I had my quarterly nephrologist visit today. It went well and I only had one prescription change to increase my Losartan dosage to 100 mL. I did my labs last week and the results were similar to previous tests. Here are some of the items that are still out-of-range:
Creatinine: 1.50 mg/dL
eGFR: 55
Potassium: 5.4 mmol/L
Urea nitrogen (BUN): 31 mg/dL
Hematocrit: 51.0%
Vitamin D: 27 ng/mL
All the other stuff were within Quest Diagnostic’s normal range.
The most important test result is probably for creatinine. This is a major indicator of kidney failure. Normal range is below 1.30 mg/dL for males. Post-transplant, my results have been from 1.40 to 1.60. Both the UCLA transplant team and my local nephrologist are good with this result. They are more worried if the number changes quickly for the worse. My blood pressure has been higher lately hence the increased Losartan dosage.
My nephrologist is also giving me a referral for a sleep study. I have been a snorer for as long as I can remember, and my sister said I sometimes stop breathing when I sleep. I have been very tired post-transplant so maybe my undiagnosed sleep apnea and anti-rejection medication is preventing me from sleeping well at night.
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I also got a reply from my endocrinologist. I have not seen her in about a year and all my prescriptions are running out. Previously, her office sent my continuous glucose monitor (CGM) to Edgepark because the reader and sensor were considered durable medical equipment (DME). I hate Edgepark. It has been a huge struggle to get anything priced and delivered. I managed to get a reader and fourteen sensor discs from them over the past twelve months. Since my prescription ran out, they were unwilling or unable to get a refill and instead cancelled my order. Sigh.
In my endocrinologist’s reply, she said she sent refills for my insulin and regular glucose test strip to my online pharmacy. She also sent a CGM sensor refill order to the pharmacy instead of Edgepark. I hope that gets processed.
I think the DME part of the prescription was the dedicated Libre 2 reader. Ironically, there was a warning sent out as the reader’s Lithium battery may overheat and catch on fire. Now I am using the Libre app on my iPhone to read the sensor, which means that I did not need the dedicated reader in the first place. Stupid.
Since my parents moved out, I have been doing a lot of microwave cooking. Purely by accident, I found out this week that you can preprogram power and time settings if the heating instructions requires it. On my microwave (Panasonic), you first set the power level followed by the cook time. If you hit the power level button again, you can put in another power/time combination and the microwave will continue cooking/heating using the second set of settings.
For example, I get these Jimmy Dean breakfast sandwiches that require a defrost program and a heating program. I used to do them separately, one after the other. Now, I can set 30% power and 90 seconds immediately followed by 100% power and 50 seconds then walk away. Of course, I do not get to flip the sandwich, but it came out fine.
In addition, I like the croissant sandwiches better than the muffin ones. They have the same content: sausage, egg, and cheese, but the muffins become chewy and hard to bite when heated in a microwave.
As I was going to bed last night, another peripheral neuropathy attack started. I found a simple diagram online and will start tracking pain location each time.
So, this time the pain was on the inside of my right foot. It just started suddenly and quickly got worse. At some point, I decided to try and go take a walk to see if that would relieve the pain. This was my first outdoor walk in a while after COVID.
It was a short 0.9 mile walk at 12:30 am. Since I have not exercised, I was fully expecting to run out of breath right away. However, I managed to go about two-thirds of a mile before feeling anything. When I experienced plural effusion previously, I could not even walk to the end of the block. Still, I am having some issues climbing stairs without breathing hard, so I need to get back to walking more.
After the quick twenty-minute walk, I felt really hungry since I did not eat dinner. At 1:00 am, the only food options were In-N-Out or Raising Canes. I chose chicken fingers. Even at 1:30 am, the Santa Ana location still had many customers. Surprisingly, I was fourth in the drive through line. The location was open until 2:30 am.
For the past six years, my only car has been a 2016 Tesla Model S. It is a very nice car, but since it is an older model, the battery range is not that great. I believe if I charge the car to 100%, the range would be about 220 miles. This is about half of the distance my Nissan Maxima can go on one tank. I have been looking for a new EV, but all of them suffer from the same short range/long charging issue. Since I have free supercharging on my Model S, it seems like a shame to give that up.
I test drove a Model Y Performance this morning at the Irvine Tesla showroom. It is definitely faster than my Model S, but it is not very comfortable. I know there is a trade-off between performance and comfort, but the ride seemed overly harsh. In addition, the speed difference is most noticeable from a standing start. My Model S is fast enough, and I am not going to drag race a bunch of teenagers in Irvine anyway.
So after further thought, I am including plug-in hybrids as part of my car search. You get the same performance and economy on short trips, and there is no range anxiety on long trips. The only issue is that plug-in hybrid models are not that numerous, especially in the luxury market segment. They are also as expensive as EVs.
For example, Lexus makes the NX with a plug-in hybrid drivetrain. I checked inventory for a few nearby dealers, and everything is over $60k. That is more expensive than the Model Y Performance.
I went to my local medical lab for a blood draw this morning. This is the same lab that I have gone to for the past ten years. During COVID, there were strict masking rules, like all medical facilities at the time. Today, the lab check-in receptionist said that masks were optional when she saw me putting on my KN94 mask. Indeed, I only saw one other patient wearing a mask, and only one lab staff out of ten wearing a mask.
Is the pandemic truly over? There has been little news about vaccine boosters and new variants. In the past, if you Google COVID, there is an interactive case count app on the result page with data from the New York Times. That is no longer available. I had to go to the CDC website to find this:
It is hard to see but the weekly case count is negligible. Should I still be worried? It has been almost six months since my last bivariant vaccine booster. Should I get another one?
I started ordering from Amazon Fresh about a year ago. I typically just go to my local Albertsons since it is near my house. I only order from Amazon Fresh when I am buying Amazon branded groceries, like their chips. Previously, you only needed to order $35 to receive free delivery. When I tried to put in an order today, I saw that Amazon raised delivery costs by a lot. Now you need to order $150 to receive free delivery. For orders less than $150, the costs are:
$100-$150: $4
$50-$100: $7
<$50: $10
I would also tip 10% on my orders, even if that makes Amazon Fresh products more expensive than Albertsons. With the higher delivery costs, my $40 order is now costing 35% more than buying similar products in person. It is nice to get groceries delivered, but it is not worth the additional cost for me. Amazon should be saving money on storefronts and logistics and should pass some of that savings to its customers, who already pay $140/year for Prime membership.
I guess I will have to make the three-minute drive to Albertsons later today.
I bought an app called Tessie a while ago that provides a lot of tracking data for my Tesla Model S. From its logs, I can figure out the timeline from last Thursday.
Start
End
Location
Description
7:43 PM
7:57 PM
105 Fwy East
driving home from work
7:57 PM
9:41 PM
Lynnwood Long Beach Fwy
tire blows out and wait on freeway shoulder
9:41 PM
9:57 PM
Lynwood Long Beach Fwy
first tow truck trying to winch car on to flatbed
9:57 PM
10:05 PM
Lynwood Compton
tow from freeway shoulder to next exit then gas station
10:05 PM
10:06 PM
Compton ARCO Station
switch tow trucks
10:06 PM
10:24 PM
Compton
tow from ARCO to 24-hour tire shop
10:24 PM
10:43 PM
Compton Artesia Tire
buying used tire and replacing blown tire
10:43 PM
11:13 PM
Compton Anaheim
drive home from tire shop
11:13 PM
11:22 PM
Anaheim Chevron Station
pull off freeway to check tire pressure and fill tire
11:22 PM
11:42 PM
Anaheim Orange
drive home from gas station
The total trip from work to home was 3 hours and 59 minutes. The scariest part was sitting on the shoulder for an hour and a half, and watching tire shop guy look for a tire that would fit my car.
I ran over something on the freeway last night. I was on my way home from work, and around 8:00 pm, I heard a loud “clunk” sound. At first everything seemed normal, but quickly the tire pressure alarm sounded. Very soon afterwards, I could hear rumbling noises from the right back tire. I tried to pull over, but the next exit was the connector from 105 East to 710 South. I was trying for the next exit but ended up stopping on the shoulder near the end of the freeway connector.
I contacted Tesla roadside service using the app and got a text saying they will get back to me. Then I called my sister, who suggested that I call 511 for motorist assistance. I did, and they suggested I call 911 since I was a road hazard. I did and was forwarded to the California Highway Patrol (CHP). Soon, a CHP cruiser showed up, parked behind me, and the trooper set up some flares. I was still texting Tesla regarding insurance information when the trooper said she will call AAA. I let Tesla know that AAA was coming, and we waited.
After about thirty minutes, the trooper came back, and said AAA was going to be another hour. She could call for a CHP tow just to move me off the freeway. Even though there was an unknown cost, I agreed since it was super scary to park on the freeway shoulder. After another thirty minutes or so, a tow truck showed up. The driver winched my Tesla up the flatbed ramp and towed me to the next exit, then an ARCO gas station.
As soon as we arrived, the other tow truck also showed up. This was the “regular” AAA tow that the CHP trooper called in. The first tow truck driver winched my car down and said the was no charge. I gave him a $20 tip for getting me off the freeway. The second tow truck driver was on the phone looking for a replacement tire for me. He did find a close match for $50, and I agreed. My Tesla uses 245/45 R19 tires and the tire he found was 245/40 R19. Close enough. Instead of winching my car up, he just drove it up the tilted flatbed. Easy.
The tow truck driver said his home base was nearby, so he knew where to get a tire at 10:30 pm. He proceeds to drive deeper into Compton and turn into smaller and darker streets. He finally pulls into a small industrial park and up to this driveway.
The place was a total mess. There were tires strewn everywhere and it looked like the lift had not been used in a long time. But “beggars can’t be choosers” right? The tow driver drives my car off the flatbed, and I also give him a $20 tip while hoping he did not drive me to a gang hideout.
In the meantime, another guy shows up with what appears to be a low-profile tire. I can see from far away that it is not going to fit my Tesla. I think the shop owner is thinking the same, and he starts rummaging to find another tire. Eventually he finds something, a used Toyo 225/55 R19, and he assures me that it will fit.
The owner proceeds to remove my flat tire right in the doorway. He then removes the old, shredded tire and mounts the “preowned” tire in its place. He shows me that they’re the “same” height and dunks the tire into a bathtub just outside the door to check for leaks. Great. I have never seen that at other tire shops. He finally put the repaired tire back on my Tesla and charged me $50. I was wondering why he did not balance my “new” tire, but I kept my mouth shut.
The tire did work, and the car seems to drive fine. Initially, the tire pressure monitoring system (TPM) showed an error in the right back tire. Eventually, the error turned into a reading of 34 PSI. By this time, I was on the 5 freeway and thought the car was pulling right. Fearing that I would get another flat, I took the next exit and pulled into a gas station. Assuming the TPM was still working, I pumped up the tire to 43 PSI, slightly less than the recommended 45 PSI.
Dammit, that clearly says INSIDE yet it was on the outside of the tire. Zero points for attention to detail.
So, four hours after pulling over on the freeway, I finally got back home. I was totally exhausted and just crashed on my bed. I woke up around 2:00 am to schedule a service appointment on my Tesla app. The earliest date was Wednesday, April 19 so I booked it but sent a text to the Santa Ana service center to see if I could walk in. Surprisingly, they answered this morning, and I was able to bring my car in at 9:00 am.
At the service center, the CSR said all the tires are worn so I agreed to replace all four. The wheel, though scuffed up, was still good. However, just buying and installing four tires came out to $1500. The tire pricing was fair, but Tesla charges $65/tire for labor to replace the tire. Not cheap, but I feel a lot safer in my car now.
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Here is the Yelp page for the tire shop. Should I leave a review? In my circumstance last night, I would give them ⭐️⭐️⭐️⭐️. They get minus one star for giving me the wrong sized tire installed backwards, and not even checking balance. If it were a normal day, I would not go there for tires. However, I know not everyone can pay $375 for a tire (and service). I can see in my prior life as a poor student, this may be my only option to keep my car running. My Tesla invoice today can get me thirty or more tires last night.
They also have a web address but the page is blank.
Arg! I totally forgot about some funds I purchased on the Fidelity app and did not download any tax forms. Unfortunately, there were some dividends, and they did provide a 1099-DIV form. It is only $400, but that is about $160 of tax that I owe.
I just sent the form to my tax accountant to see if I need to file an amendment. Both the IRS and California FTB owe me a large refund that I am applying to next year’s taxes so maybe we can just adjust the prepayment credit.
I hate taxes. It is so complicated, even for a finance guy.
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My tax guy said the amount is too small to worry. We will let the IRS and FTB contact me later, probably several months later.
I mentioned before that my parents moved out of my house early last year. They still have some items here in the house, but they moved a lot of stuff. For over a year I have procrastinated on reorganizing the house, but for some reason, I felt motivated this morning. I checked the IKEA website and some shelves that were perpetually out-of-stock were in-stock at the Costa Mesa store. I called my sister for help and she came by to pick me up in her SUV.
The KALLAX cube storage shelf. This must be one of IKEA’s most popular items. I already have one, and so do my parents. I also see this exact item in several friends’ houses. I purchased two black 4×2 shelves (as shown) for $100 each. I also bought another office desk. I used to have three tables of different sizes in my home office that were also from IKEA, but my parents took two of them to their new house. I want to set up one of the empty bedrooms into a media room, so I need a desk, some shelves, and maybe a few chairs.
This BEKANT desk was $400, so it is not cheap. My previous office tables from IKEA were purchased in 2003 and they look great after 20 years. Hopefully, this desk is also well constructed. I may need to purchase a corner desk from the same series later.
All these items are sitting in my garage. I just need the energy to cart them upstairs and assemble them, hopefully sooner than another year.
My investment guy at JPMorgan Chase is always trying to get me to invest more. Back in late 2021, I sold some stock and dropped a large amount into two new accounts, one for high-tech stock, and the other for mutual funds. Here is the return since inception for one of the accounts:
After almost a year and a half, I am still down by ~12%. Of course, it was worse last summer, but the market has not recovered back to 2021 levels. Now the fear of a recession is stronger, but I am not sure where else to invest. High-yield savings account? Treasury bills? A church friend is seeing if I am interested in his b0nd fund. It looks interesting and he is a great guy, but the buy-in is $500k.
Seeing as that I am looking into retirement, I should probably divest from stocks and start increasing the % of bonds in my portfolio.
To help ease back into bike riding, I purchased a electric bike conversion kit from Swytch. There was a lot of social media advertising, and I got sucked in. The kit was not cheap, but electric bikes are expensive. I have a very new used bike I bought before dialysis. I believe I rode it twice and it has been sitting in my garage. It is a Trek 7.4 FX hybrid. They were available from 2015 to 2016 so my bike is at least seven years old.
I opened the box and tried to install the kit on my bike today. My sister was here to try and move the tire and tube from the old wheel, but she was unsuccessful. The old tire is probably too stiff to come off the wheel so I will need to go to a bike shop. We also tried to fit the motor wheel on the bike, and we were also unsuccessful.
The instructions said the slot needs to be 9 to 10 mm. I measured the slot opening and it was exactly 10 mm. However, the axle bolt would not fit. I am unsure what to do. File down the bolt or the slot? I sent an email to customer support, but they are in the UK, and off the entire weekend for Easter. I thought I would be riding this weekend but that is unlikely at this point.
I saved the image from EMG’s website, but it was the same as the 40DC. I hope he jots down which pickup is in each location, but I guess it does not matter. I will probably use both at the same time for a blended sound.
Now I need to find my bass amp and cabinet to see if they still work.
I picked up my guitar today. I cut my finger chopping romaine lettuce for a salad over the weekend so I could not play it, but Paul explained what he fixed. The final bill was the $300 he quoted, and he did not charge me the initial $75 consultation fee.
The bass, however, is a different story. The output from the bass has been low since I purchased it used. My friend did some maintenance, but I do not believe he altered the electronics. Paul said the active pickups are bad, and suggested I replace both with some new EMG ones. I am not too familiar with guitar/bass electronics, being primarily an acoustic guitar player, so I went with whatever Paul recommended. The final bill was $50 for initial inspection, $200 of labor, $100 x 2 for pickups, and $25 for a three-way switch. He is basically gutting the electronics and rewiring everything. The $500 repair bill is likely more than I paid for the used bass, but the body and neck is in really good condition, and he said the bass will sound much better than anything I can buy at that price.
So, the total bill for both guitar and bass is about $800. I really do need to play both instruments more often now.
I am playing this online game called Lost Fortress: Underground. I actually do not like it that much since it turned out to be another pay-to-win clone, but I log in occasionally and try not to spend any money. A big part of these games are alliances that you need to join to survive. Even then, the game dynamics favor high spenders so “strong” players can steamroll all other players and non-spenders have no recourse. Whatever keeps the whales happy, so the money keeps rolling in.
Anyway, there is a huge social media component, which means lots of chats with different groups of players. Our main alliance chat can get kind of raunchy sometimes, but everyone is anonymous, so it is like every other internet forum. Last night, this mysterious message pops up out of nowhere, “Whatever shut the fuck up bitch.” Everyone was puzzled since there were no messages from the player previously. It turns out his wife saw some of the texts in the chat (there are ~90 members) and thought someone was flirting with her husband, hence the mysterious message.
Funny but sad too. The player in question has dropped from our alliance and is probably not allowed to play anymore.
I dropped off both my guitar and bass to Guitar Remedy for possible maintenance and repair. My guitar is a 2003 Taylor 414ceL4, a special edition version of the 414ce. I was given a $300 estimate to fix the frets and neck. It sounds expensive but a new 4-series Taylor is selling for $2500 now. I think I paid $1400 for mine twenty years ago.
Twenty years of inflation.
My bass is an Ibanez SR505. I bought this used many years ago, so I am unsure of its history. The output has always been low for an active pickup bass. Paul (Guitar Remedy) is going to check it out and let me know what should be done. I can get a nice new bass for ~$750 so it will depend on what is wrong with the bass.
I am supposed to go back in one week to pick up my guitar and decide what to do with the bass.
Since I am taking prednisone for anti-rejection, my nephrologist asked me to get a DEXA scan to check my bone density. I read online that taking prednisone long-term has many side effects, including osteoporosis.
The National Osteoporosis Foundation (NOF) recommends obtaining a DEXA if a patient is on prednisone or an equivalent of 5 mg/day or greater for 3 or more months.
So today I called the St. Joseph outpatient pavilion to schedule an appointment. I get most of my scans done in the second-floor radiology department. After being put on hold for five minutes, I was told the diagnosis code provided on the order was not covered by Medicare. The code was Z94.0: kidney transplant status. The scheduler said Medicare needs a code like osteoprosis, high calcium, or something like that. I Just called my nephrologist’s office to let them know and hopefully they can change the order.
I have had many medical procedures and appointments in the past seven years, and I am pretty satisfied overall. The worst part of the experience was insurance. I have both Medicare and Blue Shield. I pay almost $600 per month for Medicare, and it only covers 80% and does not cover medication. My work insurance does not have any premiums and usually pays for most things. By having two insurances, I end up paying more, not counting Medicare premiums. Recently, Medicare rejected a claim due to me not meeting my deductible. Without Medicare, my work insurance would pay for it, but since it is secondary, Medicare gets to decide how much work can pay and it is less than if I did not have Medicare. WTF?
I accidentally smacked the side of my arm on the bedroom door frame today. Unfortunately, the continuous glucose monitor (CGM) was right there, and about half of it came off my arm. I managed to hold it against my arm and was happy that the scanner was still able to read the meter. I also stuck a clear waterproof patch on it. However, I tried to read it a few hours later and it gave me a read error. Luckily, there were only a few hours left in the 14-day lifecycle, so I did not lose much.
I just got back home from seeing a retina specialist. For the past few years, I have seen this doctor each year. With my diabetes history, my ophthalmologist wanted a retina specialist to keep an eye(!) out for any retina damage.
This time, the appointment lasted less than half-an-hour. About ten minutes of that was some paperwork and waiting, and fifteen minutes of for some retina photos and a quick eye exam. I only saw the actual doctor for five minutes; he looked into my eyes using the contraption above. Even for that brief encounter, he brought a guy to take notes on the computer for him. I wonder how much his office charges for the appointment. I will probably look it up later using insurance claim records from last year.
After looking in my eyes, he said that not much has changed. There is still a thin membrane over my retinas but currently not an issue. There is also come retina damage in my left eye, but also not urgent. It was basically the same results from last year, and that is good news.
Life with chronic diseases 