Waking up and starting off the day with too much despair over the climate in this country, difficulties getting things done and other faulty connections to the world. I want the conservatives to shut up, the liberals to actually keep their word, and developers to stop telling me that being known as "J" is wrong....
There’s something karmic that when I publish a post about how changes in Facebook’s design and operating create big pains in my balls, I find I cannot share the post as a link on Facebook without first joining Google Plus.
With the last post I uploaded, it was a matter of just hitting links that had been in the same place since I created the blog last year. I guess because it was so easy a blind guy could do it, so nerdy developer who felt a need to come up with work that would justify his salary felt the need to make things more complicated.
The experience rankles me in ways that I find the election atmosphere irritating. It’s all input from extremes who try to enforce "how things should be" in the world.
People might understand this leap in my addles thinking if they see the gender options, which are "Male," "Female," and "Other." I propose changing "other" to "SSA" for "Something Scientifically Altered." I know this isn’t politically correct. I don’t care. We’ve gotten to the point that extremist want to purge classic novels of historical importance to purge the word nigger without regard to the historical context and importance. I’ve read one with the Wind and will say with absolute certainty that it would not read the same, and when I read (or listen to) something like that, I want the full monty of historical experience. "Those who forget history are doomed to repeat it" and all that. It’s probably just one of my crazy theories to correlate our repression of unpleasant disparaging things that may be offensive to some people with the rise of repressed rage that ends up spewing out with increased backlash against society...things like nut jobs shooting up movie theaters and kids going to school and shooting the place up.
To make a similar protest against the extremes that impact "my own kind," there are special handling laws for the blind. If a landlord is advertising an apartment, he cannot say "a short walk" to the busline" or "nice view." This is legally discriminatory in some states (including the one I live in) because not everyone (like me) can walk and not everyone (like me) can see. I don’t think that my limitations should be used as a restriction to what other people can say and do.
It all amounts to inconvenience for some based on the limitations and sensitivities and mandates of others.
All I wanted to do is post a link as I have on almost every post for the last year. Facebook has otherwise become mostly useless to me. I still try to do productive things on the computer and still must do things on the computer, but browsing a bright screen is neither comfortable nor pleasant to someone with extreme light sensitivity. I don’t want to join a Google Community. Don’t want to be publishing my birthday or seeming antisocial because I decline invitations to Mafia Wars and Farmville. about things that
That putting myself as "J Kozzi" violates the name policy. I suppose that my name is Jeff but most people call me "Jay" makes me a violation of all that’s right in the world. Clear warning to all you Plus 1’ers: I very obviously lied about my birthday. I am not embarrassed about my age of 43. I don’t need every pseudo friend bogging my limited time with productive vision with trivial birthday wishes, any more than I want my writing time bogged down with page after page of electronic social and privacy disclosures with pictures and contact lists and telling about myself...all on pages complicated enough that the "continue" button is not aligned with the basic page flow and thus necessitate clicking the magnifier on and off so I can search and scroll each page in two direction. And it doesn’t help my surly disposition to have some of those "continues invisible because the Google developers are so afraid I will be lonely online that only the "add more friends" option is in the "continue blue."
I ended up having to close out the window. I assume because they thought I was lacking friends, I got a news feed of people I neither know nor care to know talking about Power Fabric, and this blind guy couldn’t find the escape button that theoretically should have taken me back so I could post my link to Facebook for the "Notifications" post.
In the end, they still had direct links that could have let me link directly, but that was put under an ambiguous "More" link that was nowhere near as prominent as the "Share" link that now only allows Google+ sharing. There’s an hour of my life wasted, especially because the new FB share link would not close properly. This forced me to go to FB and try to navigate more complex and complicated screens just to make sure the link actually went through.
I am not interested in increasing social media. I just want to post the Blindsided! pieces and link them to the social media that I’ve been part of for years and can no longer effectively use. Google, please leave me alone on anything and everything except video clips of your developers getting their skulls bashed in with baseball bats.
Friday, August 31, 2012
Thursday, August 30, 2012
Notifications
Now I’m about ready to start signing those online "petitions" that tell the world "Facebook made changes I hate" or the simpler "I hate Facebook" or "Boycott Facebook." Two things keep me from doing that. The first is that I find it silly. The second is that finding those things would be a major waste of time and energy, perhaps without success.
I can see enough to use the computer only with a tandem of aid. I use a 32-inch TV as a monitor. I need the otherwise useless glasses on. I enlarge the zooms in programs and/or use big font sizes. Font sizes for emails usually have to be reduced when cut and paste into the email so people do not think I am "yelling." I use a mouse that has an option of a magnifying square.
I navigate web pages in part by familiarity in knowing where to find specific things such as links. When pages or sites I am familiar with change, this throws major chaos into my world and wastes a lot of time. U can see general shapes and layout of entire pages, or I can see details like words in limited areas. I can’t do both, and searching with the magnifier can be a dizzying experience. I cannot see an entire line of type, so need to keep moving the magnifier from end of line to front and hope I don’t overdo the vertical axis so much that I lose the line.
I am not complaining outright. I am grateful I have retained enough to be able to get by on anything on my own. It would be awkward to vent irritations about my roommate to electronic friends if the roommate had to type the emails.
Hover menus for links are impractical. I usually cannot see the appearing list while still hovering over the button that triggered the submenu. Moving the magnifier a little bit to see the list triggers a new list or makes the first one disappear. These features are nifty little developer tools and may scream "modern website" but they are not the best use for all sites and can discourage readers. The barrier can be to visually disabled such as myself, but can also effect people with unsteady hands and other disabilities.
Facebook also made changes this summer, beyond corporate structural changes that drained investors of money. Earlier this year, I could find things on the sire’s complex but not complicated layout, and they sent automatic emails for friend requests and messages. They stopped doing that. I missed a number of messages and had begun to wonder why I had become such a pariah that no one ever answered any of my messages.
Worse, the basic page has become outright complicated with multiple window panes and boxes. I couldn’t find the links to send messages, so I resorted to sniping people who were online with the IM then logging off. Up until recently, I’d get a regular email that would clearly link me to any response. I can handle regular email much easier and recommend it to friends.
Don’t send me texts; I can’t see my phone screen at all.
The magnifying mouse is invaluable to me. It makes the section of screen I am viewing really bigger inside a box that moves when I move the mouse. In doing so, it displaces the regular
I can see enough to use the computer only with a tandem of aid. I use a 32-inch TV as a monitor. I need the otherwise useless glasses on. I enlarge the zooms in programs and/or use big font sizes. Font sizes for emails usually have to be reduced when cut and paste into the email so people do not think I am "yelling." I use a mouse that has an option of a magnifying square.
I navigate web pages in part by familiarity in knowing where to find specific things such as links. When pages or sites I am familiar with change, this throws major chaos into my world and wastes a lot of time. U can see general shapes and layout of entire pages, or I can see details like words in limited areas. I can’t do both, and searching with the magnifier can be a dizzying experience. I cannot see an entire line of type, so need to keep moving the magnifier from end of line to front and hope I don’t overdo the vertical axis so much that I lose the line.
I am not complaining outright. I am grateful I have retained enough to be able to get by on anything on my own. It would be awkward to vent irritations about my roommate to electronic friends if the roommate had to type the emails.
Hover menus for links are impractical. I usually cannot see the appearing list while still hovering over the button that triggered the submenu. Moving the magnifier a little bit to see the list triggers a new list or makes the first one disappear. These features are nifty little developer tools and may scream "modern website" but they are not the best use for all sites and can discourage readers. The barrier can be to visually disabled such as myself, but can also effect people with unsteady hands and other disabilities.
Facebook also made changes this summer, beyond corporate structural changes that drained investors of money. Earlier this year, I could find things on the sire’s complex but not complicated layout, and they sent automatic emails for friend requests and messages. They stopped doing that. I missed a number of messages and had begun to wonder why I had become such a pariah that no one ever answered any of my messages.
Worse, the basic page has become outright complicated with multiple window panes and boxes. I couldn’t find the links to send messages, so I resorted to sniping people who were online with the IM then logging off. Up until recently, I’d get a regular email that would clearly link me to any response. I can handle regular email much easier and recommend it to friends.
Don’t send me texts; I can’t see my phone screen at all.
The magnifying mouse is invaluable to me. It makes the section of screen I am viewing really bigger inside a box that moves when I move the mouse. In doing so, it displaces the regular
Monday, August 27, 2012
The Good and Bad
Separate feedback has dubbed it both odd and contradictory that I continue to see a General Practitioner who I do not really like. People have been calling me odd my entire life and contrary for all of my adult life, so I don’t understand where the surprise comes from. I’ll explain the GP thing anyway.
Other friends who are far more accustomed to seeing doctors regularly don’t like my GP. One of those primary two has actually met the GP. Neither thinks he is a very good doctor. I don’t feel all that qualified to judge. I know when I have a bad doctor, such as when one scares me into surgery that can cause the very thing it is supposed to prevent. I do not, however, necessarily know when a doctor is good.
My GP has not done anything that has directly caused harm. That’s part of my minimum criteria in keeping with a doctor who may not be the best match for me. As stated above and perhaps often exaggerated with defensiveness and warped pride, I can be contrary. Don’t think I would agree with any doctor 100% and don’t want to go through the effort of training someone new how to deal with me and where the lines in the sand are drawn. I can deal with a face-to-face disagreement without getting mad, but if a new potential doctor were to try to move the line in the hopes the blind guy won’t know the difference, I’m inclined to get annoyed.
I live a fairly healthy life with two things that are "bad bad bad" according to all doctors and most common sense. I’ll save the full confessions for some other time. It’s safe to say that any doctor would have objection to either. Some doctors would decline me as a patient for one or both.
I live and eat healthier than most Americans. I don’t eat a fiber and fart rich diet chock full of fruits and vegetables with every meal, but I seldom stray into bad foods at either take-out or at-home levels. I eat few pre-pared foods and when having a choice "on the road" I always choose Subway over the burger joints. At home, I am inclined to an occasional can of soup and the worst thing to get through the door is the Hamburger Helper stroganoff. I hope that adding string beans or peas to the salty mix makes it less bad. (It doesn’t.)
None of that is enough for my GP. I appreciate that he holds the hardline, and there’s seldom conflict about it. I’m honest with him and expect the same from him. The few actual cross words have come when he pushes some issues. when the hard line holding becomes nagging, I get put off no matter who the nag is.
I am realistic. If I eliminate the few extravagances–which are never diabetic catastrophe such as a package of Oreos–I will feel deprived. That feeling is the universal doom to any diet, diabetic or average-Joe weight loss diet. No diet will work unless it can be lived for the rest of the dieter’s life. Otherwise, the gains and benefits are only temporary, and lost the first time the dieter overcompensates for feeling deprived. When my doctor gives m the impression he will never be pleased, I stop trying to please him. That does not extend to becoming contrary just to be contrary.
My doctor is no dietician and has been unable to answer some questions I have raised. He could stand to lose some weight himself, though I have yet to point that out to him directly.
Other friends who are far more accustomed to seeing doctors regularly don’t like my GP. One of those primary two has actually met the GP. Neither thinks he is a very good doctor. I don’t feel all that qualified to judge. I know when I have a bad doctor, such as when one scares me into surgery that can cause the very thing it is supposed to prevent. I do not, however, necessarily know when a doctor is good.
My GP has not done anything that has directly caused harm. That’s part of my minimum criteria in keeping with a doctor who may not be the best match for me. As stated above and perhaps often exaggerated with defensiveness and warped pride, I can be contrary. Don’t think I would agree with any doctor 100% and don’t want to go through the effort of training someone new how to deal with me and where the lines in the sand are drawn. I can deal with a face-to-face disagreement without getting mad, but if a new potential doctor were to try to move the line in the hopes the blind guy won’t know the difference, I’m inclined to get annoyed.
I live a fairly healthy life with two things that are "bad bad bad" according to all doctors and most common sense. I’ll save the full confessions for some other time. It’s safe to say that any doctor would have objection to either. Some doctors would decline me as a patient for one or both.
I live and eat healthier than most Americans. I don’t eat a fiber and fart rich diet chock full of fruits and vegetables with every meal, but I seldom stray into bad foods at either take-out or at-home levels. I eat few pre-pared foods and when having a choice "on the road" I always choose Subway over the burger joints. At home, I am inclined to an occasional can of soup and the worst thing to get through the door is the Hamburger Helper stroganoff. I hope that adding string beans or peas to the salty mix makes it less bad. (It doesn’t.)
None of that is enough for my GP. I appreciate that he holds the hardline, and there’s seldom conflict about it. I’m honest with him and expect the same from him. The few actual cross words have come when he pushes some issues. when the hard line holding becomes nagging, I get put off no matter who the nag is.
I am realistic. If I eliminate the few extravagances–which are never diabetic catastrophe such as a package of Oreos–I will feel deprived. That feeling is the universal doom to any diet, diabetic or average-Joe weight loss diet. No diet will work unless it can be lived for the rest of the dieter’s life. Otherwise, the gains and benefits are only temporary, and lost the first time the dieter overcompensates for feeling deprived. When my doctor gives m the impression he will never be pleased, I stop trying to please him. That does not extend to becoming contrary just to be contrary.
My doctor is no dietician and has been unable to answer some questions I have raised. He could stand to lose some weight himself, though I have yet to point that out to him directly.
Thursday, August 23, 2012
Ankles Aweigh!
The blind thing is enough to deal with. The ankle is an additional permanent handicap.
The basics for newer readers and people with polite curiosity about that limpy gimpy guy at East Providence Lanes a couple nights per week:
In October 2011 I unintentionally self inflicted tendon damage in my foot. Even without bone breaks or stress fractures, I developed a rare diabetic complication called Charcot "Sharko" Foot. This causes massive swelling that the body uses to protect the foot from further injury. The link tag can direct readers to more detailed posts about the condition.
Diabetic circulation is typically reduced to begin with. The massive inflammation further reduced the circulation in my right foot, and the foot was unable to get the nutrients it needed. During the periods of worst swelling and least circulation, the central bone/s of my right ankle, the talus and calcaneus, lost density and mass. This softened those bones. They moved and turned a little. The tibia no longer fits with them correctly and is permanently out of place. Direct-weight use of the ankle risks further displacement of the bones.
A "medical appliance" called a Crow Boot protects the ankle from further harm. The crow boot encases the ankle, restricts all movement, and diverts weight from the ankle to the rest of the foot and upper leg. It is awkward and clunky, but allows mobility I otherwise would not have. I am pretty bad with crutches, and my house has too many stairs, inside and out.
It’s a bulky Iron Man type contraption of hard black plastic on the outside. The inside is foam that keeps everything snug and sheltered, like a clarinet case. It’s a shell with upper and lower halves that interlock and hold together with velcro straps. With the risk that weight-bearing use of the ankle could cause the leg bone to completely fall out of place and possibly puncture the skin from the inside on the way out, I need the Crow Boot or crutches to even move around the house.
I checked the bowling center management and the United States Bowling Congress about accommodation or allowance for the boot as I certainly could not heft even my lightweight ball without the boot. As long as it is covered to prevent "outside materials" from dislodging from the boot and posing hazard to other bowlers, there are no objections or rule violations.
The Crow Boot is a permanent fixture. The ankle is not going to "uncollapse." My right leg is now about an inch shorter than the left.
Yes, I tend to move like the mummy, THUMP step THUMP step THUMP step, but that’s a lot better than not being able to move around at all.
The basics for newer readers and people with polite curiosity about that limpy gimpy guy at East Providence Lanes a couple nights per week:
In October 2011 I unintentionally self inflicted tendon damage in my foot. Even without bone breaks or stress fractures, I developed a rare diabetic complication called Charcot "Sharko" Foot. This causes massive swelling that the body uses to protect the foot from further injury. The link tag can direct readers to more detailed posts about the condition.
Diabetic circulation is typically reduced to begin with. The massive inflammation further reduced the circulation in my right foot, and the foot was unable to get the nutrients it needed. During the periods of worst swelling and least circulation, the central bone/s of my right ankle, the talus and calcaneus, lost density and mass. This softened those bones. They moved and turned a little. The tibia no longer fits with them correctly and is permanently out of place. Direct-weight use of the ankle risks further displacement of the bones.
A "medical appliance" called a Crow Boot protects the ankle from further harm. The crow boot encases the ankle, restricts all movement, and diverts weight from the ankle to the rest of the foot and upper leg. It is awkward and clunky, but allows mobility I otherwise would not have. I am pretty bad with crutches, and my house has too many stairs, inside and out.
It’s a bulky Iron Man type contraption of hard black plastic on the outside. The inside is foam that keeps everything snug and sheltered, like a clarinet case. It’s a shell with upper and lower halves that interlock and hold together with velcro straps. With the risk that weight-bearing use of the ankle could cause the leg bone to completely fall out of place and possibly puncture the skin from the inside on the way out, I need the Crow Boot or crutches to even move around the house.
I checked the bowling center management and the United States Bowling Congress about accommodation or allowance for the boot as I certainly could not heft even my lightweight ball without the boot. As long as it is covered to prevent "outside materials" from dislodging from the boot and posing hazard to other bowlers, there are no objections or rule violations.
The Crow Boot is a permanent fixture. The ankle is not going to "uncollapse." My right leg is now about an inch shorter than the left.
Yes, I tend to move like the mummy, THUMP step THUMP step THUMP step, but that’s a lot better than not being able to move around at all.
Wednesday, August 22, 2012
Caution: Blind Bowler
For newer readers and people who haven’t seen me all summer, here’s a recap of my eyes as they see (or don’t) these days.
In 2003 I had a cornea injury that I did not leave covered up long enough. My eye started "looking around" the scratch on the surface, which caused muscle striations that pulled the eye to the side. Ever-present diabetic retina problems became opportunistic. The right eye has been dark and out of alignment ever since.
In 2009, Cialis caused a vitreous blood hemorrhage in the left eye. This filled an existing cataract and the center of the eye with blood. They did cataract surgery, which gave me good distance vision but eliminated reading vision due to the type of lense they used (with no consultation with me, the patient.) Because of the hemorrhage, I let them scare me into the "preventative" diabetic laser surgery to burn the retina on the back of the eye. The stresses of that and the cataract surgery and the hemorrhage all kind of made the diabetic thing happen, which reduced my peripheral in that eye.
In January 2012 I had retina reattachment surgery and another procedure where they replaced the blood-dirtied vitreous gel with silicone oil. This brought some clarity and keeps pressure on the back of the eye. The retina reattachment did not succeed as well as either the doctor or I had hoped.
The sight in the left eye has no perineal, so with the dark right eye, I can see only what I am looking at and cannot see that too clearly. My eye takes a long time to adjust to changes in lighting and does not process light very well. I see colors better, up to certain distances. My test by finger sight ranges from one to four feet depending on how adjusted I am to room lighting. I see most people in shadows, and can’t adjust distance vision very well. That brief experience of being eagle-eyed after the cataract surgery is long past.
I see by color, motion, contrast and feel. My brain fills in gaps. Familiarity is always an asset to getting around. I can’t successfully fake it for too long anymore. I cling to the last bits of independence I have left and learned to accept offered help without much comment or resistance.
Being stubborn and fiercely independent have been assets through all this. I need aids , such as contrasting-color tape on microwave buttons or using a 32-inch TV as a monitor and a magnifying mouse and glasses to see the computer. There’s things I can no longer do, like drive, but I try what I can before surrendering helplessly to the things I can’t., but I can do most things at least some of the time.
Life has always been pretty rough for me. I am not a fragile diabetic or a fragile person, so I try not to let it stop me. I will hold on to what I have of the old life for as long as I can,
It is unlikely things will get much better, even after the silicone oil is drained out. I will always need bowling teammates to tell me what pins are still standing in between throws, but at least I will be able to tell them that I
am still standing.I’m usually aware of it when I fall down. I’m smaht that way.
In 2003 I had a cornea injury that I did not leave covered up long enough. My eye started "looking around" the scratch on the surface, which caused muscle striations that pulled the eye to the side. Ever-present diabetic retina problems became opportunistic. The right eye has been dark and out of alignment ever since.
In 2009, Cialis caused a vitreous blood hemorrhage in the left eye. This filled an existing cataract and the center of the eye with blood. They did cataract surgery, which gave me good distance vision but eliminated reading vision due to the type of lense they used (with no consultation with me, the patient.) Because of the hemorrhage, I let them scare me into the "preventative" diabetic laser surgery to burn the retina on the back of the eye. The stresses of that and the cataract surgery and the hemorrhage all kind of made the diabetic thing happen, which reduced my peripheral in that eye.
In January 2012 I had retina reattachment surgery and another procedure where they replaced the blood-dirtied vitreous gel with silicone oil. This brought some clarity and keeps pressure on the back of the eye. The retina reattachment did not succeed as well as either the doctor or I had hoped.
The sight in the left eye has no perineal, so with the dark right eye, I can see only what I am looking at and cannot see that too clearly. My eye takes a long time to adjust to changes in lighting and does not process light very well. I see colors better, up to certain distances. My test by finger sight ranges from one to four feet depending on how adjusted I am to room lighting. I see most people in shadows, and can’t adjust distance vision very well. That brief experience of being eagle-eyed after the cataract surgery is long past.
I see by color, motion, contrast and feel. My brain fills in gaps. Familiarity is always an asset to getting around. I can’t successfully fake it for too long anymore. I cling to the last bits of independence I have left and learned to accept offered help without much comment or resistance.
Being stubborn and fiercely independent have been assets through all this. I need aids , such as contrasting-color tape on microwave buttons or using a 32-inch TV as a monitor and a magnifying mouse and glasses to see the computer. There’s things I can no longer do, like drive, but I try what I can before surrendering helplessly to the things I can’t., but I can do most things at least some of the time.
Life has always been pretty rough for me. I am not a fragile diabetic or a fragile person, so I try not to let it stop me. I will hold on to what I have of the old life for as long as I can,
It is unlikely things will get much better, even after the silicone oil is drained out. I will always need bowling teammates to tell me what pins are still standing in between throws, but at least I will be able to tell them that I
am still standing.I’m usually aware of it when I fall down. I’m smaht that way.
Monday, August 20, 2012
Flashpoint
My GP and I have certain fundamental differences in approach and philosophies. He wants to paint by numbers with an objective of a long life. I want to feel good for as long as I happen to live, a quality-over-quantity preference. The last couple years of diminishing abilities has only reaffirmed my outlook.
Any doctor would have gasped in horror at my numbers in 2005 when I started seeing my GP. Perhaps a diabetes specialist would have had more experience with diabetics who were "living high" and had taken a more cautious approach to making changes. It's way too late to speculate now. Egged on by a couple friends who felt I didn't take care of myself, I went along with the changes promoted by my GP, the largest of which was doubling my dose of insulin. He did not change my daytime dose, but specifically prescribed taking an equal dose at night. Gauging my sugars by feel, I knew that most of the time my sugar ran high, it was doing so only at night.
I specify here that my highs and lows were relative changes to my own bodily system. The lows were not numerical lows by standard practices. My lows would be sugar-shock coma-inducing highs to a fragile diabetic.
This did work at drastically lowering my A1C.
This period of change, from spring to summer of 2005, also spelled the end of what I refer to as "The Healthy Years." My numbers improved, still not to the GP's satisfaction, but I felt like crap. The better my numbers got, the worse I felt.
With the onset of diabetes at age 4 and a hospitalization at age 12, 2005 at the age of 36, became my third flashpoint with the sugar. This was a period of massive change, and none felt then–or now–like changes for the better.
I encountered this GP in kind of a literal way, by accident. Results of a car accident had left me with a broken shoulder, and I ended up with physical therapy in the GP’s practice. The accident triggered a mid-life crisis. It became a practice run at being needy
My vehicle was a stick shift, unworkable with a shoulder brace and sling. I was living alone at the time of the accident and the medical aftermath. Some people in my life at the time proved themselves more loyal and caring–more there–than I would have expected. Some of the ones I would have expected to be there for me (because I had been and always was there in their times of need in so many ways) were either conspicuously absent or made the inconvenience factor well known when they were there.
I think part of the reason I have adjusted so well to the permanent disability was for having lived through that temporary bout. I looked at the new presence of an internist doctor in my life as fate, especially while in the middle of a mid-life crisis. Loose and independent threads had seemed to converge. With clearer thinking, with less acceptance of "fate" to where I ended up. With less criticism and disfavor from some of the people closest to me and if other factors had been different at the time, I would not have continued seeing my GP when the shoulder issue cleared up.
I do firmly believe that in the entire cycle of events, I would not be in this permanent predicament of neediness now.
Any doctor would have gasped in horror at my numbers in 2005 when I started seeing my GP. Perhaps a diabetes specialist would have had more experience with diabetics who were "living high" and had taken a more cautious approach to making changes. It's way too late to speculate now. Egged on by a couple friends who felt I didn't take care of myself, I went along with the changes promoted by my GP, the largest of which was doubling my dose of insulin. He did not change my daytime dose, but specifically prescribed taking an equal dose at night. Gauging my sugars by feel, I knew that most of the time my sugar ran high, it was doing so only at night.
I specify here that my highs and lows were relative changes to my own bodily system. The lows were not numerical lows by standard practices. My lows would be sugar-shock coma-inducing highs to a fragile diabetic.
This did work at drastically lowering my A1C.
This period of change, from spring to summer of 2005, also spelled the end of what I refer to as "The Healthy Years." My numbers improved, still not to the GP's satisfaction, but I felt like crap. The better my numbers got, the worse I felt.
With the onset of diabetes at age 4 and a hospitalization at age 12, 2005 at the age of 36, became my third flashpoint with the sugar. This was a period of massive change, and none felt then–or now–like changes for the better.
I encountered this GP in kind of a literal way, by accident. Results of a car accident had left me with a broken shoulder, and I ended up with physical therapy in the GP’s practice. The accident triggered a mid-life crisis. It became a practice run at being needy
My vehicle was a stick shift, unworkable with a shoulder brace and sling. I was living alone at the time of the accident and the medical aftermath. Some people in my life at the time proved themselves more loyal and caring–more there–than I would have expected. Some of the ones I would have expected to be there for me (because I had been and always was there in their times of need in so many ways) were either conspicuously absent or made the inconvenience factor well known when they were there.
I think part of the reason I have adjusted so well to the permanent disability was for having lived through that temporary bout. I looked at the new presence of an internist doctor in my life as fate, especially while in the middle of a mid-life crisis. Loose and independent threads had seemed to converge. With clearer thinking, with less acceptance of "fate" to where I ended up. With less criticism and disfavor from some of the people closest to me and if other factors had been different at the time, I would not have continued seeing my GP when the shoulder issue cleared up.
I do firmly believe that in the entire cycle of events, I would not be in this permanent predicament of neediness now.
Tuesday, August 14, 2012
Generally Unpracticed
It’s no surprise to the blog’s readers if I freely confess to being cynical about doctors. A look over the posts under the "Medical Malpractice" tag gives account of experiences and observations about the why’s. Unable to afford doctors for most of my adult life, I had to manage my own sugar with attention and common sense. Not seeing a doctor does not automatically equate with making no attempt to control blood sugars.
I approach every new doctor with hope and childish optimism that this one will be a good one. I want to have a cooperative relationship with my doctors. Theoretically, it’s in my own best interest.
I’ve tried this with my general practitioner. He is not a bad guy at all, and I don’t think he’s a bad doctor, although several in-the-know people in my life have a poor opinion of him and frequently urge me to find a good one.
I know myself. I could fire this one, but I would not run out to find another, not until I needed one again, and that is not the time to be looking for someone to guide you long term.
Despite seeing him for seven years now, the relationship remains contentious. I take my share of responsibility for that, but do know it’s not just me.
Many shades of gray cloud the situation. For that reason, I have from the beginning chosen not to name him or his practice. There are elements that I think he is wrong on and other that I know he is right on but I can’t or won’t do anyway. Many of our differences are more philosophical than black and white wrong or right. He is an internist rather than a diabetes specialist. That fact may also widen the gap between us.
I didn’t help matters much on the last visit several months ago. When he mentioned one of those things I can’t or won’t do, I accepted it as him doing his job. When he brought it up again, it came across as nagging and I slapped that down fast. I wouldn’t want to let nagging become a habit by being too accepting of it at the outset. He was probably furious with me when I left, for me being me. The GP had recommended Dr. David Greenberg–Doctor Dumbass–to other patients. I lifted my leg to show the other people the Crow boot as evidence that I had more than passing experience with podiatrists, then told them what a dumbass Greenberg is and told them how I came by that opinion. I gave them the name of Thomas Mancini as a competent podiatrist. That’s how I am.
I started seeing my GP in 2005. It’s been downhill ever since.
I approach every new doctor with hope and childish optimism that this one will be a good one. I want to have a cooperative relationship with my doctors. Theoretically, it’s in my own best interest.
I’ve tried this with my general practitioner. He is not a bad guy at all, and I don’t think he’s a bad doctor, although several in-the-know people in my life have a poor opinion of him and frequently urge me to find a good one.
I know myself. I could fire this one, but I would not run out to find another, not until I needed one again, and that is not the time to be looking for someone to guide you long term.
Despite seeing him for seven years now, the relationship remains contentious. I take my share of responsibility for that, but do know it’s not just me.
Many shades of gray cloud the situation. For that reason, I have from the beginning chosen not to name him or his practice. There are elements that I think he is wrong on and other that I know he is right on but I can’t or won’t do anyway. Many of our differences are more philosophical than black and white wrong or right. He is an internist rather than a diabetes specialist. That fact may also widen the gap between us.
I didn’t help matters much on the last visit several months ago. When he mentioned one of those things I can’t or won’t do, I accepted it as him doing his job. When he brought it up again, it came across as nagging and I slapped that down fast. I wouldn’t want to let nagging become a habit by being too accepting of it at the outset. He was probably furious with me when I left, for me being me. The GP had recommended Dr. David Greenberg–Doctor Dumbass–to other patients. I lifted my leg to show the other people the Crow boot as evidence that I had more than passing experience with podiatrists, then told them what a dumbass Greenberg is and told them how I came by that opinion. I gave them the name of Thomas Mancini as a competent podiatrist. That’s how I am.
I started seeing my GP in 2005. It’s been downhill ever since.
Saturday, August 11, 2012
Onsets
Another aspect of the Mayo Clinic’s website statement "The A1C test is a common blood test used to diagnose type 1 and type 2 diabetes..." bothers me. Specifically, I do not know that the part "common blood test used to diagnose type 1" is true.
Type two is in many ways a different disease. It’s onset is gradual and the patient can live for years without knowing they have it.
The A1C test measures sugar coating on cells in the blood. This coating forms over two to three months until the coated cells die by attrition. The A1C test can diagnose Type 2.
The onset of Type 1 is not a matter than the pancreas reduces insulin production or the body has increased difficulty metabolizing or using the insulin. In Type 1, the pancreas just stops. There is no gradual development of the condition that would show up in a test that calculated sugar in the blood over time. Doctors diagnose Type I "Diabetes Mellitus" by the symptoms in front of them. A test of the here-and-now blood sugar levels will confirm the symptoms of extreme thirst, constant urination, tiredness, apathy, sweet-smelling breath and a quick question to the patient or hir parents about weight loss.
It seems to me that claiming an A1C test as a useful diagnostic tool for Type 1 is more a matter of running profitable tests.
I could be wrong; this wouldn’t be the first time in life. I am basing the commentary on near-40 years of diabetes experience rather than academic studies telling what tests can be run for information and profit to the industry. But I don’t think I am wrong.
My onset was sudden. I do have memories of the day, true memories, not memories of retellings. I was wasted and drained and had lain down on a picnic table in the back yard and had no interest in being called for dinner. There’s no true or retold memory of a lead in to illness.
The other true diabetes-onset memories are odd snippets. I do not remember the first shot of insulin or blood tests in the hospital.
I do remember my older siblings not being able to visit, but they had been dragged along to wave from the end of the hall of the children’s ward. I remember that because one of my brothers always terrified me and I felt safer knowing he could not get near.
I remember being given tomato juice for the first time and gagging on it in distaste.
I remember playing "Old Maid" with my grandmother. She was sore winner about it, way too triumphant for having won against a four-year-old who had just learned the game. I remember suspecting she cheated. I observations of her character later in life dissuaded me from thinking that even if she didn’t cheat, she would.
Type two is in many ways a different disease. It’s onset is gradual and the patient can live for years without knowing they have it.
The A1C test measures sugar coating on cells in the blood. This coating forms over two to three months until the coated cells die by attrition. The A1C test can diagnose Type 2.
The onset of Type 1 is not a matter than the pancreas reduces insulin production or the body has increased difficulty metabolizing or using the insulin. In Type 1, the pancreas just stops. There is no gradual development of the condition that would show up in a test that calculated sugar in the blood over time. Doctors diagnose Type I "Diabetes Mellitus" by the symptoms in front of them. A test of the here-and-now blood sugar levels will confirm the symptoms of extreme thirst, constant urination, tiredness, apathy, sweet-smelling breath and a quick question to the patient or hir parents about weight loss.
It seems to me that claiming an A1C test as a useful diagnostic tool for Type 1 is more a matter of running profitable tests.
I could be wrong; this wouldn’t be the first time in life. I am basing the commentary on near-40 years of diabetes experience rather than academic studies telling what tests can be run for information and profit to the industry. But I don’t think I am wrong.
My onset was sudden. I do have memories of the day, true memories, not memories of retellings. I was wasted and drained and had lain down on a picnic table in the back yard and had no interest in being called for dinner. There’s no true or retold memory of a lead in to illness.
The other true diabetes-onset memories are odd snippets. I do not remember the first shot of insulin or blood tests in the hospital.
I do remember my older siblings not being able to visit, but they had been dragged along to wave from the end of the hall of the children’s ward. I remember that because one of my brothers always terrified me and I felt safer knowing he could not get near.
I remember being given tomato juice for the first time and gagging on it in distaste.
I remember playing "Old Maid" with my grandmother. She was sore winner about it, way too triumphant for having won against a four-year-old who had just learned the game. I remember suspecting she cheated. I observations of her character later in life dissuaded me from thinking that even if she didn’t cheat, she would.
Friday, August 10, 2012
Sugar Coating
The A1C test is a blood test that reports levels of sugar in the blood over a two to three month period. Blood hemoglobin has a memory for this.
Hemoglobin in a protein in red blood cells. Sugar in the blood will coat some of the hemoglobin cells. The A1C measures the percentage of hemoglobin cells with the sugar coating. An A1C of 5 means 5% of the cells are coated, and A1C at 15% (not desirable) means 15% are coated.
The numbering can be confusing because home testing of blood sugars work with numbers usually ranging from 100 to 600. Home monitors and A1C tests are measuring very different things. The home test tells you were you are at that moment while A1C gives an average. For being an average, the A1C can be skewed by temporary but extreme highs and lows in daily blood sugar levels.
High A1C from a "non-diabetic" can be the basis of a diabetes diagnosis. The diagnosis will probably be right. Attention to your own behavior and self honesty is important. If an A1C is run in January, it will almost invariably be higher from holiday indulgences. One week of an ice cream binge will prompt higher A1C for up to three months, even if the home monitoring shows that blood sugar levels returned to normal the week after.
A diabetic can run with the 100-140 "healthy range" most of every day, but spike in the middle of the night or after one specific meal every ay. This will inflate the A1C level. Once the hemoglobin is sugar-coated, it stays that way for its two- to three-month lifespan.
The only way to tell where are problem times of day is to self test via home pricking. Both forms of testing are recommended and neither can truly replace the other.
There are different forms of testing A1C that use different number scales. It is standardized here in the United States.
Different diabetes organizations recommend different target numbers. 6.5 was once the norm. The American Diabetes Association raised the target to 7.0 because the lower levels did not reduce risks enough to compensate for the risks brought on by hypoglycemic (low blood sugar) episodes. I know personally of one healthy person diagnosed with "pre-diabetes" at a level just under 6.0% A1C. My cynical thought is that his doctor is doing his best to earn a golf trip offered by the pharmaceuticals for prescription quotas.
Here’s an interesting study from http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(09)61969-3/fulltext: "A retrospective study of 47,970 diabetics found that [Type 2] patients with an A1C less than 6.5% had an increased mortality rate." Yes, that’s increased death for keeping the sugar too low. Things like that reaffirm my belief that being too good is not desirable. My theory is that constantly low numbers contribute to "fragile" diabetes. But I am no doctor and only have my own experiences to judge by.
Hemoglobin in a protein in red blood cells. Sugar in the blood will coat some of the hemoglobin cells. The A1C measures the percentage of hemoglobin cells with the sugar coating. An A1C of 5 means 5% of the cells are coated, and A1C at 15% (not desirable) means 15% are coated.
The numbering can be confusing because home testing of blood sugars work with numbers usually ranging from 100 to 600. Home monitors and A1C tests are measuring very different things. The home test tells you were you are at that moment while A1C gives an average. For being an average, the A1C can be skewed by temporary but extreme highs and lows in daily blood sugar levels.
High A1C from a "non-diabetic" can be the basis of a diabetes diagnosis. The diagnosis will probably be right. Attention to your own behavior and self honesty is important. If an A1C is run in January, it will almost invariably be higher from holiday indulgences. One week of an ice cream binge will prompt higher A1C for up to three months, even if the home monitoring shows that blood sugar levels returned to normal the week after.
A diabetic can run with the 100-140 "healthy range" most of every day, but spike in the middle of the night or after one specific meal every ay. This will inflate the A1C level. Once the hemoglobin is sugar-coated, it stays that way for its two- to three-month lifespan.
The only way to tell where are problem times of day is to self test via home pricking. Both forms of testing are recommended and neither can truly replace the other.
There are different forms of testing A1C that use different number scales. It is standardized here in the United States.
Different diabetes organizations recommend different target numbers. 6.5 was once the norm. The American Diabetes Association raised the target to 7.0 because the lower levels did not reduce risks enough to compensate for the risks brought on by hypoglycemic (low blood sugar) episodes. I know personally of one healthy person diagnosed with "pre-diabetes" at a level just under 6.0% A1C. My cynical thought is that his doctor is doing his best to earn a golf trip offered by the pharmaceuticals for prescription quotas.
Here’s an interesting study from http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(09)61969-3/fulltext: "A retrospective study of 47,970 diabetics found that [Type 2] patients with an A1C less than 6.5% had an increased mortality rate." Yes, that’s increased death for keeping the sugar too low. Things like that reaffirm my belief that being too good is not desirable. My theory is that constantly low numbers contribute to "fragile" diabetes. But I am no doctor and only have my own experiences to judge by.
Thursday, August 9, 2012
Campaigning Conditions
From the Mayo Clinic website: "The A1C test is a common blood test used to diagnose type 1 and type 2 diabetes..."
There is an important aspect to this for Type 2 diabetic and some healthy patients: it is used to diagnose. Over the past decade, the exact number used to diagnose Type 2 has changed up and down several times and is reported inconsistently by different sources. The pharmaceutical companies are involved in that, the same way those companies create "syndromes" such as "restless leg." The pharmaceutical companies are for-profit enterprises that are looking to sell you products, and the lower diagnosis numbers favor their sales. Realistically, how many of us would have heard of things like fibromyalgia if we had not been for all the ads hawking drug treatments? These drugs amount to patented combinations of pain relievers and antidepressants.
If you feel I am being cynical about a serious condition that cripples so many poor unfortunate women, I will steer you towards the latest pharmaceutical ad campaign. The male problems of all aging but not yet old male farts could be "Low T." Ad campaigns like this begin with apparent innocence. You can go to a web site to learn about the condition. The TV ads do not mention the new designer drugs that may solve the problem you did not previously know existed, never mind that the tired feelings and loss of drive may mean that you have this debilitating but potentially crippling condition. Future ads will sell you on the drugs; right now the pharmaceuticals are trying to sell you on a condition. You do have a condition with that tiredness and diminished drive and/or capacity. It’s called old age. Older guys are statistically more likely to carry chromosomal imperfections. Your "Low T" and diminished drive and/or function is nature’s way of making you less likely to share sperm that could produce weak or unhealthy offspring. You can try the drugs, or do what our fathers did: be more physically affectionate with your wife/partner and make sure there’s always a fresh supply of batteries in the house.
In the diabetes sense, the "created" condition is "pre-diabetes." They’re setting you up as early as possible to be receptive to taking drugs in the near future.
In fairness, early detection of Type 2 can prevent devastating ill effects of diabetes. Unfortunately, pharmaceutical profiteers help define the diseases you will soon have.
People need to use their own judgment, and take to heart the catchphrase "when diet and exercise are not enough." Your body very well has the level it wants to be at on its own. Taking drugs will almost certainly change that biochemically, but the pharmaceutical balance sheets may derive more from it than you will, and beginning the drugs too early may make your body lazy with its own functions. If that happens, you are guaranteeing lifelong dependence on the drugs.
I have overweight friends who have low A1C numbers, and fit friends who are told by their doctors that they are pre-diabetic or have "a touch of" diabetes.
Don’t tale my word for this casually, but don’t agree to doctors’ recommendations without asking questions and doing your own research.
There is an important aspect to this for Type 2 diabetic and some healthy patients: it is used to diagnose. Over the past decade, the exact number used to diagnose Type 2 has changed up and down several times and is reported inconsistently by different sources. The pharmaceutical companies are involved in that, the same way those companies create "syndromes" such as "restless leg." The pharmaceutical companies are for-profit enterprises that are looking to sell you products, and the lower diagnosis numbers favor their sales. Realistically, how many of us would have heard of things like fibromyalgia if we had not been for all the ads hawking drug treatments? These drugs amount to patented combinations of pain relievers and antidepressants.
If you feel I am being cynical about a serious condition that cripples so many poor unfortunate women, I will steer you towards the latest pharmaceutical ad campaign. The male problems of all aging but not yet old male farts could be "Low T." Ad campaigns like this begin with apparent innocence. You can go to a web site to learn about the condition. The TV ads do not mention the new designer drugs that may solve the problem you did not previously know existed, never mind that the tired feelings and loss of drive may mean that you have this debilitating but potentially crippling condition. Future ads will sell you on the drugs; right now the pharmaceuticals are trying to sell you on a condition. You do have a condition with that tiredness and diminished drive and/or capacity. It’s called old age. Older guys are statistically more likely to carry chromosomal imperfections. Your "Low T" and diminished drive and/or function is nature’s way of making you less likely to share sperm that could produce weak or unhealthy offspring. You can try the drugs, or do what our fathers did: be more physically affectionate with your wife/partner and make sure there’s always a fresh supply of batteries in the house.
In the diabetes sense, the "created" condition is "pre-diabetes." They’re setting you up as early as possible to be receptive to taking drugs in the near future.
In fairness, early detection of Type 2 can prevent devastating ill effects of diabetes. Unfortunately, pharmaceutical profiteers help define the diseases you will soon have.
People need to use their own judgment, and take to heart the catchphrase "when diet and exercise are not enough." Your body very well has the level it wants to be at on its own. Taking drugs will almost certainly change that biochemically, but the pharmaceutical balance sheets may derive more from it than you will, and beginning the drugs too early may make your body lazy with its own functions. If that happens, you are guaranteeing lifelong dependence on the drugs.
I have overweight friends who have low A1C numbers, and fit friends who are told by their doctors that they are pre-diabetic or have "a touch of" diabetes.
Don’t tale my word for this casually, but don’t agree to doctors’ recommendations without asking questions and doing your own research.
Tuesday, August 7, 2012
The ADA Wants You{r Money}
I looked over the main site of the American Diabetes Association, http://www.diabetes.org/ in late July, 2012.
The site name indicates that the ADA "owns" diabetes. Technically with the way domain names are managed, they do, at least on the .org level. The dot-com version is owned by Health Coach. The irony is that the ADA’s "org" site comes across as a lot more commercial.
"Donate" is more prominent on the main navigation bar than "News and Research" is. The prominent upper left directly below the navigation bar has changing content that confuses us who have visual impairment. The other images in the spot sell a book; beg for donations; advertise for a meal planning site; and entice browsers to be the first to raise $1,000 online in order to receive a free necklace. Th four advertising spots cycle endlessly.
Other elements of the site sell tote bags "for a good cause; ask for recruitment into support circles; list non-disappearing links with options of different ways to donate to the ADA; "pledge to end" diabetes; attend an ADA seminar "session;" sign up for "latest news ...and opportunities to support the American Diabetes Association;" chances to buy or renew a subscription to the ADA’s magazine; and a section allowing you to "shop to stop diabetes." The bottom panel is the clearest section of the entry page. It has four logos, all to assure you that passing your credit card number to the ADA online is perfectly safe.
Other than a couple pleas for money that talk about "an end" to diabetes, there is no reference to a cure or a search for one.
Hoping to find some type of research meant to cure diabetes rather than ways to manage it (alwaysto the benefit of the pharmaceutical companies,) I clicked on "Research Discoveries." A pop up bleep, but my computer blocked the ad/unsafe element without telling me what the ADA wanted me to buy or give next. That page is another eye-unfriendly jumble of content. A link list stays in place on the left, offering "research advances" and "research merit" and another opportunity to ADA magazines. I was kind of surprised to learn that PDF versions were linked, but did not follow the links to see if the PDF’s were free.
The ADA "researchers continue to make significant contributions to the care and treatment of diabetes and its complications" but "bring hope of a cure for tomorrow" rather than "research" such a cure.
The "Recent Advances" header link entices "Learn about exciting recent advances attributable to American Diabetes Association-funded researchers." One of two things explains why I could find no mention of the most promising development towards a cure (1) I’m blind and the general layout of the site made it hard for me to find or (2) the American Diabetes Association does not discuss breakthroughs developed in non-capitalist, non-pharmaceutical dominated countries like England and Canada.
I suspect the latter.
The site name indicates that the ADA "owns" diabetes. Technically with the way domain names are managed, they do, at least on the .org level. The dot-com version is owned by Health Coach. The irony is that the ADA’s "org" site comes across as a lot more commercial.
"Donate" is more prominent on the main navigation bar than "News and Research" is. The prominent upper left directly below the navigation bar has changing content that confuses us who have visual impairment. The other images in the spot sell a book; beg for donations; advertise for a meal planning site; and entice browsers to be the first to raise $1,000 online in order to receive a free necklace. Th four advertising spots cycle endlessly.
Other elements of the site sell tote bags "for a good cause; ask for recruitment into support circles; list non-disappearing links with options of different ways to donate to the ADA; "pledge to end" diabetes; attend an ADA seminar "session;" sign up for "latest news ...and opportunities to support the American Diabetes Association;" chances to buy or renew a subscription to the ADA’s magazine; and a section allowing you to "shop to stop diabetes." The bottom panel is the clearest section of the entry page. It has four logos, all to assure you that passing your credit card number to the ADA online is perfectly safe.
Other than a couple pleas for money that talk about "an end" to diabetes, there is no reference to a cure or a search for one.
Hoping to find some type of research meant to cure diabetes rather than ways to manage it (alwaysto the benefit of the pharmaceutical companies,) I clicked on "Research Discoveries." A pop up bleep, but my computer blocked the ad/unsafe element without telling me what the ADA wanted me to buy or give next. That page is another eye-unfriendly jumble of content. A link list stays in place on the left, offering "research advances" and "research merit" and another opportunity to ADA magazines. I was kind of surprised to learn that PDF versions were linked, but did not follow the links to see if the PDF’s were free.
The ADA "researchers continue to make significant contributions to the care and treatment of diabetes and its complications" but "bring hope of a cure for tomorrow" rather than "research" such a cure.
The "Recent Advances" header link entices "Learn about exciting recent advances attributable to American Diabetes Association-funded researchers." One of two things explains why I could find no mention of the most promising development towards a cure (1) I’m blind and the general layout of the site made it hard for me to find or (2) the American Diabetes Association does not discuss breakthroughs developed in non-capitalist, non-pharmaceutical dominated countries like England and Canada.
I suspect the latter.
Monday, August 6, 2012
Advance Gratitude
My blog readers who might be interested in sampling some of my fiction had a reduced-price opportunity at one story, if they read on Kindle.
Amazon has the Kindle edition of _The Aether Age Helios_ on sale for $0.99 today. I have no idea how long the sale will last.
This anthology is a concept book in the alternate history genre. The concept was a fascinating one: what if the world-changing industrial revolution occurred in ancient Egypt?
The book includes my story "Advance Gratitude," which opens with a dead grandmother and reveals the fate of her "promised one" grandchild.
http://www.amazon.com/The-Aether-Age-Helios-ebook/dp/B005EZHFRC/ref=sr_1_2?ie=UTF8&qid=1344265375&sr=8-2&keywords=aether+age+helios
My website always links to some free fiction reads under the "Short Story" page at http://www.kozzi.us/short%20stories.html
The stories here range from my "Sivil Galaxi" science fiction to mainstream humor and some of my Rhode Island stories, as well as a 2006 professionally published essay.
Amazon has the Kindle edition of _The Aether Age Helios_ on sale for $0.99 today. I have no idea how long the sale will last.
This anthology is a concept book in the alternate history genre. The concept was a fascinating one: what if the world-changing industrial revolution occurred in ancient Egypt?
The book includes my story "Advance Gratitude," which opens with a dead grandmother and reveals the fate of her "promised one" grandchild.
http://www.amazon.com/The-Aether-Age-Helios-ebook/dp/B005EZHFRC/ref=sr_1_2?ie=UTF8&qid=1344265375&sr=8-2&keywords=aether+age+helios
My website always links to some free fiction reads under the "Short Story" page at http://www.kozzi.us/short%20stories.html
The stories here range from my "Sivil Galaxi" science fiction to mainstream humor and some of my Rhode Island stories, as well as a 2006 professionally published essay.
Diabetes Development
Based on a site inspection in late July, 2012, I express my usual opinion of the diabetes industry. The site I looked over was the main site of the American Diabetes Association, http://www.diabetes.org/
I write this without clicking on any links to more involved or in depth stories. This isn’t laziness. I am legally blind, and even triple-magnified onscreen reading is usually more difficult than it’s worth. I will fact check or seek specific information, but general browsing is just too difficult.
And that difficulty is the first observation of the ADA site. Diabetes is the leading case of blindness. Therefore a diabetes site should be in large print and as easy to navigate as possible. It should not contain multiple columns and smatterings of design elements that scatter attention. The page does not follow in an easy to follow pattern. I need a magnifying mouse; I cannot see an entire page all at once in any detail. The combination of horizontal and columned elements makes it tough for me to tell what goes together without clicking on the magnifier and examining each element separately.
I thought, to their credit, that they do not use "hover-activated" or "floating" hyperlink menus. Those are next to impossible for me to catch in the magnification. I was wrong; the pop up menus actually appear too far down for me to see with the magnifying box. The first link under the first nav-bar link is a list of links that begins with the pharmaceutical company-created condition called "pre-diabetes."
The page contains at least three different navigation bars in different locations. This does not make things easy to find.
I do have training and professional experience in electronic and print publishing including layout and design, so I am not issuing empty criticism. This blog contains more thought to deign elements geared to my "expected audience" than would be readily apparent to casual observers or home-taught developers. This is "Blindsided!" and is of natural interest to other people with visual impairments. The type is large. The white on black reduces glare. The main content is arrange vertically and appears in full on zoom-magnified screens with links and extras off to the right. This positioning decreases the chance that the readers need to scroll right to see all of the main content panel at once. Other elements do not interrupt the main flow of information. I have yet to use any pictures. These aren’t of high value to blind folk and can fluster programs that do the reading.
Some of the ADA’s site’s pictures change, which is jarring to people who can’t quite see what’s happening and if the change was a rollover effect or just something that happens. The hover menu I first hit appeared over the rotating images, which as why I first thought the ste did not use hovering menus.
The navigation bar extends past the edge of the screen on my usual 150% magnification. A more casual look would have led me to miss the link for "research." Maybe I am being presumptuous, but I think that research and other details are more important than some of the links that appear more prominently. This of course leads me to a brief analysis of content, but to keep things in blog-friendly length, that can of worms will be opened next time.
I write this without clicking on any links to more involved or in depth stories. This isn’t laziness. I am legally blind, and even triple-magnified onscreen reading is usually more difficult than it’s worth. I will fact check or seek specific information, but general browsing is just too difficult.
And that difficulty is the first observation of the ADA site. Diabetes is the leading case of blindness. Therefore a diabetes site should be in large print and as easy to navigate as possible. It should not contain multiple columns and smatterings of design elements that scatter attention. The page does not follow in an easy to follow pattern. I need a magnifying mouse; I cannot see an entire page all at once in any detail. The combination of horizontal and columned elements makes it tough for me to tell what goes together without clicking on the magnifier and examining each element separately.
I thought, to their credit, that they do not use "hover-activated" or "floating" hyperlink menus. Those are next to impossible for me to catch in the magnification. I was wrong; the pop up menus actually appear too far down for me to see with the magnifying box. The first link under the first nav-bar link is a list of links that begins with the pharmaceutical company-created condition called "pre-diabetes."
The page contains at least three different navigation bars in different locations. This does not make things easy to find.
I do have training and professional experience in electronic and print publishing including layout and design, so I am not issuing empty criticism. This blog contains more thought to deign elements geared to my "expected audience" than would be readily apparent to casual observers or home-taught developers. This is "Blindsided!" and is of natural interest to other people with visual impairments. The type is large. The white on black reduces glare. The main content is arrange vertically and appears in full on zoom-magnified screens with links and extras off to the right. This positioning decreases the chance that the readers need to scroll right to see all of the main content panel at once. Other elements do not interrupt the main flow of information. I have yet to use any pictures. These aren’t of high value to blind folk and can fluster programs that do the reading.
Some of the ADA’s site’s pictures change, which is jarring to people who can’t quite see what’s happening and if the change was a rollover effect or just something that happens. The hover menu I first hit appeared over the rotating images, which as why I first thought the ste did not use hovering menus.
The navigation bar extends past the edge of the screen on my usual 150% magnification. A more casual look would have led me to miss the link for "research." Maybe I am being presumptuous, but I think that research and other details are more important than some of the links that appear more prominently. This of course leads me to a brief analysis of content, but to keep things in blog-friendly length, that can of worms will be opened next time.
Saturday, August 4, 2012
Elderly Adolescence
I use the term "elderly adolescence" frequently. I either coined the term or unknowingly absorbed it from a long-forgotten source. It is when old people get rebellious against doctors, nurses, their grown children, etc who place constant restrictions or limitations. Just because an old fart gets a little confused does not mean they are incapable of making any decisions for themselves. They get frustrated at having their remaining capabilities ignored to a total loss of control over their own lives. I get frustrated like that a lot, often because people with GREAT intentions INSIST on helping rather than asking if help is needed.
Often, the help hoisted on me is not what I wanted or needed to do. Sometimes, the presumed help actually makes what I wanted or needed to do more difficult. Think of someone moving my drink closer to me. What they have done is moved something around on a blind guy, thus increased the chance for an accident.
The whole social phenomenon makes old people into crotchety old people, and/or worsens people who were crotchety as young people.
Imagine being elderly but still in possession of a strong set of teeth, and being put in a nursing home. You will never be served a fresh apple or corn on the cob again, because "no one" in the home can physically eat those things. You miss those luxuries and ask the nursing home staff for them. They get tired of hearing this same complaint that they consider an "unreasonable" demand from anyone in a nursing home. They will soon have you labeled as one of the difficult patients and be warning every new employee against you.
The elderly have too much opportunity to look back on their lives and remember what they used to do for themselves, how they used to do things in ways that are no longer allowed by caregivers, whether due to the oldster’s decline or the caregiver’s convenience.
Getting old, or in my case going gimp, is a loss of function and independence and freedom. Neither of my two disabling problems, blindness and Charcot Foot, developed overnight, so I am perhaps too empathic to the plight of the declining elderly. Month by month over a period now approaching three years, I have had to accept more and more things I just can no longer do comfortably, if I can do them at all.
Yes, an oldster with visual or reactionary impairments may have to have a grown child take their car keys away because the oldster is a public danger who won’t stop driving on their own. But this does not mean their house key should also be taken away "because they might lose it" or "you’ll never go anywhere without one of us anyway."
The "best" way to determine the extent of exertion needed over an elderly grandma is the individual’s willing to compromise to rational argument.
Just keep in mind that "rational" cuts both ways, and the caregiver’s convenience should not always be the top priority.
Someone may need help dressing; that does not mean they should be told what clothes to wear every day. I need restaurant menus read to me. That doesn’t mean someone else has to order for me.
Often, the help hoisted on me is not what I wanted or needed to do. Sometimes, the presumed help actually makes what I wanted or needed to do more difficult. Think of someone moving my drink closer to me. What they have done is moved something around on a blind guy, thus increased the chance for an accident.
The whole social phenomenon makes old people into crotchety old people, and/or worsens people who were crotchety as young people.
Imagine being elderly but still in possession of a strong set of teeth, and being put in a nursing home. You will never be served a fresh apple or corn on the cob again, because "no one" in the home can physically eat those things. You miss those luxuries and ask the nursing home staff for them. They get tired of hearing this same complaint that they consider an "unreasonable" demand from anyone in a nursing home. They will soon have you labeled as one of the difficult patients and be warning every new employee against you.
The elderly have too much opportunity to look back on their lives and remember what they used to do for themselves, how they used to do things in ways that are no longer allowed by caregivers, whether due to the oldster’s decline or the caregiver’s convenience.
Getting old, or in my case going gimp, is a loss of function and independence and freedom. Neither of my two disabling problems, blindness and Charcot Foot, developed overnight, so I am perhaps too empathic to the plight of the declining elderly. Month by month over a period now approaching three years, I have had to accept more and more things I just can no longer do comfortably, if I can do them at all.
Yes, an oldster with visual or reactionary impairments may have to have a grown child take their car keys away because the oldster is a public danger who won’t stop driving on their own. But this does not mean their house key should also be taken away "because they might lose it" or "you’ll never go anywhere without one of us anyway."
The "best" way to determine the extent of exertion needed over an elderly grandma is the individual’s willing to compromise to rational argument.
Just keep in mind that "rational" cuts both ways, and the caregiver’s convenience should not always be the top priority.
Someone may need help dressing; that does not mean they should be told what clothes to wear every day. I need restaurant menus read to me. That doesn’t mean someone else has to order for me.
Friday, August 3, 2012
Practical Definitions
Before bridging insulin topics to blood sugar topics, I wanted to clarify some definitions, particularly ones in the label/tag bubble that serves as a link menu. I am fully aware that I am using many terms in practical definitions rather than legal or official ones.
"Cialis = Blindness" applies to all boner pills. I do apply it to posts that speak of the onset of the loss of my "good eye" as nothing can convince me that the vitreous hemorrhage would not have happened if I had not taken that damned pill. I apply it because I want the warning always prominent on the blog site, and will continue to do so for as long as the pharmaceutical companies insist that the incidences of these hemorrhages result from underlying condition/s that necessitate boner pills. This catch-22 is shameful, because the drug is intended for the people most at risk. I focused on Cialis because that is the brand that I took. The risks are the same with Levitra and Viagra. Boner pill ads warn about sudden loss of vision but fall far short of warning customers that their eyes might bleed.
I mark "Feedback" on any post that write in response to commented, e-mailed, or personally discussed reaction to a prior post.
I refer to "medical malpractice" as an ethical term, not a legal sense. If the actions of a doctor makes me want to say "Shame on you! I consider it malpractice. It does not necessarily mean something that could trigger a lawsuit, although I probably should consider consulting a lawyer about some of my experiences "Pharmaceutical monopoly" gets applies to any post that refers to the stranglehold of pharmaceutical companies over American life and economy. This ranges far and wide from deceptive advertising to actions (such as the elimination of pork and beef insulin by Eli Lilly and Company) that get decided in favor of profits over patients, to marketing drugs that have not been fully tested over the long term.
"Diabetes" refers to Type One/Diabetes Mellitus and posts that would also apply to age advanced diabetics get marked with "Type 2."
"Social Impact" posts discuss the psychological or interpersonal effects of the blindness or other conditions discussed in the blog.
"Blogging Experience" can relate and overlap with social impact, but is more restricted to observations that stem from the blog itself rather than the conditions blogged about.
When I started the blog, I thought I would be referring to my GP more often than I have so far. I’ve been seeing him since 2005. He’s never done anything to alienate me, but by my reckoning and other people who serve as caregivers or otherwise know details, he’s not a great doctor, so he will remain anonymous.
"The Healthy ears" posts talk about the time before I was seeing the GP, when I managed my diabetes in isolation from medical professionals. I felt a lot healthier before the professionals got involved.
"Caution: Blind Driver" is used when I talk of doing things that visually impaired people "shouldn’t" be able to do, such as driving a car or using power tools.
"Hemorrhage" refers to the vitreous hemorrhage that the Cialis caused. This is different from an eye hemorrhage that produces dark floaters instead of brilliant red blood.
"God Complex" applies to any and all doctors who demonstrate arrogance and "authority" far above the patients who seem to be expected to worship their word and fulfill their will. These doctors talk at patients rather than to them and do not seem to listen to patients.
The other terms should be pretty self explanatory to most, save perhaps "A1C," which will be the topic of an upcoming post.
"Cialis = Blindness" applies to all boner pills. I do apply it to posts that speak of the onset of the loss of my "good eye" as nothing can convince me that the vitreous hemorrhage would not have happened if I had not taken that damned pill. I apply it because I want the warning always prominent on the blog site, and will continue to do so for as long as the pharmaceutical companies insist that the incidences of these hemorrhages result from underlying condition/s that necessitate boner pills. This catch-22 is shameful, because the drug is intended for the people most at risk. I focused on Cialis because that is the brand that I took. The risks are the same with Levitra and Viagra. Boner pill ads warn about sudden loss of vision but fall far short of warning customers that their eyes might bleed.
I mark "Feedback" on any post that write in response to commented, e-mailed, or personally discussed reaction to a prior post.
I refer to "medical malpractice" as an ethical term, not a legal sense. If the actions of a doctor makes me want to say "Shame on you! I consider it malpractice. It does not necessarily mean something that could trigger a lawsuit, although I probably should consider consulting a lawyer about some of my experiences "Pharmaceutical monopoly" gets applies to any post that refers to the stranglehold of pharmaceutical companies over American life and economy. This ranges far and wide from deceptive advertising to actions (such as the elimination of pork and beef insulin by Eli Lilly and Company) that get decided in favor of profits over patients, to marketing drugs that have not been fully tested over the long term.
"Diabetes" refers to Type One/Diabetes Mellitus and posts that would also apply to age advanced diabetics get marked with "Type 2."
"Social Impact" posts discuss the psychological or interpersonal effects of the blindness or other conditions discussed in the blog.
"Blogging Experience" can relate and overlap with social impact, but is more restricted to observations that stem from the blog itself rather than the conditions blogged about.
When I started the blog, I thought I would be referring to my GP more often than I have so far. I’ve been seeing him since 2005. He’s never done anything to alienate me, but by my reckoning and other people who serve as caregivers or otherwise know details, he’s not a great doctor, so he will remain anonymous.
"The Healthy ears" posts talk about the time before I was seeing the GP, when I managed my diabetes in isolation from medical professionals. I felt a lot healthier before the professionals got involved.
"Caution: Blind Driver" is used when I talk of doing things that visually impaired people "shouldn’t" be able to do, such as driving a car or using power tools.
"Hemorrhage" refers to the vitreous hemorrhage that the Cialis caused. This is different from an eye hemorrhage that produces dark floaters instead of brilliant red blood.
"God Complex" applies to any and all doctors who demonstrate arrogance and "authority" far above the patients who seem to be expected to worship their word and fulfill their will. These doctors talk at patients rather than to them and do not seem to listen to patients.
The other terms should be pretty self explanatory to most, save perhaps "A1C," which will be the topic of an upcoming post.
Thursday, August 2, 2012
Price Pact with a Devil
The break in the Eli Lilly Company’s monopoly of the insulin industry came circa 1997, from the Lilly company itself in a situation like following national news by watching Jay Leno monologs.
I received an important notice from the pharmaceutical company. I was on ancient mailing lists, mostly from syringe manufacturer BD. The Lilly Company was concerned about me and wanted to remind me about the dangers of making changes to insulin outside doctor supervision. They didn’t send me such a notice when they caused diabetics who could not afford doctors when they eliminated the availability of beef and pork insulin, but they had become aware of a new peril to diabetics everywhere.
After years of monopoly and manipulation by the Lilly Company, the Humulin patent had run out. Wal-Mart’s pharmaceutical division had produced a generic.
Diabetics needed this urgent reminder for their own health and well being. They should not change insulin to a potentially unreliable product. The letter had a bunch of scare tactic propaganda in it. I choose to curtail memory to avoid incorrect memory or embellishment, but the bottom line message was one that indicated that Wal-Mart was the mortal enemy of diabetics everywhere. And as reward for being a "loyal Lilly customer," the mailing included a coupon for $5 (maybe it was $10...old memory again) off any purchase at K-Mart.
In the time since two-eye blindness onset by a dose of the Lilly product Cialis, the Lilly Company started manufacturing the generic insulin for Wal-Mart. Maybe it was even longer than that; time flies and remembering exactly has that jarring realization that a "four year old" never-seen cousin is actually now in college. The price has gone up a couple times since then, but remains less than $25.00 as opposed to the $50.00+ of non-generic.
To the best of my knowledge, the generic is still exclusively available only at Wal-Mart; I have not re-checked that fact since the last time I was away from home and needed insulin on the spot. The generic is packaged under Wal-Mart’s Reli-on "brand."
I know of and agree with many criticisms of Wal-Mart’s corporate practices. Electronics and powered devices often have models numbers or price bar codes that are exclusive to Wal-Mart while the same item has the same bar code at every other store. Despite quality or social issues regarding their employees, Wal-Marty earned considerable loyalty from me. Wal-Mart stood up to at least this one pharmaceutical giant in a way that only another corporate behemoth can successfully do. Wal-Mart has saved me thousands in the past 15 or so years, and I have never felt as if I had gotten a bad vial.
It also is apparent to me that Wal-Mart’s $4 prescription program also triggered a small pharmaceutical revolution that has been of direct benefit to American consumers. Pharmacy chains have had to come up with similar programs to stay competitive. This reaped benefits for private consumers and Medicaid programs. I lament the blow to smaller mom-and-pop pharmacies, but the competition brought too much gain to too many people for me to join any Wal-Mart protest movement.
Wal-Mart is the giant corporate enemy that is in front of our faces, an obvious enemy. I’d prefer to save my revolutionary’s energy for the less obvious enemies such as pharmaceutical companies who disguise their pursuits of corporate profit under distractions like "it’s so dangerous to change away from our product lightly."
I received an important notice from the pharmaceutical company. I was on ancient mailing lists, mostly from syringe manufacturer BD. The Lilly Company was concerned about me and wanted to remind me about the dangers of making changes to insulin outside doctor supervision. They didn’t send me such a notice when they caused diabetics who could not afford doctors when they eliminated the availability of beef and pork insulin, but they had become aware of a new peril to diabetics everywhere.
After years of monopoly and manipulation by the Lilly Company, the Humulin patent had run out. Wal-Mart’s pharmaceutical division had produced a generic.
Diabetics needed this urgent reminder for their own health and well being. They should not change insulin to a potentially unreliable product. The letter had a bunch of scare tactic propaganda in it. I choose to curtail memory to avoid incorrect memory or embellishment, but the bottom line message was one that indicated that Wal-Mart was the mortal enemy of diabetics everywhere. And as reward for being a "loyal Lilly customer," the mailing included a coupon for $5 (maybe it was $10...old memory again) off any purchase at K-Mart.
In the time since two-eye blindness onset by a dose of the Lilly product Cialis, the Lilly Company started manufacturing the generic insulin for Wal-Mart. Maybe it was even longer than that; time flies and remembering exactly has that jarring realization that a "four year old" never-seen cousin is actually now in college. The price has gone up a couple times since then, but remains less than $25.00 as opposed to the $50.00+ of non-generic.
To the best of my knowledge, the generic is still exclusively available only at Wal-Mart; I have not re-checked that fact since the last time I was away from home and needed insulin on the spot. The generic is packaged under Wal-Mart’s Reli-on "brand."
I know of and agree with many criticisms of Wal-Mart’s corporate practices. Electronics and powered devices often have models numbers or price bar codes that are exclusive to Wal-Mart while the same item has the same bar code at every other store. Despite quality or social issues regarding their employees, Wal-Marty earned considerable loyalty from me. Wal-Mart stood up to at least this one pharmaceutical giant in a way that only another corporate behemoth can successfully do. Wal-Mart has saved me thousands in the past 15 or so years, and I have never felt as if I had gotten a bad vial.
It also is apparent to me that Wal-Mart’s $4 prescription program also triggered a small pharmaceutical revolution that has been of direct benefit to American consumers. Pharmacy chains have had to come up with similar programs to stay competitive. This reaped benefits for private consumers and Medicaid programs. I lament the blow to smaller mom-and-pop pharmacies, but the competition brought too much gain to too many people for me to join any Wal-Mart protest movement.
Wal-Mart is the giant corporate enemy that is in front of our faces, an obvious enemy. I’d prefer to save my revolutionary’s energy for the less obvious enemies such as pharmaceutical companies who disguise their pursuits of corporate profit under distractions like "it’s so dangerous to change away from our product lightly."
Subscribe to:
Posts (Atom)