This is usually a tech-related blog, but sometimes, things just need to get personal.  I know, the business blogging rules are “stay away from religion, politics, personal issues”.  I don’t mention politics on here, but I’m not afraid to mention that Jesus Christ is the only way to heaven.  And well now, something seriously personal must be posted.  It is not just that I am angry, but people who get counseled into having all of their medical records handled through the Duke University Medical System need to be cautioned.  Please, for your health and sanity, stay away from this conglomerate known as Duke Medicine.  I will first give a synopsis of Duke for you ADD folk, and then give you our story. If someone at Duke who can make a difference actually reads this, instead of helping or offering an apology for the way we’ve been treated throughout the years, I’ll probably be threatened with a lawsuit… just like a scorned spouse.  I will attest that my statements are true. I may have missed a hospital stay or three, and it would be impossible to remember every single ER visit we have had.  I have touched on the highlights, and what has stuck out in my memory the most. Names have been changed to protect the guilty (and hopefully my pocketbook)!

Duke is one of the three large hospitals and/or universities in the North Carolina area known as the Triangle.  The Triangle consists of Raleigh, Durham, & Chapel Hill as well as their suburbs. Duke is big and growing. The main hospital and university is based in Durham, NC. It has medical centers across the neighboring county as well as a two smaller hospitals it has purchased. One is the Duke Raleigh Hospital and the other is Durham Regional Hospital which is also located in Durham. My wife was counseled to keep all of her medical records within the Duke system for convenience. We weren’t happy with the idea, but thought it would make seeing the many doctors easier.  Here is the truth of the matter: Once a patient does this, you are stuck. If you are seeing Doctor Y and don’t like/trust him, you are not allowed to see another doctor within the Duke system for the same issue until Doctor Y “releases” you from their care and OKs it for you to see another physician. They call it “professional courtesy”, but all it’s really just DUKE RED TAPE. But that is not the best part.  If you are seeing Doctor Y for issue Y, and are in the hospital Y, but are seeing Doctor Z for issue Z, and Doctor Y is not covering the Z issue while you are admitted, you must suffer! That’s right! You see, Doctor Z does not work with hospital Y, only hospital Z. So even though you still have ailment Z, which Doctor Y refuses to treat you for, Doctor Z will not see you, send some one who treats ailment Z to see you, nothing.  You must suffer in a hospital! I must say that this is where the Duke Medical system really shines! I know what you’re saying because I said it too, both hospitals Y & Z are Duke, and Doctors Y & Z work for Duke.  It doesn’t matter. The glorious DUKE RED TAPE strikes again! These hospitals are Duke only in name. Got a couple of problems? Too bad. Pick the one you want to deal with and go to that hospital. Your other problem will have to wait.  Let’s hope you’re not in pain and the pain is shooting your blood pressure up because Doctor Y won’t cover your pain because it is Doctor Z’s job. Doctor Z won’t do anything, and neither will Doctor Y, so you’ll end up having TIAs (transient ischemic attacks, or mini-strokes for us lay people) — good luck with that; they’ll just note it in your medical record.  Oops! I think I’ve said too much.  If that was a little confusing, I understand. It’s been a long ride. You might want to read the details that follow.

And now for the feature presentation…  Those who know me know that my wife has been ill, they may not know that she’s been ill for over 5 years, and they probably don’t know why she has been so ill.

2005
My wife is ill and she sees a doctor at least once a week. She is overweight and various organs are threatening to fail. She wants to have gastric bypass surgery, commonly known as weight-loss surgery, to save her life, but it is dangerous. Doctors cut away the top right portion of one’s stomach that is connected to the esophagus, creating a “pouch”.  The cut seals off the now-called “old stomach”.  The intestine is split, and brought up to the “pouch”.  The insurance company does not want to pay for the surgery.  I sell my truck to hire a lawyer to “convince” the insurance company to pay.  They pay and the surgery is performed by Doctor A at Hospital A.  My wife is immediately nauseous, more-so than other patients. She is unable to drink any of the required protein drinks because of the nausea and lays around in pain.  We are told various things at various times by Doctor A.  Things like: It’s all in your head. Nobody has ever been this nauseous for this long before. And, the nausea will only last a couple of weeks at the most. We have lost trust in Doctor A.

2006-2007
Getting no help from Duke Heath Care at this point in time, and my wife unable to eat or drink, Doctor Primary Care put her in the hospital on TPN (total parenteral nutrition aka IV nutrition). Having no trust in Duke Medical, she starts to see some very smart people at UNC hospital. Doctor UNC prescribes her some drugs that help her to eat a little, but she still vomits almost daily.  A pain develops in my wife’s stomach area, Doctor UNC does an upper-GI (which takes a camera down one’s throat to look in the stomach). He notices ulcers around the surgical site and can also see the staples from the surgery. Unfortunately Doctor UNC doesn’t do surgeries, and the surgeon that does is booked for months. Doctor UNC encourages us to return to Duke who can do it quicker. We grudgingly return to Duke, absolutely refusing to see Doctor A again, who thankfully has retired.  We see Doctor NoName at Duke who introduced us to Doctor B.  We have a love-hate relationship with Doctor B for the rest of the current story.

Doctor B goes in and performs what is called a gastric bypass revision.  Doctor B cut away the ulcers, removed the decaying food that somehow entered through the bottom of my wife’s unused “old stomach”, hooked everything backup up, keeping the bypass intact. Additionally, due to bad heart burn, a nerve was cut that makes the body make acid.  My wife exits the surgery with a G-tube, a feeding tube connected directly into the “old stomach”.  The nurses do not pay attention and begin feeding her protein drinks through this tube in her stomach. I will spare the details, but the protein drinks contained lactose & my wife is lactose intolerant. I will just say that she was severely bloated.

2008
More ulcers. Many ER visits to various hospitals around the area, multiple times per week at some points; if she lasted 3 days between ER visits, it was great.  New pain in the side (where the G-tube) was! Malnutrition is becoming evident. Hospitals think that she is drug seeking. She needs greater and greater amounts of morphine to kill the pain. Still unable to eat or drink much, she is put on IV fluids at home.  Doctor B referred us to Duke Pain Clinic, but at first, not to the side that handles pain, only the side that deals in psychiatric stress relief. What a crock!  After jumping through those hoops, and REDACTED, she is allowed to see someone for pain. Doctor C begins treating her for Fibromyalgia.  This helped most of the pain, but not all of the stomach pain.

2009
More malnutrition, even though she is given medicine to make her want to eat. It helps, but not enough. She begins falling quite often. She tells every doctor she sees that her leg is getting weak & tingly. Doctor Primary Care: Nothing. Doctor B: Nothing.  Doctor C: it’s weak from malnutrition, exercise.  One day my wife wakes up, her leg is killing her, and it won’t move.  She goes to the ER again and after a few hours they try to get her to walk… and she falls to the floor.  They transport her to Hospital B where Doctor D performs an emergency surgery for a herniated disc in her back. All of the other doctors had no clue of the warning signs! After the surgery she is able to lift her leg once again.  She is still falling after she is home. Doctor D tells her to stop falling.  Two months later, we go see Doctor E who says it is common for scar tissue from the disc surgery to push out the other side of the remaining disc, and he performs a disc fusion. While he is in there, he notices that my wife had actually broken her back in two. One wrong move could have paralyzed her.

2010
New year, new beginnings, right? Wrong. Stomach pain is very bad. Wife is still not eating and is constantly throwing up. Doctor B says we need to “take down” (reverse) the gastric bypass. It is called a take down because they can’t really reverse what has been done to one’s stomach. What they do is, remove the piece of intestine that is connected to the pouch. They staple the pouch on top of the “old stomach” and then cut a hole in between the two, forming a new single stomach. This surgery is as dangerous as the original bypass surgery. The surgery is deemed a success although she is still having a lot of pain near her stomach.  Before the surgery my wife makes Doctor B promise that her pain will be managed. This is a lie. My wife is in a Duke hospital, crying & rolling in her bed because the doctors refuse to manage her pain.  Thinking logically, I begin telling the doctors to contact Doctor C at the pain clinic to figure something out.  If they won’t manage her pain, let Doctor C do it.  I make multiple calls to Doctor C.  I shouldn’t have to force this! Doctor B’s “team” should be taking the initiative. Doctor C refuses to advise said team, refuses to come to Duke Hospital A because he works out of Duke Hospital B, and the best part, won’t even get a hold of someone within the Duke system that can handle my wife’s pain while she is admitted to Duke Hospital A. My wife’s blood pressure is so high from the pain that she begins having the above mentioned TIAs, which the doctors just add to her medical record, and refuse to take any blame.  They ask, do you have these often? Um, not until you refused to treat her pain. Thanks for damaging my wife even more, Duke! I yelled at my second set of medical professionals.

Now out of the hospital, Doctor C has been giving her a certain amount of pain medicine and finally performs a diagnostic test that takes her pain away. She was pain free for 3 days. The procedure she needs for longer term care isn’t available for 6 months we are told. Meanwhile, Doctor B says that another surgery is needed because my wife’s stomach isn’t emptying correctly and it is also what is causing the bad heartburn. My wife makes Doctor B promise that her pain will be managed, again. And again, this is a lie. We beg & plead that while she is hospitalized, and the pain relief procedure isn’t available for six months, to work with Doctor C, have her transferred over to Duke Hospital B, and perform the procedure while she is admitted. After all, it’s all the Duke Health Care System, correct? Doctor B and team say that they have contacted Doctor C multiple times and no one over there will budge, help, or otherwise. Thanks Duke! Again Doctor B says that the procedure won’t be performed for 6 months.

Fast forward nearly to weeks to yesterday. My wife tells Doctor C that she needs pain medicine to cover the stomach pain until the procedure can be done. She has been taking “X” to cover the pain.  Doctor C prescribes her one-third the dose, but says since this is a new, long-acting drug, it will work.  Instead of “X divided by 3″, we will call this amount “Y”.  Well, this new drug at “Y” does not work!  We called Doctor C today and was told we could bring in the drug & prescription, and Doctor C would write a new one, of the old pills, for an unknown dosage. We thought this fishy, but went along anyway. We arrived and was made to wait to see Doctor C’s assistant. When we looked at the new prescription, it was written for 1/2 of “Y”!  Now how can Duke, or any doctor possibly believe that this is acceptable? It is not only unacceptable, it wasted my time, my wife’s time, my mother-in-law’s time, and their time!  It is completely insulting to first write a prescription for 1/3 the strength and then when we come in for help, the new prescription is 1/6 the strength of the original!  HOW IS THAT LEGAL?  IT IS RUDE AND COMPLETELY UNPROFESSIONAL. Is this how Duke expects their doctors to treat patients? And at this time, I must declare that Doctor C is a weasel.  He hides behind nurses and assistants. He wouldn’t even face us. This is the second time he has done that to me personally.

We still can not even confirm that the scheduled procedure, has been moved up to next week, or if it is still 6 months away. We can’t get a hold of anybody! And, after the two voice-mail messages I left Doctor C’s assistant this evening, Doctor C might not even see my wife again.  There is another pain clinic in the area that we are looking into. It has a good reputation, comes recommended, and has promised to do said procedure in less than 6 months.  The downside is that Doctor C would need to refer my wife to them.  If he refuses, perhaps we can have hope in Doctor B, since Doctor B is the one that referred us to Doctor C.

I hear, not as frequently as I used to, how horrible PayPal is and that some people won’t use them.  That is fine with me; to each his own.  Here is just one more reason why I plan to continue using them:

I have a PayPal business account.  Attached to that account is a PayPal debit card.  Whenever a PayPal transaction takes place, I am immediately e-mailed.  Pretty nice, huh?  Now, to today… I was sitting in my wife’s hospital room, when an e-mail from PayPal came in for $.17 (seventeen cents).  How odd, I thought.  I logged into my PayPal account and did not see the transaction.  I went back to the e-mail, now suspecting it to be a phishing scam and hovered over the link.  Nope, it was a PayPal link; click!  The $.17 transaction showed up.  I called PayPal, who said (once I could get to a person!), that the transaction was placed & immediately canceled.  He said that the transaction was placed at a “bar & casino” in South Dakota.  We both thought that it sounded fishy, so I was refunded the $.17 that was still on hold, and my card canceled.  I then requested a new card via the PayPal web site.  Who knows how many hours or even days could have passed before I realized this transaction from my “regular” bank?  Perhaps not until my account was cleaned out.  And now you know why PayPal isn’t as bad as “they” say.

I have a playlist for my tv that allows me to play all of my downloaded video podcasts together.  I thought it would be useful for you so I thought I’d share.  Oh, it will also work for other iTunes devices, not just the tv.  Happy watching!

The Auto Video Playlist

Click the image to enlarge.

I ordered my iPad the morning it was available.  Actually, 20 minutes after it was available.  I thought it would be a neat device to have, but mainly I bought it for development purposes.  One just can’t be certain an app will work unless it is being tested on a real device. As iPad day approached, I was getting more excited.  With the excitement was concern, because the UPS tracking said that my iPad was still in China until Friday. Not to worry, as promised, my iPad arrived on Saturday.  And the more I use it, the more I like it! This little device is great! It is much much faster than my iPhone 3G, and the screen is really bright!  After using the iPad for awhile, the iPhone actually feels too small.  I hope Apple has some plans for the iPhone because having using the iPad, the phone just doesn’t seem quite as cool anymore.

One thing that I am really proud about, is that I worked hard to get Biblicious ready for the iPad.  After a couple of bounce backs from Apple due to a couple of bugs, one that could only be found on the device, and not the simulator, Biblicious was approved as a universal app that runs on both the iPhone/iPod Touch and the iPad.  As an added bonus, Biblicious, was the first (and currently only) iPad-ready Bible trivia game in the App Store.  As a developer, I understand making money from selling apps, but I don’t like the idea of charging customers twice, once for each platform. I may re-address my opinion in another post, if necessary.

In case you are unaware, Biblicious is a Bible trivia app that puts the player in a game show setting, with your host Flip Ant.  Even if you aren’t interested in a Bible trivia game, you need to watch one of the demo videos and listen to the host’s voice.  It’s perfect!

Biblicious has been approved for the App Store and should be available within 24 hours. What is it? Biblicious is a trivia game that I promised the Lord I would make nearly twenty years ago. However, since I don’t like the term “Bible Trivia”, I prefer to call it a “Bible Knowledge” game. It has a game-show feel with a host that reads you the questions, and answers. The host will also jab you once in a while if you get a question wrong, or are running out of time. The game has taken a few forms over the years, but during this past year, I made a concentrated effort to get the game done for the iPhone. I finished version 1.0 and submitted it for approval in the wee hours of Monday morning, and in less than 48 hours it went into review status and then approval status.  Within 24 hours it should be available in the app store.

To denote the importance of this game, as well as its future expansion (wink wink nudge nudge), Biblicious has been given its own web site.  Since there is no “lite” version of the game available, the Biblicious web site has example videos available so you can see how the came works!  I am very excited about this release, and hope that you will enjoy the game.

Thank you to my beta testers!  And thank you to my friends that prodded me when I would let the game languish.  This has been a wonderful experience for me!

Please visit Biblicious Online and take a look!

Apart from the swearing, this is a very help resource for NSTimer & malloc issues.  It contained the solution to the problem I was having.

malloc_error_break, double free, iPhone 3.0…maybe you BEEP up NSTimer?

It has recently come to my attention that some people were offended by my previous post.  Hopefully it was a wake up call. Others say that I have tarnished my name in the community.  Well, that is your opinion and you are entitled to it.  A true friend would tell you if you still had food on your face after a meal, or a booger hanging from your nose.  The realization might embarrass you, but how much more embarrassed would you be if you weren’t told?  How would you feel if your friend knew, but didn’t tell you.  Well my friends, some of you have food, some have boogers, and some have both.  :P

While you might not like how I said what I did, I still stand by it.  If you are a hobbyist user of REAL Studio, you are not necessarily the problem; we all start out as hobbyists.  However, if you want to color every other row of a ListBox control, and the first thing that comes to your mind is to post the question “how do I color every other row of a listbox” to the Forum (or NUG), then I’m sorry.  You fall into the problem category.

It has been an “unwritten code” since the dawn of programming, that apparently needs to be written down now.  When you need to figure something out and can’t, precede your question with what you have already tried.

Back to the ListBox example… if you haven’t looked at the ListBox‘s events (to get an idea of what is going on), checked the language reference (to get more detail), searched the forum (because you couldn’t possibly be the first person to ask such a question could you?), searched the NUG archives (for the same reason), or done a search on Google, well, you haven’t held up your fair share of the bargain.  Us “old timers” will come along side of you and help, but we’re not all going to do the heavy lifting for you.  It’s the old adage about teaching a man to fish.

Can we have a serious 1 on 1 chat here for a minute?  Yes, you bought your copy of REAL Studio.  But do you honestly expect it to do everything out of the box?  If so, you are kidding yourself.  Every programming language that I know about has a vibrant 3rd party ecosystem.  Microsoft, as big as it is, does not make every possible control… they let others do it so they can concentrate on the language & IDE.  If you really want REAL Studio, the great product that it is, to survive… you are going to need to support the 3rd party ecosystem for REALbasic.  And right now, it is very ill.  Who makes it ill? The community.  When you ask a question, and someone says, it is in “abc plugin” or “xyz encrypted classes”, don’t complain that it costs money or that you don’t have the actual source code.  So what? You either couldn’t do it or don’t have the time, and the solution does the job that you need it to do.  If you don’t support the 3rd party developers, they will leave because they also have a family to support.

If you want everything to be free, then you should be running Linux and programming in an open source language.