Thursday, December 20, 2012

Gun Control

I’ve been meaning to write this blog for days since the school massacre at Newtown happened. Those who know I’m an Air Force veteran will probably not be surprised that I own a gun and I favor people owning guns.

Friends, I have been shot at and I have shot at enemy troops. I do not expect that a full scale war requiring that response will occur in the United States. I’m sure my forefather farming a plot North of Gettysburg, PA in 1860 didn’t expect it either. We all know now that he was wrong and he was lucky. The war came knocking on his front steps, but it never entered his life.

I have been to Bergen-Belsen, and Dachau, and Anne Frank’s Hidden Annex. I have seen the results of tyranny taking over a peaceful people who did not have the power to resist its rule.

Our founding fathers following a war to overthrow an absent leader understood that the average man needed the means to reject authoritative rule. Yes, the 2nd Amendment says: A well trained militia being necessary to the preservation of freedom, congress shall make no laws abridging the people’s right to keep and bear arms. Please parse that sentence. It does not say Congress can’t stop people from being in a militia. It doesn’t require you to be in a well trained militia to own a gun. The beginning is a subordinate clause. It explains the reason for the sentence, but doesn’t modify it in any way. In short, the action in the sentence is “Congress shall make no law abridging the right”.

That is why I believe everyone should start with the right to keep & bear arms. However, like other rights, I do agree there are ways you might lose the right. Just as convicted felons can’t vote, I don’t want them to have guns either. I can easily see owning guns being registered and licensed just like owning a car and driving it are managed. I include testing, inspections, registering, liability insurance, and the means to revoke the right in that process. My wife had a stroke in 2006. Her Doctor submitted paperwork to the state and she was notified that she had lost her right to drive and what she needed to do to get that right back. I think we can enact the same rules regarding mental health and gun owners’ rights.

Is this change going to be easy? No. The idea for cars started when there were very few cars on the road and it was easy to enforce. The continued enforcement has been handled by requiring car dealers registering vehicles before they leave the dealership. I’ve no idea of a practical means to register already owned guns. There will be a certain percent that voluntarily do so, but will that even be 50%? I don’t think so, but I’m just guessing.

Now some of you are going to ask me, “All guns?” Do you all realize that 12% of the US population is Veterans? Want to guess what weapons we are most familiar with? Yeah.

I have a pistol and only a pistol. I’m too old and too fat to be in a situation needing an assault weapon, but if the worst comes about, you can be damned sure my fire team will have a few. I’m more likely to grab a shotgun to fire for effect because it’s point and shoot; no aiming really required.

Am I sad about the events at Newtown? Of course I am. How can any human with a beating heart not be upset over the massacre of innocent children?

Do I think that will be the last such massacre? No, but I don’t think removing all guns from circulation is the answer. That simply opens us up to more problems down the road.

Are there other steps that can be done? Yes.
a.      I’m in favor of trained staff carrying guns everywhere.
b.     I’m also in favor of limiting the size of magazines.
c.      I can also agree to limit the sales of semi-automatic weapons.

The first limits massacres by shooting the offender, the latter two by limiting the number of rounds that can be fired in a given time.

What will congress do? They are supposed to represent us, so I hope they create a registration & licensing system.

Wednesday, December 19, 2012

Question for Type 1 Diabetics about Pumps & Continuous Glucose Monitors

Friends, I’m crowdsourcing a question.
I’m going to put a lot of narrative below, but my basic questions are:
 1)      What pump do you use?
       a.       Why?
2)      What infusion set do you use?
3)      Plastic or metal cannula/needle?
4)      Have you ever had problems with insulin leaking, the cannula or needle pulling out, or any other non-standard response?
5)      Do you use a Continuous Glucose Monitoring system?
       a.       If so, which one?
       b.      What are the pros and cons of that system?
If you feel you can answer those questions without any more info feel free. You can respond with comments, you can email me at, find me on FaceBook as Jules Shore (same picture) or via Twitter @7shores.

Now for that background: My wife, hereafter known as Mrs, has been a Type 1 Diabetic for 51 years. Hold your applause please, it doesn’t mean she’s done everything right. On the contrary, she’ll be the first to tell you she isn’t a good diabetic. She has exceeded all expectations of doctors. 20 years ago when we got married, she was expected to live about 5 years. It’s 20 years later and she’s slowed down some, but she’s still ticking.

Mrs works in a Doctor’s office (Family Practice). About two years ago a Medtronic pump salesperson approached the Dr to get him to recommend pumps for patients needing that type of therapy. The Dr wore a pump for two weeks with saline in the reservoir to get a feel for it. At the same time, they recruited Mrs to try pump therapy too. Of course, she had a real live pump full of insulin. That went well so they added on some other incentives and Mrs became a pumper at the cost of $1500.

Up until that time, our Primary Care Physician was following her diabetes. Mostly that meant checking the A1c and keeping up with prescription needs. They didn’t want to follow her use of the pump, so they really forced us to get an Endocrinologist.

When we signed up with the Endo, she already had a pump and supplies, so there wasn’t any discussion of which pump to use. Within a few months, they were pushing the CGMS integrated with the Medtronic paradigm pump that Mrs is using.

Mrs’ control has been great on the pump, but frankly it hasn’t been the easiest change to make. She had a lot of problems with the first Infusion sets she used. They had a needle inside a plastic cannula. After insertion, you pull the needle out and an internal valve is supposed to keep the insulin from coming out the hole. That didn’t work for us, after a number of instances of changing the infusion set while on the phone with Medtronic customer support, we resorted to covering the hole with tape. On a following visit to the Endo, we were put in touch with a different Medtronic salesperson. They may call them case worker or similar title, but I call a spade a spade. She switched Mrs to the Sure-T infusion set. That model has a needle stay in the whole time, so there is no hole for leakage. Unfortunately it has a smaller patch of adhesive and Mrs has pulled needles out on occasion. We reinsert it and cover it with band aids or tape and change at the next expected change.

Mrs also tried the Glucose monitor system from Medtronic that integrates with her pump. Frankly it was a pain in the ass. (My blog; my rules.) She couldn’t take any of the IV covers they wanted her to use. Tegaderm works fine in the hospital, but after three days around the sensor she’d be all red and bumpy at the edges. Without a cover, the sensor adhesive would sweat off before 3 days were up. In addition, she’d have to check her BG 8 times a day to keep the sensor calibrated.

Thru Twitter contacts, I’ve discovered there are other brands of pumps and also CGMs that aren’t integrated with the pump. So I’m looking for some feedback from real users about their equipment; good, bad, or ugly. I can do research all day long, but none of that is as valuable as the info I can get from real users. Feel free to pass this around via any social media to all of the Type 1 pumpers you know.
 If there are any other sugestions, feel free to share those too. It seems strange to be newbies at the process 51 years into a disease, but it is true that we are newbie pumpers compared to some of you.

Thank you,

Friday, December 14, 2012

I Love Serials (no, no, really, I do)

In today's episode of "It's Tuesday, so this must be Belgium", a journal in search of an identity:

Previous titles/ISSNs:
0023-023X Ophthalmic Surgery, January 1970-August 1995
1082-3069 Ophthalmic Surgery and Lasers, September 1995-December 2002
1542-8877 Ophthalmic Surgery, Lasers & Imaging, January 2003-December 2012

2325-8160 Ophthalmic Surgery, Lasers & Imaging Retina, effective January 2013

I guess I shouldn't complain, they are keeping Catalogers all over the world gainfully employed just cleaning up after them. But still, does this change really make any difference to your readership?

Friday, December 7, 2012

Xmas Lights

This year's decorations for Christmas, Chanukah, Hanukmas, Christnukah, Festivus, what ever you like to call it. May everyone have a Merry Holiday season. I still limit my wishes to three: Peace on Earth, Goodwill towards Men, and a list of all the Naughty Girls within one mile of my house (but 2 out of 3 wouldn't be bad).