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Kamal Shah

Kamal Shah

Hello, I'm Kamal from Hyderabad, India. I have been on dialysis for the last 13 years, six of them on PD, the rest on hemo. I have been on daily nocturnal home hemodialysis for the last four and half years. I can do pretty much everything myself. I love to travel and do short weekend trips or longer trips to places which have dialysis centers. Goa in India is a personal favorite. It is a great holiday destination and has two very good dialysis centers.

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Wednesday, 23 February 2011 19:35

Are your shoes cleaner than mine?

Most dialysis units in India have a sign outside them that asks people to leave their footwear outside. This is to make sure that dirt does not enter an otherwise supposedly clean and hygienic area. So, patients and their attenders religiously follow this and leave their footwear in the designated area and only then go into the dialysis unit.

People who manage the unit however, do not follow this instruction for the most part. Hospital management, staff, dialysis technicians and nurses barge in to the unit almost always with their footwear on. Why this discrimination? Are your shoes cleaner than the patients'?

If regular footwear is not allowed, it should be not allowed for everyone. If it is allowed for hospital staff, it should be allowed for patients as well.

I have never understood this. I thought this was restricted to one or two hospitals. I was wrong. This is prevalent in many hospitals.

I dare not point this out too. Already, my being proactive has landed me in some trouble. I can do without more!

... http://www.kamaldshah.com/2011/02/are-your-shoes-cleaner-than-mine.html

One more mistake many people doing EOModelling with WebObjects make - unnecessarily locking attributes.

In the EOModeller tool, all new attributes come with the locking option set to 'on'. I have no idea why. This really should have a default of 'off'. The locking attribute is used when an update is being made to the database. During the actual update, the attributes that are set as 'locked' are used in the 'where' clause of the update query being sent to the database.

Typically, you would only need the primary key when you are updating a single row. Now, if you have set another attribute to be locked and you are trying to update that same attribute, you will get a 'GeneralAdaptorException'. That's because, you set the attribute to be locked and you are trying to update it!

The problem is the tool sets everything to be locked by default. What I have started doing is to set everything to unlocked except the primary and foreign keys which you never ever update in WebObjects. That has worked well for me.

Does anyone have any more insight into this?

... http://www.kamaldshah.com/2011/02/make-sure-you-do-not-lock-unnecessary.html

I have made this mistake more than once in the past.

In WebObjects, when you create a relationship between two entities using the EO Modeller, the tendency is to create the reverse relationship as well. Let me give you an example. Let's say you have two entities - Programmer and Project. One programmer can belong to only one project and a project can have many programmers (unless of course, the programmer is Shravan Kumar Mahankali, who usually can finish off entire projects, especially WO ones, single handedly!)

So, here, we need to create a to-one relationship from Programmer to Project. In the process, you have an option to create the reverse relationship (a to-many) from Project to Programmer. The advantage of creating these relationships is you can get the desired destination object(s) of the relationships by a simple method call - programmerObject.project() or projectObject.programmers(). This can be a great convenience. Without this, you would have to manually write code that would create the fetch specification and then call it - a good few lines of code!

The reason behind this is in the good old days of WebObjects, when everyone and his uncle used Apple's EOModeller tool, the reverse would always be checked by default. For all you rookies who have started using this fantabulous development platform recently, the EOModeller tool that comes with WOLips has an option that you need to select manually.

Think hard before creating the reverse relationship. Are you going to ever need the reverse relationship? Actually, even better, are you going to be using the reverse relationship frequently? After all, if ever you need the reverse relationship objects, you can always write the code for a fetch specification and get them.

The reason I am stressing on this so much is that WebObjects gets the reverse relationships in anticipation of them being used, even if they are not actually ever used. So, if you get the project object at any point in your code, WO will automatically get the programmer objects as well if the reverse relationship is defined. This may be all right if you have a few programmer objects associated with the project. However, if the number of objects can get large, this could be a recipe for disaster!

... http://www.kamaldshah.com/2011/02/beware-of-reverse-relationship-in.html

In India, dialysis professionals do not refrain from using cell phones during procedures such as starting and closing sessions. I am not sure about other countries.

This is totally unacceptable. You may be an expert at what you are doing. But please spare a thought for the poor soul on the bed. He has had a life-changing diagnosis. He is trying to come to terms with this. The procedure may be painful. It is quite daunting for him. Is your call that important that it cannot wait until the procedure is over? Ok, it might be another patient. Even if it is another patient, can it not wait for a while, until the procedure is over?

Heck, using cell phones while driving a vehicle is banned in our country! Then why is it allowed to be used during medical procedures?? Isn't this much more serious? There is a life literally in your hands!

This is something that medical professionals should really take seriously. A blanket ban on cell phones during medical procedures. That is the only solution.

... http://www.kamaldshah.com/2011/02/make-using-cell-phones-during-medical.html

Saturday, 19 February 2011 03:54

Uremic minds

I wrote about the mental aspects of kidney disease earlier too here and here. I find myself thinking about this in the past few days again. There have been, undeniably, some changes in my mental make up all along my journey with kidney disease. Isn't it natural?

When my peers were busy completing their master's in this field or that, I was grappling with basic survival - my initial diagnosis and a transplant. When my peers were getting married, I was trying to get a handle on my life by switching to Peritoneal Dialysis and get some period of sanity. When they started having kids, I had to switch to hemo and then get my home hemo setup done. Now, when I see them planning their kids' futures, I am battling comorbidities of long term kidney disease. With all this, can anyone be surprised that there are mental changes in me?

What are these mental changes? I tend to react strongly to small things. Two swallows do not make a summer. For me, often, one is enough to conclude that its summer. One small incident and I tend to generalize that that is how things are always. Working full time has probably limited that to some extent. The more someone thinks about his kidney disease, the stronger this warped thinking becomes.

People who are dealing with people with kidney disease on dialysis should always remember this. Families of people on dialysis, doctors, nurses, techs - please remember this. Please give them some leeway. Do not judge them based on such actions. Needles take their toll. They cause bumps on the hand - and the mind as well.

... http://www.kamaldshah.com/2011/02/uremic-minds.html

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