Who? Me?
Well you're here now, you might as well introduce yourself. Oh, me first? So I'm @irms and this is my blog. I care about things like entrepreneurship and how Pepsi tastes better out of a glass bottle. (read more)
Posts Tagged ‘update’
PHP/MySQL Full Database Search and Replace
September 1st, 2009
I wrote this because I often need to move data-driven sites from development to production and addresses change. (Wordpress sites, Wordpress MU, Drupal, and so on.) This means I have to go through and change every occurrence of the url as it appears in the database. So when the first few solutions for changing the site url aren’t doing the trick, I have to resort to the following MySQL snippet for updating every single table.
To find a string in a certain field and replace it with another string:
update [table_name] set [field_name] = replace([field_name],'[string_to_find]','[string_to_replace]');
Well, I got tired of doing that and wrote a handy snippet to find and replace across an entire database.
There are no checks or safeguards! This is a quick and dirty script to be used at your own risk!
But if it’s useful, please feel free to say so in the comments.
UPDATE
Added two checkboxes:
- Set the script to never timeout (use with caution!)
- Do a case-insensitive find and replace. (use with caution!)
Download the updated .rar here
Back To Square One, Medically Speaking
May 22nd, 2009
The one year anniversary of my stint in the hospital came and went without event.
After my visit to Kaiser Redwood in January, I stopped taking all meds (in February), and have been “clean” for just over two months. These months without prescriptions have made a dramatic difference in the way I feel — which is pretty much back to normal. After much deliberation, taking everything into account, I made future plans to get a third opinion after aquiring new insurance. I also made the decision to be in no great rush to get that insurance, and live like a healthy person in the mean time.
Much of this was based on the report by Dr. Rao. I’ve copied the significant portions of his report (which I obtained through requisition at Kaiser Health Information Management):
“She is 28 Y old and very healthy.”
“I am certain that her syncopal event was in NO WAY related to this possible RIGHT ICA stenosis.”
“…even if it were to be significantly stenotic, I don’t think it’s sympotomatic, and it’s not treatable endovascularly given the tortuosity.”
“The patient can certainly continue to take aspirin (tolerating it well) but I don’t think it is manadorty.”
You’ll remember that this is the same doctor that told me to “go home, and try to pretend it never happened.” While “pretending” isn’t something I can do, I figured (and was successful for almost two months) that I could continue living with the stroke-threat level lowered to blue.
That just changed.
Last week I received a letter from a Kaiser program called PHASE, which stands for “Prevent Heart Attacks and Strokes Everyday”. I was unaware that I belonged to this program, and had no cause to think Kaiser was taking the situation seriously given the stance of Dr. Rao, the expert. Here is an excerpt from that letter:
“Dear Ms. Olguin
…I assist your provideer in mailing out reminders to come in for blood tests and sending information on how to reduce your risks for heart attack and stroke. We work as a team to educate our patients who have a high-risk diagnosis.
…
…This is a courtesy letter to make you aware that you are due to complete the requested labs that your provider has ordered.”
High-risk diagnois? So am I, or am I not a high-risk patient?!
Anyway, I went in for the labs on Friday (May 15, 2009). Among the labs drawn was the Lipid Panel which is “a blood test that measures lipids—fats and fatty substances used as a source of energy by your body. Lipids include cholesterol, triglycerides, high-density lipoprotein (HDL), and low-density lipoprotein (LDL).” The results were available for my viewing (online) the next day.
Component Results
| Component | Your Value | Standard Range |
|---|---|---|
| CHOLESTEROL | 179 | <239- mg/dL |
| TRIGLYCERIDE | 112 | <199- mg/dL |
| HDL | 43 | >45- mg/dL |
| LDL CALCULATED | 114 | <129- mg/dL |
You see that the HDL component is slightly lower than the standard range. HDL is sometimes called “good cholestoral” and is said to prevent cholestoral from building up in the arties. An event that, in my case, could cost me my life. Too much cholesterol in the blood can build up along the inside of the artery walls, forming what is known as plaque. Large amounts of plaque increase your chances of having a heart attack or stroke.
On Wednesday, an RN from Kaiser called me and I returned that call a little while ago. He told me that they are taking these results seriously. That, given my stenoisis issue and incomplete Circle of Willis, my cholestoral is too high (eventhough the range is fully normal for a girl my age/size, etc), and that in consultation with my doctor, we need to change my health plan.
In addition to switching to a low fat diet, I am to restart the low-dose aspirin and, you guessed it, start on a new medicine to regulate cholestoral. Now before you get excited about my cholestoral being too high, it isn’t. It’s just too high for a person with a high-risk diagnosis. And in case you were able to forget that for two months, that’s me.
So here we sit where we sat just over one year ago. Back at square one.
Consider Me Insured
September 11th, 2008
For those of you keeping up: I am insured as of today.
I can’t tell you what a huge relief this is, but if you can do simple math, imaging no longer having a $15,000 bill every four months.
Back by Popular Demand
September 10th, 2008
I didn’t plan on writing another posting because it seemed like all I was doing was writing about more bad news, and who wants to read that? But, because you asked, I’ll give you the facts as they are right this second:
The last time I saw a doctor was just about two weeks ago and that was my neurologist. She’s pretty great by the way. She’s blunt about the situation and doesn’t try to give me hope like everyone else really wants to do. She’s also surprised that I haven’t sunk into a deep depression and that amuses me quite a bit. In spite of the reasons for going, I look forward to seeing her.
Just about three weeks ago, I was hired by a company called Band of Neighbors. These guys are really going out of their way for me, and I couldn’t ask for more. Well, I could ask for more money, I suppose, but that would just be looking a gift-horse in the mouth. With this job comes insurance.
I haven’t received confirmation of my new insurance yet, so I can’t breathe a gigantic sigh of relief. But it’s coming. I can feel it.
Using all the charm I have in my bag, I persuaded my doctor to wait until I have insurance to have the next set of procedures done. (It didn’t require that much charm, to be honest.) The onset of insurance coverage will also mean a new medicine will be prescribed to me. The last statin I was on (it’s a medicine that breaks apart things in your blood, often given to people with cholesterol problems, but in my case, just used to keep my blood ultra thin) ate away at my muscles and left me fatigued and hurting. It was a difficult time for me, and heartbreaking, I think, for the people closest to me. I was a shell of myself, but I’m better now.
I was removed from the statin, and underwent a withdrawal period which was painful, but still better than being on the Rx. As soon as I have that insurance confirmation, I will get a new statin, and have an MRI/MRA and a CT Doppler, which is all fancy-talk for fresh pictures of my brain. I’m not ecstatic about the new statin. I’m leary that it will take away my energy, which would be upsetting. I’m not exactly looking forward to the procedures either because they hurt (the medicine burns to an almost unbearable point and then it goes away). On the other hand, I am anxious to know whether things have gotten worse, better, or are the same.
Health-wise I’m doing much better than I was just two months ago. I’m still at significant risk for CVA (cerebral vascular accident = major stroke), but at least I feel pretty normal most of the time.
Things that have changed because of this beautiful mess:
- I bleed A LOT! My blood is now like water, only bright red. I was camping recently and poked my finger on a jagged piece of plastic. I didn’t know I was cut until I felt the blood dripping down my hand. Oops. Now I have to be extremely careful not to get cut.
- I am beat at the end of the day. I miss my old energy.
- Sometimes I have a hard time concentrating when I’m that tired.
- My hands and feet fall asleep sometimes for no reason.
That last one is a point of concern as it could be a sign of bi-lateral stroke symptoms.
Say what?
Well, you see, when people have strokes it’s because the brain is not getting enough oxygen (which is carried up there by the blood). When the brain can’t breathe, the half that is affected causes problems in the body, like a sagging in half of the face, loss of motor function on one side, the ability to speak or make sense of words, loss of feeling in the opposite half of the body, and so on. If these pieces of my body that are going numb, or falling asleep are a result of the issues with my brain, then that would mean that both sides of the brain are suffocating and that’s really really rare. We don’t know if that’s what’s happening yet, but that’s the talk around the watercooler.
According to my medical records, there’s already evidence of suffocation in parts of the brain, but I don’t know what that means. I’m hoping to find these things out after the next round of procedures. (When I say ‘next round’, I mean it. I’ll be doing this the rest of my life, I’m told.)
I know this all sounds very bleak. That’s most of the reason I stopped writing. There’s no good news here, and I’m not sure there ever can be. At the same time though, I feel supernaturally above the problem, and I can’t explain that properly except to say that everyday I am able to get up and go to work and make some jokes, is pretty good day in my book.
That about covers it. Any questions?
What Happened Before and a Little After (Part V)
July 10th, 2008
Update 4
So, the good news is, my neurologist is a really sweet woman who recently got a new perspective on the outer-workings of the medical process when dealing with a hospital issue of her own. She was sympathetic, helpful and sincere. A combination that’s hard to find in anybody, let alone in a doctor. Here is what went down this morning (after an excessive wait at the hospital clinic):
The Verdict
Before I say anything else, I should just go ahead and admit that the findings are a bit of a downer. On one hand, I am fortunate to know what I know, and on the other (frustrated as hell but) lucky to be able to walk about upright like a regular person whose brain breathes properly.
After sending my case out to a number of specialists, my neurologist has spoken to a team at Stanford and the bottom line is that the risk/benefit ratio for a surgical option is just not in my favor. The experts agree that I am at significant/urgent risk for cerebral vascular accident (CVA = big fat stroke), which is a mortal threat, but that intracranial surgery is (for the moment) even more dangerous. Here’s why:
- Surgery in general, always carries the usual risk of excessive bleeding or bad reactions to medicine. Brain surgery in particular has greater ramifications for that kind of bleeding.
- Surgical options for repairing intracranial stenosis (narrowing of arteries in the brain, that’s what I have) are limited because the technologies just haven’t gotten there yet. Apparently there just aren’t options available that are as good as similar surgeries in other parts of the body. Arteries are made patent (wider) all the time in and around the heart, but those techniques don’t work as well in the brain.
- In my case, specifically, the problem lies in that during surgery, even if the techniques were worth the risk, blood flow to one half of my brain would have to stop or be limited for a length of time and there’s no way for my body to compensate for that loss:
- They can’t/shouldn’t perform an angioplasty (send a balloon up there to widen the artery) because while the balloon is up there, that half of my brain will have no way to breathe (get blood) and will likely cause a stroke.
- They can’t/shouldn’t place a stint to hold the thing open, though they are often done in other parts of the body, because they can cause clotting all by themselves and there again cause a stroke.
- Other scalpel options are not available because the problem is so far into my head (literally, not symbolically) that they may kill me trying to widen the blood highway.
So. At this point in time, the only thing that makes sense is to try to ‘treat’ the risk of CVA medicinally. It was made clear to me that I am never, ever, ever to miss a single dose of asprin, but we will be experiementing with different statins to try to find a solution that doesn’t leave me hot, nauseas and fatigued. Regardless, the doctor says I will be on pills the rest of my life. In addition to the pills, I will go in every 4-6 months to have another MRI/MRA for the rest of my life. The first one is scheduled for the end of next month.
While the risk/benefit ratio for surgery doesn’t work for me now, the doctor made it clear that, one day, even a risky or damaging surgery may be the only option. The MRIs/MRAs will tell us when and if we need to reevaluate the situation, suck it up, and operate anyway. She said that I am to report any and all unusual feelings because they could be indicators of decreased blood flow to the right side of my brain. Also, another syncopidal episode (if I pass out again), could cause her to change her mind and recommend surgery.
The whole thing is a damned-if-you-do-damned-if-you-don’t-situation. ‘Treating’ my condition medicinally has implications too. One of the glaring problems being that there is possibillity that the only symptom I’ll ever have is an catastrophic stroke, which would then make it too late to try surgery. Also, statins are notorious for causing liver problems. On the flip side of the coin, trying surgery now may just kill me anyway, and you know that wouldn’t be great.
What it all means is, I am just going to have to live with it. For now anyway. Right now our hands are tied and we’re just going to have to do the best we can with what we have. God willing, we’ll find a medicine my body doens’t reject and I’ll go about my life as though nothing were wrong. The only difference between me and other people being a quietly suffocating brain, but on the outside, it all appears normal.
Needess to say, the long-awaited appointment could have gone better, and at the same time, could have been worse. The nuerologist was surprised that I remain optimistic saying that a very high percentage of her young patients are tossed into a depression and that such a thing is common — even expected. But I still feel alright. It’s a bummer and I’m frustrated by the longevity of the problem, but above that, I feel ok. Maybe a little blue.
I don’t want this to be a problem for the rest of my life, if I had my druthers, we would crack open the skull, blow into the artery and move on. But I don’t get to make this decision so I’ll deal with it.
Unless something changes drastically, I think this will be my last update. You guys have stayed with me in a digitial sense, and I appreaciate the audience, but this is just the way it is now and writing about it would be oh so boring, and probably worse to read. I better go about the business of figuring out how to deal with it, and you better get back to work — it’s the middle of the day for Pete’s sake!
Thanks everyone. I couldn’t have dreamt a story this riduculous.
Always, Always, Always,
irm jr.
Now, to find some insurance…
What Happened Before and a Little After (Part IV)
July 8th, 2008
Update 3
I know what you’re thinking. It’s been so long since my last blemail (<- that’s a cross between an email and a blog, pronounced with a hard ‘eee’ as in blee-mail, brand new word, just made it up) that you feel like we’re breaking up. We’re not. Don’t convince yourself we’re flawed just so you can break up with me before I break up with you. I know how you are, so let me explain:
[ Warning: This message is mostly concerned with the insurance scandal that has become my life, so if you're not interested, I suggest you skip to the bottom paragraph. ]
When last we spoke, I told you I had a hard time finding a primary care physician because I don’t have insurance, and many of you wrote with your insurance-getting/avoiding suggestions. Thanks, I tried many of them, but it hasn’t worked out for me, yet.
When the company I worked for closed up shop two months ago, I resumed freelancing and that’s been going pretty well. I can pay for stuff, and I make my own hours (for the most part), so I am able to deal with the effects of my medications. (More on the meds in a moment). With that handled, getting health insurance has become my number one priority.
When I discovered that I couldn’t get COBRA, I tried for a ‘Garaunteed Issue Plan’ which is insurance with outrageous premiums and a bigger chunk of the debt landing on the patient than in a traditional plan. I was denied. Post-denial, I applied for the ‘Major Risk Medical Insurance Program’, which I have recoined, ‘Insurance for the Terminally Ill’, but which, I have come to find out, has a 4-5 month waiting period, in addition to the even-more-outrageous price tag. Finally, as a last ditch effort, I attempted to get MSP (Medically Indigent Services Program), to cover the cost of an appointment with the nuerologist, but the plan was thwarted and may be denied on account of my financial stability. The irony is tortorous.
I’d already be married (to anyone that has insurance) and morals be damned, but my own mother is threatening bodily harm if I do so. I can’t stand up to my mom (anyone else is fair game). But my mom? I’m a weenie, I just can’t.
I did see a doctor at a clinic, in an attempt to get a primary care physician, but the appointment was a complete waste of time and money (I’m a cash patient! It’s not cheap!). He said, in so many words, that he couldn’t help, I absolutely must see a specialist, good luck doing that without insurance, and, yes, keep taking the pills.
Some of my former students have expressed their distaste that this ‘health issue’ would be a lame way to ‘go out’. Thanks guys. Eloquence is a hard thing to teach, but you certainly got your point across. Be assured, I have no intention to peg out so easily. I plan to die fighting crime and rescuing superheros somewhere between here and the Baltic sea. You’re welcome.
Others have written to encourage my writing, saying I should do it professionally, write a book, make a million and the devil take insurance. Who needs health insurance with a million bucks in the bank? Well, I think it’s a billiant idea, and I’m completely onboard, if someone would please just tell me how to make that happen. I’ll write articles about panda bears and marigolds for a check that size. Just show me where to place the pen.
How I’m Feeling
I’m just going to say it: these prescriptions are a slowly tightening noose around my neck, and I can’t reach my knife. I’m tired, hot, nauseas and my body hurts. It feels like someone has a permanent I.V. shoved between my muscles and my bones and they’re pushing liquid into my body which hurts because it’s stretching out my limbs – or feels like it is. I feel tired, but not the usual kind of tired. A cup of coffee isn’t going to save the hour. It’s a fatigue that saps my will in addition to my strength and leaves me lying down too much of the day. I get hot sometimes, with an unnatural heat that has nothing to do with the temperature in the room, and some sporadic dizziness and nausea that makes me feel like my eyes can’t catch up to the movements of my head. The discomfort comes in spurts, especially after I eat and shortly after I take the pill cocktail. Other than that though…I feel fine.
I feel confident, now, after two months of trying to see the pattern, that these feelings are a weird combination of the pills, the last time I slept, for how long, and when I ate. The good news is, when I feel good, I feel pretty much back to normal. That’s something, isn’t it?
bottom paragraph
Today I finally had an appointment with the nuerologist. The same one I saw in the hospital, the same one who had a family/personal emergency, the same one I’ve waited two months to see. When she learned of my no-insurance status, she didn’t kick me out of the building…she tried to help. She informed me that, being a cash patient, I could pay $550+ dollars to hear her speak for 20 minutes today in her private office, or, go by the hospital clinic first thing tomorrow morning to see her there and save four hundred bucks. I did the math and I said, “How do you take your coffee?” So. One more day. Twenty more hours. By lunch tomorrow, I may have more answers than I have now. (I’ll also be a couple hundred bucks poorer than I am now, but at this point, something’s gotta give.) As always, I am grateful for the emails, texts, and good juju everyone has sent my way. I am especially grateful to the amazing friends who sit with me on my bad days and drink tea or do nothing, because it’s all the energy I have to spare. The sitter-withers (as I now call them) should be monetarily rewarded for that kind of friendship, it goes way above and beyond the call of duty. I am humbled by your love each day.
Until the next installment,
irms
What Happened Before and a Little After (Part III)
May 16th, 2008
Update 2
Writing these emails is starting to feel more like writing a blog than it should, but how else would you expect me to keep you up to date? If you’re getting this email, then you must know me well enough to know I won’t be making phone calls 
A text message, maybe, but that’s a lot of messages flying back and forth.
Anyway, here’s whats new (again, with short and long versions for the time-conscious reader):
For The Guy/Gal On-the-Go
Nothing. Nothing is new. I haven’t seen or heard from a doctor yet despite my best efforts. Two more appointments have been scheduled for early and mid-June.
For Those Reading Email At Work
The neurology appointment we were all holding our breath over was canceled due to a family emergency on the doctors’ part. As I wrote before, this was both disappointing and frustrating. Since then I have learned that this was not just a family emergency (as if there were worse things), the doctor herself is in the hospital and will not be seeing any patients for 4-6 weeks. When I came upon this information I asked her office if it would be a good idea to find another neurologist and they said it probably would since the doctor said she wanted to ‘treat this aggressively’. During the same phone call, I mentioned that we were told that my records had been sent out to various places and that my appointment with the doctor was meant to review responses and determine the next steps. I was told that the only person with access to whom they were sent and any responses received would be, naturally, the doctor herself.
At this point, I felt it best to wait until my second appointment with a ‘regular’ doctor before finding a new nuerologist. Apparently, when one is discharged from a hospital, it is a matter of course to make a follow-up appointment, which I did, and which I tried to make good on yesterday. (Not having a primary care physician [what healthy, 27 year-old has one of those? ] the appointment was made at the Adult Health clinic in association with the hospital.) Instead, though, after more than an hour in the waiting room, I was told that there was some kind of scheduling error, the book had me down for Monday at 1:40p not Wednesday at 1:40p and could I please reschedule for the middle of June? What other choice was there? I did.
This time, justifiably annoyed, I decided to take matters into my own hands and go get one of those primary care guys. In a nutshell, many doctors won’t take you on as a new patient unless you’re a card-carrying member of some insurance plan. Oh, didn’t I mention? I don’t have insurance anymore. That’s a debacle you want no part of, but I’m going to give you the quick skinny because I like you: because of all the evil deeds I perpetrated in my younger days, the startup company I work(ed) for has a gap in funding which leaves the employees (myself included) with out many things…one of those things being a paycheck, and another one of those things being insurance. Go figure.
Incidentally, I just became aware that the instructions to have our insurance put to sleep were sent out the day before I landed myself in the hospital. Now, this is no one’s fault of course, and there’s no cause to be mad about the situation, but don’t you just have to shake your head at it? Doesn’t it make you wonder what I’m being punished for?
Again, those of you who know me realize this wouldn’t normally be an issue. “Ah Irm,” you’d say, “you’ll just go back to your carefree-freelancing days and wait out the dry period with this startup, or move to a new city and start fresh. Ya big lug. Ya buddy ol’ pal. You’re so crazy with your mobile lifestyle.” And I’d say, “Of course that’s what I’ll do, now let’s go to Starbucks and stare at each other until we make other people uncomfortable.” But this time, that plan may not be in my best interest.
Many of you have made suggestions and some of them are not bad ideas…some of them have questionable legal ramifications, but thanks for thinking of me anyway. Among these ideas (in no particular order):
- Get a lawyer
- File for welfare/unemployment/disability
- Have my car torched in a desert and use the insurance money to pay my medical bills
- Go see Dr. Qwerty over on Blackstone, he removed a growth for an uncle that everyone said was a fixture for life
- Get a job with a school district again and abuse the insurance plan
- Keep calling everyone, nurses, doctors, and staffers until someone agrees to see you
Like I said, all worthy suggestions. And you should know that I’ll be kicking this find-yourself-a-doctor-any-doctor notion into high gear once I can get this insurance fiasco under control. In the mean time, there doesn’t seem to be much else to do but wait and see (not a skill I would put on my resume).
How I’m Feeling
The truth is, and this is the scary part, I thought I would be feeling a lot better by now than I do. I thought by now I would be operating at capacity once more and be my normal self (as normal as one can be with the memory of falling to the ground for no reason resurfacing every hour or so). The reality is that I can’t really seem to pull it together enough to work or be active for a full day. I feel exhausted when I stand up for too long and I want to eat all the time when I’m not hungry. (The hunger may be my body’s way of asking for something else [which is what I think], but I don’t know what that is, so I just do as I’m asked and eat to avoid feeling weak.)
Part of this may have something to do with the meds I’m taking, but that’s just a guess. I now know that there are windows of time when I feel rather normal and those are my opportunities to get a few things done here and there, but the windows have closed on me everyday without proper advance notice.
Because of the way my energy leaves me with such a sudden rush to get out, my family and I have discussed the possibility of my wearing a medic bracelet. In the event that something should happen while I’m out and about or by myself, it may be wise to have something on my person that says ‘this girl has issues, call her mom’. I’m reluctant to order such a thing because of the what if’s. Namely: What if we’re just turning molehills into mountains?
Emotionally I feel a little…lonely…if that’s possible with people around you all the time making sure you have everything you need. But I think the loneliness is due in large part to my utter immobility each and every day. Sitting still is not something I do very well.
Psychologically I still feel optimistic. Don’t ask me why, I don’t really have a good reason to think it’ll all ‘be alright’ with the way things are happening these last couple of weeks, but I do anyway, and you should too. Together we’ll create a constant loop of positive outlooks growing ever stronger. Every day I remember that for that moment, everything is still ok.
Finally, I’ve been getting a lot of questions and emails from some who have shared, or would like to share the news/email with someone you know. I say go for it. Why not? Especially if you’re family, please do me the favor of making sure all the tias y tios have the information they would want to have. If you’re not family, share it anyway, I don’t mind.
That’s it for the moment. I’ll write again when there’s something to report.
Unending thanks for everything,
irms
What Happened Before and a Little After (Part II)
May 7th, 2008
Quick Update:
While waiting for my appointment this morning, the doctor called in with family emergency. None of her patients were seen, and I have been rescheduled for a date in June. Because of the urgency implied while I was in the hospital, we’re going to see what can be done about an earlier appointment.
When I said there were only three possible outcomes to this meeting, I was clearly underestimating fate once again.
How am I feeling? Crunchy. Disappointed. Annoyed. But having had my fair share of family emergencies, I know that there is no one to blame, and nothing to do but wait and do what is in front of me.
Updates on the way as I have them.
Irms
P.S. Thanks for all the reply emails. The response is/was something else. I don’t really believe all the positive things you had to say, but I’ll take it!