L.C. Clark's Blog, page 8

Transonic Monitoring for Dialysis Access

   The Transonic Hemodialysis Monitor uses ultrasound Doppler and ultrasound dilution (Transonic) as an addition to typical vascular access monitoring done in hemodialysis centers.  The monthly transonic test shows the access blood flow.  Knowing the access flow helps to watch out for blockage and measure the function of the fistula/graft in aid of making the access serve longer.  This equipment is attached to the line while the patient is on dialysis as seen on the photo above.
   A fistula can last up to 35 years, however, maturation takes three to six months, in rare cases, can take up to a year which is too long to wait for someone requiring dialysis.  For some patients, the fistula may never mature.  Mine refused to mature.  It was abandoned and a graft was placed instead.
   Grafts have a lifespan of approximately 4 to 6 years but can last longer, up to 10 years with proper care.  Thanks to Davita’s Transonic lady, Maria Tancioco, I get information that my 7 year old graft, through Transonic shows pretty good function.  According to Maria the typical blood flow for graft is 500ml per minute, mine is consistently at 1400ml per minute as per recent test.  
   “Measurement of flow could reduce thrombosis, increase thrombosis-free and secondary patency in arteriovenous fistulas, and reduce vascular access-associated costs”.  Vascular access maintenance such as Fistulagram, an X-ray procedure to check for blood clots or blockages and Fistuloplasty, a procedure to open blocked or narrowed fistula by stretching with a special balloon are expensive and painful.
   The sad thing is that I’ve been with several different dialysis centers managed by different providers and I found the Transonic Hemodialysis Monitor only in Davita.  That means a greater number of centers are not fully equipped.  
See also:Lifestyle Choice with Dialysis Living on Dialysis Response to John Oliver

A Glimpse of Taiwan

    Taiwan from my plane window.         On my recent flight to the Philippines, I got the chance to try EVA Airlines.  EVA is a Taiwanese international airline based at Taiwan Taoyuan International Airport near Taipei.  I had been in Beijing, Bangkok, Hong Kong and Saipan airports but I had never landed in Taiwan before.
   From the Chinese Civil War between Chiang Kai-shek's Republic of China and the Communist Party of China led by Mao Zedong, ROC was established in Taiwan.  Chiang Kai-shek moved the ROC capital to Taipei.  Under the One-China Policy of the PRC, ROC is not recognized as an independent representative of China.  


   As the world ignores Taiwan, I didn’t know what to expect at the Taoyuan International Airport.  I thought it was admirable that the airport has a library, a reading area and wall décor that encourages reading.  

   I was impressed that the Taoyuan Airport devoted a space for prayer that had three prayer rooms, one for Catholic, one for Muslim and one with a swastika on it.  
   I couldn’t read the Chinese characters beside the controversial symbol which has become known as the emblem of the German Nazi Party.  Good thing my walking Google of a daughter enlightened me. 
   That actually, “the symbol has been used by Hindus, Buddhists and Jains for millennia and is commonly assumed to be an Indian sign.” (www.bbc.com)  The oldest swastika pattern has been radio carbon-dated to 15,000 years ago.
   In fact the swastika was used by American military during World War One. The nonthreatening uses came to a halt when the Nazis used of the swastika to symbolize the Aryan race, a white god-like superior race.  Ukraine National Museum of the History has exhibits of swastika engraved treasures.  A number of phallic objects shows that the swastika pattern was used as a fertility symbol.  
   World War Two gave the swastika a dark meaning.  It became the symbol of suppression, and extermination of the Jews in Europe called Holocaust.  Back then it was used against the Jews, in today’s world it’s against any nation of color.  Swastika is now an emblem of hate, racism and evil.  
   “Consequently, Jehovah saw that man’s wickedness was great on the earth and that every inclination of the thoughts of his heart was only bad all the time.” (Genesis 6:5)  
See also:Racial Divide Creator of Poverty Racial Bullying in Dialysis Center

Picture of Being in Love

   Our perception of another person’s looks registers through the eyes but is interpreted by the brain.  If we know for a fact that the person is a senior citizen, no amount of make-up will get us to see a twenty year old.  The camera has no brain.  What it sees is what you’ll get.
   When I was with the love of my life, I took our daughter to a photo studio for a mother and daughter portrait.  I was so beautiful in the picture that it didn’t look like me at all, just like my photos while pregnant.  Back then, people said it was because I was having a girl.  That’s a Filipino superstition.  My looks in photos went back to my normal after the love of my life walked out on us.
   Fast forward to 2009, I visited the grave of the same “love of my life” at 57 years old.  Upon review of my photos taken beside his grave, it showed me looking no older than thirty.  My features were modified by one of life’s little mysteries.  Just as some people’s hair turn gray almost overnight or they shrivel and look older beyond their age as an effect of tragedy.  My proximity to him made me beautiful as it did when he was alive.  On the way home, my face changed slowly back to the way it was, not ugly but fifty something Asian.
   There seems to be a level of being in love that only the camera lens can see.  It's beyond scientific explanation.  Haven’t you ever wondered why some couples look so good together?  Yet each one is not as good looking without the other.
   Was it chemistry that sitting next to his ashes made me look young?  Was it the power of being in love, which I am still?  Was it a reflection of happiness that comes from the depth of the heart, in knowing that I would be buried next to him, and will rise with him in the resurrection of the dead?

  “Your dead will live.  My corpse will rise up. Awake and shout joyfully, you residents in the dust!” (Isaiah 26:19)
 See also:The Vow of Faithfulness Greatest Love Story Love at First Sight

Killer Dave

   Filipinos are rice eaters.  It took me ten years in America before I acquired a taste for bread.  It’s been said that wheat is good for the health.  I tried the wheat breads sold at Target.  Subway sandwich shop has Grain Wheat Bread, Italian, Flatbread, Honey Oat, Monterey Cheddar and Italian Herb and Cheese.  I tried them all.  I still would rather eat rice plus whatever Filipino dish comes with it.
   Then I found this bread with an intriguing logo.  The logo is a thug looking man playing a guitar.  The product name says Dave’s Bread with the word killer scratched on top.  It could either mean Killer Dave’s Bread or Dave’s Killer Bread.  The second is quite discomforting.  Why would a baker want to brand his consumable product “killer”?  So, what’s the deal with Killer Dave? 
   In 2005, co-founder Dave Dahl came back to his family bakery after serving 15 years in prison.  He worked tirelessly to develop a new recipe for organic and Non-GMO bread.  Dave’s Killer Bread was born.  Today, it is the #1 organic bread in the US.
   The website claims “the Best Bread in the Universe”.  I agree!  I love that there’s thin sliced so I don’t get over stuffed with carbs.  My favorite is the Organic Bread, Good Seed (70 calories).  It has tons of sunflower and sesame seeds so it stays with me longer.
   Then, I went to the Second Chances link.  What I found blew me away!  It says “At Dave’s Killer Bread, we have witnessed the power of Second Chance Employment: hiring those who have a criminal background, and are ready to change their lives for the better. It gives people a second chance not only to make a living, but make a life.”
   The Dave's Killer Bread Foundation aims to remove the stigma of a criminal record and show that Second Chance Employment is life changing.  It invites industries to become a second chance employer.  It’s common knowledge that businesses are hesitant to take a risk.  The foundation wants to share their information and understanding about employing people with criminal backgrounds.
   Under the heading “STORIES FROM THE PEOPLE WHO MAKE YOUR BREAD” are stories of employees who have been imprisoned.  This is what touched my heart, “approximately 1 in 3 of the more than 300 employee-partners at the company’s Milwaukie, Oregon bakery has a criminal background.” Employee-Partners!
   “for this means my ‘blood of the covenant,’ which is to be poured out in behalf of many for forgiveness of sins.” (Matthew 26:28)
See also:The God of the Poor Creator of Poverty Who Created Sunday

Dropout and Proud, The Autodidactic Polymath

   My life changed every five years or so like clockwork.  I was a Media Representative selling television show spots and newspaper advertising space for 5 years.
   Then, I was a public transport operator.  It started when I bought a beat up 45-seater mini-bus with no franchise.  That’s called colorum, a slang for illegal public land transport in the Philippines.  I went to the Land Transportation Franchising and Regulatory Board (LTFRB).  I got my bus a franchise to run legally.  It plied the Cavite City to Baclaran route.  Eventually, I got tired of owning a vehicle I couldn’t drive.  It was too big for little bitty me.  
   I sold the bus and bought a pre-owned 1990 Nissan Sentra and got it a franchise to run as a taxi cab.  Two years later, car brands gave an offer I couldn’t refuse, PHP50K downpayment for a brand new unit.  I sold the Nissan Sentra for PHP150K and put a down on one Toyota Corolla, one Mitsubishi Lancer and one Nissan Sentra Series 3.  I got all three new cars a franchise to run as taxi cabs.  I paid the car loans with the income.  That business was a great ride but then personal computers became more affordable.  
   After 5 years, I sold the taxi units and bought a Macintosh because my multimedia designer son, Chris told me the MAC was idiot friendly.  I taught myself the office applications.  The MAC had an encyclopedia installed in it.  I was living next to a university so I thought of putting my MAC into business by doing term papers for PHP200 fully printed ready for submission.  A year later I realized I’ve gotten good enough for an administrative job.
Ayala Avenue, Makati City
From: wikimedia.org   After 2 short stints in small companies as Administrative Assistant, I was ready for an Ayala Avenue office.  There I went from Administrative Assistant to Administrative Manager in two years.  I loved it there.  I stayed for 8 years until an opportunity to come to America dropped on my lap.
Loretto, KY, From: wikimedia.org   I flew to a small county called Loretto, Kentucky, population 623, all white.  I was probably the first Asian they ever saw.  A friend said I was brave.  My second job in Kentucky was Executive Assistant to the Retail Executive of a bank in the city of Louisville.  That job lasted for 4 years. Louisville, KY
From: wikimedia.org   All the above mentioned experiences are not rocket science but when I heard my father say “my daughter can do anything she puts her mind to,” I felt like I won a Pulitzer.  
   Someone said I must be a genius.  Another said I’m just restless and reckless.  I thought I was psycho, until I found this term: Autodidact Polymath, a self-taught person whose expertise spans a significant number of different subject areas.  “An autodidact may or may not have formal education,” (Wikipedia) They are mostly dropouts like me.
   I have never in my life pretended to have a diploma, which is easily faked.  I’m not a genius, just an Autodidactic Polymath and my father is proud of me.
See also:A Filipina's View of Rural KentuckyBonifacio, Erap and Gov. Vilma Santos Loving the Job 

Liam Hemsworth in My Eyes

   Liam Hemsworth, Miley Cyrus' man,  is famous. I have not seen any of his films.  That shows how out of touch I’ve been.  Then, I chanced upon The Duel in HULU, on one of those days when the shows I regularly followed were off season.  
   Liam Hemsworth as David reminded me of Reb, the real man on whom the character in my book REBEL was based.  I know it sounds unbelievable, how David and Reb, one American and the other a Filipino, could actually be mirror image of each other.  However, the full beard, the uncut uncombed hair, the deep set eyes would have made them identical in black and white where skin color didn’t show.
   Reb was stocky like David, not tall and skinny but not overly muscular.  David spoke like Reb, with calculated words and manly tone that gets attention without trying.  The dusty, worn-out, 1800's fashion trousers of the western film incredibly matched Reb's dusty, worn-out loose blue jeans he wore in 1969.
   The way David walked, the way he moved, the way he hid in the bushes, the way he fought a fist fight, the way he taught his wife Mirasol fire a gun and the hurt in his eyes when she turned against him, were all reminders of Reb.
   Reb didn’t wear a western gun holster like David.  He tucked his 45 caliber in his back.  He didn’t ride a horse but rode a 1000cc motorcycle.  David shoots on his horse.  Reb shot at his target with his right hand while his left held the motorcycle handlebar.
   When I was writing the book Rebel I failed to describe Reb more accurately for lack of an existing photograph of him.  After I saw the movie The Duel, I realized the book does not do him justice.  Now I realize he's a Filipino Liam Hemsworth I let slip away.  My regret went a notch higher.See also: An Excerpt from REBEL Paperback Writer - Book 2 Blog’s 4th Anniversary

The First Matriarch

   “Matriarchy is a social system in which females hold primary power, predominate in roles of political leadership, moral authority, social privilege and control of property,” 
   The first matriarch, was the first woman, the first wife, Eve.  In the Book of Genesis 2:18, “Jehovah God said: ‘It is not good for the man to continue to be alone. I am going to make a helper for him, as a complement of him.’”  Then in verse 22, it reads “And Jehovah God built the rib that he had taken from the man into a woman.”
   Let us backtrack a little.  In verse 16-17, before Eve came into being, it says, “Jehovah God also gave this command to the man: “From every tree of the garden you may eat to satisfaction.  But as for the tree of the knowledge of good and bad, you must not eat from it, for in the day you eat from it you will certainly die.”
   Eve was updated about that command when she arrived at the scene.  We know that because she said to the serpent in Genesis 3:3, “God has said about the fruit of the tree that is in the middle of the garden: ‘You must not eat from it, no, you must not touch it; otherwise you will die.’”
   A mere three verses later, Eve makes the first matriarchal decision: “she began taking of its fruit and eating it.  Afterward, she also gave some to her husband when he was with her, and he began eating it.” (Genesis 3:6)  Adam followed her wishes instead of the powerful God who created and loved him.
   There was another tree in the garden, the tree of life, which they were not forbidden to eat from, until they disobeyed the commandment, “in order that he may not put his hand out and take fruit also from the tree of life and eat and live forever, with that Jehovah God expelled him from the garden of Eʹden” (Genesis 3:22-23)  The tree of life could have given them unending life in paradise.
   Her decision gave her descendants, the whole of mankind, a death sentence.  Soon enough, Eve’s second child, Abel was murdered by her first, Cain.
   From Eve, imperfection was inherited.  Matriarchs have risen from the most unexpected places.  In Asia, where women are petite and demure, came the Filipina.  


The Filipina   The Filipina holds the purse string in the family whether a working wife or not.  Many of them work overseas to support Filipino househusbands.  Many fought the Revolution against Spain and WWII as guerillas.  They are shrewd business managers, assertive in any situation and adapts to the most difficult condition without losing charm and poise.  Thus, they make perfect matriarchs.
See also:Widow of the Living Overseas Filipina Wife, the New OFW Greatest Love Story

An Open Letter to President Duterte

From: img.rt.com   In the Bible book of 1Peter 2:13-14 it says, “For the Lord’s sake subject yourselves to every human creation, whether to a king as being superior or to governors as sent by him to punish wrongdoers but to praise those who do good.”  This is what you do, Mr. President.  You are reputed to be hard on criminals but supportive of those “who do good”.
   The list of your accomplishments in 2016 alone does not only exceed expectations of the Filipinos, they defy the normal standard of leaders all over the world.  I have here a link to the long article of Pia Ranada from www.rappler.com.  I picked a few of what I believe to be of utmost importance.“Mega Drug Abuse Treatment and Rehabilitation Center in Fort Magsaysay, Nueva Ecija inaugurated. It is being run by the Department of Health.”  Drug users are not being exterminated as bias news claim.  Those who are willing to undergo rehabilitation gets it for free.“One-stop service center for OFWs opened…has served 219,697 clients as of December 7, 2016…P455.1 million in emergency assistance extended to 10,233 OFWs displaced… in the Middle East. Of these, 2,401 availed of the government’s repatriation program.”  For the first time in years, OFWs are being assisted.“No report of laglag-bala (bullet-planting scam) since start of Duterte administration.”  CT Scan in Maguindanao Provincial…”“911 National Emergency Hotline launched”“The Presidential Agrarian Reform Council…is reconvened for the first time after 10 years…The Department of Agrarian Reform (DAR) distributes land ownership awards to 50 farmers in Cebu City, 35 farmers in Sorsogon, 175 in Occidental Mindoro, and 300 in Bukidnon and Lanao del Norte.”“271 new weather stations installed by Department of Science and Technology (DOST).”“49% or 3,965 out of 8,000 target Yolanda families transferred to resettlement sites in Tacloban.”

   You have your hands full with the overwhelming problems of the country.  However, please permit me to bring to your attention the plight of kidney disease patients.  Dialysis, the treatment for kidney disease is unaffordable to the common Filipino.  Without dialysis, the patient dies within 3 days to 3 weeks.  Most chose to die and forego treatment if it means a child will have to quit college, or the family could lose residence by missing on rent payment, or worse there is simply no money to pay for one more treatment.  Philhealth is helping some and PCSO pitches in.
   Richard Nixon, a disgraced US president, provided to dialysis patients a law that has been keeping millions alive.  I believe that if there’s any Philippine president who can do the same, it’s you.
   “there is no authority except by God; the existing authorities stand placed in their relative positions by God.” (Romans 13:1)  That same God saw it fit to put a cursing, toughie in power.  That same God reads the heart of men and must have liked what he saw in yours.(1Chronicles 28:9)
Note: This article has been tweeted to the President and will be circulated to his social media pages.

See also:An Open Letter to President Trump Response to John Oliver Lifestyle Choice with Dialysis 

Response to John Oliver

   I have been a dialysis patient for seven year this August 10, which anniversary I celebrate each year.  The first two years I did dialysis at University Kidney Center in Louisville, KY.  On the third year, the center was bought and operated by American Renal Associates.  I have been on dialysis vacationing, which put me with Satellite Healthcare in California and B. Braun Avitum in the Philippines.  I listed the providers to show I have been around.  Right now I am with DaVita.  
   I saw Dialysis: Last Week Tonight with John Oliver.  John Oliver made good points but I would like to offer a reality check.  The episode focused on DaVita making it look like DaVita has an exclusive on “bad incentives, poor oversight and profiteering”.  Bad incentives, poor oversight and profiteering describe the entire healthcare system in all of America, maybe even the entire world, not just one Dialysis provider.  I have nothing against John Oliver but he should have researched other dialysis providers and made a comparison to be fair.
   The DaVita four stars rating from Medicare which John Oliver found unbelievable comes from a survey mailed to patients.  I am one of those patients who have given those stars.  The rating doesn’t say DaVita is perfect, four stars is not five stars.  However, patients of other dialysis providers suffer wrongful death arising from staff negligence or unqualified technician resulting in hemorrhages, “lawsuit against American Renal Associates that alleged it was responsible for a woman’s wrongful death…Sheila Marie Workman died on Sept. 23, 2013…There was a large amount of blood found under her treatment chair.” (wvrecord.com)
   Fresenius Medical Care owns dialysis clinics and provides many of the products used by other hemodialysis centers.  NaturaLyte Liquid Acid Concentrate and Granuflo Dry Acid Concentrate, both provided by Fresenius was found to cause heart attack, cardiac arrest or death during hemodialysis, information about the risk of using Granuflo and NaturaLyte was withheld by Fresenius, “at least 941 dialysis patients treated at Fresenius clinics suffered cardiac arrest during treatments in 2010.” (www.youhavealawyer.com)
   The episode quoted a supposedly DaVita Educator as saying patients have declined transplant because they are comfortable with their life on dialysis.  John Oliver reacted to this as incredulous.  Reality check, I am one of those patients who have declined transplant for five years until Flora Chan, a DaVita Social Worker convinced me last year.  I got on the transplant list.
See also: An Open Letter to President Trump Racial Bullying in Dialysis Center Paperback Writer

An Excerpt from REBEL

   A reader of REBEL said that he thought the part about the main character Gina and Reb, a married couple living with her second husband and his second wife under the same roof was pure fiction because it seems unthinkable.  I’m sorry to disappoint but that part of the book along with the rest of the book is pure reality.  People do unthinkable things when the situation dictates.  Here’s the excerpt in question:
   “She realized she would be losing sex with Reb, with Marites under the same roof.  Despite her radical views on life, a three way or four way was not acceptable.  This could mean the end to her sex with Reb.  No problem, there’s still Anton beside her every night.
   That night, Anton loved the idea.  That it came from Reb showed cracks on the three way relationship.  Anton knew Gina’s big ego would not be comfortable with another ‘cook in the kitchen’.  He didn’t have to meet Marites to know, this would be the beginning of the end.  There was some gamble in sharing an address with a wanted couple, however, Reb was already sleeping in his living room anyway.  If he refused this move, it would make him the bad guy.
   “I understand why we need to do this.  We need to help Reb get on with his life so he can enjoy the same happiness we have found with each other,” Anton said, searching for any resentment she might have towards Marites.  He saw nothing.
   The two couples moved into their new place.  Gina got comfortable that Reb has a permanent shelter.  Anton felt like someone playing Bingo, with one number missing to win.  Everyone seemed happy.  Marites most of all.  Reb has finally committed to her.  He played his role of a newly coupled, sweet and loving, particularly when Gina was around.
   The first few months went smoothly.  The two men, as usual, were careful not to mess things up.  Gina and Anton got to go out more often knowing Jojo was in good hands.  She was no longer afraid of Reb taking the boy away, since they all lived in the same place now.  Unlike the neighborhood they left, no one here knew about their relationship.  They seemed like two normal couples sharing an apartment.
   As time moved on, Martial Law made a dent on the movement’s activities and finances.  Reb’s rent money started to dwindle.  Gina made up for the shortage from her own monthly budget that came from Anton’s salary.  It was making life difficult but if the alternative would put Reb out of shelter.  She would rather suffer it.”- end of excerpt.
   All the characters are in their late teens in the 60’s, when life for teens in the Philippines got exciting!
See also:Kabataang Makabayan (KM), In Hindsight Paperback Writer - Book 2 Blog’s 4th Anniversary