Chapter 563 - Just Like Old Times

About 1970 when I worked at a steel company's research labs our group bought a PDP8S computer which filled some 4 standard rack spaces in a 6' rack plus panels in an adjacent rack for extended memory and peripherals. In those days the 8K of 12 bit words was impressive in a so called desk top computer. My job was to keep the system running, build peripherals and eventually install it all on a landing that overlooked a blast furnace hearth. Quite soon, and well before the system was relocated from the lab, I needed to repair a fault in the CPU hardware at least once or twice each day. Transistors on the CPU modules (of which there may have been about 50) began to fail. I quickly became very skilled at troubleshooting and repairing the PDP8S. In time, the challenge of repairing the CPU was no longer much fun or a challenge and I became somewhat stressed, especially when others began questioning my ability. After several months of ongoing problems and complaints by our management to DEC, the manufacturer and supplier of the equipment, I was given leave and the CPU was sent to DEC's office for repair. It remained there about 1 month before being sent back fully "repaired", although the workmanship on some of the modules was rather poor. No one ever told me, or our lab, what the cause of the problems had been. I had recovered reasonably well from the stress involved in the saga. At least a year later I was having a coffee with a sales rep from DEC in our lab's lunch room when he asked me "Did they ever tell you what was wrong with your PDP8S?" "No" I replied. Another research lab way up north in sugar cane country had also bought a PDP8S at the same time as our lab did and experienced the same problems with their machine as we had. Their repair approach was better than mine; they bought several hundreds of the two transistor types that were failing and a number of hardware people replaced all those transistors in their CPU during one weekend. Their machine was then reliable. The sales rep then told me that engineering support people in the USA plant where the machines were built investigated the matter, discovering that both machines (I never asked whether there were others) had been heat stress tested in a heat tent at temperatures exceeding specifications. During my career in DEC (I later joined the company) I experienced one other occasion when I came close to breaking point during the long saga of a failing system at a bank customer site way down south (in my then management role I had made the decisions that identified the technical cause; other management scrapped the system and lost the contract) and my escape was to volunteer my demotion to a position resolving technical problems albeit of short duration. On that occasion the customer's cleaning staff used very corrosive products. Now for a third time in my life I am experiencing a similar ongoing problem which cannot be resolved.

This morning I sent the following text as an email to her neurologist:

Dr ,

During Tele-health last Thursday evening I had insufficient time to discuss [Her] pump settings with you. Her current settings are Day Rate 7.0 Night Rate 2.8 Morning Dose 1.0 Bolus Dose 2.0.

A night rate greater than 3.0 seems to cause broken sleep, yelling out while asleep (loud enough to wake me wearing a CPAP mask) and dyskinesia in her legs, sometimes her hands as well. Bringing the night rate down in steps from 3.2 to 2.8 has reduced those effects but has decreased her alertness and lucidity on waking/being woken of a morning.

To clarify, our morning routine is for me to wake at 0600 and by about 0615 to set the Day Rate and the Morning Dose on the pump. Then by 0730 I assist [Her] onto her commode, move her into the bathroom where the commode pot is emptied then, still seated on the commode, [She] is placed at a set of powered pedals to rhythmically exercise her legs for up to 20 minutes until a carer from Wild Dog arrives about 0750 to shower and dress [Her]. [She] is then transferred onto her wheelchair to have her breakfast.

As the Night Rate has been reduced [She] has become less lucid, less awake by, say, 0750 and sometimes asks to be returned to bed either before or after showering. She will then remain asleep in bed for up to an hour. In my estimation [Her] legs seem "stiffer" of a morning.

This morning at 0545 I was woken by [Her] vigorous dyskinesias rattling the guard rails of her bed. I changed the pump from Night Rate 2.8 to Day Rate 7.0 and gave a Morning Dose 1.0. I rolled [Her] fully onto her RHS and the dyskinesias faded immediately and by 0600 had ceased. There were no dyskinesias at 0615. When I checked on her at 0700 only her feet were moving with small but fast dyskinesias so I initiated a Bolus of 2.0. At 0725 her leg dyskinesias were quite vigorous. As I transferred her from bed to the commode she was somewhat sleepy, but more alert than previous mornings, able to tell me what day it was but not the date. There were no problems having her use the pedals. There were no difficulties for the carer to shower and dress her.

An example of [Her] OCD behavior occurred yesterday afternoon when, still seated in her wheelchair, I found her attempting to remove the waist band from the slacks she had removed because the band was on "back to front". A considerable amount of persuasion was needed to convince her otherwise and help her back into the slacks.

For your interest I will post a memory stick containing video clips taken early in June  and FitBit charts taken more recently. For quite some time the FitBit had not been attached to [Her] right leg because it had been bothering her but a better method of attachment is now used and is acceptable to her.

[Your secretary] has made an appointment in February  2020 for [Her] to undergo a Nerve Conduction Study and see you. We will cancel the appointment should there be any hint of COVID issues around that time.

Regards, 

So now I feel somewhat relieved that portion my burden has been communicated.