Wednesday, October 9, 2019

My Adventures in Pain and Life - 2019

My hideously ugly back. Now with railroad tracks.
CAUTION: Sue and I are "tag teamers' in raising our kids, work around the house, our law firm etc. If one of us is good at it, the other person does something else. This is the case here. I was struggling through some fairly brutal experiences in pain, trying to keep my wits about me and survive. Sue took on all the doctors and nurses and medications and treatments. As a first notch lawyer, Sue's legal skills matched perfectly with her skill as an advocate to monitor the medical treatment I received. As such, I may have gotten some minor details below wrong - in fact I'm sure of it. Take everything below with AT LEAST a small grain of salt. Note also that I intentionally left many horrific details of this story out, so you are not getting short-changed either!

During this whole ordeal, Sue spent almost every night in my hospital room. On many nights, I would have her sleep in my hospital bed for a few hours while I sat up in a chair, then we switched and she spent the rest of the night sitting in the uncomfortable folding chair next to the bed while I tried to sleep in the hospital bed. Yes, the intensive care does not want spouses sleeping there, as no bed or even a comfortable chair was ever an option for us. I'm sure Sue was even more tired than me through this whole ordeal - she sure looked that way!

In fact, assuming that at some point I am "cured", I do not want to remember any of these horrific and painful experiences. Sadly, Sue may not be able to say good bye to them as efficiently as I will be. I cannot imagine what it must have been like to be told that your husband was likely to die right in front of your eyes. The first 2 times it happened, they just told me that I was likely to die "today". The next two times, the doctors looked us in the eye, and said there was only a small chance (20% if I recall correctly) that I would be alive tomorrow. Sue insists that same conversation also occurred a 3rd time on 9/26/2019, my 60th birthday, though I do not remember that one (Happy Birthday to me - maybe they slipped me some morphine or something so I wouldn't remember?).
The mountain bike ride that started it all. ABOVE: This is a photo of my friend on the mountain bike ride on the very day in the Irish Hills of SLO where I crashed (flew right over the handle bars - because unbeknownst to me, all the air had leaked out of my front shock), and the doctors believed the infected cut on my elbow got the staff infection started in my bloodstream, which necessitated my emergency back surgery, and started my "6 weeks of Adventures in Pain". From now on, I will buy and wear elbow pads when I mountain bike ride. F*** that staff infection.

INTRODUCTION: I'll confess. I spent most of the last 6 weeks in the hospital (back and forth between Sierra and French) with 2 of those weeks in intensive care. The medical staff indicated too many times to count that I might not make it through the day.

In my blood test today 10/8/2019, my hemoglobin shot up from 7 to a 10, which is HUGE, and in my joy, I decided to let the story out onto FB, where I still had many friends left to inform of this alternate world which I lived in for 6 weeks.

Anyways, looks like I may live. Thank G*D. New lease on life. Lost 25 pounds in the process, which I'll take. Thanks for everyone's support which I can NEVER repay. Larger-than-life thanks to my wife Sue and Dr. Ron, as well as the 100's of plasma donors across the country, plus the amazing doctors and nurses who diligently kept me alive at all hours of the day and night. Its not over yet, but its going in the right direction. BTW, I am now at home - no more hospitals for me!
Thanks to everyone in advance for your kind words, assuming you are glad I'm still alive. MY LONG AND WINDING MEDICAL ROAD: The pharmacist appeared to completely miss an undetected contraindication between 2 medications I was taking (never take these 2 medications together if you want to live). I always thought the pharmacists were supposed to catch these things, but we may have just signed the thing where we declined to be counseled - I just have no idea. The new prescription occurred about 1 month before my Adventures in Pain began. The culprits? Zoloft (depression medication) and Imitrex (migraine medication). Their combination created "heart attack" like symptoms that caused me to go to the ER at French (specializing in their coronary treatment center) several times with what appeared to be a massive heart attack. Nope. The contraindication of the 2 medications created massive chest pains, and profuse sweating, but no heart attack (you could have fooled me). A stress test brought my heart beat to the max for my age (162 beats per minutes) and imaging showed a flawless heart function with no blockages whatsoever - good news. Still scared the F out of me.
A few days later, I had an emerging back pain that turned excruciating over the next few days, and required me to be put under to deal with the uncontainable pain. The 2 best back surgeons in SLO county determined that I had a staff infection in my spine, and performed emergency back surgery to save my life (in the middle of the night). They told the staff that nobody was going home tonight, and that they had to operate on me now because I would be dead tomorrow. The back surgeons had to crack open every infected vertebra in my spine, and flush out the staff infection, performing a laminectormy on each one. The doctor noted that I have massive vertebra that required the largest spinal bone tools in their arsenal. While they were in there, they performed spinal stenosis treatment on my lower lumber L1-L5, and for that I was grateful. I no longer have any lower back pain whatsoever. Yay! A twofer there. Due to the extensive nature of the surgery, I stayed at Sierra Vista hospital for 9 days in recovery from my back surgery (see photo of beautiful new scar - I converted the image to black and white because the photo was so hideous). Turns out my "Adventures in Pain" was just beginning. While at Sierra Vista, I had a "PIC LINE" installed in my right arm in order for Sue to give my an anti-biotic IV drip 3 times a day at home to combat the staff inspection, and I finally got to go home after 9 days of fun at Sierra Vista Hospital. For the first week, the staff infection anti-biotic appeared to be working against the infection, and I experienced a slow and painful but steady recovery. Until I didn't. Apparently, the antibiotic that was doing such a great job on the staff infection, within the course of 4 or 5 days, turned on me and destroyed all my internal organs, causing my kidney and liver to fail. In addition, my red blood cells and white blood cells dropped to zero, my hemoglobin dropped to zero, and my platelets went from 300 to 4 in a matter of days. This is what death looks like, several of the doctors all told me. Thank G*D for our dear friend and local SLO General Practitioner and dear friend, who we reached out to during this crisis when our other doctors would not take our phone calls. She took immediate action, gave me a blood test, and at 11pm at night got the test back, told me I was about to die and we should go immediately to the Emergency Room. We went to Sierra Vista because they had all my lab data from my recent back surgery (we should have gone directly to French Hospital, as it turns out - what do we know?).

We may really know for sure what precipitated what. By this time, too many things were crashing all at once to understand all the interactions. As an example, when I was dropped into the Sierra Vista ER in the middle of the night after I was told that I was about to die, the staff took 17 samples of my blood from my left forearm in the first hour I was there (I had the PICC line in my right arm so that could not be used for clean blood samples). They wanted 17 separate "sticks" from 17 separate sources, so they could get accurate blood samples for the blood tests. How is it that there were 17 different things in my blood to test - I have no idea!
In the middle of that night Sierra Vista called French Hospital, and told them to get their their dialysis team out of bed and into the hospital immediately, as I was about to die without an immediate concentrated red blood cell dump, and plasma infusion. They initially wanted to wait until the next day, and I overheard the folks at Sierra screaming that was not an option, and to get on the phone and get your team into the hospital now. To their credit, they did. It turned out that getting enough plasma for a transfusion took several hours, as it had to be collected from storage around the county and the state. They installed a type of PIC line that went from my shoulder and into my carotid artery and directly into my heart. My first transfusion started at about 4am, lasted five hours, and saved my life.

French Hospital has special transfusion equipment that, thanks to the amazing, committed, and skilled transfusion team of Lee, Ben, and Mike, as well as my dedicated nurse for that evening, Ryan. I LOVE YOU GUYS - YOU DID AMAZING WORK WITH GREAT HUMOR AND COMFORT - I WISH YOU WERE MY FRIENDS FOR LIFE, BECAUSE I OWE YOU MY LIFE. In fact, by the time Ben had finished my first plasma transfusion, he was well past 24 hours into his shift - far beyond the call of duty, IMHO. He humbly shrugged it off. Turns out that night was the first of 9 days of transfusions, which were long, painful, and unpleasant in more ways than I can count. Profuse shaking, insane red rash over my entire body and a bit of psychological torture as well. A 6 inch pile of blankets over my body did not diminish the shaking one iota. The process consisted of pumping all the liquid out of my body, removing all the "bad" plasma from my blood and throwing it away, and inserting the plasma from dozens of anonymous donors into my body - like a night of Dawn of the Dead. Each transfusion consisted of me receiving 4.5 to 7 liters of the plasma from strangers who cared enough to donate so that people like me would live. Amazing. I owe these plasma donors a debt of gratitude that I will never be able to pay back, but I will try. You my friends, will be hit up by me for plasma donations for the rest of my natural life - no complaining please. I will make it my personal life's goal that the next person that needs plasma like me or they will die is DAMN WELL GOING TO GET IT - JUST LIKE I DID. This, my friends, is what makes America great. We care about each other, even though we don't even know the people we are saving.
ABOVE: In intensive care, you have your own private room, and at French that means you can have your dog for company. Go figure. Theo spent the better part of 3 days with me. Then I dispatched him home, the the IC is a miserable place for dogs as well as humans.

During 2 weeks in Intensive Care at French Hospital, we tapped out all of the plasma in California in my first 3 infusions, and the subsequent 6 infusions were done with plasma first collected from the western United States, and by the end, we were receiving Plasma from the east coast, including New Jersey in one instance. One night it looked like I would miss my treatment, until we got an airlift of plasma at 8pm that apparently came in from the Airport. That was long night of fun! Am I grateful for these anonymous donors - you bet I am!

During each day at French Hospital, the dedicated team or nurses and doctors were huddling every day in my room, trying to figure out how to keep me alive for another day. We described it like a game of JENGA - you have to pull the pieces out in the right order or the tower (that's me) collapses. The doctors were calling on their colleagues all around the state and country to get advise for how to proceed with the medical conditions I had that THAT THEY HAD NEVER SEEN IN THIS COMBINATION BEFORE - they had never had so many organ, tissue, and blood poisoning failures all at the same time.

The French Hospital staff doctors commitment was complete. I can't tell you how many times, in the middle of the night, my hematologist, or infectious dissease specialist, or hospitogist or other doctors that were working my case or even doctors we had never even met or heard of before - would wander into my room, and start to discuss new ideas they were considering for treating the many conditions that were all wrong in me at the same time. Bizarrely, sometimes they were examining me into the early hours of the morning.
ABOVE: Man's best friend.

On 5 separate days (Sue believes), I was told I was unlikely to live to the next day. The doctors believed the only reason I did not die was because I happened to be very fit. I was in the middle of "balls to the wall" training for another shot at the Lonesome Miner Trail / Beverage Death March backpack in the Inyo Mountains in November 2019 (5,000 feet of elevation gain on average per day for a week, including 2 days over 6,000 feet of elevation gain with full packs), plus a 2 week diving and hiking trip to Catalina on our boat, plus a week with my dive buddies for my 60th birthday to the Turks and Caicos. All cancelled, of course. But I was swimming with Scuba fins at the pool, breath-hold diving at Kennedy Salt Water pool, mountain biking, weight lifting, and hustling a 60 pound pack up Bishop Peak. All good survival conditions for me, apparently. As an interesting side note, I got to spend my 60th birthday in intensive care (September 26, 1959), as well as our 31st anniversary, also in intensive care (October 2, 1988). Some fun. Not much of a celebration - we barely noted it, though the nursing staffing kindly helped us celebrate. A special note to my wife Sue, who stayed on top of every aspect of my treatment, and never let any of the doctors off the hook, or slip into ambiguity (or move on to other patients, not that they were going to). Her legal skills served her well, as she brilliantly researched and understood every aspect of my treatment (which I STILL don't understand, and don't really want to!). Several times, the doctors curtly inquired about her medical background, as she kept up with them in every aspect of every twist and turn the strategy of my treatment. In each case, she coyly replied that she read it on the internet (I don't think they were pleased with that answer, but I laughed quietly to myself every time!). Our lifelong friend and pediatric oncologist Dr. Ron was in Washington DC on the other end of our cell phone, available at a moments notice to keep up with my diagnosis and treatment. Some people are just brilliant, and having them in your court is no small miracle. Every time we called Dr. Ron, he dropped what he was doing, sometimes for hours, and analyzed my case, spending hours looking at our various test results, consulting with his brilliant fellow medical researchers in DC, and sending back his recommendations. In all cases, Dr. Ron's recommendations were spot on and eventually adopted by the hospital staff as the "final decision" for that hour or that day. Sue would coyly float Ron's suggestions to the staff doctors (never revealing that we were getting fed this information from another Doctor on the east coast), and they would slowly over the course of a few hours come to a consensus and in all cases adopted Dr. Rons hours earlier recommendations during the critical first few days of my treatment. My favorite quote of this ordeal. When we thanked Ron profusely for his commitment to my case, he replied: "I WANT TO KEEP MY FRIEND TIM ALIVE". Oh to be someone who can save lives - I wonder what that feels like. This statement humbles me and makes me cry - now I know how the homeless people feel when somebody cares about them when they could just "move on" (I don't have the highest self esteem!). Ron is so humble and will never take credit for any of this, but I am quite sure I would not be alive today without him and his massive medical brain that kept me alive. Its good to know that there are people out there that are so much smarter than me (Sue's smarter than me and could probably even give Dr. Ron a run for his money!).

MORE FUN: During the middle of my transfusion period, I appeared to have a stroke. That's certainly what I thought it was, and what the medical staff thought it was. But after much brain testing and scanning, it was determined not to be a stroke, but something VERY similar in appearance (Sue knows what it is called - I'm happy to just know that it was not a stroke!). For about 3 days, my pseudo-stroke symptoms consisted of not being able to speak, read, type, write, email, or watch TV (due to my eyesight going to shit all at once). Yes, that was a little disturbing too. I am still suffering from some of the cognitive disfunction of this condition, though they tell me this "should" resolve itself as well.

After 9 days of infusions, I was moved out of intensive care and was moved into in a regular hospital room for observation before release. I had the random surprise honor of sharing a room with longtime friend Ed T., who is having his own medical challenges. We pray daily for Ed and his wonderful family that he find solutions to his current medical conditions. We shared a room for 4 days with Ed, and Sue and I went to great lengths to be there for Ed at all hours of the day and night, as by then he was having an even harder time than I was. During this period, I was tested every day for 3 or 4 days to make sure my blood test results stabilized before they sent me home.

I'm not out of the woods yet. I am still on new and different antibiotics (and the fear that they could turn on me again!), as well as a massive host of drugs that I would rather not be taking. After departure from the hospital, we insisted on comprehensive monitoring, and I am getting a daily blood test for the next month, so we can detect another crash before it begins to kill me. As I started this post, I can gleefully report that my hemoglobin fortuitously skyrocketed from level 7 to level 10.2 on 10/8/2019 (level 11 is normal for me) in 1 day, so I am hopeful.

My other numbers are in the low end of "normal" range, although we know my normal range is about double what they are now. Example: normally (prior to this medical disaster), my platelet count is around 300. Right now my platelet count is about 150, which is in a normal range for an average person, just not for me. Praying that over the next few months, my blood test results revert to my normal range, so that I can go back to "normal activities" - time will tell.

By the way, this experience changed me in fundamental ways, definitely for the better, and hopefully for the rest of my life. I describe it as a "greater clarity of thought and a purity of purpose" than I had before, and I hope it lasts for the rest of my lifetime. I'm sure it comes as no surprise that I am grateful for the support of so many people, who I found out believe in me, and somehow think I am somebody special (I'm too humble to think such things - I'm not special). God-affirming thanks to the Mission SLO Docents who provided so much spiritual support to me throughout this ordeal, and whom I cannot thank enough. Plus, my special friends, and you know who you are. Nobody towers above my wife Sue, who I have no doubt was the ultimate power for keeping me alive. Somehow, she didn't crack, watching multiple times when she expected that I would die in front of her eyes.

Interestingly, while on the verge of death, I never panicked, I never felt sad, I just looked death in the face with a bit of amusement. I figured if it was my time to go, I had 60 good years (exactly, as it turns out), though I wanted more, of course (looks like I'll get some more). Where did I find such courage? It didn't come from within me that's for sure. I felt ready to meet death because I had my wife Sue, the love of my life (MRFL), continuously by my side, as she has been since we met when she was 19 years old as a student government rep and Poly Sci major at UCLA so long ago. We have been through so much together, and we continue to be as one forever.

Tim out. Note that I have left out most of the medical jargon of my condition and treatment. I'll leave it to my doctors to write up the technical report on this one-in-a-million (their words) combination of medical conditions that they rose to the challenge to treat and keep me alive.

Monday, October 7, 2019

Final Build: 2006 Dodge Cummins 2500 G56 6 Speed Manual Transmission Standard Cab Long Bed



Its time to finish my truck! Enough already. I contacted James at Poly Performance https://www.polyperformance.com so we could team up to finish my truck. I'll be documenting everything, and will be sparing no reasonable expense.

Thanks to Tom B. for getting my truck this far. The truck is roughly half way done. I'm a lousy mechanic, but Tom is a great one, so everything done so far is rock solid. Here's what has already been done.
ALREADY INSTALLED AND WORKING
- White Knuckle Rock Sliders
- Set of 4 Carli Ball Joints installed on all 4 Corners ($200 each!)
- Steering box brace, new tie rod and drag link
- Tuned King Shocks
- Firestone Rear Air Bag (No Leaf Springs) Suspension
- Aluminess Front Bumper with LED Lighting
- 2 inch Hitch Receiver front and Rear for Removable Winch
- Cargo Bed Compressor
- Hill Billy Rear Bed Sleeping Platform
- 8 Carbon Fiber Switches in Overhead for Controlling All Functions

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PHASE 1: LOCOMOTION

James and I decided to start with the power train. My truck is totally stock: 5.9L High Output Cummins 325 horse power and 610 foot pounds of torque. Engine upgrades will only be to increase miles per gallon and marginal increase in power.

Here are the generic upgrades. James and his crew will pick the components that will make this happen:
- Tuner / Programmer with integrated back up camera display
- EGT and complete complement of gauges
- Air Intake System / Perhaps even a snorkel to breath less dusty air.
- RAM Air Intake system
- "Cat Back" Exhaust System and tame Catalytic Converter, perhaps.

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EXHAUST BRAKE
- Exhaust Braking 101
For those who are not familiar with exhaust brakes, the principle is very simple: Restrict the engine’s exhaust flow downstream from the turbo when the throttle is lifted so the increased backpressure works against the engine, slowing it down. It’s a great secondary braking system for trucks that tow or haul heavy loads, and it functions by hydraulically opening the exhaust valves, releasing compression during the engine’s power stroke. (They’re also known as Jacobsen “Jake” brakes, the devices you hear used in big rigs.)
An exhaust brake is just a valve in the exhaust system that partially closes when the throttle is lifted. If the exhaust is completely blocked off, some serious braking will happen. But, at the same time, the pressure that builds upstream (which can reach 60 psi) will either explode the exhaust system or do serious damage to the engine.
To ensure those types of issues don’t occur, exhaust brakes like BD’s universal device can be adjusted to limit backpressure so as to not exceed the engine builder’s specifications: The Power Stroke should not exceed 40 psi, Cummins 60 psi, and Duramax 55 psi.
- Banks Exhaust Brake for Manual Transmissions
https://s3.amazonaws.com/assets.bankspower.com/sdc/manual/97232_dodgeexhaustbrakesystem_v4.pdf

BD Diesel Performance
Sumas, WA 98295
800-887-5030
www.dieselperformance.com
https://www.dieselpowerproducts.com/c-169-20045-07-59l-dodge-cummins-exhaust-brakes-bd-pacbrake-and-banks.aspx

Dunks Performance
541-726-1006
http://dunksperformance.com/

http://www.trucktrend.com/how-to/towing/1703-how-to-install-a-bd-diesel-exhaust-brake
- Manual Transmission Exhaust Brake https://www.bankspower.com/i-299-banks-brake-exhaust-braking-system-for-2006-2007-dodge-ram-2500-3500-5-9l-cummins-manual-transmission.html

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REAR BUMPER
James found this rear Mercenary Offroad bumper.
https://mercenaryoffroad.com/components/bumpers/dodge-bumpers/rear-high-clearance-3rd.html
I love having the exhaust go through the bumper. I'm tired of flattening my exhaust tip every time I go wheeling. We will look and see if we can make this bumper work. Time will tell. Its not cheap at $2,500!!!!

https://realtruck.com/p/fab-fours-premium-rear-bumper/v/dodge/ram-2500/2008/



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MISC ITEMS
- Upgrade trailer brake controller (the manual control knob recently broke off of it).
- Fabricate storage in the tail gate for straps and recovery gear. The Dodge has a HUGE tail gate that is full of "Unused Air". Would love to have a storage panel for all that "Rescue and Recovery" Gear!
- Winch mounted on 2" hitch receiver. Found this 15,000 capacity mount for only $53.00!
Goplus 10" x 4 1/2" Cradle Winch Mounting Plate, 15000 Lb Capacity Foldable Winch Mount Recovery Winches $53.00 on Amazon

- Bushwacker Fender Flares 
https://realtruck.com/p/bushwacker-pocket-style-fender-flares/v/dodge/ram-2500/2006/

These on Amazon are only $177 for a set of 4!

Wednesday, August 14, 2019

UCSB Anthropology Dig at Mission La Purisima Concepcion's Indian Apartments

This article appeared in the publication "Las Noticias", the newsletter for the docents of Mission La Purisima Concepcion de Maria Santisima. http://www.lapurisimamission.org

Also, check out this KEYT Coverage of Kaitlin Brown's dig at La Purisima Concepcion by clicking here.

By Tim Waag

Because of the long drive from San Luis Obispo (where I live) to La Purisima, I often bring my mountain bike and go for a ride after my docent duties are done for the day. The July 20, 2019, “Children’s Mission Life Days” was just such a day. Heading out for a quick ride before the park closed, I came upon PhD Candidate Kaitlin Brown and her anthropology crew literally up to their necks in an archaeological dig!  They all looked rather busy, but I was so excited I couldn’t resist – I identified myself as a docent, and began a barrage of polite questions to anyone who was willing to talk to me.
PHOTO: UCSB student Angelina Sanchez, find happiness digging through history.

Kaitlyn and her crew of 12 UCSB undergraduate students gave me a briefing on the field work they were performing before my very own eyes. I was hoping for an interview with Kate right then and there for an article in Las Noticias – but clearly, there was way too much going on for her to step away for even a minute! It turns out that Kate was finishing one of only six days of excavation and exploration she would have at this site. She gave me her card, and I was able to catch up with her later to fill in the information I needed for this article.
PHOTO: Lots of frenzied activity at the dig site.

While at the excavation that day, I quickly gathered some photos. Kate informed me that her work required digging through about 4 feet of “fill” used to cover up the site after its most recent excavation in the 1960’s. The site is believed to be the location of a 10 unit apartment building for “married Indian families”, each unit with 2 rooms. Records indicated that a 7 square meter section of Apartment Unit No. 8 had not previously been examined. Using her mapping and siting skills, her team was able to accurately identify the untouched 7 meter area on their first try – amazing!
PHOTO: 1883 drawing of the Mission La Purisima site. The building underscored in red may be the "Indian Apartment Dwelling" being excavated.

As a PhD candidate, Kate has spent 90% of the time on her project examining archives and artifact collections. Her excavation was minimally intrusive, and selectively identified and examined 6 distinct “units” of the site (doorway, interior, “backyard” area, “frontyard” area, etc.). These “units” only covered about 25% of the 7 square meter area, leaving the majority of her site untouched for future scholars to explore.

PHOTO: Building No. 102 in red is identified in the 1938 Civilian Conservation Corp map as the "Infirmary", but is believed to be Indian Dwelling Units instead.


As part of her preparation for site work, she forged relationships with the local Indian authorities, presented her plans, and modified them with suggestions she received. She understands that our history is an ongoing continuum of life itself, and that we are all connected to the events of the mission era in ways that continue to influence us today.
PHOTO: Yes, you get to sift through all the dirt!

Kate insisted that a paid tribal monitor be present for every day they were excavating, even though that may not have been required. She invited the Chumash to be present and participate, and that goal was achieved with the participation of a Chumash youth group. As one would expect from an unexplored site, interesting artifacts populated the small area she examined, including but not limited to: abalone shells, large pestle and grinding stone, glass (Spanish) beads, shell (Indian) beads, and various expected detritus. What was unexpected was the discovery of a musket ball in the floor — an artifact whose significance is unclear at this time.
PHOTO: Small exploration footprint. Angelina is still down in the excavation pit!


Finally, Kate indicated the desire for a unique, thoughtful and detailed public interpretive display of this Indian dwelling site — something our docents should be excited to see when it becomes available. Many believe that the public would benefit from a more complete American Indian perspective of the mission era, and filling that need at this married Indian family apartment would be a laudable achievement.

Wednesday, August 7, 2019

2019 Homeless Count for the County of San Luis Obispo, California


All photos are copyright 2019 Tim Waag and taken during the January 28, 2019 SLO Point in Time survey.

All charts and text graphics are from the SLO County Homeless Census & Survey - Comprehensive Report 2019. A PDF of this report is available at: 


https://www.slocounty.ca.gov/getattachment/f1b2caef-10c6-4415-b0ad-1396eeb97a0b/2019-Homeless-Census-Survey-Report.aspx 

I highly recommend that you download it and read it - though at 56 pages long, it is quite a tedious read - part of the reason I am breaking it down for you here. 

Click on any images to enlarge and read. Start by clicking on this one, which provides some critical information on the survey's tendency to "undercount".

INTRODUCTION: Every 2 years, every county in America counts their homeless population, in a sweeping action known as the "Homeless Blitz Count"! In SLO County, that took place on January 28, 2019, from roughly 6am to 10am.

I was again a participant in the 2019 count. I was teamed up with 2 homeless people and 1 other homeless advocate like myself. Together, our team covered one of the most challenging and dangerous areas for counting the homeless. This area includes a popular homeless haunt known as "The Circle", plus the bottom of San Luis Obispo Creek in an overgrown jungle-like area between Prado Road and Los Osos Valley Road along Higuera and west to the Freeway. This survey area also included the Sewer Treatment Plant, the Strawberry Fields, the Catholic Cemetery, the San Luis Cemetery and the Elks Lodge.

A photo of our "high performance" team is shown below (GREAT job, guys - truly an honor to be part of our team):
In August 2019, a report on the so-called Point-In-Time (PIT) count came out, with a link to the entire 56-page report (above). This post summarizes some of the more important data points in the report, from my perspective as a long time homeless advocate. As necessary, I'll include snippets from the report that support a disturbing trend or statistics.

THE YOUNG AND THE OLD: The observations and data points of the report have been divided into a homeless "youth" population (age 25 and below), contrasted with plain old homeless "adults" (over 25 years of age). It was reported that these 2 groups seldom overlap in location or interaction, so they were counted using different methodologies for purposes of this census. You can read the details in the "PIT Report".

FOLLOW-UP SURVEY: Following the all-in-one-day PIT count, which identified about 1,500 homeless people in SLO County (an increase of 32% from 2 years ago), there was a separate "in-depth" post-census survey of 481 homeless people on the street, to extract details about the nature of homelessness in SLO County.

FOUR SUBCATEGORIES: Four homeless subdivisions were given special attention in the report: 
(1) Chronically Homeless; 
(2) Homeless Military Veterans; 
(3) Homeless Families with Children; 
(4) Homeless "Youth" (age 25 and under). 
Separate statistics and data points are given for these 4 subcategories. Since my interest is focused primarily (though not exclusively) on the Chronically Homeless, I will leave it to you to read the report if you are interested in the other 3 groups.

CONFUSION FACTOR: One aspect of the report's structure initially confused me, as it distinguishes between "Government Assistance" (GA) - also known as "benefits" - and "Services Currently Accessing" (SCA). Upon further scrutiny, it became clear that GA consists of Food Stamps, Medical / Medicare, General Assistance / Relief (whatever that is), SSI / SSDI Disability, etc., whereas SCA are provided by the community generally through nonprofits (often funded in whole or part by the government), and consist of homeless support services provided by nonprofits such as ECHO, Food Bank, Shower the People, People's Kitchen, Prado Day Center, T-MHA, etc.
DEFINITE UNDERCOUNT: The PIT Report underscores what we all intuitively know: by definition, the survey undercounted the homeless. By its very nature, the PIT count is only an estimate, and given the hidden nature of the homeless population, an undercount almost certainly occurred.

From here on out, I'll give my "play-by-play" on the report, noting unusual, surprising or illuminating results, citing the page number in the report so you can access it for additional information.

Page 8 "Sexual Orientation": 22% of respondents identified their Sexual Orientation as being "not straight" (bisexual, gay, lesbian or "other"), leaving 78% self-identifying as "straight". This number is far higher than the population at large. This is a concerning though not unexpected statistic, and should be considered in efforts to prevent those at risk from becoming homeless. I will be taking that number into account when I interact with the homeless in the future.
Page 8 "Employment": Also on page 8 were employment statistics, but I found them to be misleading and / or confusing (I'm not sure which! - stay tuned for clarification from the "powers that be"). There are really 3 categories when understanding homeless employment numbers: 
(1) Employed; 
(2) Unemployed but looking for work; 
(3) Not looking for work, which could be due to being UNABLE to work. 
I COULD BE WRONG, but these 3 categories should add up to 100%.

Based on the report, here are the numbers that may be correct (note: I will be looking for clarification from the report writers on this point):
(1) 3% Full-time employment
(2) 29% Unemployed but looking for work
(3) 70% Either not looking for work or unable to work
Yes, this does not add up to 100%! Additionally, the report says that 9% were part-time or seasonably employed - not sure where this 9% category should reside, either. Let's just say I'm confused. I'm pretty confident in stating that 3% of the homeless surveyed work full time, which is a lower number than I expected. However, when you add back in the 9%, you get to 12% employed full or part-time.

Not surprisingly, while living on the streets, creek beds, or at the homeless shelter, it is difficult to hold a job of any kind, or pursue higher education, for a variety of obvious reasons. Given this fact, 12% is a higher employment rate than I would expect.

Page 12: There are 2 major shelters in SLO County: "40 Prado" in San Luis Obispo, and "ECHO" in Atascadero. In those 2 areas, a large percentage of homeless are in shelters, which is better than living out in the open. In the other areas, the majority are living on the street, as shown in this graphic. Clearly, PASO ROBLES IS IN DESPERATE NEED OF AN EMERGENCY SHELTER.
Page 13 "Homeless by Sleeping Accommodation": For those interested, these statistics related to "where the homeless rest their heads at night". No surprises here, except for how well spread out the homeless are, hiding "in plain sight" all over the place. They live in every nook and cranny of space available to them, from vehicles to overpasses to abandoned buildings.

I was surprised to see such a high percentage of homeless sleeping in their vehicles. I've observed that the homeless struggle keep their motor vehicles operational, plus coming up with the cash to maintain their registration and insurance. Getting ticket repeatedly by law enforcement does not help this "Car / Van / RV" group (isn't a Van a Car?) preserve their mobile shelters in full compliance with the law.

OUTREACH NOTE: In doing homeless outreach, approaching a vehicle that appears to be occupied by a homeless person is one of the riskiest activities that I take. When approaching any vehicle, I am always hesitant to wave or knock on the window, knowing that the occupant may not be homeless or may resent the intrusion. However, given that 26% of our homeless live in their cars or RVs, I will focus more often on vehicles I suspect to be occupied by the homeless.

Page 15 "Age Demographics": Surprisingly, the percentage of the homeless population aged 30 years or younger doubled between the 2017 and the 2019 PIT Survey, from 17% to 34%. This is an alarming statistic and does not bode well for the "millennial" generation, and I would call this a statistically significant change in 2 years - and not a good sign at all.
Page 19 "SLO County Residents Become Homeless": This statistic represents the county of residence of the homeless person when they went from being "housed" to being "homeless". In 2017, 57% of the homeless lived in SLO County when this occurred, with this number shooting up to 74% in 2019. Many claim that we attract these "undesirable homeless bums" to our wonderful SLO County, due to our lovely weather and "abundant" homeless services.

This statistic shows that their dubious justification for turning away the homeless as not being "one of ours" is rapidly becoming hard to defend. I always find it ironic that adjacent counties of a similar demographic to those of SLO County, such as Monterey - Santa Barbara - Ventura - make similar complaints, yet we can't all be correct. As this number of SLO County residents becoming homeless goes up, the argument that we should not be "too nice" to the homeless goes away.

Personally, I've never cared about this statistic: if there is a person in need, then I want to help. However, in meetings and conversations over the years, it is clear that local law enforcement and politicians have cited the need to keep "homeless outsiders" from wanting to come here. Given the trend shown in the 2019 survey, we are attracting less outside homeless people, but instead, are "growing our own".
Page 22 "Obstacles to Housing": The homeless self-reported the reasons for not being able to obtain housing  as: "can't afford", "no job", "no money for moving expenses", "bad credit" and "no car". Duh.

Page 23 "Services Currently Accessing" (SCA): The numbers are self-explanatory. The most common government service received is Food Stamps at 55%.

Page 24 "Reasons for Not Receiving Assistance": In both the 2017 and 2019 PIT surveys, 40% of the homeless did not want government assistance. For the uninformed, that may seem extremely high, but that is most definitely my experience on the street. I find a very high percentage of the chronically homeless individuals I encounter to be fiercely independent, and want to take care of themselves, no matter how poor a job they appear to be doing. Many do not want government assistance, although most seem to be receiving food stamps.
Page 25 "Monthly Income": These numbers would be of great interest to me and to the general public, but for the fact that the numbers provided in the PIT report only apply to those either employed or seeking employment (33% of the homeless), and NOT to those who are not looking for work, or unable to work (70% of the homeless). THIS MAY BE INACCURATE, AND I AM SEEKING CLARIFICATION.

Page 26 "Health": Surprise! The homeless report the following types of health conditions in frequency far greater than that of the public at large: 
- Drug and Alcohol abuse
- Mental Health conditions
- PTSD (Post Traumatic Stress Disorder)
- Chronic Health problems
- Physical Disabilities
- Brain Injury
- HIV / AIDs
However, since a homeless person can have more than one of these conditions, its not clear how many homeless are free from any of these health conditions. In other words, how many are merely "homeless" without serious or recurring health conditions?

Page 28 "Incarceration": Our homeless have a high rate of incarceration, as illustrated by the percentage that have spent a night in jail in the previous 12 months.


Page 29 "Chronic Homelessness (CH)":  Now we get to my specialty - the chronically homeless. Besides CH, there are 3 other special subcategories identified in the 2019 PIT Survey Report, and I invite you to download a copy of the 2019 PIT Survey and dive into those other categories. I will be focusing here on the "Chronically Homeless", or CH.


Page 30 PLEASE READ: This extraordinarily meaningful section of the report below (its not very long, so go ahead and CLICK ON IT!). It smacks the nail on the head, and drives home the point of the effectiveness of the "Housing First" approach to reducing homelessness.

Page 31 "Shelter Status of the CH": Again, not surprisingly, the Chronically Homeless do not generally stay in Emergency Shelters, but instead, carve out a life on the street, as somewhat of a permanent, though undesirable condition. These are the people that claim that they "want to live this way", thus making my life much harder when I try to explain why this is actually not true. UNFORTUNATELY, THE MORE YEARS THE HOMELESS LIVE ON THE STREET, THE HARDER IT IS FOR THEM TO RE-ADAPT TO THE HOUSED LIFESTYLE. IF THEY STAY ON THE STREET FOR LONG, THEN THEY DIE YOUNG.
THE SHORT EXPLANATION: In most, if not many, cases, when the homeless utter such words ("I want to be homeless"), it is because they have gotten acclimated to the homeless lifestyle over the years, as the CH long ago gave up any hope of being housed. As abundantly adaptable humans, they adjusted to living in our relatively affluent American communities, rarely going without the "necessities" for too long. Their continued life on the hard streets is not good for them, and not good for our communities at large, their protestations to the contrary.

Page 33 "Health Conditions of the CH": Once again, the numbers speak for themselves. The CH self-report Drug or Alcohol Abuse at a 72% rate, with additional health conditions scoring remarkably high as well (see chart below). This helps explain why the CH continue to be unhoused. This also illustrates why it is such an uphill battle we are fighting, to get the CH into housing that many claim they do not want!

CONCLUSION: There are a select few areas of the report in which I have a desire to call "BS", but I shall not. Also, there may be a tiny error or 2 in the statistics, but it does not detract from the report as a whole, so they shall go un-flagged as well. For a homeless "blitz" census, these statistics are pretty much as good as it gets. Our homeless population continues to grow, and our leaders are hesitant to tackle it head on, so it continues to fester. 

The homeless population in SLO County is not going away, and appears to be growing. Failure to deal with it in a meaningful way is most likely to lead to greater suffering among the unhoused, growing conflicts between the housed and the unhoused, and greater costs for the taxpayers and the nonprofits that serve the homeless.
If you have read this far - well, that is an amazing thing and kudos to you. If you want to discuss any aspect of homelessness in SLO county with me, please feel free to contact me at:
timwaag@gmail.com
805-440-9144 cell phone

Thanks go out to those who know and love our local homeless people created by G*d, see them as the beautiful (if flawed) human beings they really are, and want to make a difference in their lives.

Peace and Blessings to you and yours.