My home Internet provider is Cox Communications. They have been okay; not good but not bad. The service is up most of the time, but it feels expensive. I am paying $84/month for 150 Mbps.
Earlier this week, I received an email from Cox saying they are upgrading their service tiers so I will be getting 250 Mbps for the same price. I am assuming that they are feeling pressure from eventual competition with fiber or satellite Internet. The infrastructure is already in place so giving customers more bandwidth is likely not costing Cox that much extra.
When I purchased my current printer (HP Color LaserJet Pro M252dw), I gave my old one to my dad. It was a HP LaserJet 1022n, a small black and white laser printer. I cannot remember when I purchased the 1022n, but likely more than twelve years ago. It is an awesome printer, and still works great. Anyway, the toner was running low, so I purchased a replacement toner cartridge. The OEM HP cartridge was about $90 on Amazon, but there are lots of third party options. I finally chose one with a lot of positive reviews and Amazon reminded that I purchased the same item in December of 2014 for $20. That last toner cartridge lasted eight years! Snice I was happy with the last cartridge, I went ahead and ordered the same product. Amazon then said I could save some money by signing up for a subscription, and the typical order frequency was five months. Somehow, I doubt I will need another replacement toner cartridge in five months. Also, it was less than $15 with tax, compared to $90 pre-tax for the HP branded toner.
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I also had to buy new toner for my color laser printer since the starter toner that came with the printer ran out quickly. Because it was a color printer, the complete toner set included four colors/cartridges. Again, the OEM HP toner was really expensive, about $316 on Amazon. The third-party toner I purchased was only $60 and I cannot tell the difference between HP and not HP.
Ugh. I tested my blood sugar this morning and it was 350! How did that happen? I ate some leftovers plus some soup for dinner and had a can of soda and some “healthy” chips before going to sleep. The chips had no sugar and very little carbs so I could not figure out what happened. Then I looked at the soda can again, and I had purchased the regular soda instead of the sugar-free version. I must be getting old since this is the third time I have done this.
In my defense, the shelves are confusing at my local Albertsons. I ended up buying Dr. Pepper Cherry when I thought I was getting the Zero version. There is regular Dr. Pepper, Diet Dr. Pepper, Dr. Pepper Zero, and then various flavors like cherry and cream soda. Anyway, I drank two cans yesterday instead on one, and each can has 42 grams of added sugar. No wonder my blood sugar spiked up so high. I would hate to see what the number was right after finishing the second can.
So, it looks like the Evusheld shots worked in providing COVID antibodies. Before the shots, my antibodies count was 31. Now the levels are greater than the maximum test range of 150. I am still waiting for my nephrologist to contact me, but I believe this is the result she expected, and I will be able to go outside again.
I have worked at my current company for almost eleven years. However, it feels much shorter than that since I have been working from home, both full-time and part-time, for several years. When I first started doing in-clinic hemodialysis, I “unofficially” worked from home two days each week. At the time, my dialysis sessions were from 1:00 pm to 5:00 pm so I worked in the morning during dialysis days, then made up the hours at night or on the weekend, while taking the occasional vacation day. I went back to work in the office full-time while on peritoneal dialysis, then “officially” part-time (30 hours/week) after heart surgery and switching back to in-clinic hemodialysis.
I remember about two years ago, in March 2020, the COVID-19 pandemic finally hit Los Angeles, and our department was told to go home. At the time, many people thought the pandemic would last a few weeks, perhaps even a few months. Here we are two years later, and the pandemic still rages on. Here are some charts tracking COVID cases in Los Angeles County:
Daily new cases for the last 24 months
Daily new cases for the last 6 months
Given that I have had four Moderna COVID vaccine shots and the latest dosage of Evusheld, plus the sharp decrease in the number of new cases, I feel I can start going back into the office one or two days each week. I did pose this question to my nephrologist, and she was open to the idea, after checking if the Evusheld shots increased my antibodies count. Since most of my meetings are on Tuesdays, I was thinking of driving on Tuesdays/Thursdays to work for now.
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I received an email from work today that we are ending our indoor masking requirement. It is not good news, but one that was expected sooner than later. Since most of the coworkers in my department know my circumstances, I will still wear my KN95 masks while in my cubicle. Let us see how long I can tolerate wearing it for 8-10 hours per day.
I received my two shots this morning. The medication is a combination of two drugs: tixagevimab and cilgavimab. I was given the injections at the St. Joseph hospital cancer infusion center. Other than getting the shots in the butt muscle, it was not any different from a vaccine shot. Maybe it is given at the cancer infusion center because the is the biggest immunocompromised population?
The nurse (male) that administered the shot was very nice and we chatted a bit. It turns out his father has been on dialysis for eight years, so he understands the issues of being an ESRD and post-transplant patient. I made sure that I was getting the new, higher dosage just approved by the FDA. They did keep me for about an hour after the shots to check for any adverse reactions, but all I have so far are slightly sore butt cheeks. The injection is only good for six-months, so they already scheduled my next appointment.
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Usually, prescription drugs come with a medication package insert with a lot of small font text. I have seen this with many of my medications, including insulin pen needles. For Evusheld, the nurse showed me the insert, and it was literally blank except for the words THIS AREA IS INTENTIONALLY LEFT BLANK. I know the medication is new and is being used under emergency approval, but there must be some information. I showed my dad and he asked, “You agreed to take shots with no information?”
My parents were supposed to move today. They called MoveCentral and scheduled the movers to come today. The move window was supposed to be from noon to 5:00 pm but we asked them to come as early as possible since Laguna Woods will not let moving trucks in after 4:00 pm.
So, at 12:30 pm we got a call from the driver/dispatcher saying they will not make it today since the morning job is running long and needs three more hours. My parents were up all-night packing and disassembling furniture (me too) so this really sucks. We called the original contact person, and the only option was to reschedule for tomorrow. They still will not give us the morning slot since that requires a four-hour minimum. We are not moving that much so no way will it take four hours. She also said something about not confirming the day before. My dad did get a voicemail and text, but since he was busy packing, he did not see them until midnight. She was trying to use that as an excuse, but why were we contacted about the no show today? Were we still scheduled for today without an explicit confirmation yesterday? So much conflicting information.
Anyway, I asked the moving contact to note the 4:00 pm deadline and have the driver/dispatcher call us if they run into another “emergency” tomorrow so we are not sitting at home waiting for no-show movers. I imagine they try to book as many customers as possible, take a deposit, and hope people will not cancel when they no-show. What a shitty business model.
I am 50/50 on whether they movers show up tomorrow in time to make the move. Zero trust.
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Update: 2/28/2022 1:42 pm
Movers are here. Showed up around 1:20 pm.
Last time we hired movers, they stole a box, probably during the “lunch break” they took while driving from old apartment to new house. They got some decent Japanese ramen bowls and a few bottles of Korean plum wine.
This past Thursday I went to my parents’ new house and installed Internet and Wi-Fi for them. The $650/month HOA fees include lots of amenities but do not include electricity or Internet. Since my parents are online all the time, they chose the fastest service available at Laguna Woods, which is 100 Mbps for $50/month. After getting everything hooked up and working, I tested their Internet speed using Speedtest by Ookla and got about 85 Mbps down and 20 Mhps up. Not bad.
At home, I have the 150 Mpbs service from Cox Communications and it costs $84/month. I am also capped at 1280 GB per month and have only gone over once in the past eleven years. My home Internet is number one, four, and five results above.
The outlier is definitely number two, and you can see from the icon that it is a 5G mobile result. I was in some random parking lot near Laguna Woods and got the 290 Mbps test result. At first I thought the result is either an error, or there is some “gaming the system” going on. Just to double check, I tethered my MacBook Pro to my iPhone 12 (that is getting the 290 Mbps connection), and got around 160 Mbps.
So, the latency and upload speed is not good, but I was able to watch Netflix on my computer without any problems.
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Speaking of Internet via cable modem, Laguna Woods also includes basic cable with the HOA fees. I brought over one of the TVs my parents wanted and verified the cable channels are there. If you look at the channel list, there are a few missing channels. The biggest omission is KTLA 5, which is a popular OTA station in Los Angeles. Weird that the channel is not on the cable list of channels. Perhaps there are licensing issues? Some personal vendettas between Laguna Woods, the cable provider, and the TV station?
I have been binge playing Factorio for the past several weeks. I remember purchasing this on Steam a long time ago. Google says the game was published in February 2016; I likely got it when it first came out. Typically, Apple Macintosh computers are not known as gaming PCs. Since the new M1 Pro MacBook Pros are supposed to be pretty fast, I installed Steam and Factorio was the first Mac compatible game I tried. I cannot remember if I finished the game (launch a rocket), but I did get pretty far before. The game starts simple but gets complicated fast with all the research requirements.
This is my base with using five out of seven research chemicals:
The research tree is ridiculously complex, and each new research chemical is much harder than the previous one to produce. I stared with the red flask, then added green, black, and blue. In the beginning, you need to use conveyor belts to move raw material and WIP around. But soon, you can build floating robots that will move material for you, albeit slowly. The crucial technology to make this logistics network function requires five hundred yellow flasks. I could not construct a connected network, so my build was very disjointed, and needed me to run around as a courier. The enter research cycle for this technology took almost an entire day to complete, but now I can push/pull material from anywhere to anywhere. Unfortunately, I think i need to tear down most of the build and reconstruct it to take advantage of the floating logistics network.
I am not sure why I did not play this game all that much during dialysis. It is the perfect time suck but does require logic and concentration to build ever more complex systems. Looking back, I probably suffered from a bit of brain fog while on dialysis since it only cleans your blood enough to keep you alive. There are still lots of toxins in my blood and electrolyte imbalance is a thing. Anyway, I am taking a break to think about how to reorganize and reconstruct the base to move to the next level of complexity.
Not sure who reads this blog, but if you like building games and never heard of Factorio, get it. The game is $30 on Steam, and there are frequent sales.
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Closer view of current base. This is the first research chemical build. It is fairly orderly, with conveyor belts going to research labs. It gets a bit more complex as I tried to double up production and squeeze more and more into the same space. There are several clever (self-assessed) conveyor rerouting to have everything run automatically.
This is the right, or newer side, of the base. The black flask production was still pretty automated, but after getting the oil refineries and chemical plants, the build for yellow flasks was totally chaotic. Notice the abundance of boxes instead of conveyor belts supplying all the factories. Ugly.
However, this was just to get through the advanced logistics research, which awards you with more flexible boxes to move material through the air.
I took a quick walk outside this morning, and I mean quick.
It was only fourteen minutes and less than two-thirds of a mile. I went out to walk because my left foot started hurting this morning at 4:00 am. I got up to use the bathroom and when I returned to bed, I felt a slight twitch in my foot. From that, I knew a neuropathy attack was coming but not the intensity. After about six hours, I can defbinitely say it is really bad, like screaming in pain bad. The walk did not do anything to help with the pain, and neither did two Tylenol pills. I have resorted to using a Salonpas patch, and so far it has not helped either.
It is becoming apparent that these nerve pain attacks are happening daily or every other day. I am trying to avoid taking another medication like Gabapentin, but it looks like I have no choice.
From MedlinePlus, possible Gabapentin side effects include:
drowsiness
tiredness or weakness
dizziness
headache
uncontrollable shaking of a part of your body
double or blurred vision
unsteadiness
anxiety
memory problems
strange or unusual thoughts
unwanted eye movements
nausea
vomiting
heartburn
diarrhea
dry mouth
constipation
increased appetite
weight gain
swelling of the hands, feet, ankles, or lower legs
back or joint pain
fever
runny nose, sneezing, cough, sore throat, or flu-like symptoms
ear pain
red, itchy eyes (sometimes with swelling or discharge)
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Zero effect from Salonpas so far.
Typically, the only thing that helps with the pain is sleep. I always take Tylenol, but I do not feel is has made any impact. I have also taken some leftover opioids like oxycodone and codeine but any pain relief has been minimal. The best solution is to sleep it off, but I just woke up from bed so not tired yet. Usually the pain would prevent me from sleeping for so long that I just pass out from exhaustion. This is going to be a long, painful day.
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I feel the pain intensity is getting worse after I put on the Salonpas patch.
I just signed on to the Social Security Administration website and saw that I received a notification regarding new Medicare rates. There is a base rate for Medicare part B, plus an adder based on your AGI from prior year tax returns. Anyway, starting this year, my Medicare premium increased from $508/month to $578/month. That is almost $7,000 annually.
I am still working so I have good coverage from work. Right now, the work coverage is secondary, and it pays for all my medication since I do not get Medicare part D. My work insurance did say that they would pay for all my sister’s post-transplant medical costs. I really do not know why I still need to carry Medicare, other than the rumor that it becomes harder to get Medicare again if you voluntarily give it up. In addition, if I decide to “retire” and not get another job, I can have Medicare cover 80% of my bills for the next two years, but I will not have prescription coverage. So confusing. Is there is medical insurance that only covers the 20% Medicare co-pay?
I think I should “move” to Ontario for six months so I can get medical insurance there then retire.
Last week, my endocrinologist increased my Toujeo prescription from twenty-four units daily to thirty-two units daily. That is like a 33% increase. My existing prescription at the online pharmacy was out of date, so I asked the doctor to send in a new prescription. I had just received a “three-month supply” of Toujeo, but the pharmacy sent out another order. However, they shipped me only three pens (one package) under the old prescription but shipped nine pens (3 packages) with the new prescription. I cannot figure out the math. Also, both co-payments for the insulin were $60.
My current insulin stash. Need to refill the Humalog. Last time they sent me five boxes.
My parents’ house purchase will close escrow this Friday. I have lived with them for the past eleven plus years so it will be strange to live alone again. The last time I lived by myself was right after my divorce. My parents were living in Canada, and my sister was in Portland, Oregon. This time, my sister is five minutes away, while my parents are 20 minutes away.
Still, I think it will be weird living by myself in such a large house. The house is not huge, but 2,200 square feet is too big for one person. Also, for the past five years I have been either sick (on dialysis) or recovering from major surgery, so my parents have been doing most of the chores. I do not have many physical limitations, but they always tell me to rest when I try and help.
My experience with medical issues in the past few years has been, “If you think things are bad, they can only get worse.” I know some problems have gotten better because of surgery, but my peripheral neuropathy has deteriorated in the past year.
While on dialysis, there were many times when I thought the numbness and pain was getting worse. Looking back, the neuropathy now appears rather stable. I would get attacks every few weeks, and the intensity did not fluctuate that much. Even the everyday numbness seemed constant. After transplant surgery, my blood sugar has been difficult to control, which likely increased the overall level of neuropathy. Most nights, one or both feet would be so numb that I could barely move them.
More alarmingly, the frequency of pain attacks has definitely increased. Another attack just started about 15 minutes ago, and it is the fourth or fifth one in the past seven days. Each time it happens, I basically lose a night of sleep due to the constant pain. The intensity has increased too. Right now, each pain attack would leave my entire lower leg numb for about ten seconds, and this repeats every 30 to 45 seconds. The only remedy is to stay awake until you are so tired that you collapse from fatigue, and hopefully the attacks end when you wake up. Sometimes the pain would just start up again for several hours.
What really drives me crazy is there does not appear to be any immediate drivers to each attack. Sure, the long-term cause is chronic diabetes. The excess sugar in the bloodstream causes nerve damage, and the pain is from dead or injured nerve endings. However, the attacks are totally random. This time, I was tired after dinner, so I took a short nap. I was able to fall asleep, but the sudden foot pain woke me up after about an hour. Sometimes, I would be just sitting, either reading a book or browsing the web and the pain would suddenly appear. Frustrating.
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I may as well connect to the office and do some work since I am unable to sleep from the pain. There is a large meeting tomorrow today (12:39 am) and I need to provide many slides. I sent out three emails over the past week reminding my team of the deadlines, but only about 1/3 of the analysts responded. It is an inconvenient situation as I outrank everyone, both in title and seniority, but none of them actually report to me. It is going to look stupid for everyone if our slides are only half complete for the meeting tomorrow…
My nephrologist just called me and said my results, though positive for antibodies, are relatively low compared to her other transplant patients. Typically, they are well over 150 after three or four vaccine shots, but my result was ~31. She is going to send in a referral to St. Joseph hospital cancer center to see if they will give me one of the few doses they have. Hopefully they will give me the shot since I am pretty much a regular customer, like Norm in Cheers.
You can tell how old I am by that reference.
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Updated: 2/15/2022 1:30pm
Got a call this morning from the St. Joseph hospital infusion center (did not know this was a thing). They wanted to schedule me for the Evusheld shot. That means my nephrologist was able to get one for me. Every bit helps. The appointment is in a few weeks. I will get both shots, one in each butt cheek, and they will also hold me for an hour to watch for adverse reactions. I think I will finally feel somewhat protected from COVID after these set of shots.
My dad just asked me to order a pizza for dinner. Evidently, they burnt something earlier, so we need to order out. Being Super Bowl Sunday, I thought the wait would be well over an hour, but the restaurant said 40 minutes. Since the third quarter just ended, I guess everyone got their pizzas for the watch parties already.
My nephrologist already told me that the number is not indicative of the level of protection, and all the material from Quest says the same thing. However, I still take it as good news that I have some protection against COVID. I still need to take all preventative measures like before, such as wearing masks indoors and social distancing. Good to know that at least one of the four Moderna shots had some effect.
I had two doctor’s appointments yesterday morning. It was not planned, so fortunately they were at separate times. The first appointment was with my endocrinologist. My blood sugar has been slightly lower recently, but there is a lot of variability in the readings. She mentioned that I may have brittle diabetes, which is harder to control. The linked webpage does say that it is rare and typically found in type 1 diabetic s however. I may also have experienced rebound hyperglycemia that would raise my morning blood sugar readings even though I did not eat anything overnight. In the end, she just increased my insulin prescription again, and sent another referral for a CGM (continuous glucose monitoring) meter.
I was done at about 9:15 am but the next appointment was at 10:20 am. I sat in the parking lot checking my phone instead of driving home since I would be heading out right away again. The next appointment was with my nephrologist. She said my lab results were fine but asked me to take some vitamin D supplements since my level was low. We also talked about COVID vaccine, antibodies, and Evusheld availability.
At my previous appointment with UCLA transplant center, they said I should get Evusheld shots, but since I am not a high-risk patient, they do not have enough doses to offer it to me. My nephrologist said St. Joseph hospital only received 40 doses, and the transplant doctor is restricting access to only his patients. One of her other patients told her that UCI received 600 doses for some reason; their transplant program is not that large either. Anyway, her plan for me is to get an antibody test (I did that this morning). If I have zero antibodies after four Moderna shots, she will try and make a case for me to receive Evusheld at St. Joseph. If that is not possible, she will then refer me to UCI to try and get shots from there. I have not had an antibody test before so it will be interesting to see if I do have antibodies.
I am beginning to think that this is part of Amazon’s business model. Since I made this post in September, Amazon has failed to deliver on next day shipping several times, including today. Since my new MacBook Pro only has USB-C connectors, I purchased some adapters. The first ones I bought had fat connectors that would block ports when used.
So, I went back to Amazon and found some that had a short cable to move the large USB-B port away from the computer.
The description said that this product was available with free next day Prime shipping. I do not need these connectors today and it did not affect my purchasing decision, but I can see how having next day delivery may nudge me into buying a product instead of waiting. The fact that shipment delays happen quite often with next day delivery suggests 1) Amazon drivers have too many deliveries on each route, 2) it is part of the algorithm to increase purchases, 3) Amazon’s inventory management system is not as good as they think, or 4) all the above. The only downside is having frustrated customers eventually cancel their Prime membership, which I am contemplating. Amazon Prime video is not that great; I just need to check how cancelling Prime affects Alexa integration with the rest of my IOT devices.
Jeff Bezos (Amazon) and CCP (made in China). Both are huge assholes but very difficult to stay away from.
I received an email from Google to review my January timeline. It was not very impressive. There were only seven dots on the map, with one missing location.
Home
Sister’s house
Albertsons supermarket and pharmacy
Tesla service center in Santa Ana
Pickleball courts in Tustin
My parents’ new house (still in escrow)
Chase bank
UCLA Health in Laguna Hills for labs
On the other hand, even with Omicron variant of COVID raging, I did not get sick. I do know that several coworkers did get COVID, but fortunately none were serious.
Life with chronic diseases 