Lunch 2/6/2022

I went out earlier today to eat lunch with a friend. We would meet up often before the pandemic and we usually get pho. Since he is way out in the South Bay, we tried to find a place that was near the middle. My Vietnamese coworker recommended Phoholic in Stanton, so we met up there at 11:30 am.

Unfortunately, when we arrived, there was a huge line outside the restaurant. Since I am still leery of crowds, we decided to eat elsewhere. The restaurant is located inside Rodeo 39 Public Market, which is like an indoor open market with lots of food options. It was less crowded than Phoholic, but some eateries did have lines. We ended up at Kra Z Kai’s BBQ, which was a La0-style BBQ place. Since I am still worried about my blood sugar, I just got a chicken salad. My friend did get BBQ chicken with sticky rice to be more authentic. The salad was just okay. There was a lot of chicken and romaine lettuce, but the flavor of the chicken was bland. The dressing, however, was very salty and vinegary, so I mostly tasted the dressing. My friend said the BBQ chicken was pretty good.

Due to its location, there were many Asians at the market/food court. I thought there was still a mask mandate in California for restaurants, but about one-third of the people were not wearing masks. The clientele also trended young, and the entire place felt like it was trying hard to be trendy. Rodel 39 was about 25 minutes from my house. If I lived closer, maybe I would go back to try out more places, but as is, it is too far for a regular destination. Maybe if the pho was really really good…

Lab Visit 2/4/2022

I went to get blood drawn for labs this past Thursday. It was not planned, but my next nephrologist and endocrinologist appointments are both scheduled for next Thursday. This is good because I can get both sets of labs done with one trip.

The lab visit took longer than usual. It took them almost 20 minutes to combine both sets of lab orders into one list. The phlebotomist ended up drawing ten rubes of blood plus a urine test. The blood stopped flowing freely by the eight tube so she had to press my vein and move the needle around to fill the final two tubes. Still not as bad as the 22+ tubes I had to give for transplant evaluation labs.

I already received some results back. The two items I was worried about were hemoglobin A1C and creatinine. My A1C came back at 7.5% which says I am diabetic, and correlates to an average blood glucose of 169. I was hoping it would be lower, but still an improvement over the 8.0% number from four months ago. My creatinine level was 1.34 mg/dL. This is slightly high, but both my nephrologist and UCLA transplant center were fine with results as high as 1.5. My potassium and calcium were also borderline high, but everything else seems fine.

YouTube Recommendations

During the past two years, partially due to all my surgeries then COVID, I spent a lot of time watching YouTube videos. Views are typically split between K-Pop music videos, clips of Korean variety shows, science/technology vlogs, and whatever random content recommended by the YouTube algorithm.

Here is my YouTube journey from last night:

  • Season 9 episode 1 of I Can See Your Voice (Korea) was available online, so I downloaded and watched it. One of the tone-deaf contestants turned out to be a world-class violinist.
  • I searched for her name on YouTube and found many videos.
  • One of the videos was two Asian guys talking about a 12-year old prodigy. That turned out to be a TwoSet Violin video about Chloe Chua. Researching further, those two guys are professional violin players, and Chloe Chua is a violin child prodigy.
  • Watched a few more of their videos, but this one caught my attention. In it, Chloe is supposed to be giving Brett and Eddy lessons on playing Paganiniana. I do not know if they are playing worse on purpose, but she is awesome.
  • Here is the sheet music and performance by Hilary Hahn, another violin prodigy. This is supposed to be one of the most difficult pieces to play on violin.
  • Watching all the notes fly by reminded me of another piece of music. I used to play trumpet from junior high though first year of college, then for a few more years while I was working. I am not that good. I can play most orchestral music but have problems with high or fast notes like 16th and 32nd notes. I also do not improvise well, so any jazz solos are usually pre-written out. Anyway, something like Paganiniana on the trumpet would be Variations on ‘Carnival of Venice‘ (for trumpet or cornet) by Jean-Baptiste Arban. He published The Arban Method for trumpets and cornets in 1864 and I have a copy of it (not the original of course), though I could not play anything in the book.
  • Here is the piece played by Wynton Marsalis.

Chloe has a YouTube channel and there are several performances with a classical guitar that are great.

Happy Chinese New Year

Today (February 1, 2022) is Chinese New Year. This year, it is the year of the tiger. Here is a list of all the Chinese zodiac animals:

Our family had dinner Sunday night. We ordered some dishes from Lunasia in Cerritos instead of cooking ourselves. People traditionally eat dumplings as a New Year’s food, but we did not order any. Chinese or Lunar New Year is a much bigger deal in Asian then in the West. People here may know about it and a few coworkers tell me Happy New Year, but for most people, it is just another day.

新年快樂

Mother Of All Neuropathy Pain

I can’t take this anymore.

When the whole peripheral neuropathy pain thing started many years ago, it was coming about once a month, and would go away after about 24 hours. Recently however, pain attacks are happening about every other day. There were about three episodes, but I was able to take some Tylenol and sleep them off.

Not tonight.

I am in the middle of a huge attack. It started about two hours ago and the pain intensity has drastically increased. In addition, instead of a short burst of pain each time, attack is about three seconds of excruciating pain. I have taken the usual Tylenol, used a wand massager for an hour, and walked around the first floor of my house to no avail. I am also short of breath and sweaty from shaking my leg during each attach, as it seems to help dissipate the pain. My back is also hurting for some reason; not sure how that is related.

I see my endocrinologist in about two weeks. I am ready to ask for any medication that will relieve these neuropathy pain attacks. They were bearable when only happening once a month, but I do not think I can handle every other day. If the frequency increases further to daily occurrences, then I will be in pain 24/7.

==========

Ugh. I just went ahead and took 5 mg of Oxycodone that was prescribed for post-transplant pain. I never took the medication after surgery since it was easily tolerable. I believe I have taken the pain medication three times in the past for neuropathy pain, but it was unclear how effective it was. At this point I do not even care. Every little bit of pain relief is welcome.

Walking Outside 1/29/2022

Not good.

I finally went outside for a walk. It has been a long time since I walked outdoors instead of using the treadmill in the garage. It definitely felt much harder than before. My legs were numb and sore after the first few blocks, and I was running out of breath near the middle of the walk. I was surprised that the pace was fairly high (for me); it felt much slower during the walk. My heart rate also increased more than before where I would only hit low-80’s. This must be from all the recent weight gain, and not walking consistently for the past few months.

I walked a mile on the treadmill last week and it did not feel this tiring. I hope some of the tiredness is from the Moderna vaccine shot on Thursday, but I need to walk more consistently, especially if we are still going to Europe in June.

New Computer Is Here

Is that Grace Jones!?

I ordered a new MacBook Pro on the last day of 2021 and made a post about it. With most of the flights between US and China cancelled, I thought my shipment would be delayed. However, FedEx is not affected by commercial flights, and I received my computer yesterday. After debating for a while, I ended up getting the 14″ MacBook Pro with the 10 core CPU, 16 GB of RAM, and one TB SSD. I had an opportunity to buy a silver one from Costco for $50 less, but now that I have the computer, I am glad I waited for the Space Gray color.

So far, everything is great. By logging in with the same Apple account, it moved a lot of configuration data over via iCloud. It is much faster, even though I am not running power hungry apps like Final Cut Pro or Logic Pro. Most people get a fast Mac to run video or music production with those two apps, but I think I will stick with iMovie and Garage Band/Audicity/Tracktion for now.

Downsides? Apple seems to change ports on every new model. My 2012 MacBook Air had two USB-A and a Thunderbolt port. The new MacBook Pro had three USB-C and a regular sized HDMI port. Why? Also, my old Acer X213H monitor would not work with the new computer using a HDMI-to-HDMI cable, but I was able to find a HDMI-to-DVI cable and it worked. It is also super expensive at $2,500 before tax.

Big decision: Should I install the Mac OS version of WeChat, knowing it is likely partial spyware for China?

Embedding Spotify

I just realized you can embed a song from Spotify. Cool.

Why is there so much blank space in the block though? Playlist?

Oooh, you can see all the songs in the playlist and choose too. I wonder if it will play ads every so often.

==========

Well, the playlist was fine for the first four songs, but would play wrong songs further down the list. Not sure if this is true for all playlists. Girl Krush is a Spotify curated playlist.

4th COVID Vaccine Shot

I received my 4th COVID-19 vaccine shot yesterday. After my last appointment with them, UCLA transplant clinic put a reminder in my records to schedule the booster. Since their clinics are all extremely far away, I ended up going to my local Albertsons pharmacy and got the shot there. I did call to make sure they were offering the fourth vaccine shot, but everything was fine. I even had the CDC page ready on my phone in case they asked.

Like the other three Moderna shots I have received already, I did/do not have any reactions or side-effects so far, other than a slightly sore arm. I was hoping for a bigger reaction as it may indicate the presence of antibodies.

At least the number of cases is decreasing in Orange County.

https://occovid.com/cases

One Year!

Today is the one-year anniversary of my kidney transplant. On January 27, 2021, my sister and I were at UCLA Medica Center being prepped for surgery. At the time, we were in the middle of a huge COVID case spike that overwhelmed all the hospitals and ICUs in Los Angeles County. Little did we know that the Omicron spike would be much much worse.

However, the kidney is still working fine, and hopefully I will have many more kidneyverdaries.

MBTI in Korea

I made several posts in the past about being a fan of K-Pop, mostly female soloists, and groups. Here is a page from my Spotify 2021 review thing:

I also watch a lot of Korean variety shows, which feature many K-Celebrities. I have noticed a lot of them talking about their MBTI type, especially younger people. This was not a thing until recently. MBTI stands for Meyer-Briggs Type Indicator. From the Wikipedia article:

In personality typology, the Myers–Briggs Type Indicator (MBTI) is an introspective self-report questionnaire indicating differing psychological preferences in how people perceive the world and make decisions. The test attempts to assign four categories: introversion or extraversion, sensing or intuition, thinking or feeling, judging or perceiving. One letter from each category is taken to produce a four-letter test result, such as “INFJ” or “ENFP”.

Though the MBTI resembles some psychological theories, it has been criticized as pseudoscience and is not widely endorsed by academic researchers in the field.

https://en.wikipedia.org/wiki/Myers%E2%80%93Briggs_Type_Indicator

My first introduction to MBTI was during MBA school orientation. It was more of an ice-breaker exercise, and no-one talked about it afterwards, except whether they were E (extrovert) or I (introvert). My guess is that most people in the US do not know or care about their MBTI type, and it is seen as pseudoscience entertainment, like astrology or Tarot cards.

However, MBTI is very popular in Korea. I have seen the cast of many variety shows discuss their type on-air, like their obsession with blood types. It is probably just for fun, but like every attempt to label people, it become bad if used by government or companies to set policy or make employment decisions.

==========

A quick search on YouTube for “Amazing Saturday MBTI” returns a bunch of video clips. This is the episode I just watched that prompted this post. Sorry, no English subtitles. If you have never watched this show, it is really funny. Moreso if you speak Korean or can find subtitles.

==========

Since it was so long ago when I did my first MBTI test, I went online to try again. The first Google search result for “MBTI” produces this link to 16Personalities. I answered their long list of questions and it said my type was ISTJ-T. I guess there is a bit of science in pseudoscience since some of the descriptions agree with my self-assessment, but that is also how fortune-telling works. The career portion was most “accurate” since I do work in a field that is mentioned in the resulting report.

Blog Tagline Update

I just noticed that my blog tagline still read “Life with Dialysis (and CABG).” Initially, it was only about peritoneal dialysis since I needed somewhere to vent my struggles with the process. Along the way, I needed a quadruple heart-bypass surgery, then switched back to in-clinic hemodialysis. Having this semi-anonymous blog helped me cope with all the health issues I was dealing with.

Anyway, I did not want to delete the dialysis part since it was a huge part of my life for ~4 years. I found a website that would generate strike-through Unicode text and I replaced “with Dialysis” with “post-transplant” and left the CABG bit. I did the same for the subtitle(?) as well.

Life is definitely easier with a kidney transplant than having to rely on dialysis to stay alive, but there are still struggles. Additionally, problems like diabetes or peripheral neuropathy do not go away just because I now have a working kidney.

==========

I still have not decided what to do with this blog and my old blog on Blogger. There is ~15 years of posts on the other blog, but lots on this WordPress blog too. I think the easiest is to make posts linking both blogs and continuing here.

Natural Gas Bill

Everything is more expensive.

I just saw some posts on Nextdoor about crazy high natural gas bills so I logged into my SoCal Gas account online. Here is my payment history:

My average bill for the past six months was about $20, so the $128 bill in December is a huge increase. Looking back, this happens every winter since our house has a natural gas furnace, and it has been pretty cold at night. If you look at the usage in therms (usage), it has the same pattern.

Compared to last year however, it does seem I am paying more for gas per Therm. I found this notice on their website and indeed, every cost component is going up. For the natural gas itself, the price has gone up over 100% from a year ago.

Effective January 2021.Effective January 1, 2022, the procurement component of the core sales rate will increase 18.440 ¢/therm to 83.569 ¢/therm. This increase resulted from an overall 16.922 ¢/therm increase in commodity price and an increase of 1.518 ¢/therm in account adjustments. Compared to a year ago, the procurement rate is about 110.2% higher (39.764 ¢/therm) than what it was effective January 2021.

https://www.socalgas.com/pay-bill/understanding-your-bill/natural-gas-prices-explained#rate-change

Since natural gas is a traded commodity, i looked up some quotes online. The price did seem to increase from ~$2.50 USD/MMBtu a year ago to $4.16 today. Now quite 100% increase, but SoCal Gas is probably grabbing some margin too. Looking at my latest statement, the gas commodity cost was $0.65129 per therm in December so the additional 18.440 ¢/therm increase will show up in January’s billing. This means my January bill could be over $150.

Need to convince my parents to turn down the thermostat.

Sudden Neuropathy Pain

I was just sitting here eating lunch when I was hit with a sudden jolt of pain. This time it is in my left foot insole, right under the bone to the big toe. These painful nerve attacks are happening every few days instead of weeks and months.

Now I have to call in to a meeting with my manager. This sucks.

==========

My boss did not show up to the meeting. I did have to talk to another manager while my foot was hurting every 30 seconds.

No More Atovaquone!

During my (almost) one-year post-transplant call with UCLA this morning, the nephrologist said I could stop taking atovaquone in about a week. This was an anti-protozoa(!) medication usually prescribed to people who are immunocompromised. I was initially prescribed Bactrim(?) post-transplant but was switched to atovaquone after about a month after a test result. It is a liquid medication and tastes horrible. It also stained my bathroom sink yellow. I am super happy that I do not need to take it anymore.

La Maison en Petits Cubes

The House of Small Cubes or つみきのいえ is an animated short subject film by Kunio Katō. I downloaded this several years ago but just rewatched it.

The film starts off with an old man sitting in a small room in a house that is surrounded by water. We soon realize that due to rising water levels, he needs to keep building upwards to stay dry. As he is moving all his belongings out of the old, waterlogged room, he drops his pipe down the hatch that connects to the submerged room next level down. He decides to get some diving equipment, and proceeds to dive down to retrieve his pipe.

What follows is a trip down multiple levels of his house, all the way to the bottom floor. The dive also becomes a journey through his past: taking care of his sick wife, his daughter getting married, daughter as a small child, and to when he met his wife. We also see both of them building the small original house that now serves as the foundation of this submerged tower.

At the bottom, he finds an intact wine glass that he brings back with him to the surface. In the very last scene, we see him pouring out two glasses of wine during dinner. I assume he is toasting his now deceased wife.

Climate change message aside, I found this film really sad. I guess there are multiple perspectives: he could have lived a long, happy life and not is content with his retirement (other than the rising water). However, I see a lonely, old man looking back at happier days. That probably has to do with how I feel. Even though it has been a year since my kidney transplant, my life still feels very precarious, as if I am still on dialysis.

Even though I am not as old as the man in the film (maybe), and I did not have any children, I do have lots of regret when thinking about the past. I still think about my ex-wife, even though the divorce was over 15 years ago. Since she is still alive and (presumably) happily remarried, the sense of loss I feel is harder to define. There is also regret in the poor health decisions that lead to my bypass surgery and kidney failure. Overall, there is a fear that my life will become just like the film: sitting alone at home looking at old photos and thinking about what could have been.

The Next COVID Crisis… is Here

I just posted about this three weeks ago. At the time, I was still hoping that this next wave/spike/whatever could still be contained. No chance of that now.

https://occovid.com/cases

If you look at the previous chart for Orange County from the December 9th post, the latest “spike” was only about one-half of the case count from last year. However, that is no longer the case. The new case rate is now higher than it has ever been. I just had an appointment with my nephrologist, and she said the hospitals are getting full again, and that I should stay home for the next two weeks. Here is a chart for total US and world new cases:

https://www.nytimes.com/interactive/2021/us/covid-cases.html

https://www.nytimes.com/interactive/2021/world/covid-cases.html

1.4 million new cases for the first day of 2022. Looks like this year will not be any better than last year. In the US, with all the New Year’s Eve parties last night, the numbers will get even worse over the next few weeks.

ESRD Post-Transplant?

I guess not.

I always wondered about this. It makes sense since a kidney transplant restores almost all the functions of the original kidneys. Likely why Medicare cancels ESRD coverage three years after transplant.

I saw this paper recently: Electronic health record analysis identifies kidney disease as the leading risk factor for hospitalization in confirmed COVID-19 patients

Even though kidney transplant recipients are no longer classified as ESRD patients, this study shows that they are still as susceptible to hospitalization as those with Stage 5 ESRD. Table 4 in the paper shows:

Additional analyses using eGFR and USRDS data confirmed our findings that patients with stage 4–5 CKD, ESRD on dialysis or with kidney transplant are at extremely high risk for severe complications due to COVID-19 (Table 4).

It appears that patients with eGFR < 15 are 13x more likely to be hospitalized with COVID-19 as compared to those without ESRD. The paper suggests that “physiological stress caused by excessive inflammatory response to SARS-COV-2 infection could destabilize organs already weakened by chronic disease” or “direct organ-specific injury from SARS-CoV-2 infection could act as a second-hit to these organs.” The article also mentions “consistent with this hypothesis, kidney and heart are among the tissues with the highest expression of ACE2, a SARS-CoV-2 receptor.”

So why is the results so high for kidney transplant patients? The n value is low at only seven cases, but the risk is about the same as Stage 5 ESRD or dialysis patients. The article does not discuss this finding, but my guess is the immunosuppressive medications weaking the patient’s immune system. That and a muted antibody response to COVID vaccines. This means even though I have a kidney transplant, the risks of COVID have not changed for me versus one-year ago while I was still on dialysis.

New Computer

I just ordered a new computer. It is the new 14″ MacBook Pro with the M1 Pro chip. I was going to buy it in early December, but my sister was going on a trip to Oregon and wanted to see if she could find it at a Costco up there. Oregon does not have sales tax. At the time, I could have picked one up at a local Apple Store. By the time she went to Oregon, every MacBook is sold out, everywhere.

I ended up just ordering from the Apple Store website today. The computer won’t arrive until 3-4 weeks later. I do not know whether the new MacBooks are super popular or if production is affected by the semiconductor supply chain issues. Anyway, this is the model I bought:

https://www.apple.com/shop/buy-mac/macbook-pro/14-inch-space-gray-10-core-cpu-16-core-gpu-1tb#

I did not purchase any additional software or peripherals, so the price was $2,499 plus $4 recycling file and sales tax. Total was about $2,700. It is a nice computer, but that feels really expensive. It is to replace my old mid-2012 MacBook Air that has been running slow, and it does not even have the latest OSX version.

I mention this because I would not have purchased it several years ago. It seems way too expensive. But after going through dialysis, heart surgery, and kidney transplant, I am less concerned about being too frugal.