To be fair, much patient care happens without knowing what the patient actually does or did for a living. Sometimes it comes up organically, sometimes doctors, nurses, caregivers ask, and sometimes it never comes up.

If the patient is what we would call a “poor historian” which is a typical thing that is found with dementia care patients (do you know where you are right now? And they really don’t, so deep dives don’t occur past the how oriented to present reality is this patient, beyond those generic determination questions, when they fail.)

So let’s say she has no family. Shows up in hospital, doctors determine dementia, she’s stable and it’s time to go, physical and occupational therapy in conjunction with the MD determine a lack of safety to going home alone so it’s now decided for this patient to go to a care home, and she goes to a care home. Who then, inside the care home, says: oh, maybe I should call the Texas legislature about this random patient of whom I know nothing personal, never mind HIPAA.

How would they know? How could they talk if they did, given HIPAA?

Or there is a relative making decisions by phone who never thinks, oh, maybe I should call her boss and tell them. They just miss that part in the midst of everything else.

I’ve encountered 90 year olds that can walk, maybe even run circles around 50-60 year olds, mentally and physically.

That said, this is something we keep seeing. Feinstein was painful to see, and a clear example of what should never be allowed to happen. We need an age cap.

A policy like that is also ethically sound in that, and I’ve heard this floated before in multiple places, in that the politician will then have to sit back as an outsider and look at the impact of what they did.

As is, our politicians are free from that in being able to die in office or retire to dementia care instead of FEELING the impact of what they’ve done, or pointedly not done, while in office.

Age cap: 70. Done. You can run if you’re going to turn 70 in office, let’s be generous, but once you’re over 70 you can no longer run for an office.

Enforced retirement of judges for the same reason. Hit 70, you finish or transfer the cases you’re working on and when that’s done you’re done. Who knows how much inertia is fueling a waxing/waning cusp of Dementia judge when there’s no real focus on this across the many courtrooms of the country.

But I’ll probably be accused of ageism here. It’s a nice way to solve ethics problems, infirmity problems, and add in a soft cap term limitation.

Doctors have been saying “you need to lose weight” for a very long time, decades at least. Aside from a small sliver of patients this advice is typically ignored. People want a pill for this, not to have to give up that bucket of KFC or the supersized McDonald’s French fries.

Recently, patients raise hell with healthcare workers’ bosses if weight loss is advised because it’s “mean” or is “impacting my mental health” regarding body image. So the suggestion is not made as much in general in the last 5 years.

The problem on this one isn’t often the doctors.

Now, if a patient needs surgery and is too obese for it to happen then there’s a path forward to advise weight loss without repercussions. If cholesterol is high there’s also a path forward for advising diet change, again, without repercussions. Diabetes, again, diet recommendations so you don’t fall into a coma and die, and so you can potentially keep both your feet.

All of that said, you hit diabetes phase you do have it forever, but with type 2 you can manage it by diet if you behave well, reduce weight, and maintain healthy eating. This is great, but it doesn’t mean the type 2 diabetes is gone just that it’s well managed, or “diet managed”. Another way to think of it is that it’s in remission by virtue of your good behavior but not cured. Go on a month long food bender and things can change back again.

To reverse, you need to lose weight and adjust your diet, per your doctors instructions, as soon as your doctor tells you you are pre-diabetic.

Nutrition consults typically come with the diagnosis, but people are notorious for not following up with the next specialist. Diabetic educator is a position as well. Your doctor is booked like an airport by his/her bosses and probably can’t cram that into the 15-20min time slot allowed. Referrals are made for a reason.

Two things that commonly happen to thinking on this topic. Oh, I’m prediabetic, whatever, it’s something we watch, nothing to do here, I’m safe because no insulin required. Or, I no longer need Metformin or insulin or whatever, so I must no longer be diabetic. Both are typically wrong.

Another thing that happens is hardcore denial of even having type 2 diabetes because “I don’t take insulin.”

This isn’t all people, this is simply a piece of the mess involved with diet and exercise advice in health care alongside type 2.

In keeping with the probabilities game that is the human body, here’s a fun fact. There are morbidly obese people in the 500-700lb zone who are not diabetic and still guzzling sugar like none other. Someone has to exist on the tails of the bell curve.

As always, bring your health questions to your doctors, don’t take some random dipshit on the internet seriously.

There’s an odd mentality that you just need to dose more insulin, no big deal, when eating poorly with diabetes. Understanding is sometimes the problem.

Here’s a better way to think about it in terms of body damage over time.

Think of sugar as fuel, because it is. When you have diabetes you lack the capacity to regulate the concentration and intensity of that fuel once you ingest it. You can add other things to the mix that can and will help (insulin and various oral agents) but the efficiency and immediacy of the inherent system simply isn’t there when you have diabetes.

Think of excess sugar in the blood as a caustic fuel that slowly (speed varies by individual as well as food consumed) burns out the vasculature (blood vessels) over time.

This burn out due to excess fuel is why nerves in the feet die. Neuropathy is the official name for the numbness and tingling in toes and feet that diabetics generally, eventually, experience. The burnout is also why toe tissue dies and toes need to be amputated, along with a foot or even an entire lower leg with knee, depending. Eye tissue is another location hit particularly hard by this burn out effect from sugars.

So there’s impact over time based on how much caustic sugar fuel you pour into your own bloodstream.

Also, sugar is addictive. Like meth or heroin, people struggle with letting it go.

“The help”. That deserves more attention.

I would get a pic and send it into your closest, large academic institution, the relevant department head or professor, as well as your state department of agriculture. Tell them where. Tell them how many.

The academics can confirm species and are often the ones telling the government this, whatever this is, could be or become a problem.

“Write your legislator” is popular but “write your local academic institution” is not.

Perception management, probably. I thought terrorism applied to upsetting state entities not private ones. How, by any stretch of the imagination, is a private health insurance company part of the United States government? It’s bizarre. Jan 6 would fall under that umbrella for sure.

What do you think?

On that note, Moores reaction is interesting.

Shit, now I’m wondering. I’m talking about the pseudo apologetic one that talks about printing the gun. Not being the best person to decide this, etc.

I’m a gun owner. There is a subset of people who think that alone makes you unhinged as a human being.

Luigi is just crazy enough to do what he did (allegedly). Probably not even a gun owner beyond an engineer guy makes this tool/thing on his printer and then learns how to become proficient using that tool/thing. I don’t think Luigi was LARPing training exercises with an AK, with friends, in the northern MI woods. I think he probably approached it the same way the rest of us would approach learning Linux for our next PC build.

This is clearly a proposition intended to remove anonymity from any future shooters in NYC.

You saw the camera footage. It’s as watched as CCTV in London, apparently.

Someone, maybe, a fair point. It will probably happen at work if at all given the boring, “helper” life I lead.

But not this guy. That’s the salient point.

Bernie will remain our lost opportunity.

And he’s just been put in charge of destroying all the things fed side that actually do help the working class.

This, our situation, could be worse. And this South African child of Apartheid has the power to make it so.

This will probably be taken down, but psychology is what I do so here it is. This is not endorsement this is an explanation as to why there’s different sentiment for this shooting.

This was stated in Trevor Noah’s latest podcast in open discussion. Josh Johnson raises the point. Most gun violence stories on the news, people personally feel threatened. Outraged that they or theirs could be at a music festival, a movie, at school. Most assholes with a gun are killing innocent people, never mind all the other bits. And most are clearly a little “crazy.”

This was targeted, killer on killer, no collateral (death/injury) damage. The CEO had kids that’s the collateral damage. There’s even a lady with coffee who walks on scene then nopes out unharmed.

This isn’t endorsement. This WHY the public as a whole doesn’t seem to mind. The guy who died killed thousands. That solves the innocent part. The killer doesn’t feel threatening to any of us. Because he’s not. That solves the threat. As for sanity, gun arguments aside, the manifesto isn’t unhinged.

And so we find ourselves in an unusual space. Understandably so. This is new.

No I didn’t read the article.

That will be much more relevant in the coming days. Remember, autocrats give no fucks about even pretending to not be doing those things.

There’s no magnetic field. What’s his long term plan there?

My guess is it’s a billionaire “I wanna” thing and it goes no further than that.

Pretty sure a lot of that camera data in NYC was from Google and Amazon.

Also, META, Amazon, and Google all kissed the ring. I can’t imagine our collective data isn’t one of the reasons for the initial invitation.

You heard President Musk, they’re not getting paid.

This is how you recruit fanatics to a cause. People who do things for a cause instead of a paycheck are not employees.

No W2. I guess that’s one way to not officially be logged as working for something.