Dialysis Chair Woes (updated)

It’s about 2:30 am. I woke up at 2:00 am and haven’t been able to fall back asleep. I’ve only slept about two hours so far. Of course, I can catch up on some sleep during dialysis but usually the fistula keeps me awake, and Tuesday is when the nephrologists do their rounds so someone will wake me up.

The dialysis center changed chairs since I started dialysis there three years ago. I think it was before I left for PD. I don’t remember having any problems with the older chairs. The new ones look the same but are brown instead of green. However, they seem to give me lower back issues. Usually the nurses wants your legs up so you can’t fall forward out of your chair. Sometimes that happens when your blood pressure drops too much and faint. With the legs raised, it puts a lot of pressure on my tail bone area and it becomes very sore in about an hour. I then have to put my legs down and sit up straight to relive the pressure. With PD, at least I get to sleep in my own bed.

*Ooh, individual cubicles with lots of storage area. Very nice.*

At least my dialysis center offers patients pillows and (heated!) blankets. When I was at the other dialysis center across the street for about a month, you had to bring everything yourself. No onsite pillows or blankets offered. I’m going to try to sit on a pillow today. The pillows are really flimsy anyway, and try a rolled up blanket as a headrest to see if that helps. Otherwise I end up walking out after the session like an old(er) man.

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Wow, list price of the Champion Series 54 medical recliner is ~$2,500. Why is everything so expensive in the world of medical supplies? My home office chair was only $150 from IKEA and I’ve slept in it before.

I think they should upgrade to a full-body shiatsu massage chair. The Inada one from Japan is $8,000 but it looks much more comfortable. And it reclines.

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Update: 7:32 pm

Well, that didn’t work out any better. I tried to sit on the pillow this morning and grabbed an extra blanket as a headrest. The pillow didn’t do anything since it was very flimsy. As soon as the air was squeezed out, it became flat as a bedsheet. The blanket-pillow was better since it provided more support but since I rolled it up to get more height, each time it fell down to the base of the backrest, it was impossible to retrieve and put back under my neck. Initially, this was with both arms free. After they stuck one needle in my fistula so I can’t move it, it was super hard to reposition the pillow and the blanket. I think my butt hurt more than before so I’m not sure what to do. Maybe I need to bring in a nice firm seat cushion to sit on.

Vascular Surgeon Callback

Still waiting…

This is the second time I’ve been waiting for a callback. I got an ultrasound on my fistula last week and the surgeon was supposed to review it and let me know if there’s anything he can do to fix my fistula. Since then, my dialysis nurse was able to stick me successfully on Thursday, and got one in Saturday.

Interestingly, the same surgeon put in my PD catheter. The surgery was fine and the wound healed great but I think the placement was so so inside the abdomen so I didn’t drain well when lying down on my back. The PD nurse said the same vascular surgeon did good work, but is kind of an arrogant prick.

Sigh. I was going to call the surgeon’s office today but got busy with work. When I finally looked at the clock, it was past 4:30 pm. I’m more of a procrastinator so I usually wait a few days before calling but I know the dialysis nurse will bother me about it tomorrow.

Age of Z Origins

Despite my complaints about mobile games and microtransactions, I’ve been playing Age of Z Origins a lot in the past few days, but yet to spend any real cash on it yet. I think my interest will be short lived since I saw another flaw with the game today. I mentioned before that to continue level up, you need lots of resources. You can gather them but you can also buy just about everything in game. As the level requirements grows exponentially, it’s a contact between patience and your wallet. Also, the game has been around for two years. There’s really no skill involved. You either level up over time, or spend money to shortcut the process.

Today, a really powerful player (or a big spender), teleported his city in my neighborhood and started scouting various cities. Since the outcome of battles are determined by the power rating of your units, there’s really no contest. If you have teammates (called alliances) are near by, they can send reinforcements to help you. I’ve never seen this in action. The teleporting invader also skipped my city since I think my defense rating is about the same as his offensive rating. It reminded me of the opening scene from Mortal Engines where the rogue city of London was cruising around eating other mobile towns.

Again, if you’re on the receiving end of this, there is no relief. You will always lose if the attacker has more troops than you. There is no skill you can develop to counter these attacks. This attacker also did not stop at one attack; he/she typically hammered a lower level city four or five times, basically killing everyone in the city and forcing the other player to grind for days to rebuild their troops… or spend money. Since the only equalizer is time or money, if you don’t want to wait, then you got to spend real dollars. The first few days were kinda fun since the game economy has a lot of interdependencies but as you level up, it feels like you’re walking in a bad neighborhood, waiting to get mugged.

I think this pandemic has bee favorable for the gaming industry. All these people sitting at home need something to do. There is only so much video streaming you can binge watch. The Nintendo Switch was out-of-stock when it first came out but soon became available everywhere. I got one last year for $300. Right now, it’s out-of-stock again and slimy resellers are trying to get $600 on Amazon. Much like the price gouging on surgical masks and hand sanitizers back in March.

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Just found out that Camel Games, the publisher of Age of Z Origins is based in Beijing. I could tell they were not a US based company from the in-game dialog. The English is not bad but awkward in places, plus they sometimes use the wrong article, like “a” instead of “the”. Not that I have any secret information but with the controversy over TikTok and WeChat, I wonder what information the app is pulling off my iPhone/iPad and sending to the Chinese government?

I also read on an online review that they charge differently by region, which means US and Europe’s prices for in-game packs cost more than in Asia. I was wondering why a lot fo the super high ranked players appear to be from Vietnam if they had to pay-to-play. The game is not cheap if you want to go that route.

*In-game graphics are kinda inappropriate too. Is this how a military officer should dress?*

iPhone SE Battery Replacement

I have an old iPhone SE based on the iPhone 6. It’s probably 3-4 years old at this point and I have stopped using it when my sister gave me her old iPhone 6S. The battery was already failing when I stopped using it. Recently, I stuck an extra SIM card from my family account to run a few apps in the car. The battery seems to be worse so I spent $20 on Amazon to purchase a replacement battery. The included instructions referred me to this iFixit video:

Holy crap. You have to detach the screen and pull-out a ton of sticky tape? I’ve changed the battery in several iPhones and my Mac Air. They were super easy compared to this mess. Why does Apple do this? To prevent people from fixing their own phones? My old Samsung S5 had a cover that popped off the back and I could change the battery in 5 seconds. It seems like Apple is making it as hard as possible for end users to do their own maintenance or make repairs.

I don’t feel the urge to fix the phone now. It seems like there are lots of opportunities to mess up and damage the phone. Maybe I should leave it as is and trade it into Apple for a whopping $30 on a new iPhone 11.

Mechanical Keyboards

Since we’re spending so much time at home in front of our computers, I bought a new keyboard for my Mac Air. I hate the thin membrane type keyboards. There is no key travel nor touch so I make a lot of touch-typing errors. I learned typing a long time ago during a summer school course at Glenforest Secondary School. These were the days before computers so we were using IBM Selectric typewriters with the ball shaped typing element.

*These monsters were noisy and weighed a ton*

One of the first computers I used for work was an IBM XT clone with an old style IBM keyboard that also had very tall mechanical keys. I spent another summer typing in ocean freight data for my uncle’s company near LAX.

*I can’t remember exactly but it probably looked something like this*

With my experience, I’ve always had an affinity for mechanical keyboards. I find that I can type faster and more accurately on them compared to all the new slim keyboards, especially when you get above 80 words per minute. A few years ago, I bought a Corsair STRAFE gaming keyboard that had Cherry MX red key switches. It was huge and loud, much like the old Selectric typewriters. I brought it to work but ended up taking it home since everyone nearby could hear me type.

*I don’t have the obnoxious WASD keys called out in gray. All the keycaps on mine are black.*

Finally, back to my Mac Air. I used to have a first generation Apple Bluetooth keyboard but the connection was super buggy and it ate through four AA batteries very quickly. I then bought a slim keyboard from Amazon but it sucked for typing. I finally went out to look for a third party OS X Bluetooth keyboard and found a Keychron K4. It uses Gatron red key switches, which are a Chinese copy of the Cherry switches. It feels a bit looser than my Corsair but much better than the Apple keyboard or the crappy slim one from Amazon Basics. My only complaint? In order to include a keypad and still make it as small as possible, they made the zero key on the keypad smaller, and put the right arrow key where part of the key should be. The result is that each time I need to type a “0”, I end up moving the cursor. This is okay in Word but terrible in Excel or other spreadsheets. I think in order to make the keyboard both Mac and Windows compatible, they had to add several function, command, control, and other modifier keys, which cuts down on available real estate.

*Keychron K4. Mine has the RGB LED backlighting so each key will send waves of color across the keyboard*

In the photo above, the third right key on the bottom row should be twice the size and span across the “->” and “0” keys. The keyboard connects very easy using Bluetooth and has a built-in rechargeable battery that lasts up to seven days. Other than the zero key, it’s a well thought-out and constructed keyboard.

New Car Shopping

I guess that’s on hold too now.

About four years ago, I purchased a Tesla Model S for way too much money. My justification was that I needed a car with a HOV (High Occupancy Vehicle = carpool) sticker. In California, if you drive a pure or hybrid electric car, you get a sticker that allows you to drive in the carpool lane. At the time, there was a wait list for stickers for hybrid electrics and since my commute was ~90 miles daily, I needed a car that can take me to work and back even if I can’t charge it during the day. There was not limit on stickers for pure electric cars. At the time, we didn’t have enough level 2 chargers at work so the only safe bet that I could get home after work was a Tesla. I bought the cheapest model available at the time: Model S with a software limited 60 kWh battery and no options other than white paint and Enhanced Autopilot. For that, it was ~$72k before tax and registration. Later on, I paid $2,000 to unlock the battery to ~72.5 kWh for a bit more range.

*My car, except I have a solid white roof instead of glass*

For the HOV lane sticker, California DMV only issues them for two years at at time. The original set I got were white colored and was good until December 2018. Luckily I didn’t get mine until January of 2017 so I was able to get the next set for two years. These are the red ones that expire at the end of this year. DMV also issued purple stickers for first time applicants that lasts until the end of 2021. I believe if I wanted to keep driving solo in the HOV lane, I would need to get another car by January 1, 2021.

*The actual stickers are huge and ugly. I was tempted to just put one on the car but chickened out and put on all four.*

I did receive a call from Tesla Sales a few months ago. They offered me an overnight test drive of any model. Tesla wanted me to get a new Model S but I wanted a SUV this time so I asked for a Model X, since the Model Y was not out yet. Anyway, due to my heart issues, I never went and got the car from Tesla. Since the Model Y is out now, I wanted to compare them side by side since the Model X is so expensive. I already overpaid for one Tesla!

*Tesla Model X. I’m kinda ambivalent about the crazy rear doors.*

Now with COVID-19, and me working from home all the time, there isn’t an urgent need for me to get a new HOV sticker if I’m not going to commute anytime soon. Even when things return to “normal” and I have to drive to work again, it feels like working from home may become a more accepted and permanent part of the work environment. Maybe COVID-19 changed the traffic norms in Los Angeles going forward. I was only saving about 10 minutes each way anyway; it was more psychological than physical. Maybe I won’t need the sticker anymore and can drive my current Tesla for another 10 years.

Church Open Again

I got another COVID-19 status email from my church today. There have been quite of few of them since the lockdown started, stopped, and resumed. The church was closed for Friday and Sunday meetings for a few weeks but they are going to open this weekend again. This means full Friday prayer meeting and children’s programs, plus Sunday Worship. I think I’m still going to stay home. I haven’t been to a Sunday sermon since October of last year. It was heart surgery followed by recovery, then the COVID-19 shutdowns. There are just too many people there in the sanctuary. A few cell group member who went said the church tries to keep separation between families but the air doesn’t care. It’s like having a non-smoking section in an airplane… air circulation doesn’t really work that way. I’ll still go to the Divorce Care Group on Thursday nights since it’s only a few people in a large conference room. Several hundred plus kids is a different story.

Caniac® Club Freebie #2

So I got my free Box Combo from Raising Cane’s. They did load the free meal on to my club card within two days. In the meantime, I’m getting a lot of emails for “free” concerts on their Facebook page. Tonight, I got another email:

Surprise is right. Since the only food I order there are combos, which comes with a drink, I’m not sure when I’m going to need a second drink with my meal. Especially when I shouldn’t be drinking even one in the first place. I guess I can try to order single chicken fingers and see if that will work then add the free drink.

Dim Sum, Different Restaurant

My mom woke me up this morning and asked me what I wanted for brunch. She was ordering dim sum from China Garden, which was our usual dim sum restaurant before the pandemic. I had just printed the menu for her last night. The dishes were similar to what I ordered last week from the Dim Sum Company but more expensive. Instead of $3.22 per dish, items started at $4.58 with some items costing $1 or $2 more. I have to admit most of the dishes taste better at China Garden but its it worth it? We got seven items last week. This week, we got six items plus a noodle dish that costs $16. The total came out to ~$50 which is double what I paid last week. The drive is about 5 minutes shorter since China Garden is in Irvine and there was no line. I think most people order ahead instead of ordering on-site so no wait.

*When China Garden Irvine was full of people (*Tripadvisor*)*

Was it worth it? I don’t know. I thought the noodle dish was too expensive for what you got. They didn’t have the lobster yee-mein special anymore so it’s $18 instead of $10. However, the tofu wrap and shu-mai from The Dim Sum Company was pretty bad to the point of being inedible so it’s a wash. My mom kept complaining about the quality of food from last week so I guess we’re ordering from China Garden from now on.

iHemo Dialysis System

I’m not going to comment on the fad of naming products iXxx after Apple’s iPod/iPhone/iPad/iMac.

This is something that came out of UCSF’s Kidney Project. I made a post at the beginning of the year. Over the years, I’ve made some donations to the project but I’m always disappointed in the lack of progress and funding by the government. Pur government spend a ton of money on all sorts of useless crap but can’t find a few million dollars for artificial kidney research that will save billion? Anyway, I read earlier that the project has made some progress on the actual filtering membrane but not the challenge of making a self-contained unit that drains waste to the bladder. I guess this is a good compromise for now. From what I read, they can implant the filtering device inside the patient’s body, then connect to catheters that will drain toxins and excess fluids using an external pump. This means no needles and no blood outside the body. It’s almost like peritoneal dialysis but with the diffusion filtering done in the implanted unit instead of using your abdominal membrane. Here is an intro video:

UCSF Kidney Project website

It’s not the same as a full implantable artificial kidney but it’s a good first step. It was enough for them to win a $500k KidneyX prize. As far as I know, the UCSF-Vanderbuilt project is the only one of it’s kind. There seems to be no one working on this issue.

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I stand corrected. There seems to be a lot of participants in the KidneyX competition. Hopefully some or many will develop into something viable for use to treat kidney failure.

Fistula Update 8/8/2020

Everyday is an adventure at dialysis-land. I found out today that Tuesdays and Saturdays are busier than Thursdays because some patients only come twice a week for dialysis. When I started, I was only on dialysis twice a week for three hours per session. Over time, this has become three times a week for four hours per session. That an increase of 100%.

Since it was busy, the nurse connected me via the chest catheter first so I get all my dialysis time in. Later, after I had fallen asleep, she came and woke me up to try and stick me with the needles. She used short 17-gauge needles again even though the throughput is less. The venous needle went in okay after some digging around but the arterial one wasn’t cooperating.. After a few tries, she gave up and another tech came to try. He stuck me a bit lower in the arm and was finally able to get good position. I think it was about 7:00 am by this time so only a bit less than three hours remain.

I was tired again so I slept some more. The nurse came by and woke me up at ~8:30 am because she wanted to flush and tape up my catheter. Then she changed her mind and decided to wait until the end of the session. Great, I got woken up for nothing. Anyway, disconnecting went mostly okay. The venous needle site bled through the first gauze bandage so they had to change me while I was applying pressure to stop the bleeding. I just took off all the gauze and the hole from the missed attempt is still bleeding after ~7 hours. Ugh. I hate this fistula. Almost makes me want to ask them to keep using the chest catheter regardless of the infection risk.

Also, the second tech that stuck me is a big fan of the company I work at. Last year, I bought for him a lot of logo’ed clothing with my employee discount. He kept asking about our stock. We’re a private company so the stock is not listed on any stock market. He said to give him a day’s notice if we ever go public. He wants in on the IPO shares. Sure, so does millions of other investors. Like I have enough clout to get additional shares in an IPO. Most of the time it’s like getting free money.

Perils of Part-tim Work, Part I

We had a big week this past week at work so our CEO gave everyone the day off. Supposedly he sent out an email to everyone that I didn’t see. Then the VP of HR sent out a more detailed email that I also didn’t see. I usually read emails from both those people so I’m not sure what happened. Anyway, Friday (today) was classified as a paid holiday, which I think I won’t get paid since I switched to part-time this week. What shitty timing. I’m not sure how this works though. If I’m getting paid 75% of my salary, does that mean I get a day taken off my pay? So instead of paying me 30 out of 40 hours, I only get paid 22 hours? Also, since I didn’t know about the “holiday”, I scheduled a bunch of calls to external suppliers and was answering emails. It wasn’t a full-day but I worked quite a bit today. I was also wondering why I wasn’t getting the regular volume of emails. Duh!

Medicare Premiums Update

I just got the billing from 9/1/2020 through 11/30/2020 and it was for $1,388.10 or $462.70 per month. I think it’s the same as what I paid since the beginning of the year. It’s much higher than the base $144/month premium but worth it compared to the cost of dialysis, even at Medicare prices. For comparison, I also got the EOB (explanation of benfits) for May from dialysis:

Cost without benefits = $32,687.23
Your plan rate = $4,047,42
Your plan paid = $810.81

This is from the perspective of Blue Shield, my work insurance carrier. On medicare.gov, I found the same claim and Medicare paid $3,236.61.

Medical insurance is weird in the US. If I didn’t have insurance, my dialysis center would initially charge me the $33k for services in May, but we will probably negotiate that down to some lower number. If my work insurance was paying, then the “plan rate” would be around $26k, and Blue Shield (or ultimately my work) would pay it. With Medicare, the dialysis center only gets $4k of which Medicare pays 80%. Again, with Medicare for All at the current pricing, all hospitals and clinics would go out of business.

So just for dialysis, I’m paying $463 per month and Medicare is on the hook for $3,200. The difference comes from Medicare taxes paid by everyone receiving a paycheck.

Locksmith Door Repair

The doorknob on our door to the backyard broke a few days ago. I told my dad to find a locksmith to come and replace the lock. He, of course, wanted to see if he can DIY it and spent almost an entire day removing the lock from the door. It turned out a part of the lock was still stuck in the jamb so he could not get the door open.

Finally, last night he called a locksmith and they showed up promptly at 9:00 am today. It took them <2 minutes to get the lock mechanism out, and about 10 minutes to rekey and install a new lock. It cost us ~$210 for the entire bill: travel, lock removal and replacement, lock rekey, and part cost for the new lock itself. Their ad said they’ve been in business for 43 years and they did a quick and professional job.

Of course in the era of COVID-19, they didn’t come in the house. Initially my dad shook hands with the locksmith, after which they both paused and realized that we don’t shake hands anymore. I also make my dad wear a mask. I think this will be the new normal in interactions with strangers going forward: face masks and fist/elbow bumps.

Divorce Care Group

I went to church tonight. I mean I physically showed up to a conference room in the church office for a Divorce Care group meeting. I think one of the pastor mentioned it to me several years ago but it’s the first time the group met since then. Unfortunately, there are only two participants, including me. There was a pastor leading the group, and two guests who were divorced, met at a previous Divorce Care group meeting, and got remarried to each other.

The course is supposed to run for 12 weeks and includes videos and discussion. I believe we are cutting it down to only four weeks. We talked for a bit, watched a short video, then the pastor threw out some questions for discussion. It was a good meeting, though having a few more participants would probably help the discussion. Also there is no remote option. I had asked about joining on Zoom or something but for this kind of group, remote participation is likely not ideal.

At first, I felt embarrassed even attending the group. It’s been just over 14 years since my divorce has been finalized. A lot of people think I should have gotten over it by now and moved on. I think I mostly just ignored the issue and never processed or grieved properly. That’s why after so long, I still have dreams and thoughts that pop up randomly.

As I mentioned before, I see a lot of patients with spousal support. I think that’s great if you have it. However, if you are single when you start dialysis, it’s going to be much harder to find a partner? Who wants to go out/get married to someone which such a high mortality rate, can’t travel anywhere, and needs to go to the dialysis center three times a week?

Post #666 – Dialysis and Religion

It’s just a number.

I saw a post on r/dialysis today asking dialysis patients about religion. Pretty much in line with Reddit’s demographics, mostly liberal young white males, most of the responses were from atheists and agnostics. There were some exceptions but the non-religious majority was quite noticeable. I was going to post a reply but discussing religion online seems to be a risky proposition with very little rewards. Still thinking about it. Currently there are only 34 comments on the thread since r/dialysis is not that popular of a subreddit.

Even if I don’t post it, I’ll come back and edit this post with my thoughts, most of which I’ve posted before.

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For me, religion has always been a personal thing. I’m naturally an introvert so going out and engaging strangers in evangelism is not ideal for me. Usually I like to work behind the scenes so I fit right in with sound engineering. Even playing the bass on stage, you’re basically at the back and no one notices you anyway. I’m also terrible with having a consistent prayer and quiet time. I usually get up too late, or just fall asleep at night. I’m not very disciplined when it comes to personal time. That just means my relationship with God is not as it should be. So when people at church talk about hearing from God, I’m usually clueless about it.

Of course, as a Christian, you think about good and evil, and why things happen. Theology says God has a plan that is too grand for humans to understand. We just need to trust that God is sovereign and all thinks work out for the good in the end. It sounds and feels good, but when you are in the fourth hour of dialysis for the third time this week, and you feel totally drained, those words are of little comfort. I talk about asking the “Why?” question all the time but there’s no answer yet. It’s a daily struggle between faith and the reality of living with a chronic disease that’s trying to kill you.

There’s also supernatural healing, which is discussed a lot in the Bible, and our church is a big believer in healing. I’ve been the subject of several church-wide prayers about healing for my kidneys, but I don’t there was any physical change. This is another challenging area for me since with God’s promise of healing, there’s hope. But how long does hope last? Three years? I’m already beyond that point. Five? Ten? Twenty-five years? I’ve also mentioned that this hope has affected my decision making about dialysis and managing my health, not always for the better in hindsight. The fact that I thought dialysis was temporary for so long probably prevented me from getting a fistula until now, and taking a huge risk in having the first “temporary” catheter for 20 months.

What’s real though is the support from my cell group. I’ve only know them for four years but they have been very supportive and a big help during my heart surgery recovery. It’s good to know that a group of people know your struggles and are praying/cheering for you. I share a lot with the group, stuff that I wouldn’t tell my family. Since I’m divorced, I don’t have the spousal support that I see many patients have so the cell group is the next best thing. They all seem to be much more spiritual than me so maybe I’m learning a few things as well.

In the end, I do think you need some kind of support while going through dialysis and the entire transplant waiting game. If you can get that through family or friends, that’s great. Church seems to be another place you can get support. Also, there is the question of what happens if you die from kidney failure? Do patients normally think about it since death is so close-by? What do atheists/agnostics believe about the afterlife? Do you just die and disappear? Verifiable or not, I believe religion tries to provide an answer to that question, and it’s one less thing for me to worry about.

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As of now, I don’t think I’ll post this on Reddit.

Fistula Update 8/6/2020

For the past 2-3 weeks, I’ve been using the chest catheter because the only tech that can stick me is out. I got used to having the use of my right arm again during dialysis, and no pain! With the proliferation of personal protection equipment at the clinic, I think the risk of infection with the chest catheter is lower than before. I’m also still waiting fo the vascular surgeon to get back to me on yesterday’s fistula ultrasound.

So about an hour into the session, my current nurse comes by with two 17-gauge short needles and said she wanted to try. I think she tried once before an failed. She goes ahead and feels for my veins for awhile, and sticks both needles in one try. The arterial one did hurt on insertion even though she used lidocaine, and the venous one hurt for the rest of the session but no bruises or leaks. Since she used 17-gauge needles (thinner), they could only run the machine at 250 mL/min max. So even though the dialysis wasn’t as effective, at least the fistula got used for three hours. Now what do I tell the vascular surgeon?

Mobile Gaming Economics

<rant>

I’m pretty old. Old enough to remember a world before home computers and gaming consoles. My first computer was a Commodore VIC-20. It was a sad little computer that hooked up to your (analog) TV set. I did some programming on it using BASIC, but mainly to play games. I had some game cartridges and the rest were stored on cassette tape. I then moved up to a used Apple ][+, which I used in college, and then a Mac Plus. That computer was crazy expensive at the time for what you got and again, I mainly bought it to play Dark Castle (OMG, there is an emulated version online). Anyway, I’ve changed computers a lot over time, and also bought a few gaming consoles. Currently, I have:

Alienware R7 gaming computer
HP 9480M laptop (work computer)
Apple Mac Air (Mid 2012)
Chromebox (attached to TV)
Raspberry Pi 4
iMac (old hand-me-down from my sister for treadmill)
Sony Playstation 3
Sony Playstation 2 (with DDR dance pads!)
Nintendo Switch
Nintendo Wii

These are just the items that are hooked up and turned-on once in awhile. My parents each have a pretty current PC plus a bunch of obsolete stuff in boxes.

Anyway, I played a lot of games. Not really good at anything specific but I probably have 50+ games for the consoles and countless games for the PC. What I didn’t take into account is mobile devices. Like computers, we have a bunch of smartphones and tablets at home, mostly Apple iPhones and iPads. Since everyone is stuck at home due to COVID-19, we’re spending a lot of time on mobile games too.

I’ve noticed something different about mobile games. A lot of them are FTP (free-to-play), but then nickel-and-dime you to death. I know A games for PC and consoles are ~$60 but typically you buy it and you’re done, except for some DLC later. One type of mobile games seem to be designed to hook you in, then irritate you enough that you pay a dollar (or more) here-and-there to continue to make progress in the game, often spending hundreds of dollars. Kind of like drug dealers giving out “free samples” of crack and heroin. The other type embeds a million 30 second ads between different levels so you spend more time watching ads for apps you already have than playing the game.

Recently, I’m been playing two mobile games. One that falls into the first type is Age of Z Origins. The games starts out fine and lets you do a lot of things. Of course there is a wait timer on everything little task but you get to speed them up for “free”. As you move up the levels, the wait times become exponentially longer. Right now, one of the upgrades take 24 hours. You basically have to sit there and wait that long for the game to progress, unless you spend $$$ to purchase speed-ups. I guess pretty soon the game becomes unplayable unless you spend real money. The other is Plants vs. Zombies 2. It was published by a small company called Pop Caps but now taken over by Electronic Arts, famous for putting in microtransactions even in $60 games. There was a fiasco awhile back regarding Star Wars Battlefront II that actually affected EA revenues and stock price. Someone from EA was making excuses about asking for more money after charging $60 for the game. That comment has 668k downvotes, which is supposed to be a Guinness World Record or something.

It does seem like we’re stuck with the crack cocaine of the gaming world with mobile games. If you look in the iOS app store under games, almost all of them are “free” but with “in-game purchases”. If it is a permanent addition to gameplay or functionality, that’s fine. But for “spendable” items like gems, gold bars, etc., it’s just like getting more drugs for your habit until you quit cold-turkey or go broke. Sad.

</rant>

SRTR Reports for August 2020

Looks list another set of reports from SRTR for kidney transplant centers was just published. Here is the report for UCLA. On page 11, there is information on wait list that I posted about several months ago. It appears the deceased transplant rate after three-years is now 19.6%, down from 20.2% but probably not statically significant. It says the wait list for Type B remains unchanged at however long it takes. I wish they would just publish that number: how long did the average patient wait for a deceased donor kidney? It seems like they’re dancing around that number for all 60+ pages but don’t actually tell us. I’ll bet it’s the #1 question asked by all new patients. They probably don’t want to totally discourage people when they say 9-11 years.

I looked up Mayo Clinic Hospital in Phoenix, Arizona, and the equivalent number is 55%. That means more than 1/2 of their Type B patients received a deceased donor kidney after three years vs. about 1/5 for UCLA. Do people not fill out their organ donor cards in California?

Caniac® Club Disappointment

I was all excited to finally get a Caniac Club card from Raising Cane’s. Since I eat there a lot, I thought I would get a lot of “points”, kind of like an elite mileage club at an airlines. I registered online then read the FAQ:

Q. What are visits, and can I redeem them for anything?

A. Caniacs can keep track of their visits every time they swipe. The Caniac Club does not currently offer promotions based on how many visits you have had in the past or how many purchases you have accumulated. You only really need to swipe your card to redeem offers or enter contests, though some Caniacs do like to keep a running tally of their visits. With that said, we are currently exploring ways to further improve the Caniac Club. While we do not reward Caniacs based on number of visits,

What?! Then what’s the point of swiping the card each time? Contests? So disappointed. At least I’m supposed to get a free Box Combo but I haven’t seen the coupon yet. I did get an email yesterday about an online concert by some guy I’ve never heard of. I just checked the video link and it was ~1.5 hours long. Looks like a country music guy.