Sunday, September 24, 2017

Obamacare overload

Alright, already.

Republicans trying to "fix" Obamacare is as inane as police attempting to resuscitate a suicide-by-cop shooter.

For one thing, the Affordable Care Act as implemented has so many bullet holes in it that it is likely not savable.

One dynamic that reinforces the continuance of something like the Obamacare is the increasingly dynamic workplace.  Both Republicans and Democrats are complicit in this.

If you look at a small town you will typically see that the businesses that have the greatest longevity have some source of protected income.  I am thinking about bars with a license to serve alcohol.  Licenses create an artificial scarcity which in turn creates a steady income stream.  Because licenses are difficult to transfer, they foster business longevity.

Three things overturned the apple cart.

The economy is now Globalized.  Factories and shops are not just competing with the guy down the road, they are competing with Bangladesh and China and Mumbia.

The economy deregulated.  Sectors that are protected are shrinking.  Interestingly, the most protected sector is .gov.

The last thing that killed job longevity was the Fed lowering interest rates.  Investors are anxious to find venues that create better return pour money into venture capital.  These funds provide a war chest to nascent businesses that allow them to under-price the true cost of production.  That crushes the existing competitors.

The new entrants to the market find themselves, in turn, being crushed by even more entrants, especially after the war-chest of investor capital is depleted and they must price at or above the true cost of production.  The bottom of the dog-pile are corpses.  Only the bodies on top have enough oxygen to survive.

In the old days the employee who started with a firm as a young, healthy person was subsidizing the old guy who had been there thirty-five years and it was all invisible to the new person.  Preconditions were handled internally to the Human Relations department.

No longer.  It is not uncommon for a person to find themselves looking for employment every couple of years.  In fact, many folks never stop looking for their next job because experience taught them the horse will get shot out from beneath them.

All of a sudden, preconditions become a very, very big deal.

There is a solution, at least for most of us.  And it is not a very popular solution.  The answer is to stay healthy.  Eat well.  MOVE.  Get to your ideal weight, or close to it.  Surround yourself with positive, caring people.  Ditch unhealthy habits.

Good news abounds

Our dishwasher started working again.

It was not draining reliably and the symptoms suggested that the cause was something binding up the shuttle valve.

I did not tear it apart but suspect it was a label that we put on some of the plastic ware we use for lunches and such.

Mrs ERJ receives many return address labels from charities who want her contributions.  We have been using those labels for lids and tubs.  I think a few of them washed off and bound up the valve.

How-some-ever, our dishwasher finally passed its kidney stones and is once again running like a champ.

The downside is that I bought a replacement dishwasher.  It was on Craigslist for $65.  It was two years old and the owner had just changed his kitchen appliances to stainless steel.  The good news is that the old dishwasher started working again before I busted my knuckles replacing it and the great news is that I now have a spare.

In other good news...
I don't write much about Mrs ERJ because she is entitled to living out her own life in privacy.

Three weeks ago the director of a local non-profit organization had to leave due to health reasons.  The parent organization asked (begged?) Mrs ERJ if she could fill the gap while they hunted for a new director.

Mrs ERJ threw herself on the hand grenade and went from a life of leisure to working 50 hour weeks. 

Due to the urgency of the previous director's health issues, there was not a tremendous amount of time for overlap.  Also, since the health issue arose suddenly, the previous director did not have a lot of time to render the job into documentation.

Friday, the parent organization indicated that found a new director.  The new director will start in two weeks.  The parent organization is being smart and is planning on a two week transition.  The first week will be the administrative side and the second week will be on the "people" side.

Mrs ERJ is walking with a bounce in her step this weekend.  There is an end in sight.  Life will return to normal in about four weeks.

Shamelessly stolen from Knuckledraggin

Look at the joy on her face.

Great image.  Thanks Wirecutter.

Saturday, September 23, 2017

Seasonal Affective Disorder

While I do not dwell on the fact, I am subject to periods of depression.

I take a type of antidepressant called an SSRI, that is, a Selective Serotonin Re-uptake Inhibitor.

Historically I do well through most of the winter, spring and summer.  Fall bites me in rearmost parts of my anatomy.  October is my undoing.

I think it is like many biological processes; it is triggered by the shortening days.  Deer and sheep start cycling for spring fawns/lambs based on decreasing day-length.  Trees drop their leaves based on day-length.  Animals in temperate and arctic regions toggle between summer and winter plumage/fur based on lengthening days or nights.

The traditional literature suggests that SAD is caused by lack of light, that it is worst in December and January and February.  Perhaps it is so for Napoleon and Hitler.  Not so much for me.  Maybe I am the outlier.

I started taking my SSRI yesterday.  One of the nice things about planning ahead is that I can avoid most of the side effects by starting with a half dose.  I simply split the pills.

People on large doses who experience SAD might consider starting on even less than half.

The typical protocol when starting a patient on an SSRI is to yank them off work for two weeks.  The purpose is two-fold.

One of the reasons is that SSRIs make you sleepy.  Not a good combination if you drive to work or if you use heavy equipment at work.  Cutting the dosage means you will sleep like a log but will, likely, be able to function at work and on the highway.

The other reason is that many SSRIs, especially the older ones like Prozac (Fluoxetine) and Zoloft (Sertalin) take three or four weeks to reach their full, therapeutic potential.  This is not necessarily a bad thing because missing a dose of the older SSRIs is not the end of the world.  These older SSRIs are great choices for patients who might not have the support structure to ensure total med-compliance.  A couple of examples are of somebody who has Attention Deficit issues and might get distracted.  Another example is of a young person who might be subject to, um, romantic distractions where they are deflected from their normal routine for a few days.

Some of the modern SSRIs kick in much, much more quickly than the old SSRIs.  Notably Escitalopram and Paroxetine.  Discontinuing them, unfortunately, results in a quick loss of antidepressant activity.

One doctor told me of an Emergency Room visit by a patient.  The patient was so debilitated by anxiety and depression that he appeared to be a boneless puddle of sobbing protoplasm.  Due to the dire situation, the attending doctor chose one of the faster acting SSRIs.  The next weekend the former patient brought a friend into the same Emergency Room for an unrelated issue.  The former patient was affective, gregarious and happy.  The former patient recognized the doctor and gave hime a double thumbs-up!  What really caught the doctor's attention was that the turn-around was much, much faster than the three-to-four weeks that is typically listed.

I figure I will run at half dose for a week and then bump it up to the full dose.  I intend to make the next transition during one of my "weekends".  Then, it will not be a big deal if I take a nap in the middle of the day.

To quote Red Green, "We are all in this together."

Not a good day for the air conditioning to stop working

Image from Accuweather
Yup, you guessed it.  The air conditioner at home is down.

I pulled a panel off the furnace which is down in the basement and am running in fan mode.

This morning the basement was a 66 degrees and the upstairs at 73.

The upstairs temperature is now at 75 degrees while it is 91 degrees outside.

Nightly lows are predicted to be in the lower 60s so we will open windows and ventilate with a fan to chill the walls.  The "cross over" when the outside temps are lower than the inside temps will be about 10 PM.

Seasonable temperatures are expected to return on Thursday.  Until then it will be good swimming weather.

If I get ambitious tomorrow I will check out the air conditioner unit.

One upmanship

A man died leaving three proud, competitive sons.

At his wake each one approached his coffin one at a time.

The first one made a big show of pulling out $10,000 in one hundred dollar bills.  "This is for you, Pops.  Have a great time up there!" as he stuck the bills in the coffin.

The second one pulled out $20,000 in one hundred dollar bills and said, "Dad, remember that I love you twice as much as Billy."

The third one approached the coffin, whipped out his checkbook and wrote a check for $130,000 and slid it into his dad's hand while scooping up the $30,000 in cash.  "Really going to miss you, Dad.  Thanks for all the life lessons."

Trucks, weather and work

Yesterday was my weekend.  I took food to my parents.  Then I picked up Kubota and we looked at used trucks.

Kubota got his license last week and is seriously in the market.  His major issue right now is that he has Dom PĂ©rignon tastes and a tap water budget.

We looked at a clean 1996 Chevy half-ton.  Two wheel drive.  Good tires. 350 cid V8.  Air conditioning. The engine has 150K on it and the rest of the truck has 330K miles.  The asking price was $1500 and Kubota wanted nothing to do with it.

I wonder if showing him trucks is a waste of time.  It is hard to know if the disconnect between the market and his budget is getting through to him.  Or maybe he is just not ready for the responsibilities, and costs, of owning a vehicle.


Images from Accuweather.
Today is going to be a scorcher.  I expect that I will be in-and-out of the buildings with more time outside than inside.  As bad as it is for me, I am glad I do not have to wear "turn-out" gear like a firefighter or body armor like a cop.

Today is also my long day.  I figure it will be just like running a long distance.  Listen to all of the parts of my body and slow down when they start talking.  If they keep talking, slow down even more.

You know you have been working when...
Your hands are stiff and puffy.  My day off was much appreciated.  I feel better today.