Category Archives: Serious

Why We Can Never Recommend Duke Medicine To Anybody! a.k.a. We Have Suffered For Five Years, Thanks To Duke

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.

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.

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.

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.

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.

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.

Why PayPal isn’t as bad as you, er they, say.

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.

Not all Walmart people are bad!

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.  😛

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.

Another reason the banking industry, and in particular, Bank of America sucks.

I haven’t had much to write as of late. Well, actually there’s one thing I can’t discuss at this point in time, so I’m going to vent about the horrible “customer service” I’ve received from Bank of America…

I’ve had a long torrid relationship with Bank of America. I had a checking account with them for many years, until the day I needed to cash a check for my business before I actually had a business bank account. The tellers simply said “no” without an explanation and literally snubbed their nose at me and went back to talking amongst themselves. STRIKE ONE.

I went across the street to what is now my current bank, who said that they shouldn’t do it, but would. Ding! New customer! And, now I have a business account with them as well. Shortly thereafter I closed my checking account with Bank of America. When they asked why, I told them and the manager apologized. Too little too late.

A few years later I was out getting an auto loan and Bank of America was the cheapest. I grudgingly went with them. I understand the need to pay one’s bills promptly, but sometimes life happens. I run a business, I know, and I work with my clients when they have payment issues. But if Bank of America didn’t have their payment within 3 business days of the due date, I would get multiple calls daily from them. That is pretty close to harassment. STRIKE TWO.

Recently I “bought” another vehicle and had the old Bank of America loan paid off. They were still calling me weeks after the deal was done! Finally my wife answered the phone and told them that the loan had been paid off and without apology, they said, “we didn’t know” and wanted all sorts of other information about the new loan which why wife did not give them. Left hand, meet right hand. STRIKE THREE.

Are we done yet? Of course not! Yesterday I received a check from Bank of America for the overpayment of the loan. Today I signed the check, brought in my driver’s license, and attempted to cash a Bank of America check AT BANK OF AMERICA!! Simple, you’d think, no? No Sir! First, they wanted a thumb print. I asked why they needed a thumb print. The first teller said, “because you don’t have an account with us”. The other teller said, “it’s in case the check doesn’t clear and we need to track it back.” To which I exclaimed, “It’s your check! I’m at Bank of America and I’m cashing YOUR BANK OF AMERICA CHECK!” I then stated, that I had an account and the check was to cover the over payment for my loan. To add insult to injury the first teller then said, “And there is probably going to be a $6.00 charge to cash the check since you don’t have an account.” Is Bank of America for real? I’m in Bank of America with a check from Bank of America, made out to me, and they want to take money out of it?!?? It’s the money that they owe me! At that point all I could do was shake my head. I said, “that’s not going to happen.” The teller then gave me my license back & I then deposited the check in my own bank. Apparently, Bank of America doesn’t trust their own checks. And a check with my name and address on it, that matched the name & address on my driver’s license doesn’t qualify for validation; they wanted my unique thumb print. No wonder the government had to bail them out. STRIKE FOUR.

Can that be enough? Can I be done with Bank of America now? Unfortunately no, because they bought the company that I refinanced my mortgage through last year. Eventually they’ll find some way to stick it to me some more. I’ll go ahead and give them a STRIKE FIVE now.

Now, you may ask why didn’t I just go to my regular bank and deposit the check. Because my current bank is now starting to fail me too. In years past, I was able to deposit a check in the ATM and have immediate access to all of the funds. Sometime last year that stopped being the case and only the first $100 was available. Beginning this year, all check funds through the ATM are being held for days. I simply want my money. So I went to the bank to get it cashed to put cash in the ATM. Pretty soon they’ll want to hold that as well. With my bank’s new check holding policy, I attempted to cash a client’s check at the bank the account is drawn on. Business checks can not be cashed even with the articles of incorporation and a valid ID. Note to self. Banks suck.

To increase my cash flow, I’ve been encouraging all of my clients to pay me via PayPal. Yes, PayPal. I know others have had difficulty with them but I never had. With PayPal and my PayPal Debit Card, I can have INSTANT ACCESS to my funds. Yes, MY FUNDS, MY MONEY. A client pays me and I can go to the store and swipe my card, or go to the ATM and get cash. If PayPal can do it why can’t the banks? Even if I want to transfer money from my PayPal account into my bank account, that takes days! If I need to get money into my bank account faster, I can withdraw the money at the ATM and then deposit the cash into my bank account. What is wrong with this banking system? Again I ask, if PayPal can do it, why can’t the banks?

The future of REALbasic is unknown

I have been a faithful REALbasic user for many years.  It is such a wonderful development environment that I have staked my business on it for the past seven years.  Recently REAL Software let go a couple of key employees.  Additionally, while they put a good spin on it by saying “mini conferences around the country”, they have canceled their upcoming annual conference.  The affects of the former are already evident in that the beta process has suffered.  If this continues, the recent rock solid releases will suffer as well.  The minds of its users will say that REALbasic is again buggy and it was due to the lack of man power.

However, I think that the affects of the decision to cancel REAL World 2009 is going to have larger repercussions than REAL Software expects.  Closing down the conference, which is pure marketing, also crushes the perception of a viable product and company.  Conferences are not meant to make money.  They are there for the users.  Us.  The people who purchase the product and support the company that helps us make a living.  This announcement will shatter the hopeful, if it hasn’t already.  The conference is the only time I am able to sit face to face with many of my friends; I see them once a year.  We get to take a week off of working in order to learn and have fellowship.  It is a working vacation of sorts.  I have already spoken to people who think the cancellation is just another nail in the coffin.

And finally, I have been waiting for years for the 3rd party add-on market for REALbasic to come into its own.  I have two projects already developed and two more project partially developed.  We recently ran a very disappointing 70% off sale (test) for one of our projects.  The problem is that nobody is buying; REALbasic still has the hobbyists, and not the professional in its market.  Hobbyists either want everything for free or cheap due to their limited funds (or mindset).  Free doesn’t work for business unless it is to make people pay for the hell known as support.  Cheap?  Yeah, well, I have to feed my family, too.

Due to REAL Software’s layoffs, it was obvious that waiting for REALbasic to compile for the iPhone was unreasonable.  We have to move on and continue to innovate.  Pariahware is starting to develop in XCode for the iPhone.  Dusting off the C files in our brains and getting up to speed with Objective-C is part of that plan.  I don’t think 100% web apps are the future, but some mixture of desktop and internet applications is what is ahead.  And the iPhone is part of that strategy.

I sure hope that REAL Software survives and that REALbasic lives on as a quality product.  For building cross-platform applications, nothing can beat it.  However putting all of one’s fruit in one basket in never a good idea so getting more familiar with XCode seems like the way to go.

PGP Whole Disk Encryption — Mac OS X Style

As an independent consultant who lives by his laptop, I have had a growing concern for my clients’ data.  If my laptop was ever stolen what would happen?  I’ve been interested in TrueCrypt since it came to the Mac but found out that they do not have Whole Disk Encryption yet.  I was also scared of the Open Source route because how would I get customer service if something went horribly wrong?

I’ve been a long time user of GPG which has served me pretty well even though I’d have to hack Mail to get it to work.  Welcome PGP which is the commercial cousin to the open source GPG.  PGP just released Whole Disk Encryption so I decided to give it a shot.  I purchased/subscribed to PGP Desktop which contains PGP Mail, Zip, File Shred, IM, and WDE.  I went the annual subscription route for a few reasons rather than an outright “putchase”.  First, they are each good for a year.  That is, free-updates for a year.  Second, if you “purchase” a license, you’ll have to pay an upgrade fee after that year to get any updates, where as with the subscription, one renews for a year.  Third, doing the math, the sucscription model won’t cost more than the purchase model until year 5.  That’s right, five years.  By then who knows if something better will have come along.  At that time, I’ll consider converting from the subscription model to the purchase model.

So, how does it work?  WDE partitions your drive and puts the PGP boot loader in place.  When you start up your Mac, you are greeted which a password prompt.  If you enter the password correctly, your Mac boots as normal.  I started the WDE process on my 160GB drive and it took just shy of 3 hours (closer to 2hrs 40mins).

After 2 days I have noticed no notible speed decrease after the initial conversion on my 2.4GHz C2D MacBook Pro. I am happy that it works as advertised.  My biggest fear was rebooting after WDE was finished the initial conversion.

I have not yet set up PGP IM, but setting up PGP Mail was a slight pain because I already had Mail set up to use SSL to connect to my mail server.  I had to undo that and manually configure the POP & SMTP ports in PGP for each Mail account.

Overall, I give PGP Desktop a 9/10 and WDE 10/10.  Rock on!