Tag: Health

FreeStyle Libre and first responders

Over on Twitter, a friend asked me a question related to the FreeStyle Libre, since he knew that I’m an user. I provided some “soundbite-shaped” answers on the thread but since I got a few more confused replies afterwards, I thought I would try to make the answer a bit more complete:

Let’s start with a long list of caveats here: I’m not a doctor, I’m not a paramedic, I do not work for or with Abbott, and I don’t speak for my employer. All the opinions that follow are substantiated only by my personal experiences and expertise, which is to say, I’m an user of the Libre system and I happen to be a former firmware engineer (in non-medical fields) and have a hobby of reverse engineering glucometer communication protocols. I will also point out that I have explicitly not looked deeply into the NFC part of the communication protocol, because (as I’ll explain in a minute), that crosses the line of what I feel comfortable releasing to the public.

Let me start with the immediate question that Ciarán asks in the tweet. No, the communication between the sensor and the reader device (or phone app) is not authenticated or protected by a challenge/response pair, as far as I know. From what I’ve been told (yes I’m talking through hearsay here, but give me a moment), the sensor will provide the response no matter who is asking. But the problem is what that response represent.

Unlike your average test strip based glucometer, the sensor does not record actual blood glucose numbers. Instead it reports a timeseries of raw values from different sensors. Pierre Vandevenne looked at the full response and shed some light onto the various other values provided by the sensor.

How that data is interpreted by the reader (or app) depends on its calibration, which happens in the first 60 minutes of operation of the sensor. Because of this, the official tools (reader and app) only allows you to scan a sensor with the tool that started it — special concessions are made for the app: a sensor started by a reader device can be also “tied” to the app, as long as you scan it with the app during the first hour of operation. It does not work the other way, so if you initialize with the app, you can’t use the reader.

While I cannot be certain that the reader/app doesn’t provide data to the sensor to allow you to do this kind of dual-initialization, my guess is that they don’t: the launch of the app was not tied with any change to the sensors, nor with warnings that only sensors coming from a certain lot and later models would work. Also, the app is “aware” of sensors primed by the reader, but not vice-versa, which suggests the reader’s firmware just wouldn’t allow you to scan an already primed sensor.

Here is one tidbit of information I’ll go back to later on. To use the app, you need to sign up for an account, and all the data from the sensor is uploaded to FreeStyle’s servers. The calibration data appears to be among the information shared on the account, which allows you to move the app you use to a new phone without waiting to replace the sensor. This is very important, because you don’t want to throw away your sensor if you break your phone.

The calibration data is then used together with non-disclosed algorithms (also called “curves” in various blogs) to produce the blood glucose equivalent value shown to the user. One important note here is that the reader and the app do not always agree on the value. While I cannot tell for sure what’s going on, my guess is that, as the reader’s firmware is not modifiable, the app contains newer version of the algorithms, and maybe a newer reader device would agree with the app. As I have decided not to focus on reversing the firmware of the reader, I have no answer there.

Can you get answers from the sensor without the calibration data? As I’m not sure what that data is, I can’t give a definite answer, but I will note that there are a number of unofficial apps out there that purport of doing exactly that. These are the same apps that I have, personally, a big problem with, as they provide zero guarantee that their results are at all precise or consistent, and scare the crap out of me, if you plan on making your life and health depend on them. Would the paramedics be able to use one of those apps to provide vague readings off a sensor? Possibly. But let me continue.

The original tweet by Eoghan asks Abbott if it would be possible for paramedics to have a special app to be able to read the sensor. And here is where things get complicated. Because yes, Abbott could provide such an app, as long as the sensor was initialized or calibration-scanned by the app within the calibration hour: their servers have the calibration data, which is needed to move the app between phones without losing data and without waiting for a new sensor.

But even admitting that there is no technical showstopper to such an app, there are many more ethical and legal concerns about it. There’s no way that the calibration data, and even the immediate value, wouldn’t be considered Sensitive Personal Data. This means for Abbott to be able to share it with paramedics, they would have to have a sharing agreement in place, with all the requirements that the GDPR impose them (for good reason).

Adding to this discussion, there’s the question of whether it would actually be valuable to paramedics to have this kind of information. Since I have zero training in the field, I can’t answer for sure, but I would be cautious about trusting the reading of the sensor, particularly if paramedics had to be involved.

The first warning comes from Abbott themselves, that recommend using blood-based test strips to confirm blood sugar readings during rapid glucose changes (in both directions). Since I’m neither trained in chemistry nor medicine, I don’t know why that is the case, but I have read tidbits that it has to do with the fact that the sensor reads values from interstitial fluid, rather than plasma, and the algorithms are meant to correlate the two values. Interstitial fluid measurements can lag behind the plasma ones and thus while the extrapolation can be correct for a smooth change, it might be off (very much so) when they change suddenly.

And as a personal tale, I have experienced the Libre not reporting any data, and then reporting very off values, after spending a couple of hours in very cold environment (in Pittsburgh, at -14°C). Again, see Vandevenne’s blog for what’s going on there with temperatures and thermal compensation.

All in all, I think that I would trust better a single fingerprick to get a normal test-strip result, both because it works universally, whether you do have a sensor or not, and because its limitations are much better understood both by their users and the professionals. And they don’t need to have so many ethical and legal implications to use.

Ten Years Ago

At the time this entry is going to post, it would have been ten years since that fateful night, when I asked to be brought to the hospital, afraid of an ulcer. Instead of an ulcer (which I thought of because I vomited red — it turned out to be ketchup, rather than blood), they found I was nearly dying from pancreatitis.

It’s ten years, and I would say I’m still surprised I made it up to this point. As I already recounted years ago I spent the following year almost sure that I would not survive it – and indeed, an year later I ended up at the hospital again. I have been surprised two years ago that I turned 30, and decided to spend that day in Paris with my best friend. And now I’m surprised that I already survived 10 years, and thinking back to it, I would not expect I’ll be risking my life ever again, just as long as I keep away from alcohol.

It does not mean that those events ten years ago didn’t leave any sign. I don’t have a gallbladder, and my pancreas is connected to my stomach rather than intestine, that makes for an interesting acid reflux situation when I eat too much or eat something that disagrees with me. And the not-quite-clear-cut diabetes that sometimes confuses my doctors just as much as me. But all of these are now survivable problems, and I don’t live in fear of dying as much as I did.

I still haven’t managed to save up much money — I no longer spend everything I get and live day-to-day as I used to, but that’s mostly because I’m paid much better, rather than me acting like the proverbial ant. I just don’t want to plan for a future I’m not going to have, though I don’t want to go into the future with nothing.

The last ten years have been a different life for me. Before, and for the first couple of years after that, I could easily be classified as one of those “nerds in their mother’s basement” — although living in Italy my home office was in the upper floor instead. But soon after, friends who’ve been with me during the ordeal, or that I met afterwards, effectively helped me out of my shell, and out of my office.

A short, and obviously non-comprehensive list of things I did since leaving the hospital:

  • I legally changed my name — which is why you see me referenced earlier as “Diego Pettenò” rather than “Diego Elio Pettenò”. The name change had little to do with the hospital, and more to do with the the fact that three other people shared my old name just in my city.
  • I attended a number of different gaming cons in Italy, thanks to a friend who’s been trying to sell his game, including the one in Parma where I finally managed to meet Enrico.
  • I started (and closed), my own company. This may or may not have been a mistake, given the amount of taxes I ended up paying for it, but it was definitely an experience.
  • I started flying. Oh my if I did. And that was a huge change! I now live outside of Italy, attend conferences, meet my fellow developers. I spend a third of the year on the road, and can actually learn even more from people!

I have definitely not let my second chance go to waste, at least for what concerns professional opportunities and my career. From this point of view, it has also been very important, as it allowed for some other changes in my family life, but those don’t relate to me and so I don’t want to go much down that road.

My social life instead, well, that has not really changed much since those days. It clearly improved, as I’m no longer spending all my time in my home office, but the last few years while in Dublin it also shrunk down again. Which is why I’ll be moving to London in just a couple of months, hoping to find more people to share time with, whether it is playing board games or watching movies or anime at home.

The feeling I get now is realizing that I wasted a significant amount of my adult life without a social life, and without caring for my health enough to avoid these situations. So if I were to give a suggestion to other geeks who may now be in their teens, and think that it’s cool to be a shut-in, is to try to find some friends. You don’t have to be an extrovert for that. You can still be an introvert and like some people. And the people who you get around yourself are the people who will sustain you when you fall. And everybody will fall at some point.

As for the future. As I said previously, I’m moving to London in a couple of months. I hope there, between a number of people I already know, and the different scale that the city has, compare to Dublin, I will manage to build another group of friends to go around with. I would be a hypocrite to not admit that I also would like to meet someone special to share life with — but I’m also not counting on that to happen, as I probably am still too socially awkward for that to be possible.

How it feels to know you’re unwell?

Today’s most retweeted news in my stream seems to be an ultimatum sent by the US FDA (Food and Drugs Administration — don’t be confused by the name, as they work more like what in Europe would be a Ministry of Health) toward a service called 23andme. I got curious as I did not know the service, but the kind of reactions I read made me reach for my hand, and facepalm: most commentaries, with very few exceptions, seem to be either attacking regulation altogether, calling up for a conspiracy of drug companies (why? I’m pretty sure they’re pretty happy if third parties will tell people they have some disease for which they have treatments), or companies that do full blown genome sequencing (which seems a broken idea given that 23andme is not a service that replace them — it just provides an alternate, affordable alternative for the layman). After some ping-pong on Twitter with Jürgen I said I would write a bit about my experience and why my reaction is not the same as your average Internet user.

It’s a bit awkward for me to write thinking back to 2007, first because it’s impressive for me to get remembered it was now over six years ago this happened. But also because, as I’ll try to explain in a moment, my perspective changed considerably since then. I think the most visible difference is to be found in this post, a few months before my hospitalization:

I find this funny because lately I’ve been a bit tortured with myself about an opportunity I don’t want to miss.. but that requires me to take an airplane, and I’m terrified by the whole concept of airplane; and I’m trying to watch Nodame Cantabile to see how the protagonist (who also suffer from this problem) will get over it. Pathetic, I know.

Well, the opportunity I did not talk about in that post was an on-site interview at Google, in Mountain View, for a position of SRE in Dublin. I’ll leave the readers who haven’t paid attention to my recent move to guess where and for who I’m working right now. Yet this only happened almost six years after I was originally offered that on-site. It took a friend of mine convincing me with force to get on a plane for me to get over my fear, at least in part. As of now, I flew 14 legs this year. I’m flying two more to get back to Dublin. Last year I flew 18 legs. I got over my fear, sort of.

But the changes don’t only stop there. And they really did not move only in one direction, things are difficult. I’m pretty sure I can say that, compared to most of the people commenting around 23andme’s FDA kerfuffle, I have a better idea of my genetic risks, which I did not intend to have — this knowledge has been forced on me by what happened to me. I know for example that I almost definitely suffer from Gilbert’s syndrome and I have been thus avoiding paracetamol. Honestly, having known for sure that was the case before I was hospitalized would have helped, as then the doctors would have refrained to tell my mother that I definitely lied and drank the night before — the last beer glass I had at that point was already five years before, at the table, with my parents; I knew already that I don’t stand alcohol, and I found out afterwards (more on that later) that I’m a mean drunk.

I’ve been also told, but without certainty in this case, that the root cause of my health issues was most likely genetic — a predisposition to gallstones, gallstones that have been overlooked by my GP when I reported the abdominal pain that was the first symptom of the pancreatitis, and that even half my teachers in school expected to be a way to avoid tests — it was only if the test was for math, I hated that teacher and refused to study math for the best part of three years. My complex relationship with diabetes is also, according to some (but not all) the doctors who visited me, partly inherited. A tendency to diabetes is to be found in my father’s family, and manifested during my sister’s pregnancy as well. But at least according to the specialist who’s following me in Ireland, the primary cause of my current diabetes is the pancreatitis itself, which could have lead to mistreatment in Italy, where assuming inheritance (as my pancreas did seem to be working up to a point) brought it to be considered a full-blown type 2, instead of something that behaves vastly like Type 1, and still not being LADA.

I don’t know if HIT can be ascribed to genetics as well — but here’s where I find the idea, that people throw around, that once you talk with a doctor he or she will know everything that you have to do, is pure fantasy. When I was sent to the ICU, I was given, like everybody else, heparin, an anticoagulant – the idea is that if you’re forced to stay in bed for extended amounts of times without the ability to even stand up, you don’t want to risk thrombosis. Unfortunately, in me the end results of heparin are the exact opposite. I’ve been very lucky to survive that one — the hematologist at the hospital knew about the chance of that happening. But when I relayed this to the chief gastroenterologist at a different hospital one year later, he was convinced it couldn’t be possible.

I underwent a few further tests, and so did my siblings, when, after the ICU, and just before dismissing me, I got a high fever, and none of the stuff they kept trying to give me worked. They ended up sending cultures around different hospitals, and kept drawing blood from me daily. I can only imagine that if there was something else in my genetics that was going to distract them, they might have overlooked the fact I had a central venos catheter installed for over a month, and that caused a bad infection. After a full week of fever, it was a nurse in training telling me, and my father, his suspicion on the CVC being the problem, and admitting he couldn’t really say that to the rest of the doctors without risking losing his training spot. My father had to find the doctor responsible for the ICU, who stormed the unit, screamed at the equipe that was ignoring the CVC, and took it out himself. My fever was gone the next day.

So what I said up to now only covers some of my first reasons to think that services like 23andme, while being definitely something I’m happy to know exist, should not go unregulated. While knowing of things like Gilbert’s syndrome could have helped me, diabetes predisposition was a red herring for me. And having multiple known issues that could be the cause for a high fever would probably have killed me. I find it’s on the level of full body scans: I’m glad it exists but I’m not getting one (another?) for a long time.

But there is another side to consider, and that is the psychological issue: if you were to read every single blog post of mine between the time I went to the hospital and some time after I had surgery you can probably see that my mood was quite different than before and after. Why? Well, I lived that whole year expecting not to live until the month that was to come. I’m not kidding or exaggerating. I made my mother cry multiple times during that year because I wasn’t even planning to survive the month. I felt lonely and I ended up looking for companionship from a person that deserved better than a desperate, ready to die at any time, zombie like I was. I did not attempt suicide, as my mother understandably worried about, but you can probably see already that it had been in my mind the whole time. Spending over a month in a hospital, including two weeks in intensive care is not something I’d like to go through again — and I did end up at the hospital a few times since. I would be lying if I wouldn’t admit that every time I ended up in the ER (or A&E if you prefer), my thought was along the lines of “If it’s bad, please make it quick.” as I don’t think I have the strength, even now, to go through it again.

Again Jürgen shared a post by @mntmn that gives a glimpse of how easy it is for a software bug to give someone deadly worries. I wish I had his strength to just go through the results again independently, I doubt I would do the same — I know that the first thing I’d do would be to go see my GP, but would I have the strength of doing that, rather than just look for a quick way out? I wouldn’t bet on it right now. I feel much better, and much more optimistic about life nowadays than six years ago. It has been thanks to a bunch of friends who stuck with me while I was going down very bad roads, people who I met after who understood my fears. And yet, even without having a picture even half complete as the one 23andme would give me, I already came to term with the idea that I don’t really want children, as my genetic inheritance is more akin to a curse — not that there is any risk of that happening, given how I’m keeping single at 28.

I know people who wouldn’t be as strong as me either (and admittedly I’m not that strong), people whose first reaction would be to get a knife and be done with it. After all if the doctors need to tell you bad news, they usually call you to go to their office — and in my experience they ask you to not come alone. In Ireland I noticed quite a few ads for public service lines to support people who have been given news of cancer, and that nowadays can be less of a death sentence compared to other genetic risks. Which is what most worries me about 23andme in particular: while they make it abundantly clear for your rational mind that their results are not clinical, and that anything pointed out by them should be passed on to a doctor for a real diagnosis, people are not rational in regard to their life — not all of them at least. I know I’m not.

The final nail for me, for which I understand FDA’s position in regard to this service, has to do with what has been happening in Italy over the last year or so. A TV programme, started as a comedy but then entering some kind of “public service” kind of deal, started painting what had been considered an “experimental treatment” as a cure for a bunch of incurable syndromes and diseases. And lo and behold, to satisfy all the hatred for “big pharma”, and all the conspiracy theorists of the country, they declared that the bad Ministry closed down the Foundation that was administering said treatment just for spite. The fact of the matter is that the laboratory was inspected after an inquest was started after one of the few patients died, and they found not only code violation, but seriously threatening conditions of work. Further investigations pointed out that the so-called “Doctor” who has been brought to the attention of the media is actually a literature major. It’s basically a fraud, but people who are desperate still believe the fraudsters.

And before you say “It’s their problem”, after the media scandals on the Ministry shutting down the laboratory, judges had to allow the previous patients to get the treatment still, but to do so safely, national hospitals are used. Which means that now the Italian national health service is paying for people to get a fake treatment. Which is not something I’m proud of.

So to conclude, my opinion at this point is that I’m partial to get services like 23andme regulated — which does not mean shut down! But they need scrutiny in what they assert; bugs like the one @mntmn wrote about can kill people, it’s not a hyperbole, I’ve seen people in the hospital after the bad news. I know how they felt. And I know of some who didn’t get the strength to keep going afterwards.

Myself, I’m wondering — would I try my luck with the service? I’m living happy (or the closest thing i can afford) now, I wouldn’t want to stir up trouble. On the other hand, information is power. I’m not sure, I think I’ll speak with my doctor next week (I have an appointment already for when I’m back in Ireland), and if the service is still running then, and he thinks it can be of help, I’ll go through it. I know at least that if something comes up on the results, I would be able to call him immediately.

But this is my point of view, the point of view of somebody who has gone through the bad side of medicine and stared into some of his genetics issues… I don’t want to sound self-righteous, but I’m afraid Jürgen, with a relatively clean bill of health – the PPI response is indeed something useful to know on how much to get, but it’s not a deal breaker, given how quickly doctors seem to provide it – cannot feel how it feels to be given bad news.

Health, accounting and backups

For those who said that I have anger management issues regarding my last week’s post I’d like to point out that it’s actually a nervous breakdown that I got, not strictly (but partly) related to Gentoo.

Since work, personal life, Gentoo and (the last straw) taxes all merged this week, I ended up having to take a break from a lot of stuff; this included putting on hold for the week all kind of work, and actually spend most of my time making sure I have proper accounting, both for what concerns my freelancer activity, and home expenses (this is getting particularly important because I’m almost living alone – even if I technically am not – and thus I have to make sure that everything fits into the budget). Thankfully, GnuCash provides almost all the features I need. I ended up entering all the accounting information I had available, dating back to January 1st 2009 (my credit card company’s customer service site hasn’t worked in the past two weeks — since it’s the subsidiary of my own bank, I was able to get the most recent statements through them, but not the full archive of statements since issuing of the cards, which is a problem to me), and trying to get some data out of it.

Unfortunately, it seems like while GnuCash already provides a number of reports, it does not have the kind of reports I have, such as “How much money did the invoices from 2009 consists of?” (which is important for me to make sure I don’t go over the limit I’m given), or “How much money did I waste in credit card interests?”… I’ll have to check out the documentation and learn whether I can make some customised reports that produce the kind of data I need. And maybe there’s a way to set the term of payments that I have with a client of mine (30 days from the end of the month the invoice was issued in… which means if I issue the invoice tomorrow, I’ll be paid on May 1st).

On a different note, picking up from Klausman’s post I decided to also fix up my backup system, which was, before, based on single snapshots of the system on external disks and USB sticks; and moved to use a single rsnapshot system to back everything up in a single external disk, from the local system, the router, the iMac, the two remote servers, and so on. This worked out fine when I tried again the previous eSATA controller I had, but unfortunately it again failed (d’oh!) so I fell back to Firewire 400 but that’s way too slow for rsnapshot to do a full backup hourly. I’m thus trying to find a new setup for the external disk. I’m unsure whether to look up a FireWire 800 card or a new eSATA controller. I’m not sure about Linux’s support for the former though; I know that FireWire used to be not too well maintained, so I’m afraid it might just go down to FireWire 400, which is pointless. I’m not sure about eSATA because I’m afraid it might not be the controller’s fault but rather a problem with (three different kind of) disks or the cables; and if the problem is in the controller, I’m afraid about the chip on it; the one I have here is a JMicron-based controller, but with a memory chip that is not flashable with the JMicron-provided ROM (and I think there might be a fix in there for my problem) nor with flashrom as it is now.

So if you have to suggest an idea about this I’d be happy to hear of it; right now I only found a possibly interesting (price/features) card from Alternate (Business-to-business) “HighPoint RocketRAID 1742” which is PCI-based (I have a free PCI slot right now, and in case I can move it to a different box that has no PCI-E), and costs around €100. I’m not sure about driver support for that though, so if somebody have experience about it, please let me know. Interestingly enough my two main suppliers in Italy seem to not have any eSATA card, and of course high-grade, dependable controllers aren’t found at the nearest Saturn or Mediamarkt (actually, Mediaworld here, but it’s the very same thing).

Anyway, after this post I’m finally back to work on my job.

Health status report

For hose who’re still worried after my latest health post I have good news finally. In the past three weeks my blood sugar levels kept between 62 and 118 mg/dL which is definitely not bad. This is, though, while I’m taking both metformin and glibenclamide pills (400+2.5g each meal). I also increased my usual exercise, thanks to Nintendo’s Wii Fit (the best way to stop a geek from being sedentary: give him a chart to follow!).

My eyesight is, though, still fluctuating, although the €65 glasses I bought are definitely useful hen reading, especially stuff written quite small, I’m now using fewer days than I expected them to be used. They are also only for near sight obviously, so I can only use them to read or write, but that’s also fine. After all, they are temporarily and I paid them quite less than the ones I used before, even though the lenses are quite huge.

All in all, I cannot really complain at how things are going, if not for the fact that I’m really sleeping too little, between one thing and another; last night (at the time I’m writing) I was up till 5am to fix my radeon’s driver installation (and I just now remembered that I haven’t opened two bugs for it yet!), and the night before I was up till 3am to prepare charts for some Gentoo-related analysis.

This is mostly why I start to have a short fuse with people who attack me for the work I’m doing. I’m not expecting all the users to be thankful, and I know a lot will always complain about something, see the whole XMMS crap-spreading, but really it gets old after a while, given I’m not paid to do what I do already.

My health and my week off

I took a week off from everything this week, mostly. The reason for that is to be found in my recent health problems although it might not be easily categorised as such.

The problem is: my eyesight got a lot worse. Due to diabetes, I’m due to have eyesight problems for quite a while, and right now I’m at an historic low. I really cannot look at the monitor for more than twenty minutes, nor I can read anything at all; I cannot play with the PSP, I cannot do crosswords, I cannot read the SMS I receive (and I can only send them thanks to the qwerty keyboard in the E75).

Luckily, it’s not impairing my general movement (yet) so I’m still going around and doing the tasks that I have to, away from the keyboard. But for all that involves using a monitor, well, I’m just off for now. This all started when I stated to take meds, so hopefully it’ll get stabilised soon. I ordered a new pair of glasses, a temporary one though, that will arrive on Saturday. With that I’ll literally be back in business. I just hope I won’t start ordering €60 glasses every other month to cover for the eyesight change…

Anyway, thanks to Rcomian for the OpenMP book, it arrived today, I’ll be reading it and starting to apply it as soon as I’ll be able to see!

About my health… yes, again.

Seems like this happens almost every year, but I’m again in a health scare kind of situation. Last week I found my blood sugar level to be sky-high (over 400 mg/dl); a set of blood tests afterwards, my HbG value is 12% which is tremendously high as well.

What does this mean? Well nothing really, I just wanted to share this out. I might disappear for some more time because fo this, I’ll be trying to do more paid work than I’m doing Gentoo work right now because even when there is a national health service covering me, I have learnt the hard way that there are a lot of extra costs to the side of the health issues, that don’t write up with the actual medical coverage, nor with the loss of job projects.

So the bottom-line is, I’m going to withdraw a bit of my involvement in Gentoo for the next few weeks, and I need somebody else to pick up some of my packages and bugs. So, sorry if I cannot really work on some Gentoo things that I promised to look into soon enough, I’ll try my best but it might be hard for me.

Two years ago, today

Two years ago, today, August 12th 2007, in the early hours of the morning (3 AM) I was being brought to the hospital for my first hospitalisation ever: the start of my Pancreatitis saga (that’s the last post I was able to write in that month, a few hours before). It took me forty-two days to come home from the hospital, with sixteen spent in the intensive care unit.

After that, I’ve spent another week in hospital last year in July, and then almost the whole month of September (in a centre specialised on pancreatic diseases), in the middle of which I finally had surgery. And from there on I was finally able to say I recovered. Right now, while still having to keep sugar levels under control, I can seem to live my life normally (given I didn’t drink alcohol before, the fact that it’s now poisonous for me is no problem; and since I took my coffee without sugar before too, that’s also not much of a problem).

Two years after the fact, I’m working as hard as then, and I get the same amount of stress, which aren’t really extremely good things to be honest. On the other hand it mean I probably fully recovered by now and I can live more lightly from now on that I had in the past two years. Unfortunately I cannot simply ignore what happened; my gallbladder problems may as well be hereditary, which means that if I’ll ever have a life and a family, I’ll have to take extra care for that.

On the other hand, my reason to write this post is mostly to remind you that while I’m happy to receive appreciation tokens there are more important things in this world, so if you do find yourself willing to donate something, please do so, but in favour of research.

On addiction

So today is April 20th, or 4-20, which I learnt last year is slang for pot ; what better day to write about addiction than this? Actually, I’m going to take the point from my caffeine addiction which I discovered for sure little more than one year ago, and then have a little status report on my health for those who still are interested about it.

The addiction is not gone, and I sincerely don’t care; I had to take it slow last summer since it could have stressed a damaged pancreas, but since I had surgery the problem seems to be gone. Which is good, since I cannot go lower than three cups of coffee a day, if I do, problems ensures, migraine mostly, but not just that.

I also tried to experiment with some variant of the mochaccino; since I don’t usually drink cappuccino (which would be the latte with steamed milk) because of time constraints, but rather a “macchiato” (what is usually called a latte in the US) with normal, 1.5% milk mixed in, I just used some shards of dark chocolate from the just passed Easter (I’m still mildly diabetic so I wouldn’t be able to eat the chocolate straight away, but a little powder over the coffee doesn’t seem to affect me in any major way) and powdered them over the mug.

I could add a note about the absolute pointlessness of Easter, especially this year; I don’t really find much to party about to be honest, I’m not Christian myself, I cannot eat sugary stuff, and I’m already full of crap at home; just one of my two sisters actually had a practical view on the matter and gave me a shirt (I’m still changing my wardrobe since after losing 30kg, I went from an XXL to a M/L size)…

Anyway, the addiction to caffeine does not worry me; since I took my coffee without sugar, and the milk does not affect me that much, I can drink it at home fine; when I’m out, having some problems with milk, I just get a standard espresso without sugar (that’s probably the only change, before the diabetes I would take black coffee with sugar, and latte without sugar, but now it’s always without). It can become a bit of a problem when there is no bar or other way to get a coffee for a whole day but that’s quite rare anyway. And tea can barely work for a few hours if I need to.

The rest of my health seems to be mostly fine too, I have some various muscle pain when the weather is bad, raining or so, but that’s acceptable. Unfortunately I now have a whole drawer of my bedstand dedicated to meds and drugs; while I used not to have any at all, but that’s manageable. I still have some moments when I don’t feel entirely up to my task, especially emotionally, but it’s not tremendously bad. I guess the psychic scar left by the experience is not going to fade any day soon.

In general, life is not being extremely bad, but there are a few bad spots, especially in memories; for instance, just to stay on topic of the day, I’m still having nightmares from time to time due to the painkiller that they gave me after surgery, which brought me to an almost suicidal peek. I say to stay in topic because at the time, they told me that the alternative to that painkiller for my situation was… pot (that’s what I was told, I admit I have no idea if that’s really the case or not, and sincerely at this point I don’t really care…). I don’t smoke (but I have nothing against people smoking, cigarettes or pot), but I would probably have preferred to get high with that than being depressed by the meds.

Buying sleep (by the minute)

One of the worst thing that can happen in somebody’s life is when your dreams are scaring you out of your own sleep. As it turns out I’m in one of those situations. A nice period of my life ended just before Christmas, and now I’m in a bit of a pinch, with a late job, and no future (stable) job in view. I’m also out of luck with publishers since the last article I submitted to LWN was not even worth a reply, it seems.

I should be at least well happy about my health, one would expect, given that I am feeling better after the surgery and I just need to visit the hospital for some check-ups now. But even that is out of schedule, since I was supposed to be in for January, and it’s middle February now. The professor I had to reach is unreachable, so I had to pass through another doctor in the staff (whom I’m very grateful to for my previous staying too!).

But as it is said in Italy “one Pope dead, a new one is made”; I admit I’m not sure what the English equivalent would be but I’d expect it to refer to kings.

I’m currently feeling in quite a bluish mood but it’s going to be just fine as soon as I get some good nights’ sleep; relaxed sleep. The problem as I said is that my own dreams, or rather the content and the characters of the dreams I’m having lately, chase me out of bed. Even though I cannot remember the dreams by themselves, the general mood follows me when I wake up and, even though they should be pleasant dreams, they upset me very much.

Luckily I learnt to fight dreams, and nightmares, since I went to the hospital. My way of keeping them away from my mind is to listen to something that turns my attention to something much different just before sleeping. Podcasts have helped a lot about that, but sometimes I need more, longer content I haven’t listened to before. This is especially true when, like right now, Bill Maher is not on HBO so I cannot listen to new Real Time’s podcast episodes. For these times I corrupt a bit of my soul and buy audiobooks from the iTunes Store, yes with the freedom-hungry DRM on.

I was thus quite pleased when an anonymous sent me The Hitchhiker’s Guide to the Galaxy CDs from BBC Radio (and I have to say I envy British people for BBC Radio 4, News Quiz is one of my favourite shows). Even though it also sprouted for me a technical problem: how to convert the CDs in a format that makes use of 100% iPod’s features using just Free Software? I’m afraid I’m unable to answer that question just yet but I hope to be able to soon. Also thanks to the (for now unknown since it hasn’t arrived yet) person who sent me “I’m Sorry I Haven’t a Clue” CDs. I’m not sure what it is but I find the British humour refreshing. Yes I know this is neither normal nor sane …

The problem is that, the way this is going I’m unable to rest, even when I sleep, and thus I cannot work for more than a few hours on Free Software without my head starting to ache. And it’s difficult to sleep in the first place. While I would like to try cutting down on coffee, it turns out that I’m quite addicted to caffeine to the point that twice already in the past three weeks, when I tried to stay a day without getting one I would get a migraine so powerful I would be unable to crawl out of bed.

Anyway so that you know, even if I haven’t blogged about it in a while, nor I have opened new bugs, the tinderbox (or tinderflame to make it distinct from Patrick’s) is still working and crunching data. The new disks do help, since there was one (I’m afraid I know which one, I’ll write about it specifically in the future) that would make the system go stuck on pdflush, which as you might guess is not the nicest of the things. Now it seems to be working better.

Anyway, if you wish I made a special list to see if I can solve my sleep deprivation (although I’m waiting already a few things I ordered myself, so I should be set for a while), but even more importantly, there are two thing I’m going to ask users and developers reading me alike.

If you’re an user, try to raise concern with upstream projects about problems like proper --as-needed usage, parallel build and similar, I know my blog isn’t exactly the nicest place to look up information from but it should have enough to go around with issues like that. Any upstream package that fixes parallel make, --as-needed or autotools by itself is one less package I’ll have to look at when I decide to push forward my agenda of having proper packages around.

If instead you’re a developer, please help me by at least reviewing what I write, correcting me if needed, and especially submitting patches to my projects if you see they are wrong or incomplete. Having people collaborate on my projects is one thing I always miss.