Archive for the ‘General’ Category.

Using a CPAP is Awesome

I’ve been using a CPAP for 9 years for mild-moderate obstructive sleep apnea. It’s great. If you think you could have more energy, you’re sleepy during the day and you snore and/or have apnea (stop breathing) many times a night, you should definitely ask a doctor about getting one.


First, do you have a problem?

Take this 2 minute quiz, the Epworth Sleepiness Scale (ESS), to find out. I score a 1, which is great.

Do you wake up groggy every morning? That may be because your brain doesn’t get enough oxygen at night!

Do you often wake up with a sore throat in the morning? That’s because you snore!

Your bed-partner and/or an app can tell you if you snore or have apnea. SnoreClock worked great for me! And my then-fiancee told me how my snoring woke her and she’d freak out when I’d stop breathing for 30 seconds at a time.

But I don’t want to have to wear weird medical equipment!

Don’t worry about it’s appearance at all. The only person who will see it, your sleeping partner will LOVE that you aren’t waking them up with your snoring! They will demand that you wear it!

I love mine! I spend less time sleeping every night, have more energy, and think more clearly. And there’s a lot of science that says it’s good for a host of long-term health conditions like dementia, heart disease, etc

There’s sources that say it will take several weeks for you to gain benefit from it, that’s bunk! The very first night you have it dialed in and have a good night’s rest, you’ll know it’s working! It’s like getting 8 hours of sleep every night instead of 4, because it quite literally is!

Some Details

It took a full year to get my CPAP fitted correctly. In the end, it was a stupidly simple fix that 4 (expensive) sleep doctors couldn’t identify. I kept ripping the mask off after 1-4 hours of sleeping because I felt like I couldn’t get enough breath through the mask. The doctors said, “Well, that’s better than nothing” and I’d just stare at them with accusing eyes. The solution: I told a tech at Kaiser I needed to try different masks and despite his mild objections, he let me try some on. With 15 seconds of trying on in the office, I could easily tell it was the right call. I changed from a medium Resmed F20 mask to a large one. The VERY FIRST NIGHT was awesome and it has been ever since.

If you are struggling to get it to work your doctor says that getting 4 hours sleep with the mask is “enough”(that’s what all my doctors said), they are an idiot, don’t go back. It’s true that medical “compliance” is measured by whether a person uses the machine for at least 4 hours per night but that cut-off is for certifying commercial drivers and pilots and such with apnea . If it’s working, you’ll sleep all night with it on; if it’s not working, you’ll sleep 0-4 hours with it on.

I tried a lot of things to help improve my CPAP usage. Now, the only things I do are:

  • wash the mask cushion every 2-4 nights with hot soapy water. Maybe monthly I’ll use isopropyl alcohol for a deep de-oiling
  • Shaving before bed helps, I do it about 1/2 the time
  • If I used a humidifier, I’d probably need to do more cleaning

With Kaiser insurance, my mask replacement parts are free. But when I had a PPO, it was cheaper and easier to buy parts on Amazon than use the janky insurance system.

 

previously, previously, previously

 

 

Insane All You Can Eat Music

TL;DR: All-you-can-eat sushi restaurants in LA play loud, fast, jangly music specifically to keep people from eating too much. This scorched-earth policy ensures that no one actually goes to their restaurants!

We recently went to an all-you-can-eat sushi restaurant in Los Angeles, Fuguya Sushi in North Hollywood while our family was on our way to Harry Potter World at Universal Studios. As we were getting settled for the meal, we noticed that the music in the place was loud, jangly, fast-paced, eurobeat, simply not conducive to eating. We looked over the sushi menu, and knowing that Abigail could really put away the fish, we thought we’d get her the all-you-can-eat special. When the server came over, we ordered all-you-can-eat for Abigail and she told us that either we all got it or none of us; I rolled my eyes. Whatever. Then I asked if she could turn down the music and she tells us in broken English that the music has to stay on, and has to stay loud “for the all-you-can-eat”. She described how all of the all-you-can-eat restaurants in the area play such music so people don’t overstay their welcome.

OMG! They were specifically playing loud, jangly music to push people out of the restaurant as fast as possible! Ugh! It made for literally a tortured dining experience!

 

Here are some of the tracks we listened to on full volume while fish churned in our stomachs

Anti-VEGF Treatment for Macular Edema and CRVO

I have been getting treatments in one my right eye for macular edema related to a CRVO (central retinal vein occlusion) off and on since 2017. I am very happy with the treatments, without them I would have gone blind in that eye within a few months! The treatment has only existed for about 20 years, if I had been born earlier, I would be partially blind now!

The treatment is to get Anti-VEGF medicine, Avastin (bevacizumab) injected by needle in my eye every 8 weeks. In some people, the leak cures itself after a while, in others it doesn’t. When I first was treated in 2017, the treatments were every 3 weeks, tapered to every 8 weeks and then stopped! But 2 years later, the issue reoccured and I’ve been on 8 week call-back for something like 2 years now.

 

Summary of below: one doctor’s treatment routinely knocked me out for a whole day while the other treatment doesn’t, but both save my vision!

I’ve gotten treatments from 3 different doctors at two different practices. The treatments I received from all three doctors (Dr. Jumper and Dr. Johnson of West Coast Retina, and Dr. Vora of Oakland Kaiser Permanente) all had similar, excellent outcomes. The crosshatching and poor vision in the middle of my vision in my right eye would decrease and the acuity would improve over the course of about 2 days, with noticeable improvement in about 3 hours or so. All treatments have been effective for about 6-9 weeks.

The short term outcome of my treatments was dramatically different between my West Coast Retina treatments and my Dr. Vora treatments. There are two important areas of difference: the time to clear the bubble in my eye and my extreme fatigue after an appointment.

After a West Coast treatment, the bubble of medication floating in my eye would take about 2 hours to clear well enough for me to see clearly. Since I usually travel to an appointment on my own, this means I sit in my car for 2 hours after an appointment, waiting for my vision to clear.

More importantly, after most treatments at West Coast Retina, I would have moderate to extreme fatigue. After about half of my West Coast appointments, I needed to go home and sleep for 4 hours, even if the appointment was in the morning. Being generally in very good health, I found this disturbing; I don’t ever need to sleep in the middle of the day. I would say the level of pain would register as a 3-5 on a 10 point scale, which “shouldn’t” cause such a reaction, but it did! I came to count on being “done for the day” after a West Coast Retina appointment. I am reminded that a few years ago, my wife had synechia in both irises, which caused all manner of odd symptoms including headaches, fatigue, increased need for sleep, and irritability but did not cause eye pain per se.

I react to Dr. Vora’s treatments differently. Dr. Vora’s treatment generally feels like getting punched in the eyeball, about 3 seconds of pain at a level of 8 out of 10 and then it’s done. West Coast treatments are more like… I don’t know, getting a needle stuck in my eye, which is a bit slower of a process. Neither experience is better or worse as I am ECSTATIC that I get to keep my vision. But I can tell the procedural and pre-procedural techniques are different. With Dr. Vora, within 10-15 minutes, I’ve recovered emotionally and physically, and the bubble of medicine in my eye has dissipated so that I can safely drive. The pain is at a “2” and falls to 0 within an hour. After every treatment, I’ve been able to go about my day right afterward, which is definitely a better short-term outcome!

There’s no telling if it’s related but the treatments I received in 2017-2019 from West Coast Retina caused a remission of the symptoms, but my more recent treatment from Dr. Vora hasn’t caused a remission, I’ve been getting treatments every 8 weeks for a while now.

I don’t know exactly why these treatments have different short-term outcomes. I’ve asked the doctors and they didn’t have any comment. I’m sure that each is performing techniques they believe are best for their patients.

Getting into a Bathtub Full of Ice Cubes

I have this very intense memory from when I was about 5 years old. I was standing in front of our yellow-beige bathtub not knowing what to do. I was delirious and discombobulated and my parents were talking about me very seriously, my mom’s clear-toned, concerned voice was filling the room, and my dad speaking in his low, serious tone. I don’t remember it but they were both crying. I was flailing my arms a bit, not knowing what to do but to trust them. The bathtub was about one-third full and had all of the ice cubes in the house floating and bobbing in it. They told me to get into the tub.

I recently asked my mom and dad what happened all those years ago and their memory is a bit more clear than mine. I thought I was just standing around confused but they said all three of us were crying before they told me to get into the tub. My memory was that I just got in and although I thought it would hurt, it didn’t really. But my parents both said I screamed a lot as the ice cubes swirled around my hips, knees and toes.

A little backstory: my father has two sisters, Rita and Marcia. Marcia passed away in 2014. She lived at home with her mother, my grandmother Irene, her entire life. She worked for the Sears Roebuck catalog company for as long as I could remember, working as a telephone representative. I’m guessing she took catalog orders and such. She had a raspy, piercing, crass voice that cut the air like a rusty serrated blade. When I think of Marcia, I think of her at family gatherings hollering to my grandmother like a wild mountain goat, “Maaaa? Maaaa! What are you doin’?” She always had that piercing, negative tone, but the rest of the family was accepting of it, so I was too. I often thought about the poor souls who called Sears and she’d tell them what-for.

Back to my story: My dad said that when Marcia was a little girl, she fell off of their bunk bed and banged her teeth into the dresser. The teeth were shoved into her gums and she apparently got an infection because she developed a high fever. My grandparents called the doctor but he didn’t know what to do. My dad said to me with supreme frustration in his voice, “talking to the doctor was like talking to a taxi driver. He didn’t know what to do.” The doctors eventually had Marcia take an ice bath to try and bring her fever down before her brain got cooked. But it didn’t work. The fever got very high and my dad said that Marcia was never the same after that. Before that accident, “she was just like any other little girl”. But the high fever gave her brain damage. It deeply affected her entire life.

So there I was with a fever, my temperature was 104 and climbing despite medicine. We were all rightfully scared. I was delirious. So into the tub I went. And I am forever grateful it worked!

Get Your Medical FSA Money When Leaving a Company

You are entitled to all of your Medical FSA Money, even when you leave your company in the middle of the year.

  • Your entire election is available to spend on January 1st, even though you won’t have fully funded it until the end of the year.
  • The tax code (IRS Publication 969) has no language in it saying what should happen when you leave a company.
  • I scoured the internets for an interpretation of the law and got a “mostly yes” mixed bag of answers (see below)

I recently had an interaction with American Fidelity about getting my Medical FSA money. I left my job and then 3 weeks later I submitted an expense that had occured while I was still working. American Fidelity denied the claim, saying that my account was closed out when I left. So I wrote to them:

My recent reimbursement request for my Health Care FSA was denied because I no longer work for my former employer. I stopped employment on February xx and health insurance from my employer will end on April xx. I submitted my reimbursement request on March 1st (American Fidelity Claim #xx) . Your own website notes “…if the employee has any additional eligible claims incurred prior to [their] date of termination, those claims may still be submitted for reimbursement up to the full elected amount…” I have submitted such a claim and expect to be reimbursed in accordance with the policy you put forth on your website. Please reach out to me with an approved FSA claim or a message indicating why you are continuing to decline this reimbursement request. Thank you very much.

Their response:

Thank you for contacting American Fidelity. We understand your concerns , and we apologize for the error with processing your claim.

Upon further review, we will be able to process the claim for the 1/24/2024 date of service. Please allow 3-5 business days for processing.

 

Yay!

—————————————————–
References

I googled around for an interpretation. Here’s what I found

IRS Publication 969
“You must be able to receive the maximum amount of reimbursement (the amount you have elected to contribute for the year) at any time during the coverage period, regardless of the amount you have actually contributed.”

The “”use-it-or-lose-it” portion of Publication 969 is only concerned with possible carryover to the next year

——————-
Yes, I can get the FSA money
I need to present the claim before the “run-out period”
https://rmr.zendesk.com/hc/en-us/articles/360026564973-Using-FSA-Funds-After-Termination
https://www.askcip.com/resources/what-happens-to-fsa-funds-when-an-employee-terminates/
https://fsafeds.com/support/faq/all/1003
——————-
Strongly Implied yes, from AmericanFidelity themselves
https://americanfidelity.com/blog/reimburse/steps-hcfsa-terminate/
Employers may not limit participants from submitting claims and getting reimbursed for eligible claims, even for amounts greater than their contribution when they were employed.
——————-
Use it before my termination date / Use it with COBRA
https://livelyme.com/blog/what-happens-to-my-fsa-when-i-quit-my-job
https://employeebenefits.ri.gov/sites/g/files/xkgbur816/files/documents/fsa-faq.pdf
——————-
Maybe I can spend my FSA money
https://fsastore.com/articles/learn-fsa-cobra-coverage.html
https://wexbenefitskb.egain.cloud/system/templates/selfservice/dbinv/help/customer/locale/en-US/portal/308900000001012/content/PROD-2260/Using-flexible-spending-account-FSA-funds-after-terminating-employment-or-going-on-a-leave-of-absence
——————-
It’s a negotiation
https://www.washingtonpost.com/business/2023/03/02/work-advice-if-youre-laid-off-dont-leave-your-fsa-funds-behind/

Oakland Zoo

We went to the Oakland Zoo last week and had a great time! The building at the top of the gondola was built by Doppelmayr, the ski-lift company. Every bit of it, from the sound of the machines to the roof angles, reminds me of skiing in my younger days!

Megan’s New e-Bike!

Megan got an eBike last month and she’s loving it! Here’s some pix and such.

2023 Tern Quick Haul D8 Cargo Bike
Color: Tabasco (Orange) /Silver
Serial: LM22T50301
Manufacturer’s service tag: THR3D008
Vehicle type: Cargo Bike (rear Storage)
Manufacturer: Tern
Model: Quick Haul D8
Year: 2023
Primary colors: Orange
Seat tube length: 18in
Wheel diameter: 20in
Frame Material: Aluminum

DISTINGUISHING FEATURES: Orange with silver trim e-bike with cargo space/captain’s chair on back, stirrups and handlebar for rear rider. Front and rear fenders. Abus folding lock on downtube.

She got a captain’s chair in the back so Abigail could ride along.
400Wh battery
250 watt motor
Max speed assist: 20/28 mph (depending on whether it’s configured to be a Class 1 or Class 3 pedal assist bike. I think it’s a Class 1)
Ebike weight: 45 lbs
Max rider weight: 265 lbs
Max weight on rear rack: 110 lbs
Max gross vehicle weight: 330 lbs

Warranty: 10 years on frame, handleposts, forks. 1 year on Tern or Biologic parts

We registered at BikeIndex.org and Project529.com in case it was ever stolen.

Don’t Forget To Archive Your Old Content

This is just a reminder that while content on the internet feels forever, it isn’t.

I just noticed an email I got from Blogger.com saying

Hi Lee,

This email address has a legacy Blogger account associated with it that hasn’t logged in since 2007. In 60 days it will lose access to the account and associated content; the data will be permanently deleted unless migrated to the Google Account system at Legacy migration page.

I noticed the email today but I received it about 4 months ago. Oop! Whatever was there is gone! No sweat, I didn’t have anything valuable there… I don’t think.

 

Police and Crime in SF

There has been all kinds of news about how the “defund the police” movement and “don’t stop shoplifters” laws is killing downtown San Francisco. Here is a more clear take, illuminated by cold, hard numbers.

San Francisco police apparently started a work slow-down in 2020 and haven’t started again. Here is a chart of traffic citations issued:

(source: SFGov.org)
San Francisco has talked about changing police budgeting (“defund the police”) but is hasn’t happened (1). Similarly, no shoplifting laws have changed in California despite talk about doing so (2).

Why have they done this? There is much speculation, all of it centering around politics and money.

Read more at JWZ.org

Seen at the Library

Saw this at the El Cerrito Library! I observed a few patrons see the sign and call into the slot. Heidi, the supervisor was called over and shown the sign; she laughed and said with dismay that it was her responsibility to remove it.