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Everything posted by marshac

  1. Absolutely! You're there to help, not be a slave- you need your own sacred space and if he can't accept that it live by it, you need to step out. It would probably be worth talking to a social worker about what resources he's able to access- both in terms of home care or potentially a long term care facility. Even if you don't decide to utilize those resources you at least deserve to know what they are- also, if he does qualify for some sort of caregiver you could at least be paid for the job you're already doing.... even if you do decide this is the path for you, be sure to look into respite care.
  2. Your credit card most likely already has a RFID chip- I know all of my mastercard cards do. The chip+pin model is much more secure because it's more than just a simple entry of numbers (like your current card)- the chip itself can be queried and the response validated ensuring that the card is physically present. The user of the card is then validated by use of a 4-6 digit PIN that only they would know. Back in my IT days we used something similar called SecurID- basically it was a token you had which generated a random number every 30s or so. Coupled with your PIN you had a unique single-use password. Even today I use something similar in my own life (YubiKey). Here's the logo for the RFID enabled cards-
  3. Same.... but only because I realized that she was WAY better at coming up with them than I was, so I just used hers on everything.
  4. I believe the initial idea put forth by the Heritage Foundation was for catastrophic coverage- not the faux-luxury plans required by the ACA. With these 'metal' plans, do you think that your hypothetical $30k/yr person will shell out the $5k annual deductible their bronze plan requires? The problem with the ACA plans is that they aren't affordable to use, and as we're finding out their provider networks are pathetic. Worse still is that the "metal" plan mentality of ridiculously high deductibles have infested all the other consumer plans available. What's the difference now between a catastrophic plan from three years ago and a bronze plan now? The free rides I see in the ED are usually already those with State medicaid insurance- they pay zero in copays, so there is no disincentive to come in for every little thing. Back ache or tooth pain? No problem. How about "I have a fever of 99F"... yup, I've seen that too. And you know what? In this litigious age we live in, every one of them gets some lab work done and the rest of us foot the bill- and in this regard, nothing will change. JAG mentioned something kind of off offhandedly about abortion, but it really resonated with me- if a cake maker can be legally compelled to make a cake for a gay couple, could I be somehow compelled to perform an abortion because someone else has a court mandated "right" to one? This trend towards the creation of individual "rights" which require the service of another to render is disturbing in that if you remove the ability to freely consent or object to the transaction you are simply imposing slavery onto one of the involved parties.
  5. I think the difference is that in the case of Google, I made the choice to provide them with my name as well as made the choice to allow them to host (and harvest) my email- in return for helping them refine their marketing profile of me I gain access to their services which I deem as valuable. This willing exchange of information for service is different than intercepting Amazon orders and installing backdoors, or hacking into private networks for the sole purpose of collecting data unbeknownst to anyone else (including the rightful "owners" of the data).
  6. Well, they temporarily stayed it for now pending the supreme court challenges. As for the individual mandate, I can't wait for the next mandate that requires me to purchase a Gym membership of my choice (just as long as they have the minimum mandated facilities such as a pool, sauna, free weights, cardio, and a host of classes) in the name of reducing obesity in America... or else pay a tax. Why stop there? Maybe we should all purchase a new car of our choice (again, as long as it meets the min requirements of being able to tow 5000lbs, etc) to stimulate the economy too. Lets not kid ourselves- the individual mandate wasn't a "left" or "right" idea- it was the idea of the insurance industry- everybody seems to be losing except them.
  7. My daughter has- she was even the girl from the movie for Halloween- I was on surgery for a few months and 100 hour weeks doesn't leave much time. I'll have to check it out- we have it on blueray. :)
  8. A family member of mine works for RSA and is a very public figure in the security industry... We touched base over Christmas and I asked him how things were going- basically everyone in the tech industry is freaking out and companies overseas are shunning ALL hardware from ANY US based company.... think Cisco routers, Dell servers. etc. With such a huge industry now facing international blowback as a direct result of US government actions, you can be sure the lobbyists representing these firms are going into high gear on the Hill- for us citizens our interests are in rare alignment with big business- to stop the rampant espionage.
  9. I LOL'ed, but then I saw that the post was at "01-01-2014, 12:46 AM"... now I'm just confused.
  10. I was at Home Depot the other day and several couples were clearing out the stocks of cheap 60W bulbs... was this you I snapped a photo of? I'm a big fan of LED bulbs- with the exception of some halogena candelabra bulbs in a chandelier (LEDs aren't there yet) nearly every bulb in our place is LED (100% of our Christmas likes this year too! 55W for all the outside bulbs!).... having said that, I also understand that not everyone has $3 (up to $15+ for a Par/R type bulb), and I'm not comfortable asserting "well, they'll save money over the long run" while forcing them into the local payday loan a little quicker because I knew that they would be better off with the more expensive energy efficient bulb. This whole "phase out" smacks of the phospate ban that went through awhile ago- ban them from the consumer products while leaving the largest (commercial) consumers unscathed. If this is simply about reducing energy consumption, than chance the economics so that there is an incentive to economize- with our utility as you move up the utilization tiers, you pay LESS per kWh, not more.... if we want to save energy, fix that first- don't force everyone into more expensive bulbs in a meaningless feel-good gesture.
  11. This is a really frustrating conversation to have with patients on so many levels- I've met people who do literally everything right to manage their DM2 and I'm positive their A1c will be <=7... and it comes back 12 despite the fact that the person I'm seeing is a picture of health (if not totally ripped in the case of one guy). Then there are those who honestly simply don't care, are morbidly obese (and completely sedentary), have loads of acanthosis and are unwilling to restrain themselves even a little... I just wish I knew what to do and I often feel so helpless... frequently they already know about the sequela that accompanies diabetes- kidney failure, retinopathy, peripheral neruropathy, MI, stoke, etc- they know about these first hand frequently because they have family members that have had heart attacks, amputations, or impaired vision due to their disease...yet they do nothing... so why do they go to the doctor? Is it a small cry for help, or is it something to do? I wish I knew what to do or say... I wish I could help and serve these folks better. When I find out what the magic combination of words are that suddenly makes someone care, I'll let you know Pam.
  12. I really liked this movie, although maybe that's because I took my 4 year old daughter to it. I think it's the first Disney movie that I have seen where the heroine didn't need the help of a guy to save the day- she did it by herself albeit unwittingly.... right until the end it was pretty formulaic Disney, but then the twist. I liked it.
  13. When dealing with patients I don't know, it's always Ms for me when I address them.
  14. So I just finished interviewing at a residency program in Provo- it's probably my top pick at this point. I've never been around so many LDS folks in my life- ever. A gal in our ward was trying to convey to my wife and I how.... different.... provo is compared to pretty much everywhere else in the world. She cited a and said "that's pretty much how it is." So, oh wise users.... for those of you who have lived in Provo, what should I know about this place before I haul my whole family here? :)
  15. My wife was dying watching episode 1.... I was mostly sitting there going "meh".... this week's episode though was pretty darn funny. The best part of the show is the opening credits though when my 3 year old daughter tries to sing along. :)
  16. We put in for tickets on the 15th- We'll be in town for a residency interview at UofU. Woo hoo! I don't know much, but I do know it's a lottery for tickets- as far as I know there isn't any sure way to secure tickets... although with connections I'm sure anything is always possible. I just lack any connections. :) When we went for Music and the Spoken Word, everyone was in Sunday attire- so even though it is simply "encouraged", you might feel a bit out of place in anything less.... you would also be "that guy" wearing a Hawaiian shirt on the wide angle shot.... which could be good if you DVR the show- you'll always know where you were sitting. :)
  17. After spending a month on the inpatient psych ward in a local hospital followed by time in the outpatient clinics, my views on mental illnesses have changed a lot. First, from a purely observational standpoint, It was remarkable to see people be admitted who would literally talk to walls get better over a few weeks- to the point where I could have a perfectly normal conversation with them and discuss what their future plans were, etc. One woman with postpartum psychosis was particularly memorable in this regard. It's unfortunate that society stigmatizes mental illness because I'm sure there are lots of people out there who really could use help (either counseling or pharmacologic), but choose not to seek it out of fear of the consequences. On the ward, there were plenty of frequent flyers- the typical cycle was that they would stop taking their meds, become floridly psychotic, eventually meet the criteria for involuntary hospitalization (mainly a threat to themselves or others), and a judge would finally order them to submit to treatment- they would get better as an inpatient and then be released on a court-ordered LRA (least restrictive alternative) which would last for 90 days while requiring them to take their medication. Here's where things get messed up- as long as the LRA as in effect, the State pays for the medication, but as soon as 90 days roll around, the meds are no longer covered- you can guess the most common reason why people stop taking their meds- few people can afford the $1k+ monthly cost for their invega sustenna (or whatever other expensive psych drug they're on). So rather than continuing to pay for these meds, the public ultimately chooses (by virtue of the lack of any other option) a much more expensive option by waiting until these people relapse and require costly inpatient treatment. My main take away from my time on the psych wards were that many mental illnesses are treatable these days to some degree, but that med cost and perception are the main barriers to treatment. For whatever reason, society has placed little value on assisting people with psych illnesses and has therefore underfunded it as a whole- our local multi-county inpatient treatment area has very few beds, and the State hospital has a pretty long waiting list for admission (this is where people who need 30+ days of treatment go- it's not a psych warehouse). The methadone clinic was also illuminating- lots of people WANT to get clean, but can't afford the $350/mo for treatment at the public clinic.... that's another topic though. It's disappointing that the public discussion has centered so much on "how can we keep these crazies away from guns" instead of "why aren't these people receiving the treatment they need?" More databases designed to restrict the rights of people with diagnosed illnesses is not the answer- in fact, the existence of them merely serves to deter people from seeking treatment in the first place. I've had several patients decline antidepressants because they didn't want to appear in just such a database. What a wonderful system we've created.
  18. I think I see the miscommunication here, and you're right- that would obviate the meaning of marriage... or at least one of the perks of it. In Washington State you can't simply get married if you're under the age of 17- not only do you need a a parent to agree, but the family court system also has to approve. Clearly the writers of the law who are (in theory) codifying the values of the WA State residents are stating that generally the lower limit for marriage is 18 while making some room for exceptional cases for those underage. It's good that the statutory rape laws make exceptions for these couples. What surprised me though while reading the statutory rape laws is that it made blanket exceptions for marriage for even the youngest category (<12). So while I suppose it's possible the court could allow a 9 year old girl to marry a 30 year old man, I doubt it would ever happen in practice- that would be national news. It's not uncommon in other countries for a fairly young girl (like 9) to be married to a much older man. I understand that such a marriage could be lawful somewhere else, but just because something is lawful elsewhere doesn't mean that we need to condone or protect such action in this country (as we wound most likely never legally allow such a coupling to happen)... as I said, I was just surprised to see the exception to first-degree rape of a child, that's all.
  19. This was our experience as well- the missionaries moved on pretty quickly and we were left to our own devices. After a few months my wife and I were called to the activities committee, and I was called to lead a lesson during EQ once a month. I was usually pretty busy with the EQ each weekend helping people move, working on eagle scout projects, doing yard work for our more elderly members, etc. Despite our involvement, it was a pretty rocky transition- the logistics of navigating a new church were a little daunting at first, but eventually we figured out where things were, and who to talk to for what. The real difficulty though was the social aspect- at the time we didn't have any kids, and being converts, we didn't have any ancestor or mission stories to tell- these sound like trivial superficial things, but lacking these really was a barrier to entry into the larger ward culture, or even into any social circles- everyone seemed content with the friends and relationships they had and although everyone was always very nice, we were always on the periphery. After about two years of this, we finally stopped going- not really because of any beef with the doctrine or history, but simply because we were tired of going to a strangers house for 3 hours every week. Our LDS neighbors moved a few blocks over shortly after we joined the church- their primary reason they moved was to change wards (which they confided in us- everyone else was told it was because they needed more space), and they're very happy with their decision. We're now talking about becoming their neighbors again, so we hope to resume activity at that point. Hopefully this doesn't sound like sour grapes or anything- It's not intended to- it's just our experience joining the church. I'm hoping that once we move our new ward will be as awesome as our neighbors make it sound- I also hope to reach out and befriend any new converts that come around and make sure their transition goes a bit better than ours did- maybe have a monthly potluck or something at our house. Who knows. I'm looking forward to it though.
  20. I guess I should have been more explicit since your example is the literal implementation of the law- I was mainly referring to the fact that someone under 12 could consent as long as they're married- generally the US seems to take a dim view of child marriage, so I was just a little surprised to see it as a carved out exemption to first degree rape of a child.
  21. My first introduction to Washington's statutory rape laws was oddly enough during a church orientation session for all high school youth group leaders- I was too much in shock that they felt the need to cover this topic to think about how the law actually worked, but in retrospect, I think the law is amazingly enlightened and probably does a good job protecting everyone. In a nutshell the younger the parties, the closer in age they must be in order for it to not count as statutory rape- this graduated system I think is more just than a simple arbitrary age of consent. Chapter 9a.44 RCW: SEX OFFENSES Oddly enough there is an exemption for marriage in all the child rape laws... Does anyone have a good argument for why the State should allow for this?