Saturday, February 28, 2009

Life's To do list

Many people get so caught up in their daily work and routine that they don't realize what they are working for. Work becomes their life instead of being a part of their life. They always tend to postpone taking a break saying things like, "Let this project finish. Then I'll go to !" That is never going to happen. This project will finish. By the time it finishes, they will get involved in another project. Then another. And another.

If you get caught in this cycle, it will be many years before you realize that you have merely gone about your life, not lived it. Believe me, you will regret it deeply.

Have you seen the film Dasvidaniya? Watch it if you haven't. Its about a guy who finds out he has a terminal illness. Initially, he fumes and frets. He is totally shattered. His alter ego then advises him to do the things he truly likes. He makes a list of 'To dos'. But these 'To dos' are not the mundane things he has been doing throughout his life. These are things he had always wanted to do but couldn't. Things like learning the guitar, telling his love of many years that he loved her, visiting a foreign country etc.

Each of us should make such a list even though we do not have any such illness. The list should have the things that we really, really want to do. Things that we keep postponing. Due to whatever reason. No time, too busy with work, not enough money, too impractical, whatever. Let us make this list. However impractical it may sound.

Then endeavor to achieve these things one by one. Take the easier things first. Plan for the larger things. If we really want them, they will happen. Maybe after some time. But they will. Want real hard however.

Remember these lines from Om Shanti Om?

Kisi cheez ko agar pure dil se chaho, toh saari kayanat use tumse milane ki koshish mein lag jaati hai.

(If you wish for something with all your heart, the whole world conspires to get it for you)

I am going to prepare this list real soon.

Friday, February 27, 2009

Disruptive cell phones

The cell phone is everywhere these days. I cannot imagine life without a cell phone. I often wonder how we managed without them for so long!

Like everything, however, the cell phone has its own negatives. The biggest problem is the lack of solitude. You are always 'reachable'. I often wish that I could, for a while at least, be without a cell phone, not contactable by the rest of the world!

Cell phones can have a very disruptive presence. You are in the middle of a meeting. The discussion is very serious. Everyone is concentrating on the subject being discussed. Suddenly, someone's phone rings! Everyone's focus is lost. Everyone is thrown 'out of the flow'. To get back into the 'flow' is extremely difficult.

Most people will answer most calls irrespective of where they are and what they are doing. Why is this so? Because it is considered extremely rude to decline a call. It is rejection in some ways! Unfair, if you will. But true. Unless the calling party is sensible enough to realize. How many such sensible people exist?

One place where the use of cell phones needs to be really thought about is in the medical field. So many times, I was with a doctor discussing something very important and suddenly the doctor would receive a call on his cell phone. The entire thread of discussion is lost.

A doctor's work is very intellectual. Life-changing decisions are taken not by referring to books and articles on the internet alone. There is a very complex process of decision-making. This involves the usage of a large body of education, experience and gut-feel. It is an entirely sub-conscious process. It is not put on paper and theoretically proved. This kind of process can be totally spoilt by the ring of a cell phone.

I was shocked a few years back when I heard the cell phone of the surgeon operating on me ring while I was on the operating table. The surgeon actually answered the call. He discussed something for a good 5 minutes and then got back to operating on me!

Need I say more?

Tuesday, February 24, 2009

The American man hour versus the Indian man hour

(My blog is a good place for me to rant. Please skip this post if you are not in the mood for some really offensive ranting.)

I had to attend a meeting using webex, an online collaboration tool which allows you to share your desktop with other participants and then discuss whatever. We had a couple of participants from India and three Americans and two Indians from the US.

Webex, as I found out later does a poor job of screen sharing over low bandwidth. There is however a feature that lets you upload the presentation in advance and it is supposed to work quite well in that mode. Well, I found that out later. Unfortunately.

What happened during the meeting was that I was talking about the presentation and realized that the slides were changing much slower than on my desktop. So, I had to wait for a while till the slide changed on the other participants' computers till I resumed my presentation.

Well, this pissed off one of our Indian 'friends' in the US. He suddenly asked me if I was at home or office. When I told him I was at home, he launched a tirade about how I was wasting the time of people whose time was being billed in dollars rather than in rupees and how they all had a lot of important things to do and now they were sitting there at the mercy of my bandwidth!

To cut a long story short, the call was hurriedly closed with an agreement that the presentation would be emailed to them and they would get back with questions.

I was quite upset. Not about the presentation. But about the comment that lunatic made. What the fuck did he mean by saying that their time was more important than our time because they were billed in dollars and we, in rupees? Each individual values his/her time as important. I care less than a fuck what he is being billed at. For me, an hour of my time is more important than anyone else's in the world.

And he had the gall to say that he had a lot of important things to do! Like fuck, he did! I had much better things to do than demo my app to a pea-brained son-of-a-bitch like him! Many people go to the US on work from India and gain an unreasonably exalted sense of self-importance. They suddenly believe they belong to another planet. They start looking down upon their counterparts based in India.

I have seen this in the past too. In Effigent, we had a bunch of morons at different times working out of the US who scolded the Indian folks so badly that we had a few resignations only due to this unacceptable behavior. I took this up a couple of times with the individuals concerned and it did have the desired effect.

If this had happened when I was in Effigent, I wouldn't have tolerated it. I would have taken this chooth apart. Unfortunately, I know how much this engagement meant for our company and my boss. Thankfully, it looks like my boss is on my side. After the meeting was closed, he asked me not to send any presentation to them!

Monday, February 23, 2009

All you Java developers out there, try WebObjects!

I was introduced to WebObjects (WO) by Obul in mid-2000. That was the first time I worked with Java too. I had only worked on VB before that and a little bit of SQL on MS SQL Server. That was all the practical experience I had in software programming. Of course, I had learnt quite a lot of other languages and used them too, but all in the classroom / academic project setting.

The MVC pattern was new to me. So, all the 'actual' programming I have ever done was always using the MVC pattern. I remember comparing a little bit of ASP programming I had done during my previous job and finding it to be so 'wrong'. MVC looked like the way to go, the most obvious and intuitive way to program.

Coming back to WO, it has an excellent implementation of the MVC pattern where everything is truly divided into an M, V and a C rather than the pseudo implementations that I keep running into time and again.

I had to dabble forcefully with J2EE for a while when we had to port a WO project to WebSphere (more about why in a moment). That was the first time I realized the beauty of WO. Learning WebSphere, its umpteen configuration files and the deployment procedure was truly a nightmare.

Most of my colleagues at work also started their programming careers with WO. They all learned programming the 'right' way thanks chiefly to WO and its beautiful architecture. However, there was one major problem with WO. Apple never promoted it the way it should have. It was was somehow considered a step-son. It was often called Apple's "Best kept secret". No one will probably ever know why Apple did not promote WO.

Due to this, such a beautiful technology did not become more well-known. People who have come across it believe that it was years ahead of its time. Nothing came close to it. I can vouch for this myself. Due to this, many companies moved away from WO. There was a shortage of developers with WO expertise. You had to look really hard to find someone who could fix problems or make enhancements.

As a result, jobs in WO also started reducing in number and my colleagues at work decided to move away from WO to other technologies. But most of them I talk to these days say that they have never come across something so good as WO. They have worked on a number of technologies addressing similar problems. Nothing quite matches up to what WO has to offer.

The WO community has also made tremendous contributions to the WO tools and frameworks, Project Wonder being the most notable. They have added a humungous amount of functionality and a large number of features which makes programming with WO much more of a pleasure.

So, I say to all Java developers out there. Learn WO. You will love it!

For more info, visit the WebObjects community home page.

Saturday, February 21, 2009

The 2010 Freedom Cruise

Bill Peckham, along with a few others is organizing a cruise which will have dialyzors together with their dialysis machines! More details here.

The cruise starts from Miami on Jan 3rd, 2010 and returns on the 10th. The best part is people take their NxStage System Ones with them. So, they get excellent dialysis on the cruise. Which is really cool. You don't want to fret about fluids while on a holiday!

I have to absolutely go for this. Ideas, ideas, ideas? I need ideas. I need solutions to the problems in going for this. To start with, I have a valid US visa which is one major headache taken care of. The next step is to actually get to the US in time and get a NxStage machine.

I don't know how difficult this is going to be. I wonder if they give the NxStage machine on hire for a few months.

The best part about this is that I have time to plan for this. January 2010 is a long way off. That gives me enough time to think through this and make it happen.

Let's see how it goes!

Friday, February 20, 2009

"Is twice a week enough?"

"Of course its not!"

An acquaintance came home recently with his son. His wife was diagnosed recently with kidney disease and was put on dialysis. The nephrologist suggested thrice a week dialysis. They started off. Gradually, probably after talking to equally uninformed folks outside the unit, they reduced it to twice a week.

They knew I was on dialysis from a long time. So, they came home to discuss this with me and also wanted my opinion on Peritoneal Dialysis. I told them about my experience with PD and recommended it (provided of course, the neph was ok with it). On the subject of frequency of dialysis, I explained why more was better.

They did not seem convinced.

They argued that she was quite comfortable with twice a week sessions. She did not have any problems till the morning of the treatment. Why, then should they do thrice a week sessions rather than twice a week?

I could not argue too much.

In India, there are additional factors that come into play in the whole "adequate versus optimal" equation. Most people pay for their own treatments. This is a major, major factor. Arogyasree covers the cost of only two treatments per week. I am not sure if these people were availing of Arogyasree.

When the patient was 'comfortable' with twice a week sessions, why do thrice a week? How do you answer this? Dialysis treatments, by themselves, performed in the 'usual' setting at a hospital can be quite traumatic. Add the cost factor and you have a cogent case for 'less is better'. Atleast for the uninformed.

That is why education is so important. If people were educated enough about the long term effects of kidney disease, the comorbidities involved and the risks of being underdialyzed, atleast a part of the dialysis populace would make an attempt at getting better dialysis. Doctors fall woefully short here. The mandatory advice, given without attempting to explain the benefits in a convincing manner will never work.

The entire system needs an urgent overhaul. Bringing in counsellors who talk to the patients and understand their fears and concerns will really help. These counsellors need to be specially trained to handle people on dialysis whose set of problems is entirely different.

As I wrote earlier, there are undeniable mental aspects to a physical illness.

Thursday, February 19, 2009

Let us all sell our Ferraris!

I recently read the book "The monk who sold his Ferrari" by Robin Sharma. It was an eye opener. I have never read books on self -improvement. In fact I have never been a book reader. The only time I remember reading books was during my extended stay at the hospital after my transplant. I had become quite a voracious reader at that time, devouring complete books in a couple of days. But it was only fiction.

My reading was revived recently when Chetan Bhagat decided to write about IITians, call center employees and the mistakes in a particular person's life.

I kept hearing about this monk book so often that I always thought I must read it. Akbar mentioned it during a conversation with a few friends over dinner and advised all of us to read the book and follow it. I have always admired Akbar and his attempts at leading a conscious life. What did the trick for me however was when "Ben maharaj", a Jain sadhvi mentioned that she read a Hindi translation of the book and found it amazing! That did it. I had to read the book!

The book came with an audio CD that had the author read it out. I listened to it while going to office and coming back much to the consternation of my chauffeur who would have preferred the latest chartbuster instead! I found the CD amazing. What was being said was so true.

My life had become a mad rush. Doing one thing after another. Without stopping to even think about what I was doing. Mainly reacting to situations. Not doing what I really want to do. Doing things that I have to do. I felt like Robin Sharma had actually written the book for me after seeing what I was doing with my life!

I was shocked to realize that most of us live our lives that way.

I loved the audio book so much that I read the hard copy of the book again after listening to it. I made notes of what I considered important. The next step is implementing what I have learnt. This is difficult. But it is necessary. To make my life more sane, more meaningful.

I would recommend this book to everyone. Even those who do not read regularly. You will not regret it.

Monday, February 16, 2009

The lowly Banana Delight

Bananas have always been second class citizens in my circle, probably atleast the whole of Hyderabad too. They are available round the year. Round the year? Yeah, round the year! Who craved a fruit that was available round the year?

Mangoes are available only during the summer months. You waited for months to feast on mangoes. They are something else. Custard apples are available only in winter. Water melons again, only in summer. So, there is this 'special status' for these fruits. But bananas? Naah! You could have them at any time.

I remember this funny incident a few years back. There were a bunch of friends from school. I remember Kiran Choudhary and Ramesh Karra were among them for sure. I don't quite recollect who else was there with us that day. During some outing, we stopped by at Softy Den at M. G. Road in Secunderabad. That place was quite a rage in those days. It was the most 'hep' ice cream parlour in that part of town.

We looked through the menu. I ordered a Lychee Delight, Kiran ordered something. Ramesh looked through the menu. He zeroed in on the Banana Delight. We were quite shocked! Banana Delight? Who had a Banana Delight? That was probably thrown into the menu to make sure there were atleast 15 items in that section. They had only 14 genuine items. 14 wasn't a nice enough number. "Throw in a Banana Delight. That'll make it 15. No one will order it anyway!"

But here was Ramesh Karra clamouring for a Banana Delight! Bananas cost only 3 bucks for a dozen! Why do you want to waste money? No amount of convincing could change his mind. So, there we were. We placed the order.

Immediately there must've been panic in the kitchen! I started imagining the commotion that the 'strange' order had caused.

"Someone's ordered a Banana delight!"

"What? A Banana Delight?"

"Are you sure you heard him correctly?"


"What do we do? We don't even know what to make! No one's ever ordered it before!"

"First, send someone to get some bananas!"

After a few minutes, the three deserts were brought out. My Lychee Delight tasted quite good. Kiran's was good too. It turned out that the Banana Delight was good too!

Well, its difficult to go wrong with ice cream based deserts. Put in a scoop of ice cream. Top it with sauces, fruits and nuts and it should always be palatable at the very least!

Sunday, February 15, 2009

In search of the perfect Gatte ki sabzi

I was introduced to the Gatte ki sabzi when I was very young. My father's Marwadi friends would often send it home for us to try along with other Rajasthani delicacies like Ker Sangri.

It is an extremely simple dish. Gram flour dumplings in a gravy, to put it in one line! But it is truly amazing how such a simple thing can be made so tasty.

Rajasthan is known for such 'dry' curries - without vegetables. A lot of the food from the state is made without vegetables. An excellent example of the adaptibility of Indian food based on the territory it comes from. Most of the state of Rajasthan is desert. Vegetables were difficult to grow without the modern methods of farming. This resulted in many such foods being developed. Every cloud has a silver lining, right?!

The Gatte ki subzi is prepared by making a dough of besan or gram flour and other flavors like turmeric and red chilli powder. The gravy is curd based with seasonings.

The subzi goes very well with Dal Baati Churma and tastes excellent with simple parathas or phulkas.

You get good Gatte ki subzi in Dhola ri dhani, the Rajasthani resort on the outskirts of Hyderabad. Any joint that serves traditional Rajasthani food should also have it since it is one of the most common Rajasthani food items. But the really well made Gatte ki sabzi is to be had when it is made by a true blue Rajasthani maharaj (chef)!

One of the key elements in making this taste really good is the use of ghee to fry the dumplings and make the gravy. This adds a unique flavor which is impossible to get by using oil. Well, it certainly adds a whole lot of calories, but what the hell, you don't have a good Gatte ki sabzi everyday, do you?

Swati Snacks in Tardeo, Mumbai serves excellent Gatte ki sabzi along with Satpadi Rotli, a roti that has seven layers! This is undoubtedly the best I have had.

Saturday, February 14, 2009

Recognizing and harnessing genuine talent

Mahesh* had a flair for technology. It came easy to him. He was basically intelligent. He loved programming too. All this made for a deadly combination. He barely had three years of experience. Inspite of this, he could solve technical problems which people with double his experience could not.

I was his manager at Effigent for a few months. I recognized this ability early and encouraged him. I never considered experience to be the yardstick to measure ability. I gave him the toughest problems in our project to resolve. I would be sure he would not let me down. His ability along with this attitude were what I needed to get things done.

Unfortunately, many managers in the software industry consider experience to be the be all and the end all of ability. How incorrect they are! In my ten years in this field, I have seen that notion being proved wrong time and again. Freshers have often proved to be better than people with a whole lot of experience.

It is not my contention that all freshers are better than all experienced people. All I'm saying is that experience cannot be the only tool to measure ability. All too often, managers, people from HR make this mistake of judging someone by the number of years of experience he or she has rather than true ability.

This happened with Mahesh too.

Circumstances forced him to join another company. The "experience ruler" was pulled out to measure ability. He lost out. To start with he was placed below people with lesser capability. He was frustrated. Subsequently too, he was not accorded the respect he deserved.

Who is losing here? Everyone.

Mahesh himself, because his growth is being stifled. His self confidence is being eroded. He is getting increasingly frustrated. His manager, because he is not able to get the best out of him. Someone who can perform wonders in the technology is saddled with mundane tasks.

The role of the manager is extremely important in nurturing individuals. A manager is more of an enabler. A manager should enable his team to perform beyond their abilities. Encourage them. A gentle rap on the knuckles once in a way. Mentor them. Help them grow. A good manager can really make sure people in his team blossom.

(* Name changed)

Friday, February 13, 2009

Dialyzors, beware 'healthy' alternatives

A few days back, my mother went to a supermarket and bought 'healthy' salt - a low sodium salt. With all the noise about switching to a low sodium diet and the benefits this diet offers, she picked it up and brought it home.

I noticed the packet lying in our kitchen. I made a mental note to tell my mother not to use this salt because low sodium salt is basically Potassium Chloride. Too much sodium is bad for all of us. Too much potassium can be lethal for people on dialysis. She wasn't at home that day and I forgot all about it.

She innocently started using this salt in the daily cooking that happened in my house.

Within a couple of days of this, I started feeling a little, well, 'different'. I was not my usual self. By evening I had a congestion in my chest and felt uneasy. Too much fluid, I concluded. I got on to dialysis a little early. Put on extra ultrafiltration. Within an our of dialysis I felt the congestion in my chest ease. But it was not the usual feeling of fluid being removed. I was distinctly reminded of the first hour of my treatments at the hospital a few years back.

The next morning, I remembered the low sodium salt. Oh my god, I thought. That was it! That was the reason for these strange symptoms. I immediately asked my mother if she was using the low sodium salt she had bought a few days back. She confirmed this.

I then explained to her what the low sodium salt had. She felt guilty. But it wasn't her fault for sure!

This little incident shows how careful dialyzors need to be with what they eat and drink. Things that are touted as 'healthy' for the general population could very well be lethal for folks with kidney disease. Fruits, too, for example. Urinators (people with healthy kidneys!) are advised to have plenty of fruits. A strict no-no for people on dialysis.

The best example of this difference is the consumption of water. I keep hearing people on television and articles in magazines and newspapers exhorting people to drink atleast 8 glasses of water everyday! Allow me and I will drink 80!

Even the so-called experts are so ignorant about renal failure and its associated restrictions that it can be very dangerous for dialyzors to go by what they say. We need to be extra careful with what we eat or drink. Read the labels. And read them again. Before you try something new.

Wednesday, February 11, 2009

Different countries, different meanings

Recently I wrote about what the hoardings said on a Sunday morning. Bill Peckham, in his CKD blogroll pointed out that hoarding was a new word. That led me to think about the many words that are used differently in the US and in India.

In the above context, I was referring to what people in the US refer to as billboards. I checked Wikipedia too and confirmed that my usage was not wrong!

Another common word that is used differently is gas. In India it means nothing but a gaseous form of anything. Hydrogen gas, a gas cylinder (another phrase for an LPG cylinder) and colloquially to ask someone not to lie. "Don't gas, ok!". In the US, however, I think it is used to indicate fuel that runs automobiles, short for gasoline, probably.

My friend Dinesh, narrated a hilarious incident about one such phrase during his initial days in the US when he had just settled down as a student. He decided to start cooking on his own, tired of eating out. So, he went to a store that sells vegetables. He happens to like bhindi and asked for "Ladies fingers".

The lady at the store was horrified! She thought she had run into a cannibal!

"Ladies Fingers?", she asked slowly moving her hands behind her.

"Yes", Dinesh replied, "can I have a kilogram of ladies fingers?"

The lady, by then, was quite alarmed. Fortunately, another Indian lady overhearing the conversation rushed to the lady's rescue.

"Okra! The guy wants Okra!"

It was then that both realized what had happened! The lady quickly packed a kilogram of the "ladies fingers" or Okra as she knew it.

Dinesh, who was quite amused realizing the gaffe, took the packet and left.

Tuesday, February 10, 2009

A sore throat and fever

I have a niggling sore in my throat and a little fever. So, I took off from work today. I have been pretty much relaxing the whole day, listening to music and reading.

It is good to take it easy once in a while. And this was a good enough reason!

One thing I do whenever I have a sore throat and cough is to try this nifty little home remedy which is really, really effective. I boil a cup of water. To it, I add a quarter teaspoon of salt, about half a teaspoon of turmeric and a quarter teaspoon of ghee. After stirring with a teaspoon, I sip it slowly. I repeat this three to four times a day.

I use this every time I get a sore in my throat or have a cough and sure enough, in about a day I'm all right. Another thing I do is to gargle with Betadine germicidal gargles. I try a combination of both these as soon as I feel the sore in my throat without allowing it to become a major infection and this way, I have stayed away from antibiotics for throat infections for a long time.

I have to take medicines for so many things. With a simple remedy like this, I try to avoid antibiotics. Of course, if it becomes bad, I consult with my doctor and may need to take antibiotics.

Sunday, February 8, 2009

What the hoardings said on a Sunday morning

Looking at hoardings and billboards while driving can be quite dangerous. Irrespective of this, we have them in every city. Many of them catch my eye and I cannot help looking at them for a quick second or two before turning my concentration back to the road.

This Sunday morning, I put on Pandit Jasraj's Chadhiye Mulaka Sultan on my iPhone which has an AUX output to my car audio system and headed for Poorna Tiffins for my weekly tryst with steaming hot idlis. As I drove down the Begumpet main road, I saw Baba Ramdev in various yogic postures on the small boards that were installed on the road divider. He was in Hyderabad recently for a week-long yoga camp. Some of them had the swamiji blessing his followers. My mind went back to the voices of gratitude that I had heard on television thanking the baba for his pranayam and yoga for curing them of chronic illnesses.

At one point the picture on the boards suddenly changed to Abhishek Bachchan exhorting me to try the Idea Cellular Internet Modem. Sirji, what an idea, I thought to myself! He looked rather odd in a tight T-shirt though. I wondered how he managed to keep his stubble at the same level over the years. I was trying to do the same myself but with the hair on my head!

As I turned right at the Punjagutta cross road, I noticed Jaganmohan Reddy, my senior at school and the Andhra Pradesh Chief Minister's son smiling at me from a huge banner. Time can change so much. Apart from the moustache he now sports, this guy had changed in so many ways. Was he always interested in politics? I would never have thought.

As Pandit Jasraj broke into a taan after dexterously making his way through the mukhda of the piece, I pulled my car over near Poorna Tiffins. After I had had my fill, I got back into the car and Panditji started from where he left off.

As I made my way back home, I was quite startled by Akshay Kumar lying shirtless on the floor with a pretty lass behind him, unbuttoning his Levi's jeans! Well, well, pretty bold, I thought! Advertising has undergone such a sea change over the years. Nobody is even complaining about these ads anymore! Not that they should.

Back on the Begumpet main road, I noticed an old man letting out a guffaw with a computer placed next to him. It was a Dell hoarding. A closer look revealed it was somebody called Raman Roy, apparently the father of the Indian BPO industry. Who cares if Raman Roy uses a Dell? Who is Raman Roy? This was the first time I had heard of him. This ad sucked. When I think about the Apple ads, I really pity Dell and Microsoft. Especially this one led me to promise myself I would never buy a Dell!

As Panditji was deftly weaving his way through the closing parts of the Raag Nat Bhairav piece, I reached home and parked my car.

Paak parvar digaar, raham karo, sada rang bani rahe,
Nizamuddin Awaliya, Chadhiye Mulaka sultan...

Saturday, February 7, 2009

Cramping on dialysis

When does someone cramp on dialysis?

Based on my experience, I have seen two kinds of situations when someone cramps during dialysis:

- When the rate of fluid removal is too high
- When too much fluid is removed

What's the difference between the two, you might wonder? There is. Let me explain.

My dry weight is 79 kgs. Dry weight for the uninitiated, is the body weight when there is no excess fluid in the body. Why might there be excess fluid in the body? For the horribly uninitiated, when the kidneys don't work, fluid builds up in the body because the kidneys do not remove it.

So, my dry weight is 79 kgs. Let's say I put on about 3 kgs as a result of drinking too much water. Now the goal of dialysis usually is to come back to your dry weight. So, ideally I must remove 3 liters of water (because a liter of water weighs about a kilogram) to come back to my dry weight.

If I dialyze for 4 hours, I must remove water from my body at the rate of 750 ml/hour which is too high. Studies have shown that when water is removed from the body at a rate greater than about 400 ml/hour, it is too fast. Cramps can happen.

Another possibility is that too much water is removed, even if the rate of removal is 400 ml/hour or less. For example, let's say I did a 9 hour session and tried to remove 3.5 liters of water during the 9 hour treatment. Even though the rate of fluid removal is less than 400 ml/hour, cramps can occur because I will be below my dry weight towards the end of treatment. Basically I am squeezing my muscles of the water needed for them to function. This results in cramps.

That is why proper monitoring of the dry weight is very important. Unfortunately there is no accurate method of determining the dry weight. We have to use indicators like general feeling of well being and the blood pressure to guess the dry weight.

Who said being on dialysis is fun?!

Friday, February 6, 2009

Technology for the view layer of a web application

I have been away from coding for about two years now and away from coding for a web application for more than five years! Things have changed so much on the web app side. Complete shifts away from traditional methodologies have taken place. Adoption of new paradigms in different aspects of programming have evolved and matured over the last few years.

The most important of all developments is the move towards a more desktop application-like user experience. Web applications traditionally were slower than desktop applications. Every action required a round trip to the server. The advent of the XML HTTP Request and the subsequent Ajax revolution, popularized arguably most by Google and its applications have really changed the way web apps are now looked at by users all over.

A large number of Javascript frameworks have been developed which make it easier to build such applications for the web. So, we see people adopting this trend more widely. Some concerns have been raised about the security issues that these technologies inherently come with.

I have looked up a number of them and also consulted with former colleagues on their take on this. Many of them have used a wide range of technologies and have interesting points of view on each of them. Currently, jQuery looks to be very popular and stable. SproutCore shows a lot of promise and Apple is promoting it.

Where does that leave things like Tapestry, WebObjects and JSF? They will have to reinvent themselves pretty soon, providing similar features and the ease of use that the new kids boast of today.

I am tempted to go with one of jQuery or SproutCore. Unless of course, I can quickly master Project Wonder's AJAX components and find that they offer the same usability for the end user as the JS frameworks do. I only wish (and wish real hard) that Project Wonder was better documented and easier to learn.

Thursday, February 5, 2009

The double edged sword of the internet

The internet, as we all know can be an excellent source of information. Information from experts at our fingertips. There is a mind boggling amount of information on every subject you can think of. The internet is usually my first stop whenever I need to find out about anything.

However, the freedom of the internet and the lack of monitoring can have some rather dangerous consequences.

Recently, there was a lot of animated discussion on the home dialysis forums I am a member of (and possibly other forums as well) about a series of videos posted by someone on You Tube about the dangers of dialysis.

(I am not putting the link here because I don't want to increase the hits the videos get and increase their popularity, thus showing up higher in searches and risking more people getting misinformation.)

The videos were supposedly put up by a "University of Common Sense" and showed a person interviewing a dialysis assistant. I have never seen such blatant falsehoods being peddled as information in my entire life.

Dialysis is a life saving treatment. People with impaired renal function cannot live without dialysis. It is the only way toxins and the excess fluid that builds up in a body can be removed. This is the truth. One hundred percent.

The videos however project dialysis to be a trick played upon people by doctors to make money. They claim that dialysis is not necessary and the process is there so that the medical industry benefits from it. They say it is actually a harmful process where people die one after another. The most ridiculous claim however was that people on dialysis do not urinate because they do not drink enough water! How I wish that were true! They claim that doctors restrict a patient's fluid intake and then dialyse him or her and then they do not urinate because they have not consumed enough water.

Well, I really have no counter argument to offer to that. It is that ridiculous!

The only worry is people who have not been educated enough and are scouring the internet might see these videos and actually decide to stay away from dialysis. There are tons of gullible people out there. This video could actually lead them to death. A death that can easily be avoided.

But we are all helpless. What can we do? Outraged people have posted comments to the video ridiculing the misinformation presented there. I did a video explaining how absurd the claims were. Unfortunately You Tube requires the author of videos to approve video responses. I submitted my video response but the author did not approve (obviously!). I just put it up on You Tube with the title of the original video so that searches will show up my video too. Other dialyzors are also working on similar videos.

That is why it is important to understand that information on the internet is not sacrosanct. We need to be careful while reading anything that is out there. Unless we are very sure of the source and its reliability, we must never take what we read as the truth.

Monday, February 2, 2009

Peripheral Neuropathy update

A little less than three months back, I was diagnosed with Sensorimotor Peripheral Neuropathy. I was put on some drugs and was scheduled to review after about a month. Well, that month became three months because I was busy at work and I finally went back to the neurophysician a couple of days back.

The update I had was that there was no improvement in the numbness in my feet.

The neurophysician asked if it was getting worse. I said, "No". "That's good enough", he replied. "Good enough?", I thought to myself. What exactly did that mean?

He did some small tests like moving a sharp object on my wrists and feet. He concluded that there was nothing we could do about this. He said that this was a problem I would have to live with. "This is a side effect of your kidney disease and there is no treatment for this. Accept it as a part of your life."

That was quite a shocker!

This numbness in my feet, especially my left foot is not painful or worrying at all. But it is there. I can feel it. So, to hear that I have to live with a numb left foot all my life can be quite alarming. And then, there is the looming threat of it becoming worse.

On the dialysis groups where I posted a question about this problem, people were quite perplexed because I got this problem inspite of getting quite a good dose of dialysis. Neuropathy is quite common when people are not getting enough dialysis. One of the things people are advised to do to improve the neuropathy is to get more dialysis. I am already getting a lot of dialysis. I don't think I can get more than this practically.

So, I guess I will have to live with this. Sigh!

The number of things that can happen as a side effect of kidney disease is truly mind boggling. Every single part of the body gets affected. All this, inspite of getting really good dialysis. The problem is, I started getting good dialysis pretty late in my journey with kidney disease. Those that have been recently diagnosed should move to the "as much dialysis that I can possibly get" regime asap to minimize the concomitant problems.