Not knowing what you don’t know.

Lyric Holmans has released a Youtube clip explaining why she finds people overwhelming. You can view the clip and read a transcription on her blog. Like her, I find people can be overwhelming, and the reasons are similar – non-vocal communications.

While humans may be the only species to have developed a language, all vertebrates and many invertebrates communicate in various ways with their own species, and to a lesser extent other species. And while non-vocal communication may take second place to spoken (or written) communication in humans, it remains an important factor in our everyday communications.

For the first 60 years of my life, I was totally unaware that language (spoken or written) was complemented by other forms of communication, namely body language and facial expressions. I’m not alone. Many people don’t realise that body language exists, but nevertheless, they use it and read it every day. It’s instinctive to them. For many autistics, including myself, its not. Hence the title of this article.

During those first 60 years, I was able to read body language in domestic pets – better than most people in fact – in babies and to a lesser extent, toddlers. But apart from the way lips form with a smile or laughter I was unaware that the face, especially the eyes, can convey a whole raft of emotions and ideas. Even so, I was unable to distinguish between a grin and a grimace. I was completely unaware that humans also used posture, movement of body and hands, even vocal pitch and volume to supplement the words they use.

Now that I do know that a significant part of human communication is non-vocal, I’m able to look for it, and that in itself can be overwhelming. In the first place, making a conscious effort to look for non-vocal communication requires effort, so much so, that sometimes I forget to listen to the actual words being spoken. And then I’m always asking myself whether or not a particular facial or body movement is indeed intended (intentionally or not) to communicate something. And if it is intended to communicate something, what exactly?

I managed to survive the first sixty years of my life, more or less intact, not knowing that body language and facial expressions play a vital role in interpersonal communications. I’m yet to be persuaded that knowing it exits at all, let alone its importance, makes my communication with others, as individuals or groups, any less overwhelming. In my case it might actually make it more so. Group dynamics is another mystery to me (Lyric touches on it in the post linked to above), but that’s a topic for another day.

What next?

It’s been one of those months. Mostly “developed world” challenges, but if that’s the only world you’re familiar with they are real challenges in every sense of the word.

On the last day of June we switched internet and telephone providers. It’s not something I do regularly, but it’s a very competitive market in Aotearoa New Zealand. There are literally dozens of providers that supply various combinations of internet, home telephone lines, mobile telephones, electricity, and gas. Some provide all those products and services (and sometimes more) as a single package. However, the wife has a monopoly on choosing our electricity provider, while I make the decisions around the communication services, so I doubt we’ll ever have a single provider for all. Her priorities and mine are quite different.

We have now switched to a single provider for home phone, mobile phones and Internet, saving us nearly $50 per month. We’ve been using them for mobile phone services for some years and have been very happy with them, so when they made an offer that was to good to ignore, I decided to jump in boots and all. Usually switching between providers here is a painless operation and usually, if there is an outage, it’s often only minutes. Not this time.

The internet went down for no more than 10 minutes during the switch, but the home phone went dead and remained so. No dial tone, no anything. I won’t go into all the details, but it took two days and a replacement router before our home phone was back in business.

At around the same time, my old back injury returned with a vengeance. It still hasn’t settled down and I remain in some pain, but I’m damned of I’m going to take any more of those prescribed Tramadol tablets. My current inflexibility might make my movements appear as though my spine is made of a single plank of wood, but at least I’m moving. The Tramadol made me so drowsy and confused that I couldn’t find my way out of a paper bag, let alone safely boil water for a cup of tea.

I selectively filter some internet traffic arriving at our home network, and have done so for more than ten years., through OpenDNS’s content filtering service. It worked reliably with my previous internet provider, but was proving very hit and miss with our new provider, and nothing they did made any difference. It took me two days of trawling the internet and some experimentation on my part to find the cause. The new router requires DNSv6 server configuration as well as the usual DNSv4. While OpenDNS do provide DNSv6 servers, it turns out these do not support content filtering. Whenever the router switched from a configured DNSv4 server to a configured DNSv6 server, content filtering would cease until it switched back to the former.

Identifying the problem was one thing, solving it was another. The new router must have DNSv6 servers configured. It will not accept blank or invalid IPv6 addresses. It took me nearly half a day of scratching my head to come up with a simple solution: Configure the DNSv6 addresses to a non exiting device on the local network. That way, when the router attempts to connect to a DNSv6 server, it gets no response, so marks it as unavailable and consequently resumes using one of the assigned DNSv4 servers.

Twenty-three years ago when I was working as an I.T. engineer, the cause of the problem and a solution probably would have come to me very quickly. But then I also had access to diagnostic tools that make troubleshooting relatively easy. After being out of the industry for so long, my 72 year old brain being not quite as sharp as it once was, and having a non-existent set of diagnostic tools, perhaps I should be proud of the fact that I solved a problem that a younger generation of I.T. engineers weren’t able to, even if I did take the best part of three days to do so.

Yesterday a tree at the front of our section (property/lot) fell over blocking our driveway. Another distraction I could have done without. This morning I planned to catch up with some work that had fallen behind due to all the major and minor inconveniences over the past few weeks. We have our two grandsons staying with us for a few days, and while they do make keeping to a schedule difficult, they are a welcomed and much appreciated distraction. I had just started to cook some porridge for their breakfast when the power went off.

Disruptions to the electricity supply are few and far between, and on the rare occasion they do occur, power is usually restored very quickly. Not today. The boys waited, and I waited, and when power hadn’t been restored ofter twenty minutes, I phoned our electricity provider. In the good old days, when the lines company was also the electric power company, their call centre would very quickly know the nature of any problem and when power would be restored again. Not now.

The local lines company, being a natural monopoly cannot sell electricity, and we have no direct connection with them. We buy electricity from one of the fifty or so retailers that sell electricity into this region, and when a problem does occur, we contact our retailer. When I phoned retailer, the call centre was unaware of the problem but they would lodge a fault with the lines company who would then investigate.

That’s the problem these days. It doesn’t matter whether it’s electricity, internet, phone or gas (and in some areas, water and sewerage) the company you buy the product/service from is not the one that delivers it to your door. There’s always at least one degree of separation, which makes it just a little bit more difficult know what’s going on.

It’s times like this I wonder whether we did the right thing in removing our two wood burners during renovations last year. We removed them because their cost of running, even for just six ours each day was considerable more expensive than the heat pump we had installed a few years back running 24/7. But as the house slowly but surely got progressively colder during the course of the morning, I was starting to have second thoughts. When power was finally restored just after midday, it was a decidedly chilly 13°C inside.

A few minutes after power was restored, the front doorbell rang. Standing there, was a guy dressed top to toe in Hi-Vis gear. He was an employee of a subcontractor to a company hired by the lines company to repair and maintain the lines company network. How many degrees of separation does that make it? In the “good old days” he would have been an employee of the monopoly local electric power company. He just wanted to ensure all was now well, and to let us know the outage was caused by a car crashing into a power pole just a few hundred metre from our home. He’d been assigned the task to call on those who had lodged a fault with their electricity retailer. Perhaps an inefficient way to update their customers, but a very much appreciated personal touch that many other businesses could emulate.

Let’s just hope that today’s incident is the last “inconvenience” for some time to come.

Trapped

Well, we were for a few hours yesterday. A cotoneaster fell onto the driveway overnight making vehicle access impossible and requiring foot traffic to duck down to waist height.

The fallen tree. Rain and mist hides the background.

The weekend was marked by gale force winds and torrential rain. And while we thought we had escaped any damage, it seems that their combined forces weakened the ground sufficiently for the tree, roots and all, to topple. It’s always had a preference of growing over the driveway, and no doubt its lopsidedness was a significant factor in its demise.

Fortunately a crew from All Tree Services arrived within three hours of us contacting them, and half an hour later, very little evidence of the tree falling remained, apart from the root stump. That’s too large for their chipper and will need to be ground down. That’s a job for another day.

The tree was destined to be removed in a few years anyway. We’d planted a Cherry blossom tree and Japanese maple close by to replace it eventually, but were in no hurry to remove it as it provided shelter and an abundant supply of berries for birds in early winter. It also provided a measure of privacy, filtering the view of the house from the street. It will quite a few years before it’s replacements are sufficiently large to provide much privacy at all.

Improved service!

Over many decades (seven of them) I have had the occasional need to call on the assistance of health professionals. Most have fallen in to the non-emergency category, but there have been a few cases where without appropriate assistance I probably would not have survived – polio and hepatitis are two that come to mind.

In recent decades I have found myself in the emergency department of the public hospital in a nearby city, with no clear recollection of how I got there. I suffer from a form of migraine that often mimics the symptoms of a stroke. It requires an EEG and an MRI to rule that possibility out. Then there was kidney stones where I do remember the painful half hour journey by ambulance to the hospital.

However, today’s post is an observation of how the service of non-urgent medical treatment by General Practitioners (GPs) have changed in recent years. I can only speak of my experience in the town where I live – Feilding (population 15,000). It may be different in other parts of the country.

When we first moved here around 1986, we enrolled with a GP (general practitioner) in sole practice who shared a receptionist and practice nurse with another sole practice GP. This was an a change from what we had in our previous location. There, the family was enrolled with a sole GP where the duties of receptionist, etc were carried out by his wife. Generally an appointment wasn’t necessary. One simply turned up during surgery hours and waited. At the new practice it was necessary to make an appointment first, and usually one could be seen the same day or the next. If it was urgent, but not an emergency, then one could typically be seen within the hour. When our doctor decided to leave general practice and specialise in industrial health, we found ourselves looking for another GP.

Wanting a practice within easy walking distance limited out options to two and we settled on a group practice consisting of four GPs and a number of support staff covering several fields. At first, non-urgent appointments could be booked two days in advance, but over the course of a decade, waiting times became longer until it reached the stage where non-urgent bookings were typically a week away.

Since the start of this millenium there had been discussion about forming a community health centre for Feilding that could provide additional services beyond those that a typical small private or group practice could provide. It could be viable only if all the GPs in town provided services from the same facilities. It was a slow process but a few years ago Feilding Health Care Hauora Tangata opened for business.

While it provided radiology and other services previously only available in the city of Palmerston North (about a 30 minute drive), I can’t say there’s an improvement for non urgent medical attention. At this point I feel the need to mention that what constitutes non-urgent now includes conditions that would have been deemed urgent just a few years ago. Take for example my recent experience.

Weekend before last, I did something that caused an old injury to flare up. When I was 17, I suffered a lower back injury that resulted in one collapsed disc (two vertebrae now grind against each other wearing their faces down), one seriously compressed disc, and another with less severe compression. Over the years I have learnt to manage the injury, and for the most part, it doesn’t cause continuous pain. When I am careless and do something to silly, I can find myself in considerable pain exacerbated by any movement of the torso or legs. This was one of those occasions.

There are a number of exercises I have been taught to assist in recovery when my mobility is compromised like this, and generally within four or five days after a flare up I can reach the stage where the pain has been replaced by discomfort. However this time, the pain severely limited what I could do. As the weekend rolled around again, there had been no improvement and my mobility had become more restricted. So first thing Monday morning I phoned to make an appointment to see the doctor.

It was then that I was reminded how much of an improvement had been made over recent years. After describing my condition to the receptionist, I was advised that my assigned GP was away until August and even though I was in considerable pain and could scarcely walk, it didn’t qualify as urgent and there were no non-urgent spaces available for the next month! After some strong words from me she relented and said she would arrange for a duty nurse to contact me later in the day to evaluate my needs.

At four thirty, the nurse phoned and after a short discussion, she too said that I wasn’t able to book an appointment. However, I could see a doctor if I attended the after hours clinic which opens at six each evening, although I might have to wait a while before being seen. I was there before six but already there was a line of people at the check-in desk. Just as it was about to be my turn, the receptionist put an “Appointments closed” sign in the desk. I wasn’t pleased, and in the condition I was, I didn’t care who knew.

I think the receptionist took pity on me and said she’d try to have me seen by a nurse. Well, that’s better than nothing I suppose, and half an hour later one appeared. She told me the good news. All the doctors on duty were fully booked up for the evening, but if I drove across to Palmerston North I could attend an after hours clinic there. I asked if I could be guaranteed being seen, but no, they too ran their after hours service on a first in first served basis.

By this time my pain was so severe that I could only talk in gasps, and as best as I could I asked if it was reasonable to expect someone of my age, who has nyctalopia and cataracts in both eyes to drive to Palmerston North at night when they can barely walk or sit just on the off chance that a doctor might be able to see them. She conceded it wasn’t reasonable. How generous of her. I asked her what my options were to which she replied she wasn’t sure but she would find out.

She returned about ten minutes latter to give me “great news” that if I was prepared to wait and if a doctor finished all their cases before eight o’clock then he/she would see me, but there’d be no guarantee that I would be seen. I waited. And waited some more.

Some acquaintances tell me I have the patience of a saint, and on Monday evening that played to my advantage. Two people who were ahead of me in the queue were becoming more and more agitated as time wore on. Eventually one, then the other left in anger after waiting around an hour and a half. Ten minutes later, my name was called.

To cut a long story a little shorter, the doctor decided there was no new nerve damage (I’d already determined that) and that with some pain killers, I should be back to normal within a week. I was sent home with a single pain tablet to be taken when I arrived home. A short while later I received an SMS message informing me that a prescription had been sent to my preferred pharmacist and could be picked up in the morning.

The prescription was for Tramadol, which I’m supposed to take three times a day. No way! I tend to experience the worst side effects of every medication, and Tramadol proved to be no exception. Within an hour of taking it, I became fuzzy headed, unable to think clearly and found difficulty staying awake. Shortly after, my irregular heart beat became pronounced. I regularly miss about one heart beat in ten, but it increased to one in every four or five and was very noticeable to me. Then a headache set in. About time to research Tramadol’s side effects.

The possible side effects as described on Drugs.com make alarming reading, and the description on the NZ Health Navigator only slightly less so. I took two tablets yesterday, and only one today and I’m struggling to keep my eyes open as I compose this post. However, I think it has done the trick in relieving the pain as I am now able to do my exercises for managing back pain. Fingers crossed it stays that way.

On a brighter note. I received a phone call shortly after six last evening from Feilding Health Care inviting me to get my first Covid jab. They had a few surplus doses and if I came immediately I could receive my first of the two Pfizer shots. The wife and I were there and had our first vaccination within half an hour, and our next vaccination is booked in for later this month. We had been booked in for our first jab in August, and while there’s no sense of urgency here in Aotearoa New Zealand, it is comforting to know that our personal risk is now even lower than it has been.