(I've written an explanation elsewhere of why disclaimers of this sort may be necessary.) 

Tuesday, June 30, 2009  

Call me foolish, but I signed up to run in the Kenwood Footrace again.

It's a 10 kilometer race (6.2 miles), held every year on the 4th of July in Kenwood, a little town near Sonoma, California. There are various things I like about the event: it's conveniently near where I live, a lot of people participate in it, there's always a lot of spirit, it's more affordable than most community races, and the rural setting is attractive.

The only big thing wrong with the race is that the course involves a lot of hill-climbing, so it's a difficult race to run fast. Last year I was hoping to make my best time ever in it, and instead made my slowest time ever because of a problem which caught me by surprise: a pain in my right hip flared up suddenly, two miles into the race. I was able to keep running, or at least hobbling fast, but I sure didn't set any speed records. Whatever happened to my hip, it took a long time to heal (the pain would sometimes come back during long runs, for a few months afterward). I hope whatever it was doesn't come back. It shouldn't -- it didn't come back during the Napa Marathon in March (which was longer), or during The Relay in May (which was hillier). I wish I knew exactly what it was that caused my sudden hip problem during last year's race; if it was something I did wrong, I'd like to know what it was, so that I can avoid doing it this time.

But it always is a gamble, signing up for these things. No matter how ready you think you are to run the race when you register for it, there's always a chance that you'll have a surprise coming to you on race day. I guess that's why there's always a feeling of tension (much like stage fright) while you're waiting for the starting gun. I'm getting better at handling that; I used to get an upset stomach while I was waiting, and I'm past that stage. All the same, there is always tension, which is a little odd because nothing much is riding on how well I do in the race. There isn't any possibility that I'm going to win it, and nobody is going to care whether I turn out to be the 200th or the 500th person to cross the finish line. It's important to my health to keep exercising, but it's not important to my health to do well in a race.

On the other hand, it's hard to keep exercising if you're utterly indifferent to how well you do at it. You want to feel as if you're making progress. Participating in events like this helps me stay focused on, and interested in, my daily exercise routine. So, anyway, I'll run the race on the 4th, and I'll try to do better than last year. Unless I hurt myself again somehow, I'm pretty sure I can do that.

Monday, June 29, 2009  

The heat wave that started on Saturday seems to be over. When I went running at lunchtime, it was warm enough that I took a water bottle with me to be on the safe side, but it stayed in the 80s.

I was slow today, more or less by design. I felt that my long run yesterday, when it was hotter, took something out of me, and I didn't want to push myself too hard today. None of my running buddies were available to go with me today, and I wasn't under any pressure to keep up the pace. So, I just relaxed and jogged along.

In the evening I went to my yoga class, and we had an easier-than-usual class, with several relaxation poses. Maybe that's why my blood pressure was down this evening. That, and the successful resolution of the glucose-meter crisis (an imagainary crisis, it seems) which I described yesterday.  

I'm going to continue using the meter I have been using, but checking it occasionally against the new one I bought yesterday to make sure they still agree (they did this morning). The reason I'm not making the new meter my primary one is that it's a stripped-down model which lacks some of the memory features that I had grown accustomed to.

And now I must close, as I have task of learning a song from a recording that's in the unspeakably difficult key of A-flat minor, and then figuring out how to play it in the less difficult key of C minor. I'm afraid I'm going to have to play it at a rehearsal tomorrow, and I want to be at least half-way ready not to embarrass myself. 

Sunday, June 28, 2009  

I had a real crisis of confidence today. Maybe "crisis of confidence" is not the phrase I'm looking for -- "episode of paranoia" might be a better fit. Anyway, lately I've been maintaining two incompatible views in my head at the same time: on the one hand, congratulating myself (rather publicly) on the great results my glucose meter has been showing me over the past year -- and on the other hand worrying that my glucose meter might have something wrong with it which is causing it to read low, and therefore I'm just making a fool of myself by bragging about good results that aren't real. Until today the self-congratulatory view has been winning out, but I couldn't quite get rid of the nagging concern that maybe my meter was playing me for a fool.

This morning, when I read the fasting result of 72, I began to feel like the film noir protagonist at the moment when it dawns on him that he's being had, that the woman who talked him into murdering her husband is also arranging for him to go to take the rap for it. I looked at that number on the meter, and thought "72? This is too good to be true, and I've been an idiot to believe it. This meter has something wrong with it. My glucose has probably been high rather than low for months now, and I've been eating way too many carbs because I was fooled into thinking I was getting away with it!". My mind raced ahead to the humilating retractions I was going to have to post on this site, and maybe on the dLife forum too.

But what if my meter wasn't reading low? I had a long trail-run planned for this morning, and maybe I needed to take in some carbs, just to make sure I didn't conk out during it. (We've been having a heat wave this weekend, and I knew the run was going to be difficult.) I had a fairly high-carb breakfast, and I took off for the state park with a glucose gel in my pocket in case I got hypoglycemic while I was on the trail.

I picked the trails that offered the most shade; I did get tired and unsteady on the steepest climb, which made me wonder if I was having a blood sugar problem in one direction or the other, but generally I felt okay. When I got home I felt as if I might possibly be low (although fatigue and dehydration can make you feel the same way, and I lost a little over 5 pounds from sweating during the run). I checked; my meter said 113. How could I verify that?

I then remembered that I had been sent a free meter in the mail, from a company hoping to get me locked into buying their test strips. I had tried the meter a few times, and it seemed to me that the thing was erratic, giving results that varied too wildly to be plausible. But what if it was accurate and my usual meter was not? I tested with that free meter, shortly after testing with my usual one, and the result said 160 rather than 113!

That was when my confidence went into deep decline. I thought I had finally seen through the deception: my usual meter was telling me what I wanted to hear, instead of telling me the truth. All my boasts about how well I was managing my diabetes were based on false information.

And at that point I had to leave the issue alone for a while, and go attend to something besides my own problems. A member of a musical organization I belong to has been struggling with cancer, and a bunch of us had arranged to go to her house and play music, to see if we could raise her spirits. As often happens with cancer patients who have a particular event to focus on, she was able to store up a supply of energy for the occasion, and instead of listening to the music from her sickbed (which had been her original expectation), she was out in living room playing with us the whole time. Sometimes what cancer patients need more than anything else is something interesting to do. Spending all your time concentrating on being sick doesn't energize you, but it can be energizing to spend a bit of time concentrating on the things that you enjoy about being alive.

I'd like to be able to say that visiting someone with a bigger medical problem than mine caused me to achieve a sense of perspective about my diabetes worries, but the truth is that I couldn't let go of the glucose-meter issue, and I was getting depressed about it. On the way home from her house, I was thinking about what I should believe about the two meters, and why. I decided to do an experiment with test fluid rather than blood. When I got home and did that, I only found more reasons to suspect that the free meter I'd been sent was erratic in its measurements. This time it read 27 points lower than my usual meter, instead of 47 points higher! Also, my usual meter gave a result in the middle of what its range was supposed to be with test fluid, which seemed reassuring. Okay, so what the hell was going on?

I decided to buy a new meter, as I didn't trust either of the two I had. I went to the drugstore and bought one, brought it home, and decided to do a 2 hour post-prandial test after dinner, comparing my usual meter against the new one.

The results: the new meter agreed with my usual one. The two readings were 110 and 111, which is more than close enough to be considered the same result, given the repeatability specs for glucose meters. So, essentially, I had allowed myself to experience a bunch of emotional turmoil today, over a problem which seems to have existed only in my imagination.

I think I'm going to throw away that free meter that was sent to me. You know the saying: a man with one watch knows what time it is, but a man with two watches isn't sure. I certainly don't want to have three glucose meters, and if I'm going to get rid of one, it's going to have to be the one that, on the same day, gives results well above, and then well below, the other two. If one of the three is unreliable, it almost has to be that one. The odds seem to be heavily against both of the others being defective in a way which causes them to agree very closely with each other.

By the way, my blood-pressure reading of 125/75 was measured after today's crisis of confidence rather than during it. The result might have been very different if I'd taken it earlier in the day!

Friday, June 26, 2009  

My two-week fasting average is down to 79. I never thought I'd see that happen. I'm sure most experts would have predicted that it couldn't possibly happen. I read so often about the inescapable progression of diabetes (it always gets worse as time goes on, anyone who thinks he can reverse it is deluding himself, blah blah blah). So how come, after 8 years of treating diabetes without medication, my results are better than ever? Even if we agree that I am violating the laws of nature, there still remains the interesting question of how I am managing to do so.

Not that everyone is interested in that question. Where diabetes is concerned, a lot of people don't want to hear about exceptional cases. Somebody on the dLife forum told me, if I understood her correctly, that she has relatives who are very well informed about current scientific thinking on diabetes, and they they say someone like me cannot exist. So there.

Well, call me biased, but I can't let go of the idea that I do, in fact, exist, and that my medical history is as I've described it. So, if I have done what can't be done, why was I able to do it?

I can only offer a hypothetical explanation, but that's better than no explanation (or the hypothetical explanation that I don't exist). My hypothesis is that adult humans retain at least some capacity to experience change and growth in areas which we usually think of as permantly fixed, or even declining over time. The body adapts -- if we give it something to adapt to.

The "training effect" -- that is, the physical changes brought about by athletic activity -- are an example of what I'm talking about. Go to to the gym and hang around by the weight-machines, and take a look at the people working out there. Trust me: those people don't have those muscles because they were born with them. I haven't done anything that dramatic, but there are a few indications, visible to the naked eye, that my body has made some physical adaptations to all the exercise I've been doing since I was diagnosed in 2001. There are places (mainly on the backs of my hands and feet) where a network of blood vessels is bulging visibly under my skin. I never used to be able to see anything like that. Exercise, if you do it long enough, adds new blood vessels, and expands the ones you had already. The blood vessels I'm noticing under my skin were mostly there all along, but they weren't as big as they are now, and maybe that's why my blood pressure used to be so much higher in 2001 than it is today (even though I was taking blood pressure medicine then and I'm not now).

Our natural assumption is that we are born with all the blood vessels we need, and that we don't expand them or add new ones over the course of our lives. Maybe that's true for a lot of people, but it doesn't seem to be true for people who work out frequently. That must be at least part of the reason why they have a lower risk of heart attack and stroke. For them, the cardiovascular system is becoming stronger over time, not weaker.

Another assumption which most people make (at least those people who have a personal interest in diabetes) is that we are born with as many beta cells (the insulin-producing cells in the pancreas) as we are ever going to have, and that if we lose some of them to diabetes there is no chance of growing any new ones. Apparently this is not strictly correct -- the body does grow new beta cells. The problem is that it grows them slowly. For most people with Type 2 diabetes, beta cells are being harmed (by the effects of high blood sugar) faster than they are being replaced, so the replacement process can't keep up with the ever-increasing need for more beta cells. So, for most people with Type 2 diabetes, the body's capacity to produce insulin declines gradually over time. I have been assured this is inevitable, that there is nothing I can do about it. However, the fact that my fasting level has been going down over time suggests to me that my insulin-producing capacity must have been going up rather than down over the past year. Can it be that, by keeping my blood sugar within the normal range over an extended period, I somehow enabled my body to "catch up", and replace enough beta cells that my insulin-producing capacity is actually higher this year instead of lower?

I can't prove that this has happened, and I have been assured, by people who claim to be in the know, that this cannot happen. But if it didn't happen, what did happen to give me these results?

Until it is proved to me that my apparent success is an illusion, I'm going to continue to believe in it.

Thursday, June 25, 2009  

A mild day -- when I went running at lunchtime the temperature was in the low 70s. I ran today's very hilly route last week -- on two different days -- and my pace was 9:54/mile both times. Today it was 9:44/mile. (That's the same as my pace yesterday, but yesterday I ran an easier route, with less hill-climbing.) So, it's progress! Not a lot of progress, but progress all the same. My running buddies still finished ahead of me, but not by as much as yesterday.

A real runner would be able to achieve a much faster pace than 9:44, even on steep hills, but we can't all be real runners, can we?

I have a confession to make: I'm getting really sick of summarizing my meals every day on this blog. I started doing it on January 1st as a kind of New Year's resolution, partly in answer to a few inquiries from people wanting to know what I was eating. I thought that, over time, the creepiness of announcing what you had for lunch to anyone in the world who might be curious about it would wear off. It hasn't. I guess what I'm most embarrassed about is my hasty and unimaginative approach to breakfast. Not being a morning person, I allocate almost no time to the morning meal. I don't even see it as a meal, just a necessary chore which I must attend to before I can leave for work (take shower, put on clothes, fill stomach, lock front door).

Another problem I have with giving daily food reports is that I think it encourages the food obsession which distorts most people's view of diabetes. Nearly everyone who is diagnosed with diabetes has one question ("But what can I eat?") and one hope ("If I change in my diet, maybe this will go away"). Diet is certainly relevant to diabetes management, but I suspect that what you eat is not quite as important as how much of it you eat, and neither of those things is quite as important as how much you exercise. If I'm encouraging anyone to think that food-choice is the main issue in diabetes management, I want to knock it off, because I don't really believe that myself. After today I think I'm going to go to a different format.

Anyway, I've been reporting on my meals for six months now, and if anyone is curious to know what kind of foods I eat I can always refer them to my blogs from early 2009. I don't think the solution to the diabetes problem can be found in my food journal, though. My exercise journal, maybe.

I'll still comment on food from time to time, when I think I have something interesting to say about it, but no more daily briefings!

I'm not sure if this is about food or not, but what do you think of the message that Burger King is sending with this ad?

Save your eyesight, the fine print reads: "Fill your desire for something long, juicy and flame-grilled with the NEW BK SUPER SEVEN INCHER. Yearn for more after you taste the mind-blowing burger that comes with a single beefpatty, topped with American cheese, crispy onions and the A1 Thick and Hearty Steak Sauce."

Didn't Lenny Bruce go to jail for a comedy routine that was fairly tame compared to that?

Wednesday, June 24, 2009  

It was supposed to be hot today, about 90 degrees. Didn't happen. It was a comfortable 70 degrees for my lunchtime run. I went on a hilly route on which, last week, my best pace was 9:54/mile. This time I was a bit faster, at 9:44/mile. It didn't mean I was able to keep up with my running buddies, who are much better hill-climbers than I am, and who finished well ahead of me. When I met up with them at the end, they reported that they'd achieved a 9:05/mile pace. So, I made a little progress, and they made more. It's hard to see how I'm ever going to catch up with them if that trend continues. They hang back with me some of the time just to be sociable, but when they're feeling frisky and they think they can set a speed record for themselves, they go for it. Today they went for it. That's okay. Someobody's got to be the slowest one in the pack; that's my role and I fill it to the best of my ability.

It's surprising how dramatically a big bag of spinach cooks down into a small volume. I took a 6-ounce bag (which is bigger than it sounds), rinsed it, and put it in a covered pot on the stove, with no more water than what was clinging to it after the rinse. Spinach is more water than anything else, and the water is expelled as you cook it -- so that, instead the pot running dry from the cooking, it ends up with more water in it than there was at the beginning. The nutritional facts for that amount of spinach: only 10 grams of carbohydrate, 4 of fiber, 4 of protein, and none of fat (although, to be honest, I drizzled some olive oil on it). Also, 80% of my Vitamin C needs for the day, and more than 100% of my Vitamin A needs for the day. None of which would matter if I didn't like spinach, but fortunately I do. The only problem with spinach is the link to violent behavior -- but I looked into that, and it turns out that only Popeye is affected that way. The rest of us can handle it. Anyway, it's nice to have a satisfying vegetable dish that's so easy to fix and so full of vitamins.

More music-making tonight -- once again, creating order out of chaos, taking unfamiliar songs in awkward keys and gradually figuring out how to make something of them that works. But it doesn't leave me much time for blogging when I get home. Tomorrow will be more of the same. I like to be involved in intense musical projects, but I also feel relieved when they're finished and my schedule is no longer being taken over by them.

Tuesday, June 23, 2009  

Not much time for blogging tonight. I got home rather late from a music rehearsal, and I have to be up early tomorrow for a phone conference with some people in Israel.

My, that's a low fasting result; I assume the reason for it was that last night I had a rather small dinner, had it early, and had nothing to eat later. If this downward trend continues, I might actually have to start seeing midnight snacking as a good thing. But I'd have to see a pretty definite trend before jumping to that particular conclusion. I suspect that my actual fasting level is holding steady around 80 these days, and the vagaries of the meter cause it to read above or below that center point from day to day.

My weight isn't holding steady, though; it's climbing. My exercise intensity has been reduced in recent weeks because I've been trying not to push myself too hard while I wait for the last lingering effects of my cough to disappear. Normally I do an exceptionally long run on the weekend, and another on Wednesday, and lately I haven't been doing that. But I'm probably taking in as many calories as if I were still working out that hard. I find that it's pretty easy for me to make a change in my exercise habits, and pretty hard to make a change in my eating habits.

I enjoyed the rehearsal tonight -- six of us gathered at a quiet place in the country, working out arrangements for songs which, to some of us, were quite unfamiliar. We had no sheet music, and in some cases no chord charts either; we were trying things out, discovering what worked and what didn't. In other words, we were creating order out of chaos. It's a process that I love being involved in, at least when it works, and tonight it was working. It's good for the blood pressure.

Monday, June 22, 2009  

On Saturday I was buying some things at an Asian market (things that are either overpriced or unavailable in ordinary grocery stores) and I came across a box of White Tea, at about half the price I've seen it elsewhere. I bought it more or less automatically -- I'd been planning to try White Tea to see if I liked it, because of the health claims that are being made for it.

And then, while I was driving home, it dawned on me that I could not remember what health claims were being made for the stuff. I had a vague recollection that it had been shown to do some great thing or other, but whether it was supposed to lower my blood pressure, regulate my glcuose, cleanse my arteries, boost my immune system, or give me powers and abilities far beyond those of mortal men, I couldn't for the life of me remember. Whatever I had once heard about the stuff must have impressed me, or I wouldn't have made a mental note that I ought to try it. But that was the only impression that stayed with me -- that I ought to try it. Why I ought to try it was the part I couldn't remember.

I think maybe I should get out of the habit of reading about the magical healing powers of this or that foodstuff and laying in a stock of it. Often it turns out that I don't especially like it, and that subsequent research doesn't support the health claims that were originally made for it.

I didn't even know what White Tea was. Perhaps the name designated a different plant species, unrelated to the one from which tea is normally made? No, it turns out that the White Tea, Green Tea, and Black Tea all come from the same plant, and the difference is in how they are processed. White Tea is the least processed of the three (it is steamed, but not fermented); also, white tea contains buds, not just leaves, and the buds and leaves are gathered at an earlier stage in the plant's growth. Because it is comparatively unprocessed, White Tea retains beneficial properties that are at least partially lost to processing of other teas.

So then I looked it up what the benefits of White Tea are supposed to be, and I found a variety of claims, most of which are based on how it affects mice. The main claims are that the anti-oxidants in it act to prevent cancer, that it has antibiotic properties, and that it aids in weight loss by breaking down fat.

Anyway, I brewed a cup of it, and found that its flavor is on the subtle side -- you might call it "delicate" if you're in a good mood, or "weak" if you're in a bad mood. However, that was mainly my reaction when it still very hot; as it cooled a little in the cup the flavor seemed to get stronger. I didn't steep it as long as I was supposed to, so maybe it's my fault that it seemed weak at first. In the end I decided that it was a perfectly acceptable tea, but I didn't fall in love with it. (Not that tea in general is a subject on which my passions tend to run high, you understand.) I will probably take this tea to work, and use it to help me get through my mid-afternoon sleepy phase. And then I can sit there at my desk, fully alert if I'm lucky, and pleased to know that I am reducing my risk of getting cancer -- or at least my risk of getting mouse-cancer.

I didn't work out hard on the weekend -- in fact, on Saturday I didn't work out at all -- so I didn't take a rest day today. I think I'm giving up the idea of using Monday as my rest day. I think I'll start taking my rest day on the weekend instead. There are some advantages to that approach. For one thing, it means that I don't have to keep explaining to my running buddies at work why I'm not running on Monday. Also, it gives me a chance to free up a Saturday or a Sunday from a task that I might not have much time for. And I don't mind that I also have yoga class on Monday evening -- I don't see yoga as exercise, exactly; it isn't any harder to do yoga when you worked out earlier in the day than when you didn't.

It was sunny today during my run, but it was a bit breezy, and it wasn't uncomfortably warm for running -- about 82 degrees. Summer's getting off to a late start.

I don't care what anybody says about summer "officially" starting on the solstice (in other words, yesterday). There's no real basis for that, apart from journalistic convention. If summer means anything, it means the warmest three months of the year, wherever you are. Around here that would be June, July, and August. Usually it's warmer than this by June 1st. We're just getting a mild summer this year -- so far! Sooner or later we'll get a heat wave that will make the paint fall off the walls.

Friday, June 19, 2009  

Every Friday, an e-mail message from dLife News pops into my inbox, with a subject line which quotes the title of the lead article -- or, in some cases, the titles of two articles yoked together by a semicolon. For example: "Does Medical ID Work?; Finding Time to Exercise". When two titles are quoted, the combinations are sometimes a little incongruous:

The effect can be particularly strange when one of the articles is a recipe and the other is not, I find.

Today they really outdid themselves. My inbox now contains a message with the subject line:

Maybe that's a recipe I don't need to try.

I was expecting my fasting test to be up a little today, after a substantial restaurant dinner yesterday with a lot of carbs, and I was figuring it would be necessary to make today a low-carb day to make up for it. But my fasting test was 76, and I didn't think that argued in favor of a low-carb breakfast. So I had cereal. Fairly low-carb cereal, as breakfast cereals go, but I had a banana too. I didn't want to get hypoglycemic before or during my run today. (And I didn't, but I might have if I'd followed up on my intention to make an omelet for breakfast.)

It a bit warmer during today's run than it was during yesterday's -- about 85 degrees. I got thirsty before I was done, and I had to admit that we're now getting to the part of the year when I need to carry water with me, even on a run that's less than 5 miles. It wasn't warm enough to make it hard to run, though.

I've been too busy in the evenings, working on music, and getting to bed late. I'm sure I'll sleep late tomorrow to catch up, but it would be better if, on weeknights, I could find a way to get sleepy when I ought to be going to bed. I'm great at getting sleepy in the middle of the afternoon (that has always been my gift), but I'm never more wide-awake than I am at midnight. After work tonight I went to a yoga workshop on "restorative poses" -- resting poses designed to teach you to relax. I kept dozing off during them -- which is fine, and more or less par for the course, but I don't think I would have done it quite so much if I'd been getting enough sleep this week. (At least my blood pressure was good when I got home.)

I would probably be better off working the graveyard shift -- which would have been possible over the last month, when I've been collaborating remotely with software people in Israel. But after next week I'll be working with somebody here in California, so I can't just make that switch and stick to it.

It's a difficult thing being a nocturnal animal.

Thursday, June 18, 2009  

It's finally starting to heat up a little, after weeks of very mild weather. It was around 80 when I went running today. Not that 80 is very warm for California in mid-June, but I haven't been running in warm weather for a long time, and you have to get used to it gradually. I don't want it to get into the high 90s before I'm ready. If it sounds as if it would be impossible to run when it's in the high 90s, keep in mind that I'm in Northern California, near the coast, and the humidity is almost always low here. I can run when it's that hot, so long as it isn't humid.

I got a chance to find out what it's like to run in damp heat, during a business trip to Austin, Texas. It's amazingly difficult. It feels as if you're on a mountain top, and not getting enough oxygen. I suppose that isn't an illusion -- if the air is dense with water vapor, it can't be as dense with oxygen. The humidity crowds the oxygen out of the air, I guess. That's what it feels like, anyway. Runners who live in humid areas have to do their running early in the morning or not at all. When races are run in Hawaii, the start time is usually at dawn if not earlier.

Anyway, the warm-weather run today wasn't too hard on me, but I did have my usual summertime problem of not being able to cool down afterwards. I could take a very cold shower -- in theory. In practice, I can't take it. Today I took as cool a shower as I could stand to, but I would have had to stay in it a damned long time to get my core temperature down, and I needed to get back upstairs to work. So, I had to spend a long time mopping myself with a handkerchief after I dressed myself and got back to the office. I had to meet with a visiting manager from Scotland, too, which made me worry about the impression I was going to create, but fortunately our meeting was delayed for a couple of hours, and I was cool and dry by the time I sat down with him. It turned out that he's going to be moving here in August, and is house-hunting locally. I warned him not to assume that what we're having today is a heat wave -- it will get a lot warmer here by August, and he needs to get prepared for that. What I really meant was that I need to get prepared for that.

Some musician friends of mine were playing at a restaurant/bar tonight and I went there to have dinner and listen. It ended up being a pretty high-calorie, high-carb dinner, but most restaurant dinners are. I don't think I did myself any real harm, but my fasting test will probably be a bit higer than 82 tomorrow. I'll make tomorrow a low-carb day to make up for it.

The owners of the restaurant are from Tibet, but they like Irish music, and they hired my friends to play at their daughter's wedding coming up shortly; they invited them to play at the restaurant too.

Half-way through their set they asked me if I brought my fiddle and wanted to play a few tunes with them. I would have liked to play with them, but I hadn't brought my fiddle, because it was their performance, and I had no business showing up at it with an instrument that they hadn't asked me to bring. The etiquette of music-making is a delicate thing, and I try to play it safe.

Wednesday, June 17, 2009  

I ran exactly the same route today as I did on Monday, and according to my GPS unit I also ran it at exactly the same pace, down to the second. How's that for consistency? I was hoping to be a little faster this time -- a second faster, anyway -- but at least I'm doing better than I did last week. 

I started using the new batch of test strips, worrying that my low readings lately might be revealed today to have been an illusion created by a batch of strips that read low. Well, that's not the case, if this morning's fasting result of 76 is any indication. If there's any illusion here, it would have to be caused by the meter itself rather than the test strips.

My blood pressure is down, too; that's as much good news as anyone is probably entitled to in one day.

This evening I came home from work a bit later than planned, because I needed to meet with someone who was visiting from Santa Clara, late in the day, and he was held up. I got home feeling pressed for time, because I had to leave for a music rehearsal in Sebastopol soon. I was thinking at first that I didn't have time to prepare anything that would be good for me, and I should probably just get in the car and stop along the way for some kind of fast-food meal. But then I thought, why don't I see what I can do with the time I have? I had a bunch of vegetables in the refrigerator that needed to be used. I chopped up some purple onion, threw that into a wok with some olive oil and turned on the gas. While the onion was cooking I chopped up some garlic, asparagus, broccoli, mushrooms, red bell pepper, and seitan (wheat-gluten, a non-meat protein food), and threw all that in on top of the onions in the wok, and stir-fried everything with some Thai red curry sauce (thinned out with vegetable broth). I covered the wok for a little while to get everything cooked evenly, and soon it was ready. And it was good. Not all of my hastily improvised recipes work out well, but this one did.

I didn't time myself, but the whole operation couldn't have taken me much longer than 15 minutes. I still have just as many fingers as I did before. And surely the resulting dinner was better for me than any quick hunger-stopper I could have picked up while driving to the rehearsal.

The rehearsal was, once again, great. It took place in a quiet semi-rural neighborhood outside Sebastopol. When I arrived, our host's cat was catching a mole in the field in front of the house. Afterwards, when I left, I had a good clear view of the stars. And I recognized an old friend: the bright red star Antares, in the constellation of Scorpius. A factoid I have never gotten out of my head, since my days as an amateur astronomer, is that Antares, a "supergiant", is so large that if the sun were to grow overnight to the same size as Antares, the planets Mercury, Venus, Earth, and Mars would all find themselves well inside the sun. Don't panic, though: this is not likely to happen in your lifetime. The sun will turn into a red giant eventually (scorching us, though not literally engulfing us), but the crisis which will bring that transformation about is not expected for another 4 billion years or so. Relax, we've got time. Concentrate. Eat your vegetables.

Tuesday, June 16, 2009  

I'm about to start using a new batch of test strips tomorrow -- I hope it doesn't turn out that these low fasting test results I've been getting lately are an illusion created by a batch of test strips that read low.  I would expect to have a somewhat low reading today, because my dinner yesterday consisted mainly of vegetables. But 72? It almost seems unrealistic.

My recovery from the virus continues. I still have a little bit of a cough (once I get a cough, it hangs around forever) but I'm feeling good. My run today was at a faster pace than yesterday (9:48/mile), but it was a less hilly route today, so I shouldn't make too much of that. Still, it's nice to see some numerical confirmation of my subjective feeling that I'm getting stronger.

Had a nice evening working on a musical project with friends. We had quite an ensemble, and were working out arrangements. We had two singers, a guitarist, a bass-player, a drummer, a harpist, a concertina-player, and a dulcimer player. I was playing my fiddle, but not playing the melody as I usually do -- I was developing harmony parts, which is something I've always wanted to learn how to do. It turns out the way to learn how to do it is to do it. That's true of a lot of other things as well, I've noticed.

I'm going for the record at work: there are now five different people who have some claim to being my boss. I've met two of them in person (they're local), and spoken on the phone to two more (they're in Washington and Israel); the fifth one I have never met, although he's local -- I'm not sure he has even heard of me, but I'm to consult him on certain operational issues, and it's considered likely that he will become my boss in a more direct way later on.

When everybody is your boss, nobody is your boss -- a situation which has some superficial attractions, I must admit, but is not really good for your career. The freedom involved comes at a high price in anonymity, and anonymity makes you a natural target for headcount reduction whenever the next round of layoffs somes along. For that reason, I hope things will become simpler eventually. One of my bosses will be leaving the company next month, so that will narrow it down to four (only three of whom I'm actually in touch with currently). Of course, the main problem with answering to more than one manager is that you don't know what to do if you get conflicting directives from them. So far, that problem has not arisen. I'm hoping it doesn't, if only for the sake of blood-pressure control.

I just measured my blood pressure, and it was up significantly from yesterday; I don't know why, but maybe it's because I'm writing about work. So I'd better knock it off.

Monday, June 15, 2009  

If you want a low-carb alternative to chips and dip, try endive leaves (with their natural scoop shape) and hummus. Don't say I never told you anything useful.

My recent minor illness didn't have any lasting effect on my blood sugar or blood pressure, but my weight is drifting upward -- I've been exercising a bit less than usual, and eating more. I don't especially believe in the adage about feeding a cold, but when I have a cold (and I'm past the worst of it), I tend to crave high-calorie comfort foods, so I do tend to feed a cold whether I believe in doing so or not. For the past 2 weeks I've had little appetite for vegetables, and I'm sorry to say that I've had to throw away several that I didn't use in time (which always seems sinful, or at least embarrassingly dumb). I tried to make up for it by roasting a variety of them for dinner tonight.

Usually Monday is my rest day (apart from the yoga class) but I took it easy, comparatively speaking, on the weekend. I did a hike (and not a terribly long one) on Saturday, and a short run on Sunday. Usually I do a pretty long run on the weekend -- I think of the weekend as my opportunity to practice endurance sports -- but this time I was trying to take it easy in hopes of getting this cold completely out of my system.

Here was the trail I hiked on Saturday -- and a rather fearless mountain-biker I saw, about to plunge down a steep and rocky slope around the next bend. He must have made it, because I didn't come upon his body later in the hike.

Anyway, I didn't feel as if I knocked myself out so much on the weekend that I needed a rest day today. Also, I was feeling more energetic than I had last week and I wanted to see if I could pick up the pace a little today. It turned out that I could. I ran a very hilly route that we use a lot at work, and for the past two weeks my mile pace on that route has never been better than 10:13; today it was down to 9:54. So that's progress. And I felt good afterwards.

I felt good during yoga class, too -- that's been a struggle as well since the cough started a couple of weeks ago. So, another good sign. Also, my pupils are the same size -- no recurrence of that Adie's Pupil thing I had last week.

Now I have my sights set on the Kenwood 10K race, on the 4th of July. I usually run that race, even though it's a difficult one because it's a hilly course. Last year I was disappointed in my slow pace, which resulted from a sharp pain in my hip which developed suddenly during the race. I'd like to erase that experience this year, by running faster but not hurting. I don't know if I can actually do that or not, but there's only one way to find out!

Friday, June 12, 2009  

Oh, cool -- my pupils are the same size today...

...or pretty close to the same size, anyway. Certainly closer than yesterday. So I'm getting over the Adie's Pupil thing. My eyes still look like the eyes of a serial killer, but that's a separate issue.

My slow recovery from the cough continues -- I feel about 5% better each day. Today I actually felt pretty close to normal. However, I think I'm going to restrain myself this weekend from doing any extreme workouts. I was too hard on myself on the two previous weekends, which probably set back my recovery from this virus I've been suffering from.

Not that I'm going to slack off entirely -- I'll work out. I just won't push it too far.

My numbers look good today. Blood pressure is down; I think the reason why is that I had a big project to finish off this week, and I was worried about being able to meet the deadline, but it all worked out. Late this afternoon I was able to check in all the files that I needed to hand off to a software engineer in Israel, who has to get them by Sunday. I was afraid I'd have to work Saturday to make it happen. It happened today instead.

I'm going to try to take it easy tomorrow. I need to get a haircut -- that will be my big adventure for the day.

Thursday, June 11, 2009  

And now for something weird (but familiar, at least to me, because it happened to me once before). In the afternoon I was having slightly blurred vision in one eye. I checked in the bathroom mirror, and sure enough: I've got Adie's Pupil again:

Adie's Pupil is a rather rare condition in which one pupil is persistently wider than the other. The first time I had it (maybe 4 years ago -- and in the same eye, by the way), it alarmed me because I thought it meant I had a brain tumor or something. My doctor was concerned when I told him about it on the phone, but when he examined me and could find no other indicator of anything wrong, he referred me to an eye doctor. The eye doctor had to do some measurements on me and then do a bit of book research, but he finally concluded that Adie's Pupil was what I had. He said that it's not harmful, and it goes away by itself. The exact cause is unknown; it usually develops while the patient is recovering from a respiratory infection (which was the case with me at the time, and also happens to be the case with me this week). Remarkably, the condition has never been blamed on diabetes -- surely a first in the annals of clinical medicine.

The last time I had this, the difference in pupil width was more dramatic, and it took a few days to go away. The case I have today is milder, and it's fading faster. It's now been about 5 hours since I noticed the problem in the bathroom mirror, and right now the pupils appear almost equalized. Unless something else happens I don't think I've got any reason to call my doctor.

I'm still continuing my slow recovery from the cough; I did a slightly longer run today. It still wasn't easy, but I felt better during the last mile than I had during the first, and I felt better rather than worse afterwards.

I was playing with some friends at a pub on the weekend, and we captured the attention of a very tiny junior musician.  He was fascinated by the musical instruments and wanted to take part. We let him beat on a hand drum for a while. He didn't exactly stay on the beat (neither do a lot of 40-year-olds I could mention), but he brought to the performance such a hilarious mixture of shyness and exuberance that it was a treat for us to have him there.

It would be nice if all of us could find acceptance everywhere, just by hanging around looking cute. (But then, I guess we'd also have to look cute.)

Wednesday, June 10, 2009  

My slow recovery continues. I ran again today, and again it was harder than usual, and again I felt good afterwards, so no harm done. Numbers are good.

A question posted on the dLife forum today, about the difficulty of fitting exercise into one's daily schedule, made me wonder how this very familiar complaint would sound if we applied it to life's other basic chores:

I've never heard anyone talk that way about working, bathing, sleeping, or eating, but everyone talks that way about exercise.  I think this is a psychological issue rather than a scheduling issue.

If we want to do something, it gets done. If we don't want to do it, but we accept that we have to do it, it gets done. If we don't want to do it, and we haven't yet accepted that we have to do it, then we have a schedule problem.

So, I'd say the first step towards finding time for exercise (and any other time-consuming aspect of staying healthy) is accepting that, yes, indeed, you have to do it. Don't try to talk yourself into it, don't debate the matter with yourself -- just accept the idea. Make it one of your basic assumptions about life. File it away in the same mental cabinet where you keep your copy of the Fifth Commandment. Just settle the matter in your mind, permanently: yes, I have to do it.

Until you get over that mental barrier (and many people never do), you tend to waste a lot of time making half-hearted efforts to talk yourself into doing what's necessary, and often failing. So long as you continue to see exercise and other health habits as optional extras, this will be a roadblock for you, and it has to be eliminated. Once it is, getting your workout done will come as naturally to you as any of the other basic tasks of daily life. Yes, unexpected things do come up in life, and sometimes you don't get to work out when you want to, just as you sometimes can't sleep or eat when you want to -- which doesn't have to stop you from making up for it as soon as you get the chance.

I have it easier than a lot of people in this regard -- the circumstances of my job make it easy to exercise in the daytime, on most days at least. Occasionally my schedule at work leaves me with no way to fit in a workout, but in that case I find a way to get the exercise done in the evening. I seldom miss a planned workout simply because of schedule problems. If you're operating on the assumption that you have to do the exercise, you will usually find a way to get it done. If you are operating on the opposite assumption, you will find nothing but obstacles in your path.

Tuesday, June 9, 2009  

Okay, I felt better today, and my test results were better. I wouldn't say I'm fully restored to health, but I felt better today than I did yesterday, and I bet I'll feel better tomorrow.

I thought it was okay to risk going for a run. As it turned out, the run felt only a little more difficult than usual, and I didn't feel bad afterwards, so I assume it did me no harm. And it has to have done me good, because... uhm, because I think so.

I try to be scientific about this, but you can only carry that so far. There are always going to be a few decisions you have to make based on intuition or a leap of faith.

Rosiglitazone, a diabetes drug which recently received a bunch of negative publicity because of a study which seemed to show that it increases the patient's risk of heart attack, has been kinda sorta vindicated by a 5-year study called RECORD (Rosiglitazone Evaluated for Cardiac Outcomes and Regulation of Glycaemia in Diabetes). The study found that the risk of most cardiac events for patients taking rosiglitazone is no worse than for older diabetes drugs such as metformin or sulfonylureas. The study notes somewhat airily that "the only adverse finding was a doubled risk of heart failure", but this was balanced out by lower rates for other problems, such as stroke.

Based on the summary article I read, it sounds as if rosiglitazone was only compared to other diabetes drugs, not to behavior-based methods of controlling diabetes. So the study only tells me that rosiglitazone is no worse than competing drugs -- which to me is like saying of a scandal-plagued Wall Street firm that a careful study uncovered no evidence that it was any worse than its immediate competitors. Okay, fine, but that's not saying much.

Somebody on the dLife forum has been evangelizing rather feverishly for a type of surgery called the Duodenal Switch, mainly intended as a cure for obesity but also found to be very effective against Type 2 diabetes.  I looked it up to see what the procedure involves. Holy Mackeral, it involves:

I'm told this works really, really well for diabetic mice, and also for diabetic people in those countries where the procedure is freely available. Americans may need to go overseas to have it done. (That sounds attractive -- who wouldn't want to combine major abdominal surgery with long-distance travel?)

I would guess that humanity, like the small intestine, can be divided into two unequal parts: those who look at the illustration above and think, "Man, I gotta get me some of that!", and those who don't. I don't.

Monday, June 8, 2009  

I woke up Sunday morning feeling fine -- seemingly quite well recovered from the bronchitis I'd been suffering from recently. As it happened, I had long ago registered for a 10K footrace in Sonoma that was being held yesterday, and I figured I might as well go ahead and run it. I didn't think I could run it fast, but I felt perfectly able to do it. So I did it.

My time of 58:59 would normally be nothing to brag about, even for a slow runner like me, but the fact that I was home sick on Thursday and Friday (and legitimately so) entitles me to some kind of extra credit points. So I'm going to call that a pretty good performanace under the circumstances.

However, the way I felt after the race made me realize that it must have been too soon to try something like that. I was much more tired than I had ever been after a 10K race before, and I also felt chilled and weak, and some of my cold symptoms started to reappear. I think I set my recovery back a few days. I did work today, and I managed to do a gym workout without difficulty, but I'm sure I would have been feeling a lot better today if I hadn't done the race. I also think my fasting blood test (only 98, but for me that's unususally high) and blood pressure (133/82 -- definitely high for me) would have been better. I just pushed myself too hard.

My habit of using exercise as daily diabetes therapy has also got me in the habit of assuming that a really hard workout will always make me feel better rather than worse. And 99% of the time it does! Not 100% of the time, unfortunately. All the same: I think my basic approach of not shirking a workout if I can help it is a good one.

Hot news from the American Diabetes Association's 69th Scientific Sessions (in New Orleans last week): an international committee of experts has recomended that the Hemoglobin A1c test, which indicates how much glucose has been in the blood over a period of about three months (rather than how much is there at a given moment in time) should be used as the standard diagnostic tool for diabetes. Their reasoning is that the A1c test, which is not "fooled" by short-term fluctuations in glucose levels, catches many cases of diabetes that are missed by other kinds of testing. (When a hospital in Boston tried giving the A1c test to every adult patient who checked in there, they discovered that a startlingly large percentage of the patient population was diabetic -- but didn't know they were, because glucose tests had missed it.)

Of course, what needs explaining is not why this change is a good idea, but why it wasn't made years ago. It seems to be a true no-brainer. Given the volatility of blood glucose levels, it is obvious that we can't rely on a test which provides only a momentary snapshot of a fast-changing value. The larger trend is more important. If the A1c test is equivalent to the Dow Jones average, the plasma glucose test is equivalent to picking one stock at random, asking how it did today, and taking that as proof that the market is down. And yet, strange as it seems, the plasma glucose test, and not the more sophisticated and useful A1c test, is still the standard diagnostic tool for diabetes. It's as if climate scientists were trying to keep track of weather trends by writing down any jokes David Letterman happens to make on the subject. 

Saturday, June 6, 2009  

Okay, I'm back -- life resumes now.

I stayed home from work Thursday and Friday (something I don't often do), and spent most of those two days alternately reading and napping. And, of course, coughing, but that had diminished greatly by Friday evening, and when I did cough it didn't hurt, so my bronchitis episode was clearly winding down.

When I say that I was "reading", I actually mean re-reading. When I'm ill, I don't have enough mental energy to take in anything new. I fall back on familiar tales. In this case, classics -- The Aspern Papers by Henry James, and Dangerous Liaisons by Choderlos De Laclos. These are pretty unhealthy classics, to be sure. The James story is about a literary scholar, an obsessive collector of the relics of a famous poet, who tries to perpetrate an outrageous confidence trick on a reclusive old lady, in hopes of filching from her the letters that the poet wrote to her in her youth. The Laclos novel is about a heartless pair of French aristocrats who amuse themselves by corrupting a teen-aged girl purely for the sake of humiliating her husband-to-be. Both novels are about people who have become isolated from society as a whole -- so isolated that they no longer see any reason why society's rules should apply to them. These are stories of illness -- moral illness, of course, but with a lot of emphasis on the separation from the world that any sort of illness can impose on us. When we are ill we are no longer part of society. I didn't consciously choose these books with the intention of ramping up my feeling of unhealthy isolation, but that was the effect. I guess my unconscious mind decided that, if I was going to inhabit the world of the ill for a while, I might as well be wallow in it. Maybe this had the effect of making me appreciate the return to health all the more.

Anyway, I felt a lot better yesterday evening (and went to the gym for a rather easy workout, which was more than I could do on Thursday), and today I felt better still. I thought I should ramp up the exercise a little today, but I also thought it might be too early to go for a serious run. So, I decided to go for a hike instead. That's something you can always do at an easy pace if you need to. I figured I'd just amble around at a reasonable pace, stopping to take pictures often. This worked out quite well; I felt fine all the way through.

My hike was in the local state park, my favorite location for outdoor exercise of all sorts. This is one of the state parks that our governor (you've probably heard of him -- a fellow named Schwarzenegger) is planning to close because of the California fiscal crisis. Well, he can "close" it if he wants to -- but if he wants to keep me out of there, he'll have to spend a lot more money on that effort than he ever spent on keeping the place in operation. I can't believe the park is actually costing the state significant money. The park has no facilities to speak of, apart from 2 outhouses and one drinking fountain, and maintenance of the park seems to consist of removing trees that fall across the trails during winter storms. Part of what I like about the park is that it's "unimproved" -- it is simply what the inland hills of California look like without human intervention.

The trails themselves seem to be maintained naturally by all the people hiking, running, and mountain-biking over them.

And, of course, there are the equestrians -- whose contribution to the trails is a little less helpful, in my view.

The park doesn't exactly have a well-defended perimeter, so I'm pretty sure people who want to get in there will always be able to get in. I hope so, anyway. For years that park has played an important role in my exercise program, and therefore in my diabetes-management program. I'm not giving that up just because a bunch of cranky old men in Sacramento can't agree on a budget.

Thursday, June 4, 2009  

Sick day today -- I'll be back when I'm more functional.

Wednesday, June 3, 2009  

My cough was driving me crazy today. I'm not really all that congested, but that horrible tickling sensation is impossible to ignore, so I keep coughing and hurting my throat. I've been using menthol cough-drops, and they haven't been giving me much help. I did some internet research, and it appears that theobromine is now believed to be more effective even than codeine as a cough-suppressant. You can't buy theobromine as a supplement, but fortunately there is a food which contains a lot of it: dark chocolate.

Chocolate is usually not something that people with diabetes regard as a health food, but I was able to find a variety that is advertised as "sugar free" (it's full of malitol, though, which has less impact on blood glucose than real sugar does, but not zero impact, as some would have us believe). Anyway, I tried some after dinner. The verdict: yes, it did help a lot with the coughing. Yes, I did enjoy it. No, the effect did not last more than a few hours.

Even if it's "sugar free", I can't be downing chocolate bars several times a day until my cough goes away, so I'm not sure this is a real solution. However, because I am desperate to get some sleep tonight instead of lying awake and coughing, I'm going to have a half a bar of the stuff before I go to bed. If my blood sugar is elevated in the morning, I think I will decide that this is not an appropriate midnight snack.

Further research indicates that a more practical solution is to buy cocoa powder (which has more concentrated theobromine in it than chocolate bars do), and make a sugar-free hot cocoa from it. Maybe I'll try that tomorrow. 

Tuesday, June 2, 2009  

Although I felt better in general today than I did yesterday, my cough is worse and it's making my throat sore. So, I thought I had probably been pushing myself too hard and should knock off the heavy exercise for today. I went to the gym and did 30 minutes on the stair-climber. It's a pretty minimal workout, but I figured that's about as much as I need to be doing today.

There was a TV right in front of the stair climber, with no sound and no subtitles. It was showing "All My Children", the same show that was on the last time I did a workout in that gym on that stair-climber (and that was weeks ago). Based on what I could glean from the purely visual aspect, nothing has changed on that show in recent weeks. The same bearded guy is still in jail, the same baby is still in intensive care, and the same young woman with red hair is still spending too much time with the same arrogant bad-boy. Not knowing much about soap operas, I wonder if these shows are sort of frozen in time (like the old Peanuts comic strip), with the basic situation preserved forever like a fly in amber. I don't know why I find that depressing but I do -- which I guess is why I usually prefer exercising outdoors, where I don't have to keep track of such things.

I was playing music with friends tonight, and I had a few coughing fits that were pretty disruptive and embarassing, but for the most part music took my mind off the cough (just as exercise does). When you have a cough, you need a distraction. A horror movie would probably work, except that watching a horror movie would just create a bigger problem for me. I have much too active (and too vivid) an imagination; if I go to a scary movie, my life is not worth living for the next several days, what with all the monsters hiding in the bushes by my porch and the axe-murderers hiding in the back seat of my car. It isn't worth it.

There was another cake at work today -- a dark chocolate fudge creation about the size of an ottoman. It wasn't anyone's birthday, though, and no fuss was made over it, so I wasn't under any pressure to have any. I was tempted, though, especially when I got hungry around 4 PM. I resisted the temptation. It's nice to know I'm capable of that. With the very light workout I did today, there was no way I could rationalize having a dessert between meals, even though rationalization is pretty easy when you're feeling hungry.

My fasting test was back down today, and blood pressure down somewhat despite the coughing fits. I hope the cough settles down pretty soon. I'm supposed to run in a 10K race on Sunday, and I'd like to start feeling strong again by then. 

Monday, June 1, 2009  

Maybe my long run yesterday was a bit premature. I felt fine, then; but today I felt pretty weak all day. I managed to run, but it was a struggle. It's a good thing I ran, though, because two of my immediate coworkers had a birthday and there was a cake in the afternoon, and it would have been bad politics to refuse to have any. Just as well that I'd gone running earlier in the day.  I was coughing more today, but curiously enough the cough went away while I was running. Then it came back. That's an odd phenomenon I've noticed before: if I exercise while I'm slightly ill, the illness recedes for the duration of the exercise. Prompt, temporary relief. Very prompt, and even more temporary.

I suffered from insomnia last night (not because of the cough -- I just couldn't get to sleep). This affected me today, certainly in terms of the way I felt, and perhaps also in the slight increase in my fasting glucose (and the greater increase in my blood pressure).

I wasn't sure that I felt okay about going to my yoga class tonight. I was afraid that I'd feel too unsteady for the standing poses (especially the balancing-on-one-foot poses), and in fact I did have some trouble with those, but I didn't disgrace myself. With yoga, as with exercise, I generally go ahead and do it, if I'm not feeling well but I'm not feeling so awful as to be sure I can't do it. I give my body the benefit of the doubt, because I assume that, even when I'm under the weather, both exercise and yoga are likelier to help me than to hurt me. We did a lot of yoga poses tonight designed to lift and open the chest (counteracting the tendency most of us have, most of the time, to curl forward and collapse the chest). I think it was helpful to me.

But I need to get more sleep tonight than I did last night, so I'd better bring this to a close.

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