In this video, I draw on the US Navy’s Code of Conduct for its SEAls and apply it to those on Dialysis.
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The hypotension event depicted in the video below took place on Wednesday, 5/3/2023. I was the victim of this event, and know that others in my situation will profit from its content. Watch and learn from my experience. Hank
Those of us on Dialysis have to keep life in perspective. Compared to many other endeavors, we have it pretty easy. Keep a steady pull. Never ring the bell.
There is a widely circulated story about “putting down the glass.” The story goes like this:
A psychologist was giving a lecture on stress management to a group of students. As she raised a glass of water, the students expected her to ask the typical “half full or half empty” question. Instead, she asked, “How heavy is this glass of water?”
The students shouted out answers ranging from a few ounces to a couple of pounds. The psychologist replied, “The absolute weight doesn’t matter. It depends on how long I hold it. If I hold it for a minute, it’s not a problem. If I hold it for an hour, I’ll have an ache in my arm. If I hold it for a day, my arm will feel numb and paralyzed. In each case, the weight of the glass doesn’t change, but the longer I hold it, the heavier it becomes.”
The lesson of the story is that we must put down the glass of water to give our arms a break. This applies to stress management as well. We all have stress in our lives, but it’s important to put it down for a while and give ourselves a break.
This lesson is particularly relevant for those on dialysis. Dialysis patients have to deal with numerous physical and emotional stressors, such as the time commitment of dialysis treatments, dietary restrictions, and potential complications. These stressors can take a toll on a patient’s mental and physical health.
To reduce stress, dialysis patients should practice self-care and engage in activities that bring them joy and relaxation. This could include exercise, meditation, spending time with loved ones, or pursuing a hobby. I do this by writing this blog, making what I think are cool videos, and taking care of our 1/2 acre part of heaven. It’s also important for patients to communicate with their healthcare team about any concerns or stressors they may be experiencing. I have found mine to be always open, caring, and interested in my well-being.
In conclusion, the “glass story” teaches us an important lesson about stress management. By putting down the glass and taking a break from stress, we can improve our mental and physical well-being. This lesson is particularly relevant for those on dialysis, who face numerous stressors in their daily lives. By practicing self-care and communicating with their healthcare team, dialysis patients can reduce stress and improve their quality of life.
Speaking of self-care, I’m off to take my evening shower.
Today’s blog will look into recent medical developments for those interested in Dialysis regardless of viewpoint.
This past Sunday’s The Wall Street Journal, in a front-page article titled “ChatGPT Doctors Will See You Now” by Nidhi Subbaraman, reported that already, in California and Wisconsin, Open AI’s GPT is being used to scan patient messages and draft responses from their doctors. Such use is being rolled out as we “speak.” Here’s the kicker: ChatGPT scored better than real doctors at responding to patient queries, according to a study posted in the JAMA Internal Medicine Journal, a peer-reviewed source. The use of Artificial Intelligence is coming like a freight train. Be prepared to get onboard or get run over.
Recently, Garmin, the GPS/navigation people, rolled out the Dexcom Connect IQ app for Garmin devices. This app supports tracking glucose levels on a Garmin Smartwatch or bike computer. Remember that you need the watch and a Dexcom G6 or G7. Using the app, users should be able to glance at their watch while bike riding to ascertain their current glucose level.
In an article by Robert Hart on April 28, 2023, titled “One-Hour Diabetes Procedure Offers Fresh Hope For Ditching Insulin,” in Forbes, it was reported that a single outpatient endoscopic procedure provides glucose control, a potential improvement over drug treatment. They don’t know why it works at this time, but blind tests are encouraging. The procedure is nonsurgical and involves flexible tubes, lights, and cameras that aid doctors in seeing inside the body, and patients are discharged on the same day as the procedure. Sounds almost too good to be true. Standby.
Lastly, Fierce Healhcare in an article published in Digital Health on April 26, 2023, by Annie Burky titled “DocGo aims to bring kidney care the final mile by partnering with Fresenius Medical Care” to include remote patient monitoring, chronic care management, and urgent care services. Since 2019 DocGo has been FMC’s preferred medical transportation partner. The new service aims to “offer a solution for nephrologists to help patients truly manage their chronic conditions.” Centering around the analysis of “Big Data,” DocGo suggests it will catch trends before they become life-threatening and greatly aid patients toward the “really needing help” end of the spectrum. We’ll see. I already feel that I have more than enough of “Big Brother watching me.”
On Monday, April 24, 2023, on page A12, The Wall Street Journal ran an article by Aaron Zitner titled “‘Very Happy’ Americans Are Pleased to Say Why.” The article concluded America’s happiest people have a few traits in common: They value community, close personal relationships, tend to believe in God, and generally are older and often in their retirement years. As I tend to do, I pondered how this set of concepts or behaviors might apply to those on Dialysis, the target market of this blog. With this in mind, I cranked up my subscription to ChatGPT and entered the following Prompt into ChatGPT’s GPT-4 Model. The results are given below.
Model: GPT-4
Prompt: America’s happiest people have a few traits in common: They value community, close personal relationships, tend to believe in God, and generally are older and often in their retirement years. Write a 2000-page or more word essay expanding on this with emphasis on how this might help dialysis patients with citations and references at the end. Write at least at the college level.
Introduction
Happiness is a universal human pursuit. It is the emotional state that everyone yearns to experience, and it is often considered the ultimate goal in life. Various factors contribute to the happiness of an individual, and studying these factors can help us understand the foundations of happiness better. In the United States, research has shown that the happiest people tend to have certain common traits: they value community, have close personal relationships, believe in God, and are usually older individuals, often in their retirement years (Westerhof & Keyes, 2010). This essay will explore these traits in-depth, focusing on their potential to improve the quality of life for dialysis patients.
I. The Importance of Community
A sense of community has been identified as a key contributor to happiness. Studies have shown that people who feel a strong connection to a social group are more likely to report higher levels of happiness and life satisfaction (McMillan & Chavis, 1986). This sense of belonging can be even more crucial for dialysis patients undergoing a physically and emotionally demanding treatment process. Inclusion in a community can provide these individuals with emotional support, practical assistance, and a sense of identity and purpose (Davidson, 2017).
Dialysis patients can benefit from being part of a patient support group, where they can share experiences, advice, and encouragement with others going through the same treatment (Cohen & Wills, 1985). Additionally, healthcare providers can help facilitate the creation of these communities and involve patients’ families and friends to create a more inclusive and supportive environment (Davidson, 2017).
II. The Role of Close Personal Relationships
Strong personal relationships, including friendships and familial bonds, are fundamental to happiness (Diener & Seligman, 2002). These relationships provide emotional support, companionship, and a sense of security that contribute to overall well-being. For dialysis patients, nurturing close personal relationships is essential for maintaining mental health and coping with the challenges of treatment.
Studies have shown that patients with strong social support have better adherence to treatment, lower levels of depression, and improved overall quality of life (Gallant, 2003). Healthcare providers can encourage the involvement of family members and friends in patients’ care by educating them about the treatment process and providing them with resources for support (Davidson, 2017).
III. The Impact of Spiritual Beliefs
Belief in God or a higher power has been linked to higher levels of happiness and life satisfaction (Diener, Tay, & Myers, 2011). For dialysis patients, faith can provide comfort, hope, and a sense of meaning during difficult times. Spiritual beliefs can also help individuals cope with the uncertainty and challenges associated with their treatment, providing a sense of purpose and direction (Park, 2010).
Healthcare providers can support the spiritual well-being of dialysis patients by acknowledging and respecting their beliefs and by facilitating access to spiritual care resources, such as chaplains or support groups (Davidson, 2017).
IV. The Wisdom of Age
Older adults, particularly those in their retirement years, tend to report higher levels of happiness compared to their younger counterparts (Stone, Schwartz, Broderick, & Deaton, 2010). This increased happiness can be attributed to factors such as accumulated wisdom, greater emotional regulation, and a focus on meaningful activities and relationships (Carstensen, 2006).
Dialysis patients, regardless of age, can learn from the happiness of older adults by prioritizing meaningful relationships, practicing emotional regulation, and seeking out activities that provide a sense of purpose and accomplishment. Healthcare providers can help facilitate this process by offering resources and support for patients to engage in activities that promote well-being and personal growth (Davidson, 2017).
V. Applying the Traits of America’s Happiest People to Dialysis Patients
By understanding the traits that contribute to the happiness of America’s happiest people, healthcare providers, and caregivers can develop targeted interventions and support systems to improve the quality of life for dialysis patients. Emphasizing the importance of community, close personal relationships, spiritual beliefs, and the wisdom of age can help these patients cope with the challenges of their treatment, foster resilience, and enhance their overall well-being.
Conclusion
In conclusion, the pursuit of happiness is a universal endeavor, and understanding the factors that contribute to happiness can provide valuable insights for improving the quality of life for dialysis patients. By focusing on the traits shared by America’s happiest people, such as valuing community, nurturing close personal relationships, maintaining spiritual beliefs, and emulating the wisdom of age, dialysis patients can enhance their well-being, cope more effectively with the challenges of treatment, and ultimately, experience greater happiness and life satisfaction.
References
Carstensen, L. L. (2006). The influence of a sense of time on human development. Science, 312(5782), 1913-1915.
Cohen, S., & Wills, T. A. (1985). Stress, social support, and the buffering hypothesis. Psychological Bulletin, 98(2), 310-357.
Davidson, K. W. (2017). Creating a supportive environment for dialysis patients. In C. R. Thomas & S. M. Smith (Eds.), Comprehensive Clinical Nephrology (6th ed., pp. 171-180). Elsevier.
Diener, E., & Seligman, M. E. (2002). Very happy people. Psychological Science, 13(1), 81-84.
Diener, E., Tay, L., & Myers, D. G. (2011). The religion paradox: If religion makes people happy, why are so many dropping out? Journal of Personality and Social Psychology, 101(6), 1278-1290.
Gallant, M. P. (2003). The influence of social support on chronic illness self-management: A review and directions for research. Health Education & Behavior, 30(2), 170-195.
McMillan, D. W., & Chavis, D. M. (1986). Sense of community: A definition and theory. Journal of Community Psychology, 14(1), 6-23.
Park, C. L. (2010). Making sense of the meaning literature: An integrative review of meaning making and its effects on adjustment to stressful life events. Psychological Bulletin, 136(2), 257-301.
Stone, A. A., Schwartz, J. E., Broderick, J. E., & Deaton, A. (2010). A snapshot of the age distribution of psychological well-being in the United States. Proceedings of the National Academy of Sciences, 107(22), 9985-9990.
Westerhof, G. J., & Keyes, C. L. (2010). Mental illness and mental health: The two continua model across the lifespan. Journal of Adult Development, 17(2), 110-119.
Thursday morning, I had my monthly appointment with my Dialysis Team. The Team facility is located across the street from the CVS where my most recent request for a Libre 3 sensor prescription has languished since April 14. I went to the “Consultation” window and was soon approached by a white-coated individual I assumed to be a pharmacist.
I showed her my CGM order on my phone’s CVS app, and she punched some info into her computer and soon informed me that CVS could not fill the prescription as prescribed by my GP. The problem was that the extant script was for three sensors for 90 days, refillable three times. Since the sensor only lasts 14 days, the script was for too few sensors. Further, CVS could not and would not fill the script. She stated that CVS had notified my GP’s office of this conundrum but had to date received no response.
Readers of this blog know that I have been pounding on the system for lack of medical acumen in this area and have repeatedly spoken to the voice on the other end at my GPs, attempting to straighten this out. I called the Doctor directly (I have concierge privileges which I pay for) and informed him of the situation. He checked on his end, and yes, CVS had notified his office, but the notice did not trigger the need for a response for some tangential reason.
Bottom line, while I was on the phone, my Doctor sent a fax to CVS with the correct script and promised me he would personally follow up with a call to CVS to ensure compliance with the requested script.
Do I have a great degree of confidence that the matter is settled? NO!
My CVS app now shows, “Your insurance requires approval.” Reading the tea leaves, I’m stuck paying full freight and buying my sensors from HealthWarehouse.com. So much for insurance and all the hype in the news about CGMs now being covered for Diabetic patients who take insulin. The “system” doesn’t care! I’m tired of shooting myself in the foot over this and ready to move on. The “system” has won.” As the picture below infers, our healthcare “system” has its head up its ass!
As luck would have it, sometimes modern electronics fail us. Recently the sensor for my Libre 3 Continuous Glucose Monitor began provoking false low glucose readings, which resulted in alarms. I’m talking about indicating that my Glucose was in the fifties. If this were so, I would be shakey, probably in a cold sweat, and noticeably irritable; I was none of these. As a diagnosed diabetic of thirty-plus years, I KNOW what it feels like to be hypoglycemic. Not so here.
I put up with this crap for about six days before changing to a new sensor, and the problem disappeared. This is the first sensor in about a year’s experience in using Libre 2/3 products that I have had any problems with.
Since I am paying out-of-pocket for the sensors, I decided to give it a go by contacting Freestyle Product Support. I did a Google and arrived at a support page to fill out a couple of inputs for support. The inputs forced the user to input or choose a selection where the sensor in question was throwing an error code. My errant sensor was not throwing any error codes, erroneously reporting low glucose. So I was forced to phone their support line. For the record, the number is 855-632-8658.
After setting up an account and providing info from the Libre 3 app, I was informed that Freestyle would replace the malfunctioning sensor and provide me with a return package to return the bad sensor to them for analysis.
The whole cycle took half an hour but look at it as if I saved the $100 or the replacement cost. BTW, the order for replacement Libre 3s that my GP placed with CVS (for my international readers, CVS is one of the largest US drug store chains) is still listed on my CVS App as “Processing. We’re working on your order.” Which raised another question: Why can my Brother-in-law Jerry walk into a CVS in Podunk, Indiana, and pick up Libre 3s, but here in the Dallas-Fort Worth area, they have to “work on it?”
To keep things interesting, I took the raw text from above and shoved it into Designs.ai’s video maker portion of the apps. The result for your viewing pleasure (and should be awe) is embedded below. All I provided is the test; AI found and selected all the clips, voice, etc. This technology is absolutely awesome!