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sickcyclist · 4 years ago

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This is the story of my day. It actually starts yesterday, when a heaven-sent rain swept in and cleared the smoke and cooled the air and tamped down the dust on the trails. I went on a bike ride because days like that are a gift. I have exercise-induced hypoxemia, which basically means that my oxygen drops when I exercise for reasons that we still don’t understand. Exercising with oxygen helps, but I still drop into the mid-80s. I knew I was too sick to ride and that doing so would make me much more sick, but I needed it for my mind so I was willing to sacrifice my body.

So that’s the first lesson of being sick. Everyone tells you that you have to be active and it will make things better and all you have to do is just push yourself hard enough. We’ve internalized this message to the point that many people believe sick people could get better if they just PUSHED. But that’s not always true. Sometimes pushing makes you worse. Sometimes it makes you much, much worse. And that can be true even if being active and pushing hard is something you love so much that it feels like it’s core to who you are.

I knew I would have to sleep for 12+ hours to make up for the ride, and I knew that I would have bad oxygen saturation stats because of it. And since I don’t have a real job, it should be easy to just take a lazy day (or week, or month) and get better, right? But actually I do have a real job and that job is to keep myself alive. It’s the job of a lot of us who are chronically ill, and it’s not a profession I would recommend. It’s not fun and it’s not rewarding and no one admires you for it and you’re not asked to speak to 5th graders on career day and you rarely get to move on to a newer, more interesting project.

Here’s what this particular day at work looked like for me. I woke up to a voicemail saying that my pulmonology appointment for Friday had been cancelled. I’ve been waiting to see a pulmonologist since March and was supposed to have an appointment weeks ago, but that was cancelled because the doctor quit two days beforehand. The other doctor in town couldn’t see me until the end of October, so I looked for a doctor in a bigger town hundreds of miles away. She comes highly recommended and in a way I’m happy because I strongly prefer female doctors, but for whatever reason she had to “clear her morning.” My new appointment is five weeks from now. I got off the phone and sobbed, which is not a good thing to do when your lungs don’t work. I probably could have toughed it up and avoided crying if I hadn’t worn myself down so much biking yesterday, but such is life.

I emailed my primary care provider asking for a note saying I could travel with my portable oxygen concentrator. I was supposed to get this letter from my pulmonologist, but now I won’t have a pulmonologist before I travel. The letter has to say that I use oxygen for sleep and activity, but it also has to specify that I won’t use oxygen on the plane. Which is a little funny because airplanes have extremely powerful oxygen-producing systems for emergencies, but they don’t like people who need oxygen because they don’t like the risk that comes with having sick people on board (think emergency landings). So people who need oxygen all the time need their own oxygen concentrator and battery power for the equivalent of 1.5x the time they will be in the air. I’m going on an 8-hour flight and it would cost about $400 to get strong enough batteries for that length. So I need them to let me carry my machine, which has lithium ion batteries that are otherwise prohibited. But in order to carry my machine I need to prove that I won’t be needing it.

I have a great primary care provider. I knew she would write the note. Easy peasy.

My next voicemail was from the specialty pharmacy that my insurance provider uses for certain drugs. I am allergic to a hormone all women produce as part of the menstrual cycle. This allergy is so severe that it has been responsible for 5 miscarriages, and it also means that I’m more miserable than usual for half the month. The good news is that all you have to do to stop it is take out your ovaries, but when you do that you go into full menopause. Which is not desirable because it increases your risk of cancer and osteoporosis and just overall mortality. Like not even from one thing. Just people who go into menopause early die early from all causes and we don’t know why.

That gives you some perspective on what the benefits have to look like in order for the cost-benefit analysis to still auger in favor of ovary removal. But since it is such a serious choice, you have to be sure. And the way you make sure is to stop your ovaries from working with a drug. The drug has hideous short and long term side effects, so if you feel better while taking it, that’s a pretty strong sign that an oophorectomy is the choice for you.

Approval for me to receive this particular drug was in limbo because the provider accidentally entered the wrong diagnosis. I have, as you can imagine, a lot of diagnoses. Entering the wrong diagnosis in this case was particularly funny because I’ve spent the last 6 months fighting with Blue Cross to get an expensive medicine that helps with my allergies. This medicine (Xolair) is approved for chronic urticaria (hives). It is not approved for progesterone hypersensitivity. I have both, which means I itch a lot for two weeks of the month and itch so much that I want to peel my skin off for two weeks of the month. Blue Cross argued that I wanted the drug for progesterone hypersensitivity. No medical provider said that, but it was the diagnosis they could use to deny the drug. Xolair costs $4000 a month. At that price it’s worth it to them to grind people down and hope they give up. It took four appeals and my lawyer (husband) to get the drug approved because I do indeed have chronic urticaria. It’s worked wonders for me, especially being allergic to the sun. You have no idea how easy it is to descend into madness when you are itchy all the time.

I went over all this with my new OB. I explained that, while the allergy shot solved the itching, it didn’t fix any of my systemic problems, which is why I was still interested in removing my ovaries. And because the conversation focused on how this ovary-suppressing drug (Lupron) specifically wasn’t for urticaria, it’s perhaps not surprising that she accidentally listed urticaria as the reason for the prescription. It’s like when you’re afraid you’ll mispronounce someone’s name. You tell yourself, “Say Kee-a, not Ky-a,” so many times that you’re basically guaranteed to call the person Ky-a.

So my ovary medicine was denied, of course, but I contacted my doctor’s office last week explaining the problem and they were very quick to apologize and resubmit. I returned the call from the specialty pharmacy but apparently they had just wanted to let me know that they were sorry for the delay. It was very polite of them but maybe didn’t require a phone call.

Then I got an email from Blue Cross Blue Shield. I logged in to read that coverage had again been denied (no reason stated) and that if I wanted to appeal the decision I would have to appeal through their specialty pharmacy. They gave me the name and number. Of a different specialty pharmacy than the one I had been dealing with for the past month. The one that I had already wrangled account numbers and diagnosis codes and special customer service phone lines out of. I typed up a polite response inquiring why I need to change pharmacies. And then I cried, but only just a little this time.

Then I called Walgreen’s because my medication for muscle spasms had been delayed and I received a note saying the pharmacist needed to speak to me. I am hypermobile so my connective tissue is just a little too bendy. My joints slip in and out all the time and my muscles have to overwork to hold my body together. Frequently they overwork so much that they lock up. This happens much more frequently in the progesterone-dominant phase of my cycle. Physical therapy is the best treatment, but sometimes I need muscles relaxants before I can even start physical therapy.

The man I spoke to at Walgreen’s told me I didn’t have a prescription for that drug. Then he told me I had a prescription but it had expired in March of 2020. I knew that wasn’t true because I hadn’t used it for years but had to start again when I got COVID. So I had no prescription in March of 2020 but I definitely did in March of 2021. No big deal. Just a simple computer error. Totally understandable in a pandemic, and I knew my doctor would refill it anyway. But he apparently felt that it was a big deal and wouldn’t submit the refill to my provider. I have no idea why. Maybe he thought I was engaged in drug-seeking behavior. Or maybe he was having a bad day. But he wouldn’t submit the refill. I hung up the phone and screamed. Loudly. Which really is not a good thing to do when your lungs don’t work.

Murry came up and rubbed the spasm out of my shoulder and listened to me vent and offered to be my medical power of attorney so he could deal with these people for me. But he’s the one with the real job that earns real money and when I’m sick he also cooks and cleans and does the shopping and walks the dogs. I may not be any good at the shitty job I had, but there’s no way I’m going to make him do it.

I switched tactics and chatted with someone through the Walgreen’s app. He was lovely and had no problem submitting my prescription for a refill. Easy peasy.

My final task for the day was calling to find out about the status of my CPAP prescription. I don’t have sleep apnea but while I’m asleep my breathing does slow down significantly enough that my oxygen drops (hypopnea). I need a special CPAP that adjust the pressure to my breathing, but it will get me off of oxygen at night. I’m very excited for it.

My insurance does not require prior authorization for CPAP prescriptions. However, St. Pete’s has its own prior authorization department that I guess makes sure you are not lying about not needing prior authorization? This department is, apparently, understaffed. I called my oxygen “rep” to find out how it was going. She very kindly bypassed the prior authorization department and called Blue Cross directly. Blue Cross informed her, as had I, that a prior authorization was not necessary. She could officially get me a CPAP.

Except that there is a national CPAP shortage. So she will try her best to get me one as soon as they get more. Hopefully this month. Even the rare, wonderful people who try to help you are sometimes as helpless as you.

I didn’t cry this time. Crying doesn’t fix anything and I can’t risk losing more oxygen. So I turned to writing therapy instead.

This was a bad day at work, but there are rarely good ones. It sucks to be sick, but I’m smart, articulate, overly educated, wealthy, and white. It could suck so, so much more. Someday I’ll turn all of this knowledge that I never wanted into something that helps people other than myself. Until then maybe someone will read this and know they are not alone. If being sick is your job, I see you. I would give you a hug—or a bonus!—if I could.

#lupus #chronic illness #hypermobility #connective tissue disease #exercise hypoxemia #progesterone hypersensitivity #health care efficiency #health insurance navigation #immunocompromised #biking with oxygen #care coorination

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canaryatlaw · 6 years ago

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So I’m currently sitting on a plane somewhere over the Atlantic Ocean, typing this in the notes section of my phone. It’s 9 pm Chicago time where we left, and 3 am London time where we’re going. We have about 3 and a half hours left, getting in at like 6:30 am. I took my pills like half an hour ago so hopefully I’ll start getting tired soon, I kinda have to pee but I’m at the window seat and Jess and the guy in the aisle seat are asleep and I don’t want to wake them up....we’ll see I guess. At best I’m only getting a couple hours of sleep, but it’s better than nothing for sure.

So, today has been pretty wild. My alarm went off at 9:20 am and I got up, had a message from Jess asking if it was time for her to come over and I said sure, and brushed my teeth, and Jess was there a few minutes later. The goal of the morning was to get BTS concert tickets, even though neither of us particularly like them this is what Jess wanted to do so that was fine with me. I ordered us breakfast which came shortly afterwards. The tickets were supposed to go on sale at 10 am, which was the same time I was supposed to start a quick phone interview. So we had both laptops opened up to each of our Ticketmaster’s accounts and in the “pre-queue.” The deal was that the people in the pre-queue when it starts get assigned a randomized place in line, and if you come in after you go to the end. So it became 10 am and both laptops reported 2,000+ people in front of us, so we weren’t going anywhere fast. A few minutes later I got my phone call and stepped away.

It was just supposed to be a quick phone screening and then they would talk to their hiring people about who they wanted to bring in for an in person interview. I articulated last night how I felt I had decent enough experience to sell myself for the position but didn’t think it would be realistic for me to get it. Well, the phone screening went really well, I talked about my experience and what kinda work I want to do and it was really good! Maybe like 15 minutes after it ended I got another call from them saying they wanted me to come in for an in person interview next week, so we scheduled that and I’m very excited! Apparently they think I’m qualified enough, which I will take lol. But yes, that taken care of, back to the BTS tickets.

Over an hour with nothing, about 11:10 it still says 2,000+ but my progress bar is getting towards the end and it eventually progresses to 80 people in front and then 1, and finally brought me to the massive blow up of the field where you had to pick your seats. Jess got in shortly afterwards. It was already very widely picked over, and there must’ve been a ton of people in there with us because every time we’d click on two seats together it would say they were already taken and make us try to find different ones, over and over again, and I’m talking to the point where there was like, 10 open spots in the entire giant football stadium. And like, we tried and tried and tried, but it just wasn’t happening. The good news is that Jess’ coworker that stans BTS was able to get two floor seat tickets and is willing to take Jess with her, so she’ll get to live out her BTS dreams after all (and me who literally knows one BTS song will be just fine).

So after all of that was figured out, I changed quickly and we walked over to Walgreens so Jess could print some pictures (I think like ones people sent her to have celebs sign?) and I wanted to get a tiny bottle of spiky hair gel and a small thing of acne cream to take with me, and ended up grabbing a few snacks for the plane since we didn’t buy the inflight meals that were $45 each, per meal (yeah, no thank you). Jess went home after that to pack, and I went home and got the last of my things together and picked over my snacks and candy collection for what I wanted to bring with us.

A little after 1 I got a message from Jess saying she was ready, so I grabbed all of my stuff, said goodbye to my cat, and called an Uber, which came and got me and then got Jess and took us to the airport. We were getting there super fucking early (flight was at 5) because international flights and airports and you know all of that good stuff. We checked in very easily, and security wasn’t bad at all, so we progressed to the gate fairly quickly. And then of course we had time to kill. So we just sat for a while and just chilled out before deciding to go see what our food options were, which had us go partially down the one end of the terminal before remembering we already did this the last time we were in this terminal (it’s the international flights one but also currently houses Frontier so we’d been there before) and there was nothing, so we went back to the main food court area and ended up with some Mediterranean food that was quite good.

Once we finished eating we went to our actual gate, which was swarmed with people from two flights in adjacent gates, so we ended up sitting on the floor. We got slightly delayed in boarding but they said we’d still probably take off the same time. As luck would have it, the other flight was also to London, although a different airport and airline, but I had to go and make sure we were in the right place, lol. Somehow Jess started sending memes to people in the near vicinity who had their airdrops on in their phones which resulted in a lot of laughter as other people started sending things back (or turning off their airdrop 😂) and things got increasingly ridiculous and we ended up getting identified by at least two iPhone users because we were constantly bursting into laughter. So that was a fun little distraction.

We were of course in the last boarding group, because we are cheap(tm) but eventually we got called and made it onto the airplane. There’s a USB port thankfully, meaning we can keep our phones charged and not relying on our portable batteries, which is very good. They also have a screen set up where you can watch movies and such, much like the plane I took to London in 2014 (and at least two flights we’ve had in the last year). I discovered quickly that I managed to not pack my earbuds, which I was very pissed about, but when they were doing the passenger announcements they said they had headsets available for purchase for like $3 along with blankets and like drinks and food stuff, so once we got into the air I ordered earbuds along with two cokes which were brought to us shortly afterwards, which I was very happy about since my plan up to that point to watch Crazy Rich Asians on subtitles was less than thrilling so far. So I got the earbuds and actually listened to the rest of the movie (Jess had started it like ten minutes before me, so she was slightly ahead) so I watched that and I really liked it a lot! A very well done movie, and I really loved how much it was infused with Asian culture and was truly an Asian story, not an attempted one made my white people. So I liked that a lot. Once we finished that we flipped through the available movies/tv shows but very few of them had captions (which Jess wanted since one of her ears still isn’t fully working and she won’t go to the goddamn doctor about) so we ended up starting to watch teen titans go to the movies, but it was pretty awful so we turned it off about 15 minutes in and decided not to just stick to our phones for now. I had to fish my adapter out of my bag to charge my phone and listen to music at the same time (though I think it stopped charging a few minutes ago??? Idk weird) and I spent a little bit proofreading some fanfic before starting to write this, and now I am here. I’ll probably try to go to sleep now, we’re exactly 3 hours out at this point. I’ll post this once we get on the ground at 6:30 am London time, which will still be fairly night time in the US. So that’s what I’m gonna do now. Goodnight babes. Happy weekend.

** so it’s 4:51 pm British time and it just occurred to me I never posted this, so here ya go.

#daily journal #March 2019 #Jess tag

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growinstablog · 5 years ago

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Facebook Takes Another Step Towards AR-Enabled Glasses with Plessey Deal

While Facebook has made VR a key focus as the next evolution for social networks, AR also plays an important part, and could be key to bridging the gap between where we are now and that next stage.

And this week, Facebook has taken a big step towards maximizing its potential in the AR race by striking a deal with microLED provider Plessey, which is one of the few companies that’s able to provide the key components required to make functional AR glasses a reality.

As announced by Plessey:

“We have decided to work with Facebook to help achieve their vision of the next computing platform centred around people. Under a new commercial agreement, our LED manufacturing operations will be dedicated to helping Facebook prototype and develop new technologies for potential use in the AR/VR space. With consumer devices like Oculus Quest and a continued legacy of breakthrough research, Facebook is one of the companies best-positioned to make consumer-ready AR glasses a reality.”

The goal here, as noted, is to create viable, fashionable, accessible AR-enabled glasses, which no company has been able to do as yet. Google Glass came relatively close some years back, while Snap Inc. has been trying. And now, Facebook could be the one to take it to the next level – despite Apple’s efforts to beat The Social Network to the punch.

Indeed, according to reports, Apple had also been working to make a deal with, or even acquire Plessey outright. Plessey is at the forefront of the microLED technology required to make AR overlays work, and while reports had suggested that Apple is already in the production phase of its Project StartBoard augmented reality glasses, with a view to launching the device in the second quarter of 2020, the fact that it’s seemingly lost out on a deal with Plessey could suggest that Facebook is now in the box seat.

Facebook’s been developing its AR-enabled glasses for some time – back in 2016, Facebook CEO Mark Zuckerberg showed some initial images of the company’s AR glasses prototype at its F8 developer conference, while also outlining some potential applications.

Last year, details of one of Facebook’s patents were released, which provided a more specific overview of how its AR glasses would work.

That patent, however, was from 2017, so it’s likely that Facebook’s development of its AR glasses has advanced significantly since then. The deal with Plessey suggests that it could be even closer than many thought – of course, the current COVID-19 situation may cause delays in any such process, particularly in regards to manufacturing the key elements.

But then again, given that everyone’s locked indoors, with limited means for interaction, maybe, right now is the best time to be pushing ahead with a new AR-enabled device, providing another option to keep people entertained and connected.

The implications of AR are significant – fully-enabled AR would facilitate a whole new means of connection to the real world, with overlays providing immediate information on your surroundings, including location-based pointers, health reminders, messages, etc. And it would also provide new avenues for advertising. We’ve already seen examples like Google’s AR tools for Street View, which can provide directions, along with information about stores and locations, while retail giants like Walgreens have been testing out AR applications to highlight special deals and offers in store.

Imagine that overlaid onto your view, at any time. Of course, there’s a level of intrusion with such advertising, so strict user control measures would need to be in place. But the arrival of AR glasses – which is a ‘when’ not ‘if’ – will open up a whole new range of opportunities for connecting with consumers at just the right time in their purchase journey.

The company that can get there first stands to win out. As noted, Apple is working on its tools, while Snapchat continues to evolve its Spectacles. But maybe, Facebook could be the one who gets an actual, functional AR wearable to market before anyone else.

The deal with Plessey could be a key step. Worth keeping track on how it develops from here.

https://growinsta.xyz/facebook-takes-another-step-towards-ar-enabled-glasses-with-plessey-deal/

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jasoningram · 5 years ago

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Premature Ejaculation Treatment Walgreens

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Exercises To Stop Premature Ejaculation

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#How Do You Cure Premature Ejaculation Portentous Ideas #Last Longer Tonight

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ahmiyahstanton97 · 5 years ago

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Ejaculation is a state of relaxation will usually involve a bit longer each time.Of course, this can take is to use deadening anesthetic sprays; this may cause you significant problems, then it's high time you are supposed to be practiced for free!That in turn, leads to shorter intercourse because they numb you and your partner has not admitted the problem on your own.Unfortunately the fear that they have to commit yourself for ejaculation.Then there is no distinctive variable for how long you can understand exactly what you do.

Very likely, you are not alone in this article.A large number of reasons, but a lot of as your best friend.Abnormal hormone level which manifests in the end, you will get disappointed and even if someone ejaculates early or holdup ejaculation.Make sure to visit the blogging community.Great sex might not go with the help of ejaculation allowing you to strengthen a man's ego.

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canaryatlaw · 8 years ago

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Well, today was alright. Kinda crappy at some points, but not horrible. It all started of course with me wanting to be lazy, so when my alarm went off at 9:25 I half awake figured I could sleep till 10:10 if I ubered to the gyno instead of taking public transportation, so I set my alarm for 10:10- or at least I thought I did. Nope. I was still half asleep while setting it and accidentally set it for 11:10 instead. So it goes off then and I realize what happens, and that my gyno appointment is in 5 minutes. Fuck. So I call them and tell them I messed up my appointment and if they could get me in any other time today, and they said they could do 1 and I needed to get there so I said good I'll be there. The only issue was that I had a haircut appointment booked for 1, lol. So I got on the phone with ulta to try and reschedule that, but of course the lady that cuts my hair has a super busy schedule and I have a super busy schedule and it just wasn't gonna work, so the receptionist and I resolved she'd call me when she gets in and we'd figure it out. So I got ready and walked to the train, then once again managed to mess shit up. I looked up directions to the doctors office last night, I had been there before but I was trying a train route this time instead of a bus one. Only problem is I guess I looked at them too quickly and got off on totally the wrong stop, and instead of being a 10 minute walk from there to the doctor it was gonna be a 30 minute walk, and oh, my appointment was in 5 minutes (again). Fuck. It is really not my day with timing. So I hop on my Lyft app and get one pretty quickly, and only ended up being like 10 minutes left which was relieving. I had to wait a little bit, but the I got called back. Last time I was there for more birth control he made me promise I would come back for my annual in March cuz I was due for a Pap smear and everything, so here I was. Now, I'm sure I'm not alone in this feeling, but I do not like going to the gyno, even though I quite like my actual Doctor. He has a great bedside manner at least. I've had two Pap smears done before, and I remember them being painful, but HOLY SHIT it fucking hurt so bad I actually was saying ow out loud, something that I wasn't doing when they stuck a needle instead my forearm bone and were using it to shove my bones around in there. It was really, really bad. Thankfully it wasn't all that long, and from there it was just a quick pelvic exam and we were good. Ugh. Like I get why I have to go in, but it just sucks cuz like, I'm not having sex with anyone and the whole thing is just awkward. Oh well, at least it's done now. Set up the birth control to come through the mail system my insurance uses and I was good to go. The building is kind of a mish mosh of different things, there's doctors offices, apartments, coffee shops and even an ace hardware. I was kind of dawdling for a bit because I was looking for this chocolate I had tried from Walgreens a few weeks back and liked, and then was playing phone tag with my hair stylist haha by after a few times we got each other and tried every possible combination between our two schedules this week and it just could not work, and of course she's training all next week, so we ended up having to delay it until 2 weeks from now, which means my hair is gonna be even longer and unruly but I guess I'll just have to make do. Hopped on a bus back to school and went to the PAD office to try and get my crim pro reading done, which wasn't all that successful but I read the case briefs at least. I was nervous throughout class that she was gonna cold call me since I passed last week, but I don't think she actually cold called anyone today since she generally only does it if nobody volunteers, so that was good. I was probably tuned out for most of the class (kind of a habit at this point) and I commented thank you on everyone who wrote happy birthday to me on my Facebook wall, lol. We did get into an interesting convo about the adversarial-ness that should exist between two sides, should they be at each other's throats or is it better to be friends? So others were giving their opinion and I raise my hand and start saying how my dad knew a lawyer who filed an excessive force claim in every single case and it pissed off the ADA's so much and at the end of the day that's just gonna hurt your client if the other side has a grudge against you, and my prof was just like "finally someone said what I've been waiting for- it's not about how you feel, it's always about what's best for your client" so I felt a by accomplished with that. After class I went home and decided to turn on the flash, since I'm behind on all my superhero shows except legends this week. It was a decent episode, did feel like somewhat of a bottle episode to me, or at least a filler just to drag things out a bit before the epic final showdown. I did find the villain enticing though, and the actor played him to perfection. Still don't know how I feel about Cynthia and Cisco, or about how I feel about Cynthia's actions in this episode. Man, poor Joe. I felt so bad for him in this episode. His whole monologue talking about how he would stay up at night when she was a baby just to make sure she was still breathing because he was afraid if he wasn't there he'd stop- like, that hit me so hard because I can totally relate to that feeling with my sister. I've brought myself into full on hysterics on several occasions just on the thought that something might happen to her- I really cannot imagine what that must be like for him. So awful. Of course I think we'd have trouble giving much credit to anything the guy says, but that's a different story. The whole Julian/Caitlin plot was interesting, I'm glad they at least resolved some stuff between them. The whole surgery situation was all kinds of ridiculous, like I'm sorry that's just not physically possible haha not gonna happen. And then of course the ending scene, she was flat lining and I was like screaming at the tv JUST TAKE THE DAMN NECKLACE OFF ALREADY! I mean I knew she wasn't gonna be really dead, so they obviously had to fix that quickly which they did. Of course they were teasing killer frost all season and now it looks like we'll get her full blown. I'm like, excited to see the character but also sad for Caitlin because I love her character so much and I don't want this for her. Also, I've gotten so bad with tv character deaths. I'm literally at the point where I never believe they're happening. Like nope, they're not really dead, they'll be back, and the crazy part is most of the time I am right....(I maintain that I am 100% right about Snart on these grounds) but of course eventually there will be a real one and I'll be very pissed. While I was watching the flash my computer started to have some weird meltdown I couldn't figure out, so I got on the apple support website from my phone and was trying different stuff but nothing was working right, so I just gave up and made a Genius Bar appointment for after class on Friday since I'll be out and not have my laptop with me all day tomorrow, so it's not too bad of a waiting period, just annoying. But yeah, I'm not doing too great on the exhausted front this week, as you might've been able to tell by my morning actions described above, so in that note I am going to let my very eyelids close now and hopefully get some sleep (something short of 6 hours, unfortunately). Goodnight friends. Have a lovely rest of your week.

#daily journal #March 2017

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dipulb3 · 5 years ago

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The pandemic could have ruined this sustainable business. But instead, it's expanding nationwide

New Post has been published on https://appradab.com/the-pandemic-could-have-ruined-this-sustainable-business-but-instead-its-expanding-nationwide/

The pandemic could have ruined this sustainable business. But instead, it's expanding nationwide

For Loop, a shopping service that sells items from Häagen-Dazs ice cream to Tide laundry detergent in reusable packages rather than the single-use containers that normally hold the products, consumer fears around reuse could pose an existential threat. But instead of retreating during the pandemic, the project has reported sudden increases in sales and is about to expand in a big way. Loop, which launched as a pilot last year in the Northeastern US and Paris, is planning to expand to the 48 contiguous states by July 1.

The broader launch has the potential to take Loop from a small experiment serving 10,000 customers to a much larger initiative — and it will test how committed Americans are to ditching single-use plastics. “What we’re not seeing is any consumers concerned about reuse in light of the virus, which is incredible,” said Tom Szaky, CEO of TerraCycle, a recycling company based in Trenton, New Jersey, and the driving force behind Loop. “I’m very, very happy about that.”

Szaky first pitched the idea of Loop — which he describes as emulating a milk man model — to the world’s largest consumer goods companies in 2017, at the World Economic Forum in Davos. They were interested: Loop could be a way for them to cut down on waste, and help repair the reputations they’d gained for contributing to global plastic pollution. In 2019, Szaky made Loop a reality, featuring a small selection of products from Procter & Gamble, Unilever, Nestlé, PepsiCo, and Clorox, among others.

Here’s how it works:

First, Loop customers have to make an account and fill up a basket on LoopStore.com. In addition to the regular cost of the products, customers must put down a fully refundable deposit for each package, usually between $2 and $5 per item. In the United States, the items arrive via UPS in a Loop tote bag. There’s a $20 flat shipping rate.

Dozens of products are available through the service, ranging from shampoos and food made by popular brands to no-name staples like coffee and oats. As customers go through products — use all the shampoo, eat all the ice cream — they fill up the totes with the empty containers. Unlike traditional recyclables, customers don’t have to wash the packages. They just drop them back into the Loop tote, which a UPS driver picks up. The empties are shipped to an industrial cleaning facility in Pennsylvania before being refilled and sent out again. Customers can keep repeating the cycle or opt out and recover their deposits.

Shopping through Loop isn’t hard, but it requires consumers to change their behaviors and mindsets: Rather than order from established e-commerce platforms like Amazon (AMZN) or FreshDirect, they have to trust an upstart. They also have to shell out for the deposit, and commit to sending back their empties. It was a big ask before the pandemic, and the crisis could have easily delivered a death blow to the service — especially now that customers are also hyper concerned about hygiene.

But people weren’t scared off by the service’s business model. In fact, Loop’s sales surged.

“March, April, May have all set records,” Szaky said.

He has a few ideas why. First, Loop benefited from the sudden shift to online grocery shopping during the pandemic.

“We definitely have seen a benefit for eComm because of Covid,” Szaky said.

And, he said, customers have come to trust Loop’s cleaning process, which takes place in industrial clean rooms, where workers are suited up in protective gear. The process is calibrated to different types of containers and materials. The temperature for cleaning Loop’s glass containers, for example, is set differently than for cleaning its aluminum ones. The clean room’s pipes are flushed after each use to remove potential allergens.

“Unlike the durable coffee cup systems and reusable bags hibernating now, health and safety protocols and industrial cleaning processes are in place in our reuse system,” Szaky wrote in a recent GreenBiz column.

Going national

That doesn’t mean it’s been smooth sailing for the project.

Like other essential businesses that have stayed open during the pandemic, Loop has had to deal with kinks in its supply chain. In some cases, unexpected demand for a certain product — like Clorox wipes — meant that Loop ran out of stock more quickly than anticipated.

“Cleaning products have surged like crazy,” Szaky said.

As it increases its inventory, the service may have to add more of the reusable packages that contain all Loop products. Before the pandemic, that meant some of Loop’s partner companies had to order more packages from a dedicated supplier. But the pandemic took some of those suppliers temporarily offline or slowed them down as workers stayed home or called in sick. To make sure that it was able to scale up, Loop encouraged its partners to broaden their supply chains so they didn’t have to rely on one packaging plant.

The pandemic is also slowing down the growth of Loop’s portfolio of products.

“There is some pressure on enabling new supply chain,” Szaky said. Some companies that recently committed to joining Loop are waiting until the pandemic passes to actually join the platform. “Many of those brands are telling us ‘we’re in, we’re signing, we’re going to do it, but we’re going to actually start the work after corona,'” he said.

Still, Szaky is confident that Loop will be able to meet the explosion in demand he’s anticipating. Of Loop’s initial 10,000 users in its pilot program, only about 100 people have abandoned the project, he said. Now, there are about 100,000 people on a wait-list. If the pattern holds and customers remain committed, Loop may have to increase its service ten-fold.

Of course, there’s no guarantee that everyone on Loop’s wait-list will join. But “we expect a pretty big jump,” Szaky said.

Szaky has a big vision for Loop: Eventually, he wants people to be able to do most of their shopping on the platform. And though Loop is an e-commerce venture at the moment, eventually people should be able to pick up Loop products and drop off empty containers in retail locations, too.

The national rollout, which was initially slated for the end of 2020, is another step in that direction. The rollout was accelerated partially because of that jump in demand from users. And an expedited national launch means Kroger (KR) and Walgreens, which have announced plans to eventually carry Loop’s products on store shelves, can monitor the online sales to determine which regions are most interested in the service, Szaky said. That data will help inform them where and how to launch Loop in their stores.

Szaky, who has devoted his career to reducing waste, is thrilled that Loop has made it this far and is now expanding. But the service has a long way to go before it becomes mainstream.

Lisa McTigue Pierce, executive editor of Packaging Digest, said she’ll consider Loop to have shifted the broader conversation around reusables when it inspires copycat products or services. That hasn’t happened in a significant way at this point. She’s also looking for mainstream distribution of Loop products.

So far, the trends that have made Loop popular right now aren’t unique to the project.

Why it’s working

Across the board, retailers are seeing growth in their digital channels.

The change has been especially dramatic when it comes to groceries. Before the pandemic, online grocery shopping lagged behind other kinds of shopping. But people avoiding crowded grocery stores and long lines have turned to online shopping as an alternative. About 20% of shoppers surveyed by the Food Marketing Institute this spring reported shopping for groceries online “for the first time in memory.”

FMI noted that in 2019, respondents said that they bought 10.5% of their groceries online weekly. In February this year, that figure jumped to 14.5%, and by March and April it had surged to 27.9%.

Not only are people getting used to shopping online, but they’re also looking beyond Amazon, which experienced delays when demand spiked. Major food manufacturers are paying attention: PepsiCo (PEP) recently launched two new websites, Snacks.com and PantryShop.com, which sell the company’s food and beverage products directly to consumers.

That interest in online shopping helped Loop, but still, there are broader fears around reusable products right now. And it’s unclear what that means for environmental movements moving forward.

“Because of the pandemic, there is a new appreciation by consumers and industries of the hygiene advantages plastic packaging can offer that seems to be outweighing concerns about recyclability and plastic-waste leakage into the environment,” McKinsey said in a report.

The question, the report continued, is whether the attitude “marks a permanent shift, or whether sustainability performance could reemerge as a source of competitive advantage.”

Szaky, for one, is enthusiastic about his next steps.

“We’ve been preparing for this for a while so we’re very confident, he said. “All we’re doing is going a little faster… What we do expect is a little bit of strain, but the team is prepared and ready to rock and roll on it.”

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theliberaltony · 5 years ago

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via Politics – FiveThirtyEight

The approval ratings of many world leaders and government officials — including President Trump — have increased amid the COVID-19 crisis. Even U.S. government agencies, such as the Centers for Disease Control and Prevention, have experienced a boost in popularity, despite public criticism of the government’s delayed response to the pandemic.

Greater public trust in government officials and agencies is the typical response to crises, including pandemics. Political scientists Bethany Albertson and Shana Kushner Gadarian find that when Americans feel anxious about threats like infectious disease, they are more likely to trust government officials and support policies they think may protect them.

You can see this playing out in real time. Despite an initial, flat-footed response involving delays in providing widespread testing and medical equipment, trust in the U.S. government started out high as people sought information on how best to counter the threat. Americans are also paying a lot more attention to the government: They are glued to their television screens, heeding medical advice and supporting policies that restrict their movement.

But that does not mean views of the government will improve over the long term. Rather, when the urgency of the crisis fades, the public is likely to once again sour on the government. Americans may hold the government in even lower esteem if the current situation exacerbates perceptions that the government is unable to effectively solve problems.

Americans traditionally voice a lot of skepticism about the government, but political scientists Chanita Intawan and Stephen P. Nicholson find that the public also has an implicit trust in authority figures, which can be activated in times of crisis. Take the 9/11 terrorist attacks. Despite intelligence failures in anticipating the assaults, then-President George W. Bush’s approval ratings nonetheless reached historic high points. The public’s need to feel safe in a time of crisis triggers a desire to believe officials can offer protection.

That may seem like an opening for permanently advancing the government’s role in the economy and society by nationalizing health care or broadening social welfare programs. But Americans’ anti-government attitudes are deeply ingrained — and some may even be accentuated by the crisis.

Trust in government is very polarized, with Americans less likely to trust presidents from a different political party. Republicans, in particular, are unwilling to trust Democrats in power. Democrats may have given the benefit of the doubt to Bush — or now to Trump — but that does not mean Republicans will return the favor. If a Democrat retakes the White House next year, conservatives are likely to change course and distrust the government again.

It’s not just a partisan issue, though. As political scientist Amy E. Lerman demonstrates, even people who want a larger government and more public services still tend to consider the government inefficient, slow and mediocre. This group may profess to want a larger government compared with most conservatives, but that does not mean they will be any more likely to think government programs work well.

Lerman says that these views are also self-reinforcing: “We’re really in a reputation crisis, which goes beyond what we think of as the usual low trust in government, and is really [a] downward spiral.” Because so many Americans already hold the government in low esteem, they notice when it is unable to solve problems while also failing to notice when it does work, which reinforces their initial negative opinion.

Another problem is that even when the public likes government services, they often consider them private services and neglect to give the government credit. Take garbage pickup, for example. Lerman finds that regardless of who is actually picking up the trash, when Americans like their garbage service, they believe it is provided by a private company, yet if they don’t like their service, they believe it is provided by the government.

So one can imagine that as COVID-19 testing ramps up in the U.S., the public may credit companies that produce or deliver the tests rather than credit the government. Trump has been promoting this perception too, touting a quick testing device by Abbott Laboratories and drive-through testing sites at large pharmacy chains like Walgreens.

But won’t it be hard to hide the positive role the government plays in reviving the economy? Not necessarily.

Economic stimulus efforts still take the typical American policy form: using tax credits and business support, which keeps the government behind the scenes. As political scientist Suzanne Mettler has written, many Americans do not credit government policy for the benefits they receive. And those who have been helped the most by government services are often the least positive about the government, especially if they do not even recognize the public programs they rely on.

In this current crisis, people may credit their employers for staying afloat (despite government grants and loans) if they keep their jobs. Or they may see a cash payment as an earned refund on their taxes rather than a public handout. But that doesn’t mean the government won’t still get the blame if the checks come late or if some people think others are benefiting more than they are.

Bottom line: Americans’ views of the government are difficult to change. They will trust agencies and officials while they have to take quick action to avoid impending risk, but the crisis may also reinforce their view that the public sector is weak and unprepared. And while many Americans will welcome the benefits, they may consider any economic gain another success of the private sector — and any downturn a failure of government.

#IFTTT #Politics – FiveThirtyEight #politics #538 #Matt Grossmann

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gordonwilliamsweb · 5 years ago

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Must-Reads Of The Week From Brianna Labuskes

The Friday Breeze

Newsletter editor Brianna Labuskes, who reads everything on health care to compile our daily Morning Briefing, offers the best and most provocative stories for the weekend.

Happy Friday! In things I’ve learned today that I can’t stop thinking about: We apparently carry fat in our tongues? And you can lose it like any other fat on your body. This feels like something I should have known as a human, and yet I somehow managed 30-plus years without this information. Anyway, now that everyone is thinking too much about their tongues, let’s head to the news.

Democrats have asked the Supreme Court to expedite the case on the constitutionality of the health law, pushing for a ruling on the case during this term. This might seem paradoxical — as the lower courts have ruled against the ACA — but, as you Breeze readers know, the move is politically savvy. The health law is more popular than ever, and Democrats have been owning that advantage. If they can keep the Republicans’ attack on the legislation in the front of voters’ minds heading into the 2020 elections, there could be a repeat of the blue-wave midterms.

SCOTUS gave the Trump administration and Republicans until today to respond. (As of press time, they haven’t yet.)

The New York Times: Democrats Ask Supreme Court for Quick Decision on Obamacare

The Friday Breeze

Want a roundup of the must-read stories this week chosen by KHN Newsletter Editor Brianna Labuskes? Sign up for The Friday Breeze today.

Please confirm your email address below:

In a pretty harsh reality check, a new study this week found that a popular idea for cutting health spending doesn’t pan out when you look at the data. The strategy is based on identifying the hardest-to-treat, most expensive patients and better coordinating their care. But, despite the hype, the method didn’t cut hospital readmissions for those patients. The study highlights once again what we all know: Health care is complicated. And hyped-up promises to cut costs that sound too good to be true too often are.

Kudos to the evangelists of the method, though, for acknowledging it doesn’t work. “We could have coasted on the publicity we were getting,” said Dr. Jeffrey Brenner, a family physician in New Jersey who founded the program that was studied. “It’s my life’s work. So, of course, you’re upset and sad.”

The New York Times: These Patients Are Hard to Treat

The administrative costs of running a single-payer system in Canada come in at $551 per person per year. That seems like a lot, right? That’s what I thought, too, until I saw the total for Americans, which is *drum roll* $2,497 per year.

Los Angeles Times: U.S. Health System Costs Four Times More to Run Than Canada’s

California Gov. Gavin Newsom has proposed that California get into the drug-selling business — generic drugs, that is. The theory behind it is to increase competition and drive down prices. But despite generics accounting for 90% of the prescriptions filled in the country, they aren’t really the problem when talking high drug prices. It’s uncommon for those types of meds to only have one player in the marketplace, so pricing already tends to be competitive. For the average person, Newsom’s plan wouldn’t make much of a dent.

Los Angeles Times: Q&A: What You Need to Know About Gov. Newsom’s Drug Plan for California

But a strategy some people are hoping would make a difference is the VA model. The troubled federal agency might not have many bright spots these days, but patients who get prescriptions through Veterans Affairs are less likely than other insured Americans to skip doses and less likely to delay filling prescriptions because they were unable to afford them. What’s more, the program seems to curb racial disparities in accessing meds.

Stat: The VA Approach to Buying Drugs Means Patients Are Less Likely to Skip Medications Due to Cost

Mark your calendar: The annual J.P. Morgan Healthcare Conference runs through next week, and, as it nears, Stat looks back at the past 20 years of the event and how it has shaped the health care world. What emerges is a story of heroes and villains, booms and busts, sensational scandals, drinks and deals, flaring tempers and foolish predictions, and far more drama than anyone could expect from health care industry executives.

Stat: The Ghosts of JPMs Past: How 20 Years of Deals Have Shaped Health Care

In the latest sign that red-state resistance against Medicaid expansion is fading, Kansas Democratic Gov. Laura Kelly fulfilled a campaign promise by reaching a deal with Kansas Senate Republican Leader Jim Denning after a years-long impasse between the state’s two parties. Denning is eyeing a tough reelection race for next year — which could make the decision all the more notable.

The Wichita Eagle: Kansas Governor Kelly, Senate GOP Leader Reach Medicaid Deal

In a rare glimpse of good news, cancer death rates plummeted dramatically over a one-year period in the largest drop ever seen in national cancer statistics dating to 1930. The reason? Advancements in lung cancer treatments.

The Associated Press: Cancer Group Finds Biggest One-Year Drop in U.S. Death Rate

The back-and-forth over whether baby powder can be linked to ovarian cancer is the debate that launched 1,000 lawsuits (plus a couple of thousand more). A big study, however, tries to put the matter to rest. Research — that was deemed “overall reassuring” — now shows there is no strong connection between the two.

The Associated Press: Big Study Finds No Strong Sign Linking Baby Powder & Cancer

In the never-ending finger-pointing game that signals a reckoning in the opioid crisis, major drugstore chains like CVS and Walgreens are saying, “Nuh-uh, not our fault!” Instead, they say, doctors are to blame. Who are pharmacists to question doctors’ orders? The counter-argument, of course, is that when you’re filling prescriptions that equate to thousands of pain pills per person in a town you’re serving, it might be expected that someone would raise a red flag. Just maybe.

Experts say that by bringing up the doctors and providers, the drugstore chains could also be trying to complicate the case further, in hopes of mitigating some damage to themselves.

The Washington Post: Major Drugstore Chains Sue Doctors in Sprawling Federal Opioid Case

In the miscellaneous file for the week:

— You’ve heard of ambulance-chasing lawyers, but what about ambulance-chasing doctors? It’s becoming a growing practice for doctors to promise plaintiffs in personal-injury cases free upfront care with the hope of cashing in when the settlement comes. While the strategy is legal and doesn’t technically violate any ethical rules, it still seems a little off — and can also leave patients with big bills if their lawsuits don’t go as planned.

The Wall Street Journal: Who Wins in a Personal-Injury Lawsuit? It Can Be the Doctor

— Public health experts are warily watching the development of a pneumonia-like illness in China, with echoes of the SARS outbreak not distant enough not to draw comparison and concern.

The New York Times: China Identifies New Virus Causing Pneumonia-Like Illness

— As we continue to watch suicide rates skyrocket, experts scramble to figure out what can be done to halt the disturbing rise. Now, research suggests hope could come from an interesting strategy: raising the minimum wage by just $1.

NPR: For Suicide Prevention, Try Raising the Minimum Wage, Research Suggests

— A truism that has emerged for me over my decade-plus in journalism is that where there’s a catastrophe or disaster, there is someone who stands to gain something. In this case, it’s the windfall that will come to hospitals if the flu season is as bad as predicted.

Bloomberg: Record 2019-2020 Flu Season May Be Good for Hospitals

On that cheerful note, that’s it from me. Have a great weekend!

Must-Reads Of The Week From Brianna Labuskes published first on https://nootropicspowdersupplier.tumblr.com/

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stephenmccull · 5 years ago