06 September 2017

Helpful Hints for a Happy House: Fire

Let me be abundantly clear: This is a general guide. I don't know what your local building codes require. You should check them, since I didn't.

Despite a proclivity to starting non-destructive fires, I'm actually quite paranoid about unintentional fires. Southern California is a hotbed for wildfires, and we happen to live in a Very High Fire Hazard Severity Zone.1 Every year, the fire department encourages brush clearance via threats of fines and exorbitantly high removal fees. And yet an alarmingly highly number of my neighbors still have wood shake rooves covered in pine needles, despite Los Angeles banning them in 1989.2 Burbank is actually making people remove them,3 while my neighbors ignore maintenance to avoid triggering replacement requirements. So how do I sleep in this tinderbox neighborhood? Smoke alarms! Smoke alarms EVERYWHERE!

There are two different types of smoke detector sensors - photoelectric and ionization. The National Fire Protection Association recommends using a combination of both.4 There are dual sensor detectors, but only one of the sensors has to pass to get the unit certified.5

There are also different ways to power alarms: high-voltage, low-voltage, and batteries. If you have user-replaceable batteries, change them every six months. I put a reminder on the calendar and change every single one at the same time. If one alarm decides it wants to have its batteries replaced early, it still gets the regularly scheduled replacement. Saving an extra battery or two is not worth the hassle it would become after a few years.

Speaking of replacements, the actual alarms need to be replaced about every ten years. Each unit should have a replacement or manufacturing date. Again, I recommend changing every unit at once.

You know that little "TEST" button that you are supposed to hit once a month to deafen yourself? Well, the good news is it tests the alarm. The bad news is it doesn't actually test the sensor. Smoke, like that sold in aerosol cans, is the only way to test the smoke sensor.6

Some alarms can be interconnected, either wired or wirelessly. If one senses smoke, they all go off, making them better at alerting occupants.7 Usually only alarms from the same company will talk to each other.

There are other features, such as internet connectivity, built-in carbon monoxide detectors, and easily accessible battery compartments that don't require taking the entire damn thing apart. Our house sports heat detectors interconnected with the smoke detectors,8 though we narrowly escaped installing the residential fire sprinklers required for new builds in California.9 If our landscape sprinkler system ever gets fixed, we'll probably get a controller that also connects to the smoke detectors so the grass doesn't get charred.

My final recommendation is to clean your dryer vent and duct. Lint gets past the screen and builds up over time, creating a fire hazard.10

25 August 2017

The New SMS Protocol

It's no secret that missed doctor appointments cost doctors oodles of money.1 For some reason, doctors don't like this, so patients receive oodles of appointment reminders. Mailed reminders and phone calls are quickly becoming things of the past, in favor of cheaper alternatives often bundled into existing medical scheduling software. There are lots of obvious plus sides for the doctor, but what about for the patient?

Doctors are on the very short list of people who get my cell phone number. I don't want to play telephone tag when waiting for biopsy results. Plus there are all those nifty laws requiring doctors to keep personal information safe. I felt I could trust them. That trust crumpled under an avalanche of text reminders.

I received the first from Dr. Plastic Surgeon, alerting me to an upcoming appointment. In a week. I was miffed, but that was nothing compared to my mood after I received one the day before and the day of. I did not miss that appointment, if only to have a little chat with the receptionist.

Dr. Dentist and Dr. Optometrist soon followed suit, and I had more little chats. It's the same story every time. "We didn't text you, our scheduling software did." Somehow not a single office administrator understood their office is ultimately in control of said software, from purchase to configuration to use. Medical offices should not be hiring anyone who exhibits this level of cognitive inertia.

Some doctors also have my email address, usually for sending me forms to fill out ahead of time. On top of appointment reminders, I'm also receiving workshop bulletins, surveys, and my personal favorite, new product announcements. Every single one of those gets reported as spam. Every single time.

New patients fill out extensive questionnaires including contact information. Most of them very specifically ask if they can leave phone messages and with what level of detail, such as test results. Where was this level of concern when someone clicked "Yes" next to "Send text message reminders?" It's much easier for a random person to see an SMS snippet with a doctor's name on a phone screen than it is for a random person to listen to someone else's voice mail. I can't wait for the first lawsuit due to the wrong person seeing a text reminder for an obstetrician.

28 July 2017

Now in Laser Vision!

I had Lasik nearly a decade ago. A brief cost-benefit analysis indicated I should do it regardless of price, I did it. As my astigmatism was carefully seared away, perfect vision emerged. In fact, it was even better than perfect! I was the proud owner of 20/15 vision! Note the "was."

About 8.5 years later, I noticed my vision was decreasing in precision. I wasn't happy, but my hefty Lasik fee included free enhancements for life*, which is just marketing-speak for doing the same procedure again. I went in for an eye exam. The good news? Sufficiently thick corneal tissue. The bad news? Waiting six months.

Dr. Lasik has the crazy notion that only those with stable vision should get their eyes lasered. Since my vision wasn't checked for longer than I care to admit, the only way to prove stability was waiting six months and getting another exam. In the mean time, I wore glasses.

I'm not known for patience. And yet, I survived for EIGHT months, due to some paperwork problems involving digging my old chart out of a sub-basement under a bridge. The last couple months were touch and go, but I digress.

You must have a valid driver/competent adult to take you home, and in return they get to watch everything on a large tv provided. Pictures are even allowed, so time for explicit eyeball surgery!

⚠️ Warning: Explicit eyeball surgery!

Step one is confirming that the  eyes do in fact exist. To keep things that way, 5 dots are drawn on each eye. Or maybe it was to carefully calibrate points on the cornea. Regardless, it was very reminiscent of the radiation tattoos for perfectly alignment.

You can't tell with the hairnets, but I'm the one in front.
Four little hooks hold the eye open. Very Clockwork Orange.

A femtosecond laser creates a thin flap in the cornea. Some low-cost surgeons still use a blade, which has higher risks. Do not recommend.

Say hi to Dr. Lasik!

The flap is carefully folded down with a tiny foam brush. The bottom isn't detached, so it can be reused later.


The main laser reshapes the cornea, turning it into a front lens that corrects for the deficiencies in the actual lens. In other words, pew pew!

The flap is dangling down from the bottom.

After sufficient zapping, the cornea flap is carefully replaced. No stitches, staples, or eye glue is necessary - the flap stays in place by itself. Unless you start rubbing your eye or or jabbing it with a fork. So don't do that.


Look into my eye. Look closer. Closer. Now you are under my control. Also, you can see the flap back in place.

The whole thing was repeated for the other eye, and I was ready to head home. Someone put goggles on me to prevent accidental touching, followed by sunglasses strong enough to prevent most screams due to bright light. Lastly, a generous dose of Valium prevented me from caring.

A checkup the next day confirmed I didn't knock the flap out of place. The goggles! They did something! More importantly, my vision was back to 20/15. I can see faerie dancing on the head of a pin. Assuming there was a faerie small enough to dance on a pin. Or a pin big enough. And within my line of sight.

Aside from some mild dry eyes for a couple weeks, everything went according to plan. Miraculously, I failed to find a new and interesting way to poke myself in the eyes! X-ray vision is yet to emerge and there are no signs of optic blasts anywhere, but I'm still happy with the results. 

*For those wondering why the original procedure including a lifetime of free enhancements, it's a numbers game that makes for good advertising The $4995 cost (now $5494) doesn't seem as bad when you start adding in a few do-overs. Most people over 30 never need one, and the technology is constantly improving. The only catch is no tech upgrades are included, but I was happy to pay $250/eye for a significantly faster healing time.

17 June 2017

The Fish Tank Compulsion

Many people associate hand washing with OCD. The person obsesses over hand cleanliness, so they create a ritual around washing their hands properly to alleviate the anxiety. Sometimes the ritual is scrubbing a certain number of times. Sometimes it is a certain manner of washing to get rid of all the dirt and germs. Regardless, continually washing ones hands all day does not actually accomplish anything positive. Even I have dealt with compulsions in the form of rituals to achieve the necessary level of cleanliness.

Before college, I had a fish tank. Cleaning that fish tank brought up a lot of contamination issues. I put towels down everywhere so no stray drop could get through. Once the dirty water was out and the clean water in, it was time for decontamination. Everything had to be done in a very specific order to prevent contaminating anything. First my clothes went into a pile in the bathroom. I carefully piled them such that no wet spots touched the floor. Then I washed my hands and arms three times, as three was number necessary to get rid of any yucky fish water. If I didn't feel like I sufficiently scrubbed myself, it become four or five times. Next, I wrapped myself in a clean towel and went back to my room to change. All the towels and clothes were carefully carried downstairs and straight into the washer. Just in care, I washed my hands again between carrying the pile and turning on the washer. No sense in getting fish water on the washer controls. Finally, I sprayed down everything with antibacterial cleaner. The outside of the fish tank, all nearby hard surfaces, the bathroom sink. Everything. After waiting a few minutes for the cleaner to work, all the surfaces were wiped down with paper towels. The paper towels went straight into the trash. Finally, I washed my hands another three times. Contamination from the fish water was my obsession and this ridiculous cleaning strategy was my compulsion.

What happened if something went awry in my plan? Disaster. One time I ran out of antibacterial cleaner. I needed a new bottle from under the kitchen sink. I tried to open the door with my foot, but the childproof lock kept me out. I asked my dad to open the cabinet for me. He refused, saying I should open it myself. In desperation to finish my cleaning, I eventually opened it myself while in a teary mess. My life-preserving decontaminating ritual was ruined.

For years, I refused to touch that part of the cabinet. No amount of scrubbing or chemicals could disinfect that area sufficiently, as the fish water penetrated the wood. In fact, I never touched it again. It wasn't until the cabinet was replaced that I opened the door under the sink normally.

Such a rigorous cleaning regiment is clearly not necessary to prevent fish water from ruining my life. Fish water isn't even that horrible compared to other possible contaminants. Somewhere in my brain I always knew this wasn't logical. And yet I continued for years, as performing the compulsion was infinitely better than not doing it.

After years of cognitive behavioral therapy, I now know how harmful it is to keep performing the compulsion. Instead, through countless hours of exposure and response prevention (ERP), it is possible to overcome the compulsion. Exposing yourself to an obsession and sitting through the anxiety instead of performing the compulsion is incredibly hard by itself. A therapist or ERP coach makes it mind-numbingly painful by constantly reminding you about how horrible the situation is and not letting you cheat. Eventually, the ERP makes it possible to function without performing the specific compulsion. Sometimes the compulsion goes away completely. Other times, the desire to compulse remains, but is bearable. Either way, it's better than living with horrible, time-consuming ritual.

01 May 2017

Combating OCD

It is a common trope to declare oneself as OCD due to some specific desire of orderliness. Shockingly, keeping the house clean or carefully ordering books doesn't qualify as a symptom of OCD by itself. Some people with OCD are complete slobs. Others just shove all the books on the shelf where ever they fit. Merely preferring something a particular way is normal. Having it completely take over everyday life is when it becomes an obsession.

Obsessive-compulsive Disorder consists of two parts. As described above, the obsession can be nearly anything. Many of my obsessions are around what I consider perfection. The compulsion is something that eases the mind and makes the obsession go away. Mine are often fixing things to make them perfect. Even that last sentence needed to be perfect, so I rewrote it three times before convincing myself to move on.

Rewriting a sentence a few times doesn't seem like a big deal, but it is part of a much larger problem. If my blog posts aren't perfect, readers will see these imperfections and think I'm an idiot or incapable of properly editing my writing. In reality, these responses aren't actually likely. In my mind, I need to prevent people from thinking poorly of me. And therein lies the problem, causing me to rewrite sentences and even paragraphs over and over.

The only proven method of combating OCD is through exposures. Exposures have absolutely nothing to do with streaking. An exposure is purposely creating an appropriate obsessive situation and not performing the compulsion to make the anxiety go away. It often takes weeks or months of daily exposures to combat just one obsession.

Exposures suck. Really really suck. Even minor ones. You can't just do it for five minutes and declare it finished. The entire point is to sit with the horrible anxiety until it decreases. A typical exposure lasts forty-five minutes to an hour. The anxiety may not decrease at all for awhile. For it to work, you have to keep at it, repeating the same exposure daily until the anxiety decreases or disappears entirely for an obsession.

Any exposure worth its salt is mentally draining. Two a day, plus an hour of regular therapy and an hour of group is also physically draining. Just this half day routine is enough to leave me useless all afternoon.

Most people with OCD have a large pile of obsessions. That means each of these obsessions needs to be treated individually. The obsessions are usually ranked into a hierarchy, from least horrible to completely life-destroying. As the lower obsessions are conquered, the higher ones become relatively easier to experience.

Even with countless exposures, some obsessions and compulsions never go away entirely. You just have to be diligent about not falling back into old patterns. It's a lifelong struggle. And on that note, I'm going to hit "Publish", without checking for spelling and grammatical mistakes.