Ten years after the fall

Dear Bloggers,

In 2003 we just moved into this house, I slipped and fell down the stairs. The doctor was called and as it looked bad as they thought i had broken my neck or spine, the ambulance service was called. The light was out in my head and things past around me in a far distance. The paramedics were rushing in, to treat a man who’d had made a crash landing from the stairs, when they spotted me lying in the middle of the hall next to the staircase.

I was conscious, alive and talking with a double tongue- but my blood pressure and pulse were normal, Only my head and left hand hurt. I can't remember much of that night. The next morning when i was woken up by the nurse. The doctor said that i should consider myself lucky.

It was 11am and I said i wanted to go home: but the medics persuaded her to stay at the hospital.'If you get a second chance in life, you ask yourself what you are going to do with it,' 

My head soon hurt so much that I was sent for a CT scan.
The scan showed I was suffering a contusion but there were no hematomas on the scan but there was a lot of activity across the brain.‘I’ll never know what happened. Last thing i remember that i was on top of the stairs. 

I was transferred to the head trauma centre at the local hospital in Heerenveen, and by the time my wife arrived from our home 15 minutes later, They gave her a status update that there might be a chance on brain damage and only time could tell.
Thankfully the paramedics did everything to save me, but my life nonetheless changed for ever that night.Before her accident, this fit and fiercely independent young man, who became friends with everyone became a lot more distant even to the ones the closest to me. Emotional there was no such thing as that one guy that I vaguely recognized from the past. The body was me but I was trapped in my own brain. And somehow I am still searching for the old me. 
 

  
I was now facing an arduous recovery. The injury left me with a blurred vision in the left eye, extreme exhaustion and what I would describe as a ‘constant heaviness’ in the head.
Now, ten years on, I need 8 hours sleep a night any less and I suffer from‘cracking headaches’ that can last for several days. And I am yawning all the way when i am behind the wheel. I also have occasional memory lapses. I am still hopeful things will keep improving, but there are no guarantees.'I could have kept a diary so I can remind myself I am getting better,' but no I didn't and it is hard to remember after all those years.
Every year, 21,000 people are admitted to hospital in the Netherlands with a brain injury. 

It’s likely that I've hit the wall with my head when I fell down the stairs or was knocked out by the hard floor. But the causes of brain injuries can range from falling down the stairs, to a stroke or heart attack that interrupts the brain’s oxygen supply.
‘I made a really good recovery they say, but often patients don’t do so well.
'It depends on the kind of injury, as well as the support they get,’ said my Neurologist.
When the brain is injured, it swells like any other body part, he explained.
‘But the skull is fixed — there’s nowhere for the brain to go, so it gets squashed. That’s why rapid diagnosis is needed.

‘The regions of the brain that control the basic functions that support life can get squashed out of the tiny hole at the bottom of the skull where the brain meets the spinal cord. That’s often what kills patients.’ More and more people are surviving brain injury and stroke, but the long-term consequences can be devastating. In my case my character changed.
The area of the brain that controls emotions may be damaged, as a result of which a patient’s personality can change. Rates of depression and anxiety are high, often leading to relationship breakdown. And that is something that still scares me.

Cognitive and memory problems are common, too, which can make your job impossible.
The brain moves when it is injured, which may cause the axons — fibres that send signals between brain cells — to tear, so signals travel more slowly.Tiredness is also a problem, as the brain must work harder in everyday tasks. The area controlling sleep can be damaged, too.

After leaving hospital, I spent at least four months at home, sleeping for much of the day and taking short walks. In the beginning I was falling over and I lied to my wife that nothing happened.
Gradually, the energy began to return. And before long, I hit upon a desire to take a long walk.Secretly, I made plans to get back to the point were i was before the accident. So with a lot of help from good friends. I learned most things back although calculating from the head is still not back, furthermore my character has still not changed back. I am more grumpy and I am missing the soft side of me. It is somewhere out there but I have not found it yet. I am afraid that somethings are not changing back.

‘If you get a second chance in life, you ask yourself what you are going to do with it,’
‘I wanted to get away from everything to think.’ In July, five months after the accident, I set off and got back to my working place again. Language was the main problem as English is the language used among an international crew. My wife had to do the talking as I could not find the words. Very irritating when you know what to say but simply cannot speak the language anymore. I was totally frustrated and went off like a mad man on my wife. Who had done the best way of English she could but there was no appreciation from my side only anger.

The doctors thought it would provide a goal, and a good rehabilitation process.
‘I think I was still slightly not with it. Lots of people have said to my wife, “I can’t believe that you don't let him go” but she said he is 35 and I still love him. I guess that she is longing for the guy she dell in love with. I was so focused on my own recovery that I forgot to work on my soft side. They couldn’t really stop me even if they’d tried. I’ve gone deep but believe me, I never been a quitter.’

It was a journey that would have tested even the most hardened. It has been hell week for more than a year in a row. Most people I met were doing just a section of the epic stretch. They were astounded that this young man was attempting to do the whole thing alone.
I practised from dawn till dusk on languages for six months, with only a few stops. I had to get back in the saddle and feed my family again.

I endured moments of ‘desperate’ loneliness and such a sore head that ‘if someone had offered to cut it off, I’d have said yes’. 
 

Some things, though, have changed for the better.
‘I don't think I’ve become a nicer person. Everyone in my family says they preferred the old me. 'It’s as if I’ve had an edge knocked off, I don’t have the energy to bulldoze through life anymore. ‘I’m less patient, and more openly emotional. I’ve got a calmness that I’ve never had before.’ Before I would fight with everyone and take up the discussion.
I prefer not to dwell on what happened that night it sometimes makes me curious, but I’m not sure I want to open that door again.

The doctors warned me that my brain injury can lead to depression, but I think it’s had the reverse effect on me. ‘From the moment I woke up that morning in hospital, I felt like I was drunk and really happy. ‘I’ve experienced depression, and it’s only when you nearly lose your life that you feel guilty that you ever had those dark thoughts that you wanted to end it.

‘You think: “Woah, hang on a minute! I actually want to stay alive.”



The Old Sailor,

Surviving the heatwave with Diabetes

Dear Bloggers,

When temperatures start to get out of control, so can you’re blood sugar can get out of control.. Both hot and cold weather extremes can harm your testing equipment and your medications and have a negative impact on your body’s ability to produce and use insulin.

Research shows that when it’s hot out, more people with diabetes end up in the ER and are hospitalized because of heat illness. The number of deaths in diabetes patients due to heat illness also increases in summer. Low temperatures can be an issue for people with diabetes as well.

But you don’t have to let the environment have the upper hand. Taking a few smart precautions can help you outsmart Mother Nature. Here are the adjustments to make depending on where you live and the weather forecast.

 

Managing the Summer Heat

Take these steps to keep your diabetes under control when the temperature soars:

Stay hydrated. “The problem is that in the heat, people tend to get dehydrated easily. When you’re dehydrated, you have higher concentrations of blood sugar because less blood flows through your kidneys. With less blood, your kidneys don’t work as efficiently to clear out any excess glucose (blood sugar) from your urine.” When it’s hot, be sure to drink plenty of water or sugar free beverages. Don’t wait until you are thirsty to replenish fluids.

Store your medications properly. High summer temps can affect your diabetes medications, glucose meter, and diabetes test strips. “When it’s hot out, it’s easy for insulin and other drugs to become degraded,” Be sure to store your medications properly out of the extreme heat. Never leave them in your car on a sweltering summer day, for instance. “It could get up to 50 degrees inside your car."

If you’re traveling, don’t forget to take your diabetes medicines with you. You may need to carry them in a cooler with an ice pack. Just be sure they’re not sitting directly on ice or the ice pack.

Stay out of the heat of the day. Exercise is an important part of diabetes management and blood sugar control. But you don’t want to be outside exercising during the hottest part of the day. “Get in your exercise first thing in the morning or once the sun goes down,”. Another option is to work out in an air-conditioned gym.

Know the signs of low blood sugar. Some of the symptoms of heat exhaustion are similar to those of low blood sugar, or hypoglycemia. These include sweating, light-headedness, shakiness, and confusion. “You may think it’s the heat and not recognize that your blood sugar levels have fallen to dangerous lows,” Be aware of the warning signs of low blood sugar and keep some carbohydrates with you to eat if you need to raise your blood sugar. Have a plan for a medical emergency.

 

Test more often. You may need to test your blood sugar levels more frequently so that you can adjust your insulin and your diet as necessary. Talk with your diabetes educator about guidelines if you're unsure of the best schedule.

Mind your feet. People with type 1 diabetes and type 2 diabetes are susceptible to problems with their feet. In the summer you face the temptation to go barefoot or wear open sandals that expose your toes … to trouble. Always wear shoes that fit well, even in warmer months. And at the end of the day, check your feet for any cuts, scrapes, blisters, or bruises. Don’t ignore injuries to your feet. Get medical treatment right away.

Surviving the Winter

Freezing temps and inclement weather can make it more challenging to stay on top of your diabetes. Here’s what to watch for during the colder months:

Keep your supplies out of the cold. Just like extreme heat, extreme cold can affect your insulin and cause your glucose monitor to stop working. Don’t leave supplies in a car when temperatures outside are below freezing.

Do your best to avoid getting sick. When you’re sick, you’re stressed, and being under stress can raise your blood sugar. Also, when you don’t feel good, you’re likely to not eat properly. Wash your hands with soap and water often so that you don’t spread germs. “We recommend diabetes patients have a sick-day kit at home. Fill it with soup, sugar-free cough drops, tea things that will make you feel better and that you can access easily,”

Avoid packing on the pounds. Managing your  type 2 diabetes during the holiday season can be tricky. Many seasonal treats are loaded with carbohydrates that cause your blood sugar to rise. Plan your meals and pace your special treats so that you don’t greet spring a few pounds heavier. Even a small weight gain makes it more difficult to control your diabetes and blood sugar levels.

Keep an eye on your feet. Diabetes can cause a loss of feeling in your toes and feet. Protect them with the right winter footwear, especially in snow. Apply moisturizer to your feet to keep your skin healthy. Inspect them regularly, and if you notice an injury that doesn’t heal, seek medical attention. Don’t wait. Also important warm your hands. “If your hands are cold, you may have to warm them up to get a good blood sugar reading,” Wash them in warm water before testing.

Don’t skip your workouts. It can be hard to get motivated to exercise in winter. But exercise is an important part of diabetes blood sugar control. It helps if you dress in layers when you’re exercising outdoors in the cold. Or join a gym where you can work out indoors. Another option: Work in exercise at home by taking the stairs, lifting weights, and exercising to videos.

At this moment I have to deal with the summer heat and my type 2 diabetes

When the hottest days of summer hit, people with type 2 diabetes need to pay close attention to their condition. Here's how to savor the season without health worries.

Summer conjures up images of backyard barbecues, pools and beaches, street festivals, stargazing, and more. But summer heat can add to the problems faced by people living with type 2 diabetes. In fact, studies have shown that during a heat wave, emergency room use by people with diabetes increases. And while most people with diabetes are aware that extreme heat poses a danger, they may not always know when to take precautions..

If you have diabetes, the high heat and humidity of summer can be difficult for your body to manage. The problem with hot weather is the combination of temperature and humidity.

Elderly people are at particular risk, but people of all ages with diabetes should be aware of summertime dangers. These include dehydration, heat exhaustion, and foot problems.

Dehydration is your enemy

Everyone, regardless of their health status, should make sure they drink enough fluids during the summer. People with type 2 diabetes, however, face an additional challenge because when their blood sugar levels are too high, they may be passing more urine than usual which means they are losing fluids more quickly. Add sweating into the mix and you have a recipe for speedy fluid loss. Certain medications, such as metformin (Glucophage), also increase the risk of dehydration.

If you are out and about on a hot summer day, make sure you have enough of these beverages on hand to stay hydrated:

• Water or seltzer
• Sugar-free lemonade or other drinks

Also, avoid alcoholic drinks and caffeine. Alcohol and caffeinated drinks are usually okay in moderation but too much of either one can cause you to lose more fluids. And remember to bring along snacks in case your blood sugar drops.

Diabetes and Heat Exhaustion If you’re going to be outside, be alert to these symptoms of heat exhaustion:

• Dizziness
• Fainting or near-fainting
• Sweating to excess
• Muscle cramping
• Cold, clammy skin
• Headaches
• Rapid heartbeat

Check blood glucose levels often. Aim for checking four times each day and before you drive.

With the proper precautions, people with type 2 diabetes can get through the summer and enjoy summer activities with no worries.

The Old Sailor,

You might lose thousands when refinancing your mortgage

Dear Bloggers,

When you and your spouce get into the adventure of buying property you need to borrow some money if you are a regular Joe like me and no I did not marry a rich chick like Paris Hilton. So you end up at a bank (too expensive and complicated as I didn’t have a regular job.) I am not a financial wizard and yes I must admit my wife understands these things better than I do.

We had just borrowed about two hundred thousand Euros and my question was pretty simple: "How do we pay you back?"

The woman on the other end of the phone, however, couldn't tell me. Ten days had passed since we signed the papers to refinance our home and, with the summer holidays approaching, I was worried our first payment would be late. She tried to soothe me with perhaps the most misunderstood phrase of the refinancing process: "Don't worry. You get to skip a payment."

Had I listened to her, it would have cost us thousands of euros. And if you are one of the millions of homeowners who will refinance in 2013, it could cost you, too. 

If your resolution is to save money or get control of the family budget, refinancing remains a really good option. But the idea that “skipping” the first payment can be pain free, financially speaking, is a myth, repeated over and over by loan officers like mine. Sometimes they are lying, sometimes they are misinformed and sometimes they are just trying to get an annoying borrower like me off the phone. But with rare exception, they are giving bad advice. (News flash: Whenever a bank seems to be doing you a favor, it probably has a hand in your wallet.)

Real estate transactions are already confusing enough. There are questions surrounding when you make your last payment on the old loan, when you make your first payment on the new loan, how many extra days of interest you pay toward both your old and your new loan, and when you are paying for both loans. We'll get to those tricky issues in a moment, but the priciest mistake you might make in a refinance is also the simplest one to correct. 

You've heard this before, but this time, it's probably true: mortgage interest rates are at historic lows, and there may never be a better time to refinance.  It's hard to imagine rates going any lower than the 3 percent range they are at now, but it's easy to imagine that, at the first signs of a real economic recovery or real inflation, they will climb sharply during 2013.  The low interest rates that the Nedrlandse Bank has imposed to boost the economy have been punishing for many, notably savers, who can barely earn 1 percent interest on their bank accounts and certificates of deposit. The one perk for consumers from the bank’s interest rate policy is the ability to get cheap home and auto loans. If you haven't refinanced your mortgage in the past 24 months or so, you are missing out.

Fortunately, many Dutch homeowners have gotten the message. According to the Mortgage Bankers Association, mortgage holders engaged in €603 billion worth of refinancing in 2012. In fact, more than four out of five new mortgages in 2012 were refinanced loans, not home purchases.
I wish there was a way to know how many of those borrowers chose to skip that first payment.

'Can I get that in writing?' 'No'

My loan officer was lazy, I believe, and -- knowing that my loan had closed and all the commissions were guaranteed -- just wanted her off the phone as soon as possible. My wife’s  call was unusual.  She is always overly cautious when she sets up any kind of new loan payment, as the chances for error are great: a wrong loan number on a payment, a bad address, etc. So she always makes the first payment early to make sure nothing goes wrong.  That good habit proved profitable this time.

When we signed the loan papers, there were no payment instructions in the closing documents (not terribly unusual). My loan officer said I would receive payment coupons later.  But when 10 days passed, and we heard nothing, She called them and She was sent to the bank's customer service line, where she was informed that there was no record of our loan. (Did that mean we didn’t have to pay it back? Sadly, No.) 

Customer service transferred me back to my loan officer. She assured me that their computers would catch up to my urge to pay the loan, and we’d get payment information soon. Incredulous that they seemed not to want my money, My wife persisted. She tapped a few keys on her keyboard, made us wait a minute, then told us that our loan had funded on May, so I didn't have to make a payment until June. 1.
"But my documents say repayment begins May. 1," I said. "So you're saying there will be no late fees if I don't pay May. 1?"
"
Yes," she said.

"Can I get that in writing.?”

"No. I can't do that."

At that point, I did what any mature consumer would do: I laughed. And then I muttered something about the 100 pieces of paper they just made me sign, with innocuous documents putting the finest point on everything you can imagine, like the form I initialed in multiple places agreeing that, yes, I am known by Jake, Jacob, Mr.J. and various other nicknames. Yet I couldn’t get the bank to put something in writing saying when we should make our loan payment?

Our loan officer didn't laugh, but eventually she put my wife on the phone with a supervisor who sounded very grave. She'd done additional research, she said, and found out that the reason customer service couldn't find my loan was because it had already been sold to another bank. 

Steep penalty anyway
But I'm not writing to warn you about late fees. There's a much bigger culprit here you have to worry about.  Had I followed my loan officer's advice and skipped a payment, even if the bank waived the late fee (which the manager said was likely), I would have paid a steep penalty anyway.  You've probably guessed the punch line: there's no such thing as skipping a payment. In reality, homeowners are borrowing that money and extending the loan term for an extra month.  The payment will be tacked onto the end of the loan, with interest.  How much? If it's a conventional loan, that’s 30 years’ worth of interest.  Effectively, you are borrowing one month's payment for 30 years. Ouch!

"Skipping is a misnomer. A better description would be ‘deferring with additional interest added,'" 
Just how much extra interest can skipping that first payment cost you? There are too many variables to create a decent rule of thumb. But let me give you an example of how I think it would be. A payment that is miniscule to one is a fortune to another. I’ll give you the numbers, then you can answer your own question. They are for a €100,000 on a 30-year loan at 6 %.

The initial interest payment on a €100,000 loan at 6% is €500. It is .06 times 100,000 divided by 12. If you skip the first payment, the €500 is added to the balance, making it €100,500. In the following month, your interest payment will be €502.50. The additional €2.50 is on the €500 you skipped. Further, the interest payment will remain higher throughout the remainder of the life of the loan, relative to what it would have been had you not skipped the first payment.

 
If your loan runs for the full 30 years, you will end up paying an additional €2993 of interest. If you pay the balance off after 15 years, it will cost €864 in additional interest. If you pay off in 5 or 10 years, it drops to €205 and €486.

Forget the €75 late fee. That's real money. Hmmm...a payment that is miniscule to one is a fortune to another.

Some loan officers say they only won't offer the "skip-a-payment" option unless the refinance closes toward the end of the month, when the homeowner might have trouble coming up with the extra cash for closing costs and a fresh mortgage payment close together.  Others say they offer it all the time.

To be clear: Most borrowers don’t actually complete their 30-year loans before moving or refinancing, so few would end up paying that high a penalty. Also, it's important to note that my bank didn't even hold the loan, so they weren't profiting from the “skip-a-payment” advice.  I believe this is usually a lazy mistake, not a greedy one. Still, the basic truth holds.  Don't be tempted to skip a payment when you refinance unless you really, really need the cash for some unusual expense ( Christmas credit card bills are probably not the best reason.)

Skipped payments are not to be confused with other loan closing related interest payments, including:

Your last payment on the old loan. You can't skip that, either. If your loan closes near the end of the month, you should still make the scheduled payment to your old bank. Why?  Interest is actually paid in arrears, meaning you pay at the end of the month the cost of borrowing the money for that month.  It's confusing, because mortgage payments are really two payments at once -- last month's interest and next month's principal.  

To keep it simple, if your loan closes on the Nov. 30, you will be paying November's interest with your Dec. 1 payment, along with December’s principal. You won't need to make the December principal payment if you refinance on Nov. 30, but most folks pay far more in interest than principal because they are early in their loan's term, so the overpayment won't be large. Just pay it to avoid late fees, and enjoy any refund that comes your way. 

Pre-paid interest. When your loan closes in the middle of the month, your new bank will make you pay up-front (as opposed to in arrears) daily interest for the remaining days of the month. If you close on the 20th, you'll pay 10 more days of interest payments.  That's OK, it means you won't owe the money on the back end of the loan.

It's important to keep all these quirky, refinance-related interest payments straight when talking to your loan officer, so you'll know what to do when he or she suggests you can skip a payment. 

None of this should scare you away from refinancing, which is really the only way you can make the recession work for you.

But remember, you are refinancing to save money, and you probably shopped around trying to save €50 here or €100 there on closing costs; don't lose thousands of Euros because of one false move after closing.

The Old Sailor,