Bariatric Surgery Update

Jun. 28th, 2017 11:03 am
[syndicated profile] mathbabe_feed

Posted by Cathy O'Neil, mathbabe

I’m back from Ireland. It was as magical as I’d hoped. We had such a blast and I’ll always remember the trip, and also how much more mature Wolfie is than me in the context of long lines at airports, even though he’s only 8 (his words: “Of course I do get impatient, mom, but I just hold it inside and I think about positive things like that we’ll eventually be home and that we’ll be able to see our family”).

Also, after coming home yesterday, I went to a nutrition seminar for bariatric surgery with my husband. I have officially completed all the paperwork (tons of it) so right now I’m in the waiting phase, hoping that my insurance clears the surgery soon so I can get on with it. As usual, I’m impatient. I should probably try to channel Wolfie here.

I’m guessing it will be another 6 weeks before I get the surgery, so around August 9th. That’s four weeks for the insurance to clear, and then once that happens, I need to be on a very strict diet for two weeks heading into the surgery. Theoretically I could get cleared in two weeks, and I could even just start the diet early, but since it’s so intense I’m probably not going to start until I have a date.

The strict diet is essentially a protein-drink only, starvation diet meant to reduce the size of my liver in order for it to be not in the way for the actual laparoscopic surgery. It turns out that many people of my weight have “non-alcoholic fatty liver,” which just means a liver that’s bigger and contains more fat than a normal liver. It can get in the way of the surgeon’s tool, which can be a problem. The good news is that livers respond quickly to dieting, so the two week extreme diet goes pretty far in decreasing the size of the liver to a manageable obstacle.

I’ve been practicing making protein shakes lately, mostly with fruit and milk, in order to get used to them, because generally speaking they’re horrible tasting and sickly artificially sweet. I have found a pretty good one though, by which I mean it’s not too sweet, and I just tried it alone with water, and it was actually fine. The trick is: lots of ice and a really good blender. I got a “Ninja Professional Blender with single serve” and it’s perfect.

Also in last night’s seminar we went over the diet for the various stages of recovery. Here’s a cheat sheet:

  1. For the week after the surgery, you’re never hungry and you only drink, but the weird thing is you have to drink tiny 1 ounce cup of water or broth every 20 minutes while you’re awake.
  2. For a few weeks after that you eat every three hours, even though you’re probably not hungry, but it has to be the pureed like baby food or applesauce. The reason is that your stomach is still healing and is swollen, and might not be larger than the size of a straw in places, so larger chunks of food could get stuck. You also drink tiny amounts very often but you can’t drink and eat at the same time.
  3. After that you start introducing slightly less pureed food into your diet. You eventually eat pretty normal food but your stomach is much smaller than before, so way less of it. They suggest you eat mainly protein, and you eat that first, followed by vegetables and fruit.
  4. They also give you the following long-term rules: never eat and drink at the same time. Never drink carbonated beverages. Try to eat on 25% of your diet in fat, and avoid refined carbohydrates forever. Also, take vitamins every day for the rest of your life.

If that all sounds like a major behavior change, you’re right. It’s intimidating. On the other hand, the people I’ve interviewed have all told me the one thing that I think makes it possible: namely, that you’re not hungry all the time, even though you’re eating way less. That small amounts of food fill you up for hours. This sounds like a miracle to me, as a person whose hunger rages at me like someone screaming in my ears on a daily basis. So I’m taking a leap of faith, knowing that I’m pretty good at following plans I’ve set for myself, and also knowing that once you’ve developed a habit, it’s not that hard to follow it.


Wednesday?

Jun. 28th, 2017 07:50 am
jhetley: (Default)
[personal profile] jhetley

Air temperature 56 F, wind south about 5 mph, scattered clouds and patchy fog from rain overnight. Fetched newspaper without terrorist attack.

rydra_wong: The display board of a train reads "this train is fucked". (this train is fucked)
[personal profile] rydra_wong posting in [community profile] thisfinecrew
In case anyone's got some spare cash they found down the back of the sofa:

The National Immigration Law Center have donation-matching up to $100,000 to help them create a Rapid Response Fund:

Donate to NILC

Planned Parenthood Action have donation-matching up to $350,000:

Donate to PP

The Climate Science Legal Defence Fund have matching up to $50,000:

Donate to the CSLDF

The National Network of Abortion Funds have matching up to $50,000, and their solicitation e-mail ends "Let’s fund abortion, build power, and radically love each other," bless them (they're also the only organization I've encountered where a staff member has their preferred pronouns in their sig which makes me feel warm and fuzzy):

Donate to the NNAF

If you know of others, please comment!
rydra_wong: The display board of a train reads "this train is fucked". (this train is fucked)
[personal profile] rydra_wong
In case anyone's got some spare cash they found down the back of the sofa:

The National Immigration Law Center have donation-matching up to $100,000 to help them create a Rapid Response Fund:

Donate to NILC

Planned Parenthood Action have donation-matching up to $350,000:

Donate to PP

The Climate Science Legal Defence Fund have matching up to $50,000:

Donate to the CSLDF

The National Network of Abortion Funds have matching up to $50,000, and their solicitation e-mail ends "Let’s fund abortion, build power, and radically love each other," bless them (they're also the only organization I've encountered where a staff member has their preferred pronouns in their sig, which makes me feel warm and fuzzy):

Donate to the NNAF

If you know of others, please comment!

(X-posted to [community profile] thisfinecrew.)

Interesting Links for 28-06-2017

Jun. 28th, 2017 12:00 pm
andrewducker: (Default)
[personal profile] andrewducker

CIA Exploits Against Wireless Routers

Jun. 28th, 2017 10:35 am
[syndicated profile] bruce_schneier_feed

Posted by Bruce Schneier

WikiLeaks has published CherryBlossom, the CIA's program to hack into wireless routers. The program is about a decade old.

Four good news articles. Five. And a list of vulnerable routers.

The Blood is the Life for 28-06-2017

Jun. 28th, 2017 11:00 am
miss_s_b: (Default)
[personal profile] miss_s_b
miss_s_b: Vince Cable's happy face (Politics: Vince - happy face)
[personal profile] miss_s_b
Definitely not standing: Jo Swinson, Jamie Stone, Layla Moran, Wera Hobhouse, Tom Brake, Tim Farron, Alistair Carmichael, Norman Lamb, Ed Davey
Probably not standing: Stephen Lloyd, Christine Jardine
Probably standing:
Definitely standing: Vince Cable

... Oh arse.

Look, coronations are bad. The "candidate" does not get examined, does not get their feet held to whatever fire the membership is stoking, does not have to state any positions before the crown is lowered. Recent political leaders who have had a coronation rather than an election include TMay, Arlene Foster, and Gordon Brown. We do not want to be in that company.

But even if coronations were ok, the coronation of someone who's published views are 1, so often at odds with the membership and 2, so changeable depending on who he is talking to... Lads, this is really, really, REALLY not good. And given the article I linked to in the very first piece I wrote on potential leadership elections after the GE, this whole situation smells really fucking funny and I do not like it one bit.

I'm in conversation with a bunch of other senior Lib Dems members of the awkward squad to try to do something about this. I mean, if there was a proper election and the members decided that Vince was the best person, that's one thing, but this is just a subversion of party democracy, and I hate it. Eurgh.

But if we can't do something about it... I don't know. The scissors are feeling very close to my membership card right now.

ETA: OfC given the legendary efficiency of the LDHQ membership department, if I were to cut up my membership card and send it back we'd probably have had another 2 general elections before they got round to processing my resignation...

Daily Happiness

Jun. 28th, 2017 02:21 am
torachan: ryu from kimi ni todoke eating ramen (ramen)
[personal profile] torachan
1. This morning and early afternoon was ridiculously super hectic, but thankfully things died down and I was able to get out of work at a reasonable time.

2. Some people at work got me a birthday cake today, which was totally unexpected and a nice surprise. :)

3. Look at these Molly paws!

Made it!

Jun. 28th, 2017 09:50 am
rmc28: Rachel smiling against background of trees, with newly-cut short hair (Default)
[personal profile] rmc28
I'm forty years old today. My second birthday Since Cancer.

I've not done much about it: cakes in the office yesterday & I may get a takeaway tonight rather than cook.  I am vaguely thinking of doing Something on the weekend that includes 1st October (my arbitrarily-declared Happy Being Alive Day) but I haven't worked out what Something will be yet.  In the meantime, a good friend is holding a party on Saturday so I'm going to enjoy being part of their celebration instead of organising my own right now.

Meme

Jun. 28th, 2017 09:03 am
legionseagle: (Default)
[personal profile] legionseagle
Gacked, this time round from [personal profile] moetushie and [personal profile] el_staplador.

Pick any story I've written, or, in the case of my longer, chaptered works, any chapter from any story I've written, and comment to this post with that selection. I will then give you the equivalent of a DVD commentary on that snippet: what I was thinking when I wrote it, why I wrote it in the first place, what's going on in the character's heads, why I chose certain words, what this moment means in the context of the rest of the fic, lots of awful puns, and anything else that you’d expect to find on a DVD commentary track.

My fic can be found here or here
siderea: (Default)
[personal profile] siderea
Constant readers will recall that I wrote a three-part post titled, "Why You Can't Find A Therapist, No, Really". I posted Part 1 on Sept 1st and Part 2 and Part 3 on Sept 30th of last year.

The clinic I work for as a contractor recently paid me, for my last pay period, an amount of money that was four times my typical earnings. Admittedly, how much I actually get paid fluctuates pretty wildly, but I figured I would have noticed having either 4x in arrears or having seen 4x as many patients as usual. But I'm paid via direct deposit, and the corresponding statement saying what I was getting paid for is put in my mail box at the clinic, so I had to wait till I was back in the clinic – today – to pick it up and find up why I was getting all this money.

The statement mystified me when I got it. It was two whole pages of pairs of canceled previous payments and replacement payments and at first I couldn't make heads or tails of it, and then I realized that I was looking at a statement where almost all the patient sessions listed had happened in 2016.

As I mentioned, last month, for the first time in decades, we got a raise. A big raise. Not big enough to be adequate, but big enough to be astounding. It was, we thought, effective starting May 1.

No. Turns out the raise was retroactive. To – apparently – Oct 1, 2016...

...The day after I posted the final sections of "Why You Can't Find A Therapist, No, Really".

Rumor has it that the raise – more properly, the increase in rate paid by at least two of the Medicaid providers – happened because MassHealth (Massachusetts Medicaid) leaned on them to do so, to fix the emergent strike.

Um.

MassHealth? Are... are you there? Are you reading my journal?

If so, thank you! (If not, still thank you!)

I have a few other suggestions for things you could fix!

For instance: I'm currently doing an amazing job (or so my chart reviewer wrote) doing care coordination with a big medical team involving four clinics, three hospitals, and family all involved in the care for a patient with an emergent psychotic illness. I can do that because the patient has MBHP, and MBHP pays for case coordination if it's extramural. I'd like to point out that it's insane that if I have a 15 minute conversation about the diagnostic formulation for a challenging and high-risk case with an in-house psychiatrist, I don't get paid for it (and neither do they), but if I do the same thing with a psychiatrist at a different clinic, I do. How wack is it that I literally wouldn't be able to afford to spend the sort of time on this case that I did (and continue to!) if the patient hadn't coincidentally decided he didn't like my clinic's available psychiatrist and went and found himself another one through his PCP. Surely this can't be the incentive system you want me or the patient (or the psychiatrist) to be functioning under – one where patients are incented to get their psychiatric care from an entirely different facility from their therapist.

And thank goodness that he had MBHP, as pretty much an amazing fluke. No other MassHealth payers pay for care coordination at all. If this guy had been on NHP or Tufts/BMC when he came down with schizophrenia... I shudder to think. Do you realize how much I've been on the phone with MGH's ER and APS and social workers and psychiatrists at local mental hospitals in the last six months?

Don't you think there should be some sort of provision for what happens when someone presents with a psychotic disorder? Like, when a provider slams the big red "R/o Schizophrenia" button, the payer has to start paying for some case coordination? (I'd also recommend that for substance abuse cases, where patients can manipulate providers around meds; and in mandated reporter cases, where you should probably have payers pay therapists for their time filling in DCF/DPPC/DES or whatever.)

I have to think that the time demands of handling such a high-risk case are part of why some – maybe many – therapist are leary of working with psychotic or other high-risk patients. I've been there. I've twice spent four hours – half a work day – keeping a patient in crisis calm and coordinating with the BEST team and then the hospital, and never saw a dime for any of it. Who wants to bring a patient onto their caseload, for whom the total compensation divided across the total hours of work for that one patient come to less than minimum wage?

And I'm just talking about care coordination – I'm not even talking about CPT 90839 and 90840 which last I checked were still universally unfunded. Funding that would be way cool.

I have many other fine suggestions – I swear many of them even aren't just suggestions you pay me more money! I'm happy to talk more about reforms in mental health care.
[syndicated profile] smartbitches_feed

Posted by Carrie S

B+

When Dimple Met Rishi

by Sandhya Menon
May 30, 2017 · Simon Pulse
RomanceYoung Adult

When Dimple met Rishi is adorable and funny and utterly delightful. It was just what I needed during a stressful day.

Here’s the plot setup: Dimple is eighteen and about to go to Stanford. She resents her Indian-born mother’s attempts to mold her into a traditional woman. Dimple’s plans revolve around school and career, with no interest in marrying and having children. Above all else, she resents any suggestion that she would go to college to get a husband. Since Dimple’s parents are very protective, Dimple is surprised but thrilled when her parents readily agree to let her spend part of the summer at Insomnia Con, a summer program on web development held in San Francisco.

Meanwhile, Rishi, who is also eighteen, tells himself and everyone else that he is happy to be a model oldest son to his parents, who are also from India. Rishi used to love drawing comics, but he has set that aside, applied to MIT, and plans to have a career in computer sciences. Rishi trusts his parents to arrange a marriage for him.

As a matter of fact, Rishi’s mom and dad are acquainted with Dimple’s mom and dad. They think Rishi and Dimple might be a great match, so they send Rishi to Insomnia Con to meet Dimple. However, Rishi’s parents don’t mention to him that Dimple’s parents haven’t told her anything about Rishi or the possibility of an arrangement. Dimple’s parents don’t tell her anything about Rishi either. When a total stranger walks up to Dimple at a coffee shop at Insomnia Con and says, “Hello, future wife!” it doesn’t go well.

Happily, the big misunderstanding is cleared up almost immediately so Dimple and Rishi can get on with becoming friends who absolutely do not date because Dimple is not looking for a relationship. Of course, it immediately becomes obvious to one and all that Dimple and Rishi are fabulous as a couple. They respect each other (eventually), they balance each other’s hang-ups as the best couples do, they are both very smart and very funny, and they have fantastic chemistry.

All of this makes for extremely fun and swoony reading. This book is set up as an opposites attract book, with Dimple determined to chase her dreams and Rishi resigned to fulfilling the dreams of others. However, they have more similarities than differences. Their only real conflict lies in Dimple’s fear of romance distracting her from her career and her independence.

The degree of swoony can be seen in the “not date” when Rishi takes Dimple to Two Sisters Bar and Books (a real place that recently closed, alas). Rishi and Dimple first met at a wedding when they were kids, and at that time Dimple was reading A Wrinkle in Time. So, at their table Rishi has a present waiting for Dimple – a special edition copy of A Wrinkle in Time from the year they met.

In turn, Dimple takes Rishi to a place where they have an amazing view of the San Francisco Bay Area. She tells Rishi that she’d like to make their “not date” a date, but wonders if he feels like there’s a point to dating since she’s not sure she’ll ever want to get married. Rishi says that tradition is important to him, but:

The point of dating you, Dimple Shah, is to get to know you. To spend time with you. To see the way you push your glasses up on your nose when you’re especially moved by whatever you’re saying. To smell your amazing shampoo. To feel your heart beating against mine. To see you smile. To kiss you. So maybe all that other stuff that’s important to me can take a backseat for now. And maybe I’m totally fine with that…if you are?

Pardon me while I pass out for a while.

There are only a couple of nitpicks standing between this book and an A. One is that Rishi and Dimple seem to have a lot of free time for two people in an incredibly complex and difficult competition with high stakes. Another is that the conflicts are so nicely resolved about two-thirds of the way through the book that the ensuing complications feel contrived. Granted, they are the kinds of contrivances that two eighteen-year-olds would generate. The better things go with Rishi, the more nervous Dimple gets, until she’s second-guessed herself into a state of complete panic. It does make sense for her character, but it also means a smart and admirable heroine suddenly seems obtuse and inconsistent, purely so that the story can keep going for another hundred pages.

Generally, however, this is a lovely book. It is sweet and funny and heartwarming. The parents and Rishi’s brother get some chances to shine and Dimple’s roommate is a good, if confused, friend. Both Dimple and Rishi have solid character development. Dimple has to learn to trust in a relationship and Rishi has to learn that his dreams have value. The ending is, appropriately, HFN instead of HEA, but it’s very satisfying. I happily recommend this book.

More CritRole

Jun. 27th, 2017 11:37 pm
aris_tgd: Jon Snow "Now, gods, stand up for bastards." (Jon stand up for bastards)
[personal profile] aris_tgd
Episode 54: Holy balls.

More things )
conuly: (Default)
[personal profile] conuly
If you want to be intensely spoiled for next season, clicky clicky. I can't wait!

Edit: Yeah, the nod to a certain government official — we thought we were being cute, and now, I find myself longing for George Bush, wishing we could have George Bush back in the White House and remembering him fondly.

Yeah, Rob, you and me both. Never ever dreamed I'd be nostalgic for those days.
ed_rex: (Default)
[personal profile] ed_rex

One of the things LJ has that I don't think DW does, is feeds from such things as Scott Adams' Dilbert. I can't much abide Adams' politics, but his comic still makes me laugh more than most, and so when reading my LJ friends' page, I have for years clicking the link that would take me to the latest installment of his comic.

But, I've been ridiculously busy of late; keeping up with my reading has been a matter of desperate baling while the waters pour over the gunnel's at best.

And so it was that, maybe four or five weeks ago, I decided to just skip a Dilbert as it came down my feed. And then I skipped another, and another, and another. And cetera.

Three weeks into the experiment, I realized that I hadn't missed his cartoon at all. And a week or two after that — tonight — I said to hell with it. If I'm not going to read the damned thing, I might as well unsubscribe.

And so I did. Farewell, Mr. Adams!

dialecticdreamer: My work (Default)
[personal profile] dialecticdreamer
Road Trip Confessional
by Dialecticdreamer/Sarah Williams
part 1 of 2, complete
word count (story only): 1244


:: Part of the Polychrome Heroics universe, my Mercedes story group, and the Road Trip series. ::


::Pay Special Attention: Cash compares workaday supervillainy to the range of reactions G gets due to gender and misgendering. Joshua hints that he has very, very strong tensions between wanting to acknowledge G as a boy, and wanting to save the things that were part of Gabrielle Bishop's childhood. The matter is not discussed long, nor resolved, but it hints at a deep wound.




By the time the turn signal clicked for the exit marked “Eureka,” the only sounds loud enough to muffle it were the hum of tires on the freeway, and the soft, breathy snoring that had fallen into Mother Nature's version of Pong, where G inhaled as Madelyn snored, and vice versa.

Cash adjusted his head against the deluxe wheelchair head rest, toggling off the micro-speaker embedded as a fine copper mesh above the gel padding. If he kept the sound mix in single digits, even G, who had a teenager's hearing range and sensitivity, couldn't hear anything but a whisper of dissonance.

“I swear, I am going to have to flip a coin to decide whether I need sleep or a beer more,” Joshua told him quietly, pinching the bridge of his nose instead of trying to rub the bloodshot itchiness away. “Is your friend… I mean, this is a huge pile of money for bare property.”
Read more... )
minoanmiss: Minoan lady holding recursive portrait (Recursion)
[personal profile] minoanmiss posting in [community profile] agonyaunt
http://www.sfgate.com/entertainment/article/Dear-Abby-Serial-father-keeps-chummy-11237805.php

Dear Abby: I recently met a 28-year-old father of three I~Rm interested in. He seems wonderful. He's a hard worker, takes care of his responsibilities and is an amazing father to his children. They~Rre all still very little, but they're great kids. The only thing that~Rs been on my mind lately is he has a lot of baggage. Those kids are from three different women. He gets along with all of them very well, to the point that they sometimes do stuff together with the children. They go out to places, or sometimes he invites them over to his place to swim in the pool. I understand that he has to maintain a healthy relationship with his exes for the sake of the children, but I never thought it would be this 'healthy.' I have never experienced something like this. I appreciate him being up front about everything, but I can't stop thinking about it. Am I overreacting?
Three's Company


Dear Three's Company: I don't think so. While I admire the man's devotion to his children -- not to mention his skilled diplomatic ability -- it does appear that he has a problem making a lasting commitment to a woman. Unless you would seriously consider joining this 'harem,' I urge you to religiously practice contraception. If you would like children in the future, it would be better to approach it with someone who isn't as marriage-phobic as this young man appears to be.

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