrowing, which I refused, especially as he never paid back the last debt) and no one else would lend him any more - he's already overlimit with the bank etc. So it was either getting on his knees or getting a job.

Do they want him to? And can they afford to "lend" him this money? I hope they know it's not likely they'll see it back...

Oh yes. The were always disappointed he never called them. And they are relatively wealthy and can easily afford it. We had a long discussion about whether it was a good idea in which I expressed my concerns about the probable black-hole effect. They consider it a gift to help him with his education. The money itself is not a problem, the question is whether it helps by enabling him to continue his education, or just puts off the day when he has to face economic realities.

Maybe they will be able to help only with educational expenses, and leave him on his own for everything else.

Thats the trouble with money, you can't control what it gets used for. We give him the money. He pays his fees. If he doesn't use the money to pay the fees then what.

So you can't have the school bills sent directly to you (or doting grandparents), bypassing feckless youth altogether?

Not that I know of. It is supposed to be his responsibility. Sometime he is going to have to learn to be responsible. I don't think that taking it out of his hands is really helpful in the long term. Either he learns to do it right or everyone gets tired of supporting him and lets him drop. I thinks its been made clear that this is really the last last chance, are you sure about that, really really sure, final decision, no doubts, OK.

I fear that there is still little sign that he has learnt to take responsibility for his spending, and that we will be faced with more debts next year. Sooner or later reality has to hit him in the face. I still hope it can be achieved without too much pain or permanent damage.

He was disappointed to find that this university was more like a school than a university. That isn't too surprising, it is one of the former further-education colleges that got promoted to university status in the last round of the Government's egalitarian policy of "Why should university education be free-issue, reserved for the intelligent? Everyone should have the opportunity to benefit from it and pay for it" A great step forward for political dogma and for the creation of a class of unskilled white collar thickies who are above getting their hands dirty. I'm sure this great country can afford such indulgences.

Why "we"? Is he over 18? Or is the age of majority in the UK 21?

He is indeed technically an adult and responsible for his own errors. However it wouldn't be much of a father who turned his back on his son and let him stew because he fucked up.

This is interesting. I and many of my friends paid for our own college educations. It seems as though kids in the UK tend not to do so. I'm sitting here just WISHING my dad paid for more of mine!

The idea is they are supposed to get a soft loan from the government, which they start to repay when their earniings go above some threshold level. However a means-tested contribution (up to about £1500pa) is expected from parents. The only trouble is it is calculated from the earnings the year BEFORE. So with Lyudmila falling ill and dying during last academic year, they seriously overestimated my means and put me on the max. It is theoretically possible to get it reassessed, but of course I didn't have time to jump through the necessary hoops.
The problem is that he didn't apply for this course until the last minute, after he finally realised that pretending nothing had gone wrong wasn't going to get him back in at Hull. So he won't get his loan for another few weeks, and needs support for that time, because of course he made no financial preparations whatever, and has used all his available credit.

We occasionally have discussions about the linkage between freedom of progeny from parental control and freedom of parents from responsibility for same.

Ah. And does he advocate the former without the latter? The little skunk.

Hmm.
Yes he's a lazy skunk too. When he got into difficulties last year I asked to see his bank statements, cheque stubs etc. He made the excuse that he had lost all these things when his wallet got stolen in Hull. Well obviously he was lying, he had a wallet not a handbag, to carry 6 months bank and credit card statements, a cheque book, a paying in book, all the receipts and invoices and so on, but I left it at that. He was too lazy to even cover his tracks. Now THAT'S laziness. One should at least make one's lies consistent. Today I was emptying the overflowing wastepaper bin in his room (now empty, after shipping his stuff to London), and found a pile of bank statements stuffed in it.
I've got another use for his room for a few weeks. The local college asked if I could help by accomodating a Russian exchange student for a few weeks this term. That's handy, a bit of native conversation to keep Natashas language up, another potential babysitter, and they pay me a pittance for it too. Just need to give it a good airing first, and shoot any socks skulking under the bed.

All good! Let's hope said student is pleasant and clean.

Hmm yes. My previous experiences of such visitors have been good, but you never know.

When he failed to pay his tuition fees last year the University were charging him something like £30 per MONTH in interest, that is about 40%pa. I could see it was going to come back to me one way or another sooner or later, so the best thing seemed to be to take over the debt and make a repayment agreement, so that at least the interest stopped. However he reneged on the agreement, and even at one point denied its existence (although he admitted it later).
My objective is to correct his world view to improve his chances of surviving in it. If I use too much stick, eg throwing him out, then I lose any influence. The stick also has to inflict pain without doing damage. Denying him education would do permanent damage. Whether what he is doing is any better education that he could get at work is a moot point, my parents are marginally in favour of the educational establishment, I am marginally in favour of industry. I don't mind yielding that point if they are paying. This is diplomacy again. One must not lose sight of the objective, and not cling dogmatically to strategies that failed to work. Rights don't really come into it.

C.R.A.P.

Another political whinge of the month. The pundits are banging on about state pensions. The recipients want the state retirement pension rate linked to average earnings. The taxpayers don't, because of the demographics. It will lead to a rapidly increasing tax burden. The flipside and current situation is a deteriorating state pension that will soon become worthless and pointless continuing. I don't understand why we can't heve a demographically determined retirement age, you know like the oldest 20% of the population get a wage-linked pension or something like that. That would be permanently sustainable.
Of course then Europe comes into play. Maybe Brussels would insist on a common retirement age across the Community. So it would place an increased burden on countries with a longer lived population. Well, they've dealt with that sort of thing before, with (eg) the Common Agricultural Policy (CAP) which passed subsidies around to normalise farm produce prices. But what politician would dare to propose, by analogy, a Common Retirement Age Policy? :-)
I don't either, especially as people are healthier longer now. The retirement age of 65 in the U.S. is a joke, as most people are now in late middle age at 65, and not physically ready to retire. However, the AARP (retired person's lobbying group) froths green at the mouth at any urge to make the retirement age 65.
So that means you get specimens like my father, who I love dearly, BTW. He just hit 65 this year. He is delighted. He runs three miles a day, fixes electronics for everyone on his block just for the joy of smelling solder, lives in a house that is paid for, and has combined pensions from his working life of $73,000 a year. Now that he is 65, he can dump the private insurance he's paying for and go on Medicare, and he gets a whopping $1300 a month from Social Security. I'm sorry, but much as I love him and wish him well, I don't think he needs those benefits, and I think they should go to someone else.
Aloha, Red Catharine.

Yes and there is still pressure for 'early retirement' here, although the practice is becoming frowned upon. Ageist recruitment policies, illegal in the US, are still rife here although awareness is increasing. The media are often commenting on how silly and undesireable it is, but there isn't really a debate because I have never heard one interview where anyone argued any defence at all for ageism. The employers are not all stupid, they must consider that the policy acts in their interest, and its only if their perceived losses are addressed that the problem will be solved. I think a letter to the BBC is in order here.
It is crazy that as long as I am self employed, I can't find enough time to do the work that comes to me without advertising, but if I tried to find full-time employment I would probably be considered past it.
I must admit I only really started this discussion for the punch line of the acronym.

How 'bout Yugoslavia!
Sounds like fun. How often have you wanted an excuse to set fire to a large government building. Fairly frequently -- I'm from Hawaii.

Nice to see a change of leadership, lets wait and see what that means. Its a damn complicated situation out there, and anyone who thinks that getting rid of one leader is going to make all the problems go away is living in dreamland. It's not every region that turns into a verb. ("Balkanization") On the other hand Milosovic was certainly a troublemaker. I'm a little surprised he didn't make a more violent stand, you know, drive tanks through the crowds or something heroic like that.

I think he is a classic bully and was probably hiding in a coat closet somewhere.

My ears are still ringing.
This is the aftermath of Natasha's 7th birthday party.
A dozen screaming kids running around the house for two hours.

Oh My God. At least we know you'll go straight to heaven; you've served your time in purgatory.

Are you sure there are no screaming kids in heaven. I mean, where do they go then, do they have their own private room in heaven, or do screaming kids automatically go to the other place.
This sort of question exercised me for some time a while ago, not what happens, I'm an atheist, but what the god-botherers believe about it. How to explain the church-school teachings to an intelligent seven year-old so that it makes sense. We had the heavenly mailbox concept: when you go to heaven with body parts missing are you made whole again, if so, do they keep the amputations there somewhere for later reattachment? Natasha pondered whether Mama had two breasts in heaven, and decided that everyone had a mailbox and all their bits, hair trimmings, nail clippings, Mama's breast, my right little fingertip (lost to an industrial transmission belt some years ago) all went to heaven early and were stored awaiting the soul's arrival.
The other thing was, the church teaches that if you aren't good you'll go to hell. Rubbish! How many people do YOU know who went to hell, at least by the church's consideration. Even politicians have nothing but compliments for an opponent once dead. I have never heard a priest say "Well we did what we could for him, but I'm afraid on balance the old bastard's probably not made it. The best we can hope for is a few millenia's roasting." It's always "Well he can rest in heaven now." Of all the people I have known who have died I have never once heard anyone postulate that the deceased might be in hell. The statistics just don't add up. Either they are lying when they threaten you or they are lying when they talk about you after you've gone. Both simply can't be true.
I pondered these matters with the vicar after the funeral. He was a nice guy, very intelligent and a former physicist, and was quite amused by the ideas. He was under no illusions as to the nature of religion. You might ask why an atheist needs a vicar at a funeral, but I can assure you there are very good and valid reasons.

As reform Jews, we do not believe in Heaven or Hell. When I asked my mommy what happened when my friend Tonya died, she said that Tonya is gone from earth forever and that's why we're all really sad. I said that Mrs. Modder (my first grade teacher) had said that Tonya was in Heaven. Mom said, "Well, do you remember when Ma'ai told you that her family said all haoles are rich? We talked then about how some people believe what we don't believe. We believe that as long as you remember Tonya, a little piece of her is alive in your head, but she's not really alive anywhere else."
Satisfied me then and continues to do so.

Sounds about the same as what we did. I explained that people believe different things about this but they don't really finally decide what they believe until they grow up. She understands that what I believe is different from what the school teachers believe. I think finds mine more coherent but theirs more comforting, and is happy to live in a world where both viewpoints exist and sees no real need to reconcile them or take sides.

At least that's it over for another year, except for one who is staying overnight, and one who's parents seem to have abandoned her here. I think they expect me to take her home when I've had enough. Maybe they hope I won't, I don't know, they have a small house and a lot of kids.
Typically the surgeon's kids treated us to an anatomy lesson - every sentence contained 'willy' or 'penis'. How enCHANting. Ah, children... the little fairy people. They're almost as hyperactive as their dad. He's one of those that keep a 4wd and go offroading at weekends.
The hard part wasn't living in an ear-defender zone, or ensuring that the bullies got to beat up the other bullies (and protecting the professional victims), but clearing up the toys in the living room beforehand. We started at the shallow end and worked our way to the deep end. The carpet was blinking in the unaccustomed daylight. We filled a binliner with toys that were broken or no longer wanted.
That and an evening spent wrapping parcels: about 16 layers for pass-the-parcel and 15 small toys for prizes and so on. And a day off work for cooking and shopping. I made a 'bran tub' with polystyrene beads and a large cardboard carton from my workshop. Right now the three girls are taking turns to jump into it.

FYI, these are NOT American birthday traditions. I know what they are, but they still sound weird.

Well the bran-tub isn't a tradition either, but it seemed like a good idea. It is a tradition to have games and give out little prizes to the winners, and somehow make sure everyone gets something. I thought it would simplify things if winners got sent to pick out of the tub, then at the end everyone who hadn't won anything got a dip, then a free-for-all for anything left. That way I could cover for an uncertain number of participants.
Taking an example from the commercial organisations I kept the party down to two hours. That meant I didn't have to organise too many games. After taking away time for eating and for general running about screaming, terrorising the cat and such like, pinning-the-tail-on-the-donkey and pass-the-parcel was about enough to fill the time.

They just found an unexploded parcel at the bottom.
OK - Finally disposed of the surplus child - yes I had to get all three dressed and into the van to take this one home. They just don't think about the fact that I don't have someone to leave in charge of the kids.
Now they are playing vampires: kind of cute since the friend has a Transsylvanian grandmother, although I don't think that occurred to them. Her mother occasionally complains jokingly about her blood-sucking in-laws.
Did you ever read any of those Terry Pratchett "Discworld" 'novels'. He has a series set in Uberwald, which I eventually realised was a literal translation of Transsylvania from Latin (or Romanian) to German.
We don't do parties at home every year, sometimes we take advantage of the of-the-shelf job at the local steak-house. Thats what most of the kids get most of the time, and quite like, but Natasha specifically asked for an at-home party this year, and generally they say it is more fun. Of course. No interfering waitresses. When I feel it is too much hard work I think about the £100 or so I am saving (and still think it's hard work).
The girls just invaded the office. My god, they are playing 'maternity ward' now. "Deep breaths!" "Push!" "Wah Wah!" "Its a girl." Where do they get these games from? Now they are doing a breech birth! I imagine they'll be doing cesareans on their dolls next. Barbie with bikini line scar? IVF anyone?

Now, if they were small indigenous children living in, say Darkest Africa, one could say they were practicing rite-de-passage rituals and papers would be written about it.
Yes it did occur to me. Last night we had finished clearing up and earlier visitors had left. I was doing some ironing and Natasha was sitting in a corner doing something with her Pokémon cards, and my mind suddenly threw up an overlay of an equivalent stone-age scene. The only real difference is the 'props' thanks to mass production, the human activities don't change much.
I told the friend's mother about the maternity game. She was startled but then explained that her daughter had recently been asking about 'where babies come from' and had been given some straightforward and fairly detailed answers. She felt that in common with most of our generation she had not had anything like adequate explanation from her parents, and wanted to avoid that trap. Fair enough, I always answer Natasha's questions like that.