Tamara Unleashed

After a week of daily exercise, sometimes feeling the effect of the drug on my appetite and sometimes feeling starved and one day of really low energy, I face my weigh in today with trepidation. If it was another week of minimal loss I would be very disheartened.

Fortunately I lost 4.5# which is just over 5# in 2 weeks which is going to be help reinforce my improved behaviors. Today was day 21 of exercising.

The journey continues.

I was on Hold for 3 hours and 33 minutes listening to muzak and messages telling me that most things can be handled on line and that I will be asked to share personal information that they can share. I cleaned out my inbox that had over 3300 items. I found 2 that I wanted to respond to. I read several articles, ate lunch and was just trying to figure out what to do next when the SSA representative answered. I appreciated that she did not apologize for the long wait.

I explained what I needed and she said I can do that online. Essentially I just need to do a new application using my SSN. She stayed on the line until I was well into filling out the application. I did plead for her to give me an appointment anyway just in case. It was at this point I explained that I had heard from 2 sources that I did need an appointment and I had waited on the line for 3 and a half hour just to get an appointment. I was extremely pleasant. I was not upset with HER at all. I would have asked her some questions about how she was doing, but that would’ve just taken time from someone else.

I successfully filled out the application except I made a mess in the part about prior marriages that I am not sure now this happened. There is no data marriage one; marriage 1 looks like marriage 2 and marriage 2 looks like marriage 3. The system would not accept application like this so I entered the data in the right places for marriage 1 and 2, and deleted data from marriage 3 except there is yes/no button for one question that cannot be undone (or at least I can’t figure out how to do it). Thus I get error messages for all of the fields not filled in for marriage 3. While I can save the application, I cannot submit it because of the yes/no button.

So now I face another call and likely long wait or just keep the May 1 appointment.

Before the call ended, the representative asked me to make sure to cancel the appointment if I don’t need the time which I said I would of course plan to do. I asked her how to cancel and she said to call the national number I had waited 3.5 hours to get an appointment. REALLY.

I had assumed I would get a email confirmation of appointment with option to cancel. Clearly there are improvements to the software and overall user experience, but the 3 SSA representatives I have spoken with over the years have be very pleasant knowledgeable and professional.

While I had the time today to do the wait and get my issue dealt with, most people would not be able to wait it out. I could Hate the federal government because of this experience but I don’t. Imagine the outrage if someone wants to access mySSA.com and there is a ERROR message that the server is offline for updates. Constituents would call their Congressional members to complain and the members call While House.

No matter what the challenge there is significant disruption associated with trying to solve or improve the problem that will negatively impact constituents who will complain. There is disincentive at every level to change. So things remain outdated far longer to avoid the complaints from angry constituents complaining about how poorly the government works.

A real conundrum.

I had intended to wait until I was 70 to start collection Social Security under my own number as I was eligible to collect survivor benefits from my first husband. I had NO idea this was the case until a SSA employee told me in a consultation in 2021 when I initially filed. With all the uncertainty, I decided to go ahead and convert 6 months early. I went online and was not able to figure out how to make this change.

Yesterday I left a message at the extension of the Nashville SSA employee that had been so helpful. The extension no longer belonged to Tonya, but I thought what the HECK. I also called the Nashville SSA office and waited on line for about 25 minutes before I got dropped. This was midafternoon.

This morning I found on a AARP website that this sort of conversion needs to be done in person so I called the Nashville office in hopes there was an option to just make an appointment. After waiting about 30 minutes, it sounded like I was being connected and then line went blank with no Muzak or messages, but I was still connected. I wasn’t sure what that meant but I waited 5 minutes just to make sure it was not the “next in line” place.

I decided since I was in Nashville anyway, I might as well drop by the office to see if I can walk in or at least get an appointment. The very nice security person just inside the door confirmed I did need to make an appointment to make that change but there was no way to make an appointment in person. He suggested I call the National SSA number rather than the Nashville number. I dialed from the parking lot.

There was an option for “make appointment” and then I was told it was a 120 minute wait to make an appointment. I have been waiting 1 hour and 9 minutes thus far. I will be ignoring all calls – anything that might accidentally disconnect me from this call.

To be fair, it may have been this bad BEFORE the recent mass firings of probationary employees but I doubt it.

One of the recorded messages is to please stay on the line to provide feedback which I will and hopefully the survey separates the system experience from the SSA employee experience because I expect the experiences will be quite different. I do hope people are not being too hard on the Federal employees right now. They are not at fault here.

If I am successful in getting an appointment, it may all be for naught if the government shuts down. Such a SHIT show.

Craig’s friend Susan (and now mine as well) moved from Prescott AZ to Lafayette IN a few years ago to be near her only remaining cousins. It was a decision that made sense post Covid but it did not work out as planned for a variety of reasons. The winter weather was very isolating and COLD. Susan was resigned to making do because the thought of moving again was stressful. Six weeks ago Craig and 2 friends (Dan and Bill from Prescott and Kingman AZ) decided it was time to get Susan back to Prescott where she has more friends, the weather is much warmer and the support services for older persons are excellent. A perfect duplex was quickly identified in Prescott. The hardest part was Susan accepting the short term stress of a move for the longer term gain. Many things fell into place (no lease penalties on her current place and new landlord renting below market rate) and the choice became obvious. Over the past 3 weeks Susan has been packing and I have been assisting as a Project Manager although Susan is super organized and has required little support.

Craig and I are driving up to IN on Sunday and will get the moving truck on Monday and start loading. We are going to trailer her car behind the truck so we can both drive. Susan will fly to AZ on Tuesday after we are done loading. A 3 day drive after the stressful month of packing would be cruel and unusual punishment. It is a 24 hour drive which we will do over 3 days starting Tuesday. Susan will get to Prescott Tuesday night and stay with Dan until we arrive at the end of the week with her possessions. We will get her stuff unloaded and unpacked enough to ensure she is functional in her new space before we fly back to Indy on Tuesday the 25th to get our car and drive back to Nashville.

We did investigate using a moving company or pods but we wanted to be sure we could make the moving in process as easy as possible. The only way we could be sure we could be there when the stuff arrived was to drive it.

I am very much looking forward to the car trip and look forward to seeing that part of AZ. I have never driven a big truck with a trailer so there will be a bit of a learning curve. I may not change lanes very often. I am sure there will be a few blog worthy experiences on this adventure.

Stay tuned.

At Nashville Tools for Schools, one of the least favorite tasks is to manually clean the metal that is used to make the metal support for rectangular tables. The metal comes from source coated in oil which must be removed with solvent before it can be welded and/or painted. This requires meticulously wiping down every surface of the metal bars with the solvent. Not hard but BORING.

There are soaking tanks that can be purchased for this purpose, but they are expensive and often for smaller pieces than needed for the tables. So Craig decided to undertake fabrication of large piece of equipment that would eliminate the need for manual cleaning of the metal pieces. This has been a labor of “love” for the past 2 weeks. In stimulating his creative and problem solving juices, he was able to pull his attention away for the daily depressing news for several hours at a time.

He was able to source most of the parts from the many, many things he has collected in his shop over the decades. He did need to purchase the soaking tank. He found a great metal oblong metal box with a hinged, rubber sealing lid long enough for the pieces that NTFS uses at a very reasonable price. Unfortunately what was delivered did not have a hinged, rubber sealed lid. As it turns out, the price on the tank that he purchased was an error and they sent the box that went with the price. Craig sent a very polite letter back to company and asked for the product he ordered at the price he ordered it which was on his invoice and still on their website. I was curious how they respond but they agreed to pay to ship the wrong tank back and send the tank he ordered if he paid for the shipping of the second, correct tank. This was still a great deal over what the correct list price was.

In the meantime, he used an old bed frame to make the metal support frame to hold the tank and secured it to a wooded platform on wheels so it could be moved around. The metal bed frame is a lot thinner metal that what he is used to working with so his welding skills improved. Once the tank arrived he had to customize it for the following functions. The soaking solvent needed to be pumped out, filtered and then pumped back into the opposite end of the tank to move the solvent from one end to the other to improve cleaning. While the filtered solvent can be reused for a long time, eventually it will need to be changed so he added a drain to the tank.

He fabricated a metal box for the pump that was placed inside the tank with a hose pumping the solvent out.

On the right side, there is the power source for the motor to pump the solvent through a red diesel fuel filter. The filter exit hose is secured along the underside of the tank to the opposite end where it is pumped back into the tank. He installed a switch to easily operate the pump.

On the opposite end is the faucet where the filtered solvent is pumped back into the tank and the drain in the corner. Below is the yellow on/off valve for easy drainage.

The final step was to install some crosswise bars along the bottom of the tank so the solvent can circulate under the pieces. There are extra pieces of rebar in a purple container on the outside to lay down between the multiple layers of the metal pieces to ensure the solvent can do its work.

Today he has had the pump on for several hours and it is working well.

We can’t wait for the next order for tables to come in so the guys at Tools can enjoy NOT having to manually clean the metal.

As you may recall, Craig and I built this barrier to keep water running from the adjacent pasture onto our yard and it has been quite effective for that particular spot. Later in the year we added some tree trunks along another fence line using the tractor.

With a couple of winter rain storms we had lots of downed branches, some of which were quite large. Saturday and Sunday were nice days so I undertook cleaning up the fallen tree parts. To the right of the big barrier we built last year, there is a gently slope so some water is still coming across the fence line and ending up on our driveway. There are plans for moving more tree trunks in place with the tractor. I can’t use the tractor to move tree trunks so I decided to make my own “less effective” barrier with by tree debris.

While this is obviously not water tight, I don’t think it will take a lot of encouragement to send the some of the water down the hill in the pasture rather than our yard. Craig wisely didn’t share with me exactly how ineffective he thinks this will be. I called this functional strength training on my fitness app and enjoyed the outdoors. Every little bit helps.

This is how spokesperson for Musk’s Starship launch described last Wednesday’s post launch explosion. I registered to the end of a couple of Rachel’s podcasts to find the terminology. When I heard it, I thought I would not forget it, but I did.

Great term for what is happening with our federal government. A new acronym – RUD

Due to my cooking, Craig has put on about 15 pounds. Over the past several months I have worked pretty hard to help him not gain more – I think successfully. Today he announced that he was going to lose 5 pounds by next Sunday.

My response to him is Good for you!!! I will do what I can to help.

My internal response is NOT FAIR. He will likely be successful while I am struggling.

This is yet another male/female difference. My observation is that with calorie reduction and increased activity males can generally count on losing a few pounds but this is not necessarily the case for women.

I could sabotage his efforts by making a batch of oatmeal pecan cookies but I will play nice.

At some point in the past 10 years, I realized that this simple drawing was helpful to the understanding of most things in health and perhaps life. When you measure any characteristic in a population, for example weight and then plot it on a graph, it will be a bell-shaped curve. The peak of the curve is then what is defined as normal for a population because that is the average. Those to the right of the peak would be varying degrees of overweight and those to the left would be underweight. The average for males and females would be different but there would be significant overlap in the curves. Thus weight alone would not be a good way of determining male versus female.

There are many differences between the skeletal muscles in males and females but I want to highlight a couple for purposes of this discussion. Skeletal muscles are the ones that we have voluntary control over (the ones that make our skeletons move.} Smooth muscles make up our internal organs and we have little voluntary control over those muscles (intestinal contractions or peristalsis).

There are two types of fibers in skeletal muscles, fast twitch for quickness and power and slow twitch for endurance. Males have more fast twitch fibers and females have more slow twitch fibers. If you graph out density of fast twitch fibers of males in one graph and fast twitch fibers in females in another graph, there would be an area of overlap as below. Thus, you could not use the amount of fast twitch (or slow twitch for that matter) to determine if a number was from a biologic male or female. Females that overlap with male fast-twitch density are likely more competitive in athletics than other females.

These sex differences emerge during puberty. Individuals go through puberty at different ages – generally 11- 14. Males that go through puberty at a young age are going to have a huge competitive advantage over boys that go through later. This is on full display at a middle school track and field event. Some 8th graders look like adult males and some still look like children. Is it fair that they compete against each other in events?

Hip width is another interesting consideration. Males have narrowing hips than women. Wider hips are thought to make vaginal childbirth easier for females. But the graphs of hip width would overlap between males and females to some degree. Females with narrow hips often look like males from the back. Again this may be a big advantage in competitive sports. Fortunately, having narrow hips, does not preclude a female from having successful vaginal childbirth.

So if the primary concern regarding transfemales competing as women in sporting events is competitive advantage, then perhaps it is time we develop an index of biologic characteristics determinative for competitiveness in each sport and use the index to determine who competes with whom rather than sex alone.

If a individual born as a male but strongly identifies as female starts testosterone blockers at puberty to stop the development of male secondary sexual characteristics, the “male muscle” advantage will not develop and competing with individuals born female would be more fair than this individual being forced to compete with males.

The decision to use hormone blockers should be decision between the parents, the child and the health care team. It has nothing to do with politicians. Hormone blockers are reversible if it is not the right decision. It gives the child the best chance of living in the body they identify with. If a child must wait until they are an adult to transition then the transition is more complicated in all aspects but certainly in competitive sports. The individual who identifies as woman who goes through puberty with testosterone will have a biologic competitive index on the male spectrum than female spectrum but still be comparable to the unusual individual born as female but with the competitive characteristics of males.

So if all of the angst about transathletes is about competitive fairness, then sex should be taken out of the equation all together. There is more than enough data that can be used to determine competitive index for each sport and those that fall into certain bands on the index would compete against each other independent of what reproductive organs they have.

This is a very complicated issue that is important to a very small number of individuals around the world. As with most big cultural shifts such as increasing understanding and acceptance of sex and gender diversity, it will take time to sort out off of the downstream implications of transitioning. This should be allowed to happen and evolve as new and more information is available. It should not be a political hot potato.

Craig and I have had a lot of conversations about this, but I have never tried to write about it before.

You may be wondering how happy I am to no longer be working at the NIH. I had intended to work until I was 70. If my position had not gotten so “toxic” for my mental and physical health, I would likely still be there until November of this year when I turn 70 However, if I were still there, I would likely be on target to be purged relatively soon because I was the co-founder of a sex and gender minorities working group (less formal than a committee) in the National Institute of Diabetes, Digestive and Kidney Diseases (NIKKD). This week, all the employees of the Office of Sex and Gender Minorities at the National Intitutes of Health (mothership for the institutes) were fired or placed on administrative leave. With more time, DOGE will dig into institute level data and find those individuals who were on institute level groups.

This NIDDK working group started with a lesbian woman, myself and a hetero man from the institute communications office. I was involved because I had more knowledge than most about sex and gender terminology and challenges based on the Prevention of Lower Urinary Tract Symptoms (PLUS) research consortium that I had founded. The purpose of the group was to discover ways to prevent bladder problems in women and girls. I had to the group of over 50 scientists (majority female) grapple with the question “how are we going to define women?”. There was one person in the research group that was a lesbian and worked at Howard Brown, a health care facility in Chicago that provided care to the LGBTQ community. She educated us and encouraged us to be deliberate in our decision making.

This was the first of many, many questions that almost brought me to my knees over the first 2 years of the consortium. It took me a while to truly understand the sex and gender issues and the importance of them.

Lesson 1 – Sex is biologically determined by external genitalia – males have a penis and females do not for the vast majority of individual. However there are babies born with both male and female reproductive organs and baby boys that do not have a penis due to faulty genetics. For most people this is a black and white issue and it is hard to imagine anyone that does not into this dichotomy.

Lesson 2 – Gender is a cultural construct – how a person feels; how they identify. People born with a penis might be much more comfortable with the behaviors and activities that society has defined as for girls and women and vice versa. Some individuals may be comfortable in roles assigned to men and women independent of their reproductive organs or simply not identify one way or the other. At this time a biological male cannot give birth but he can assume the role of a mother.

Lesson 3 – Sexual Attraction is separate from sex and gender. A person can be attracted to someone like them or someone opposite of them or to a person who does not identify as a man or a woman.

Lesson 4 – A transsexual person does not identify as the gender of the body they were born into. For someone that is comfortable in their own gender this is very hard to fathom and it makes people uncomfortable. For some trans individuals dressing as their preferred gender may fulfill their needs; for others, they need hormonal therapy to suppress or enhance biologic characteristics; some need to have breast implants or breast removal (top surgery) and some need to have their genitals altered to match their gender identity (bottom surgery). There are NO rules. It is about the person living their life as true to themselves as they can be.

Once I had these 4 lessons straight in my mind I was less confused and realized these are deeply personal issues that no one chooses. Aside from causing others discomfort and confusion, how someone identifies and who someone chooses to love should not concern anyone. I do understand the angst about transfemales (biologic males) in competitive women’s sports but it does not need to be the political hot potato it has become. I will do a separate blog about that.

From a scientific perspective, there may be important health considerations beyond sexually transmitted infections in some of these small sex and gender groups that do not fall into the traditional dichotomies of male/female, man/woman. We have no way of knowing this because the Case Report Forms in all of the NIH research only collected data about biologic sex (male or female).

So this was why I was willing to get involved. We needed to start at the very beginning and begin to gather data about not just sex, but gender and sexual attraction as well. The PLUS consortium scientists had many protracted discussions about this – everyone agreed we needed to ask the questions but there was concern as to how the participants would feel about being asked. What we found out is that no one cared. They simply answered the questions and there were no concerns. There were very few individuals that chose not to answer the questions but no more than did not answer other sensitive questions such as income level.

Why is this important? When you have enough data on smaller groups of people (minorities) you can start to find out if there is any difference in the way they respond to a treatment. If there is a difference and it is a positive or negative difference, scientists work to discover why and it could potentially lead to a discovery that could impact the majority in a positive way.

So the NIDDK working group of 3 gradually became a working group of about 30 over about 18 months after we educated or colleagues as to why it is important to ask the questions. The group transitioned to a formal committee about the time I left in 2021 and then disappeared over night after the election in November. Hopefully enough data will have been gathered in the last 2-5 years when these questions were asked to provide a foundation for more directed research in the future once sanity is restored (I am being optimistic here).

How did PLUS handle these issues? We asked the questions (sex, gender and sexual attraction). As one of the proposed barriers to bladder health is bathroom access and cleanliness, we recruited sex and gender minorities into our focus group research to see if there were any issues unique to them. We intended to mail surveys out through the mail to be filled out by the woman in the household. We needed to know if it would make a difference if the person answering the survey was a biologic or transfemale. What we discovered is that while the reasons for lack of bathroom access might be different, the questionnaire worked well in both groups. The good news is that the survey is inclusive for all women. However, the number of trans women is so small that it may be difficult to determine if there are any differences between the groups. BUT at least we asked.

I am very glad I am not experiencing the current chaos at the NIH.