Always follow your doctor’s advice. Recommendations and observations are my considered, but personal opinion.

Key: HBPM = Home Blood Pressure Monitor

My story

I recently went for my age 65 “Welcome to Medicare” physical. I was only three years late! No excuse-I’m a physician and should know better. My primary care doctor took my blood pressure, and it was marginally high. It was unclear if I needed to go on blood pressure meds or not, and he suggested that I self-monitor my blood pressure at home. I had a barely used Omron blood pressure monitor that I bought about five years ago, so I thought I was all set. However, my monitor would give me a reading only about 50% of the time. Otherwise, it gave me an error message. This started my search for a good quality home blood pressure monitor (HBPM). I was surprised at what I discovered, and I think you will be too.

This post is all about blood pressure, blood pressure monitors their benefits and limitations, and how to present the most precise data to your doctor so you can get the best treatment possible. If you are one of the 68 million American adults with high blood pressure, this is a must-read. If you know someone who has high blood pressure, send them this link.

Note: This is a long post with a lot of useful information. However, if you want to cut to the chase, read the conclusion and model recommendations at the post’s bottom.

Why is it important to manage your blood pressure?

High blood pressure is called the silent killer because high blood pressure can go unnoticed until it is too late. High blood pressure is associated with many health problems, including heart disease, stroke, dementia, blindness, and kidney failure. Many blood pressure medications are inexpensive, so there is little excuse to not treat your blood pressure.

Is your doctor’s blood pressure reading accurate?

A doctor’s machine is likely to be more accurate than a home machine. However, blood pressure readings are often taken incorrectly in a doctor’s office with a patient balancing precariously on an examination table, feet dangling. No one asks the patient if they just had a coffee or if they need to go to the bathroom. Providers can’t spend five precious minutes to run and average three separate blood pressure readings. This is why doctors now advise home monitoring as it gives a much more accurate view of a person’s blood pressure in the real world.

Wrist vs. arm cuff machines.

The most common types of HBPMs take their readings from the wrist or the upper arm. In general, wrist machines are not as accurate, especially if you are over 60 (your arteries are less elastic). Also, wrist machines are less tolerant of improper blood pressure taking procedures. Because of this, most doctors advise that you use an upper arm cuff machine. Naturally, you need to follow the manufacturer’s instructions to get the best results with arm cuffs as well.

There are some isolated instances where a wrist cuff may be preferred over an arm cuff. There are medical situations where you should not use an arm cuff. In addition, some may have arms that are too large for a standard arm cuff. Lastly, individuals may find the discomfort of an arm cuff intolerable. In these specific examples, a wrist cuff may be preferred.

Your doctor can tell you which type of device is best for your clinical needs.

The reality of home blood pressure machines.

Since my old machine was giving me error messages, I purchased a new one for $29 on Amazon. I bought the monitor based on nineteen thousand reviews, with the majority of them being 5 stars. Also, the machine was an Amazon Choice.

I was surprised by the inconsistent readings that the machine gave me. Since most HBPMs are relatively inexpensive, I began to buy and test different units. I added some more premium/validated machines into the mix to see if they were any better. I then started to do head to head tests comparing various devices. I felt that the information that I was uncovering would be of benefit to others, and so I further expanded my research to be inclusive of a variety of price points and brands.

The bottom line is that all of the HBPMs that I tested gave variable test to test readings. However, there are simple ways to get the best measurements possible, and over time your readings will still provide your doctor with valuable information about your blood pressure.

Blood pressure is dynamic.

Your blood pressure changes throughout the day. It is lowest when you sleep and it starts to increase during the early hours of the morning. In most people, it will peak in mid-afternoon and then start to fall towards nightfall.

Many things impact your blood pressure: eating, drinking caffeine, smoking, physical activity, taking a shower, crossing your legs, having a full bladder, experiencing strong emotional feelings, and more. Therefore, your results will be more meaningful if you standardize your pressure-taking procedure.

Here are three steps to standardize your blood pressure reading.

1-Technique.

Take your blood pressure at roughly the same time every day.

In a perfect world you would take a reading one hour after you wake up, and a second reading in the late afternoon/early evening.

Before taking your blood pressure, empty your bladder.

Wait 30 min after eating, exercising, drinking coffee, smoking, or bathing before taking your blood pressure.

Sit and be still for at least 5 minutes before you take your first reading.

Sit in a supportive chair. Your cuffed arm should rest on a table (a kitchen table works well).

Your feet should be flat on the ground.

Your blood pressure cuff should be placed at heart level.

2-The power of being average.

One of the secrets to making data more accurate is to take multiple samples and then average those numbers. Take your blood pressure three times, waiting around a minute between each test. Then average the three numbers (many machines will do this for you automatically). Use the average as your blood pressure reading.

If your HBPM does not automatically average its last three readings, it is simple to do it yourself.

Here are three similar blood pressure readings that were taken approximately one minute apart:

135/78, 142/75, 131/80

Add up the top numbers: 135 + 142 + 131 = 408, then divide by the number of readings, in this case 3. 408/3 = 136

Then do the same for the bottom number 78 + 75 + 80 = 233 and divide by the number of readings (3). 233/3 = 77

Your average blood pressure for the three readings is 136/77.

If your machine does not have an averaging function it is easy to use a simple calculator to crunch the numbers.

3-Use the right cuff size!

Many machines have a universal cuff that will fit most arms (8.5-16.5 inches in diameter). Some machines will come with a smaller cuff. Cuff size will be listed in the device’s product description.

It is essential to use the right cuff size to get accurate results. You can measure your upper arm using a tailor’s tape measure. Name-brand companies like Omron, A&D, Beurer, and Welch Allyn sell optional cuffs to fit very small or large arms. Some off-brand companies have specific models with cuffs made for larger arms (check the product’s description). Make sure you follow the instructions in your machine’s user manual as to how to place the cuff on your arm.

How does your home blood pressure monitor work?

Place your ear on someone’s chest and listen for their heartbeat. You have just used the auscultatory (listen) method to monitor their heart. Now take your fingers and feel for their pulse on their wrist. Now you registered their heart beats using the oscillatory (vibration) method.

Non-digital blood pressure machines required the examiner to listen (auscultate) for heart sounds using a stethoscope. Digital blood pressure machines use the oscillatory method to feel for the pulse. That is why it is essential to be still when using one of these machines.

A HBPM measures the cuff pressures where it can feel a pulse. It then compares this data to an internal lookup table to determine a person’s blood pressure. This information is shown on the machine’s display.

Blood pressure machine validation.

Many countries and national groups have protocols to verify the accuracy of blood pressure monitors. This process is called validation. Only around 10% of HBPMs in the US are validated. Why so few? Because it is expensive to have a third party test a machine. In the US, this process is done under the American Medical Association’s guidance, and validated machines can be found here: https://www.validatebp.org/.

Testing involves measuring the blood pressure of a group of subjects with a medically standardized blood pressure device. Then the subjects have their blood pressure taken three times with a home blood pressure machine, and these values are averaged. The average is compared to the reference machine, and if the numbers are close enough to the reference, the machine is validated. How close is close enough? Machines can be off +/- 10 points (or more) and still get a passing grade. That is a 20 point spread!

An actual validation scatter plot from a Beurer BM85 machine. If the machine was 100% accurate all of the dots would form a single line at zero. This plot reveals that on average this machine reports results that are 10 mm higher than the reference device. In addition, there are a number of times when it was more than 10 mm off. This machine was validated. From: Wetterholm M, Bonn SE, Alexandrou C, Löf M, Trolle Lagerros Y Validation of Two Automatic Blood Pressure Monitors With the Ability to Transfer Data via Bluetooth J Med Internet Res 2019;21(4):e12772

If you want to dig deeper, here is a paper that proposes a universal standard for validation.

https://www.ahajournals.org/doi/10.1161/HYPERTENSIONAHA.117.10237

It states, A device is considered acceptable if its estimated probability of a tolerable error (≤10 mm Hg) is at least 85%. This means that a machine can be off less than or equal to 10 points 85% of the time, and off more than 10 points 15% of the time and still be validated!

Validated vs. non-validated machines.

Less than 10% of HBPMs in the US have been validated. Some other machines will claim that they passed some sort of other accuracy test and may state, Clinically Proven to be Accurate, whatever that means. The vast majority of HBPMs do not list that they have undergone any official testing or validation.

In general, I did not find validated HBPMs to be more consistent than those that were not validated. However, validation indicates at least some sort of commitment to quality by the manufacturer. Is that enough of a reason to buy a validated HBPM over one that has not been validated? More to come on that topic.

What does FDA Approved/FDA Cleared mean?

Some HBPMs proudly print the FDA logo on their packaging. So what does that mean? Unfortunately, not much. The FDA must approve all medical devices for sale in the US. To be approved a device has to show that the benefits of using it outweigh the risks. The FDA does no testing, and relies on information supplied by the manufacturer. Some HBPMs will proclaim that they are FDA approved, but they are more likely FDA cleared. To be cleared all a company has to show is that their device is similar to already approved devices. Since most blood pressure monitors are designed very similarly this isn’t a very high bar, and says nothing about how well the device works. Home blood pressure monitors are considered Class II FDA products. What other medical products are also in this category? Condoms and bandages, to name two.

Device Longevity/Construction Quality.

A few devices listed their projected lifespan, sometimes reporting five years for the device and two years for the cuff. In addition, the Cleveland Clinic says that the typical lifespan of a HBPM is around 3 years. This is a reasonable lifespan, as these consumer level machines operate under high pressure. You may get more than three years from your device, but once you get past three years, most experts suggest that you check your HBPM against your physician’s machine yearly.

Generally, inexpensive off-brand machines were constructed more cheaply than known-name devices. However, there were some off-brand HBPM that seemed to rival brand-name devices in build quality. Within a brand, HBPMs seem to be built similarly across their line. Name-brands differentiate their models on features rather than construction quality or accuracy. All models in a line appear to be equally accurate (or inaccurate depending on your viewpoint).

Testing your machine at the doctor’s office.

The proper protocol for checking your device against your doctor’s professional machine involves five steps, and I estimate that this procedure would take around 10 minutes. Since many doctor appointments are less than 15 minutes long, it is unlikely that your physician would have the time to do such a test. However, you could take your blood pressure with your machine after he/she takes it with their professional one. This will give you a rough idea of your machine’s accuracy, but it is hardly a gold standard test.

Here is a link to the American Medical Association’s recommended protocol to test your blood pressure machine against your doctor’s machine: https://www.bluecrossnc.com/sites/default/files/document/attachment/providers/public/pdfs/ama_how_to_check_bp_monitor_for_accuracy.pdf

I was able to compare some of the HBPMs against a reference Mercurial Sphygmomanometer. The results showed that the machines that I tested gave results similar to my reference standard. In other words, their results were in the same ballpark. Thanks to my wife, Dr. Julie who lent her arm for many of my tests.

If you don’t record it, you didn’t do it.

The most important thing you should do after taking your blood pressure is to record your averaged blood pressure and the time and date that you took it. The simplest way to do this is to track your results with pen and paper. You can do this in a little notebook or write your numbers on a calendar or in a log. In addition, list any medication changes on your timeline.

You can download this blood pressure log for free from the American Heart Association. https://www.heart.org/en/health-topics/high-blood-pressure/find-high-blood-pressure-tools–resources

Using the American Heart Association’s log is easy and the results are clear.

Writing your results on a simple calendar is a great way to track your BP values.

You can download free calendar templates to use with your spreadsheet program. This one is for Google Sheets. The resulting calendar is neat, easy to read, and professional looking. This template can be found here: https://www.vertex42.com/Files/download2/gdrive.php?file=2021-calendar-light

There are many smartphone apps that will record your blood pressure and turn those numbers into useful graphs that provide a visual picture of your blood pressure over time. Apple’s iPhone includes a free app called Health, and for Android users, there is the Google Fit app. Both of these allow you to enter your BP numbers manually. Also, they can wirelessly accept data from certain Bluetooth-compatible HBPMs.

Here is a screenshot of a monthly blood pressure plot using Apple Health. The graphing makes it easy to interpret a large amount of data in seconds. Apple Health exports its data as an XML file, which can be cumbersome. You may find it easier to simply show your doctor the app, or send them a screenshot of your data.

Blood pressure machine manufacturers have created their own phone apps to be used with their Bluetooth-enabled HBPMs. However, many of these apps will allow you to manually enter data, so you can also use them with your non-Bluetooth devices. The apps vary in functionality and sophistication, but they all record the basics. In addition, they let you export your data and send it via email. Some will also let you output your data to Facebook or Twitter, although I have no idea why you would want to do that. Omron’s Connect app exports its data as graphs and charts (it is pretty visual), or as a CSV file. Other apps may send their data as a CSV file, XML file, or JPEG image. A CSV file is useful in itself, but when opened in a spreadsheet program you can sort the numbers in any way that you need to. For instance, you can turn the numbers into a graph.

You can print the output from a health app and present the hard copy to your doctor. If you don’t want to mess with exporting data you can just have your doctor view the app on your phone when you go for a visit, or send him/her a screenshot. Apps present their data in a very clear easy to digest linear fashion.

Many health apps output their data as a universal CSV file. A CSV data table in itself is useful, but with a little spreadsheet work it is possible to explore you data in many other ways.

Lastly, you can bring your machine into your doctor’s office, and he/she can scroll through the gadget’s memory. As a doctor, I would advise against this. Viewing readings one screen at a time isn’t very compelling. Most doctors will scroll through the first few numbers and call it a day. Using a physical list (like a calendar or log) or a health app on your phone makes it easy for your doctor to absorb and interpret your data.

Your privacy and smartphone apps.

I’m a big fan of smartphone apps as they do such a nice job at curating blood pressure data. In addition, some apps will monitor other numbers like a consumer’s weight, oxygen levels, or blood sugars. However, all of this sensitive information goes back to the app’s company, and some users may be concerned that their private health data could be shared inappropriately.

Apple notes that one of its missions is to protect your privacy. If you have privacy concerns, but you still want to use an app, I would suggest using the Apple Health app and manually entering your blood pressure values into it.

How consistent are HBPMs?

I tested dozens of blood pressure machines and took hundreds of measurements using a controlled protocol. An accurate device should always give similar readings when each reading is done one minute apart. However, that was not the case for any machine that I tested.

Sometimes a machine would give fairly consistent repeat readings. At other times the same machine would give a random high or low reading. More expensive machines were no better than cheaper machines in this regard. Likewise, validated devices fared no better than machines that were not validated.

Hardware/ Software (Algorithms).

The physical components of all machines are essentially the same. A little DC motor powers an air pump, a simple computer board houses a CPU and a pressure sensor, a release valve slowly lowers the cuff’s pressure after it is inflated, a solenoid valve rapidly drops the cuff’s pressure when the test is complete, and a LCD panel displays the results.

The difference in machines is in their software. It would make sense that more expensive machines would have software that gave more accurate results, but I did not see that in my testing. Within a brand, the lowest priced machine tended to be just as accurate (or inaccurate) as the most expensive one.

Different brands implemented their blood pressure routines differently. For instance, the Welch Allyn and the Walgreens machines that I tested tended to inflate their cuffs very gently, where a Topffy machine squeezed my arm until I screamed, Uncle! The Welch Allyn determines its readings while it inflates, making the total test time a bit shorter. The Omron brand claims that it reads more data points. However, this didn’t seem to make that much of a practical difference in my tests results.

A machine’s software can add features like memory, data averaging, multiple user profiles, and other things. Many of these options add little cost to the device’s manufacturing. This is why you may see a $20 no-name machine that has more features than a more costly name-brand’s base model. So why don’t the name-brands incorporate more features into their base models? Likely, to differentiate their line. Features can be reserved for their more expensive models to encourage you to up-buy to those devices. (my personal opinion)

Features.

Here are some features that your machine may or may not have.

-Carry Case or Bag. This is a nice feature as HBPMs are bulky. However, it isn’t a must, and you probably have a little bag around your home that you can use for storage purposes.

-AC Socket/AC Wall Adapter. All HBPMs use AAA or AA batteries, but some also have a power jack so you can also plug into mains power. Some units will also include the wall wart, but it is a separate purchase for other devices. For most consumers, the ability to use AC power isn’t a must. Monitors that use AAA batteries will typically test between 250-300 times before you need to replace them. Monitors that use AA batteries can go from 400-1500 cycles (depending on the model) before the batteries need to be changed out. HBPMs with Bluetooth tend to use up batteries a bit quicker than those that don’t have this feature.

-Guest Mode. This is a feature that some Omron HBPMs have which allows you to take a single blood pressure measurement and not have that value enter into your unit’s memory. This function may be handy if you have an Aunt Tilly who always wants you to take her blood pressure when she comes over for Sunday dinner. You can take her BP without corrupting your own data. Check out your instruction manual to see if you have this feature.

-Memories. All of the monitors that I tested will remember past test values. This number can be a low 14 for the Omron Series 3 to over 100 memories in some other models. It is best to record your blood pressure values on paper or with a smartphone app, so having many memories isn’t as necessary as you think.

-Multiple Users. Some machines have two different memory banks, which allow two users to record their blood pressure readings independently. The Beurer BM76 ($50 at Costco) can record values for four separate users. Separate memory banks can be a nice feature if all parties remember to switch over to their assigned memory bank. I suspect that it is common for people to forget to do this, resulting in the corruption of the other person’s data. This is one reason why it is a better option to record your blood pressure readings elsewhere.

-Averaging. This is the feature that I use the most. Your machine takes your last three readings and averages them (so you don’t have to do the math). Many machines have this feature. Other machines may do other types of averaging, for instance averaging a user’s total memory bank or their AM and PM readings. Make sure that you read your machine’s instruction manual to understand what type of averaging, if any, your device does.

-Triple Check Averaging. the Omron Series 10/Platinum, the Rite-Aid Deluxe, the Equate 8000, and the Walgreens Premium blood pressure monitors that I tested can be programmed to automatically take three blood pressure readings in a row, and then average the results. This is a convenient feature. If the machine has Bluetooth it will upload the results directly into your smartphone’s health app.

-Pulse/Irregular Heartbeat Monitor. All machines that I tested have this feature. For some users recording their pulse rate is essential. These machines also look for irregular heartbeats. However, that is a pretty rudimentary function on these gadgets. If you have a history of arrhythmias, talk to your doctor about ways to monitor that issue.

-High Blood Pressure Warning/WHO Classification Indicator. Many machines will give the user some indication that their blood pressure is OK or too high. However, blood pressure is a straightforward measurement. It is easy to determine if your pressure is too high (or too low) by looking at the numbers.

-Time/Date Stamp. All machines that I tested, except the Omron Series 3, the Hylogy, and the A&D 651, had this feature. It allows you to look back at your memory entries to determine when a past reading was taken.

-All-In-One Machines. Some manufacturers have machines where the control assembly is mounted on the cuff. I did not review any monitors in this category, which is a subcategory of the upper arm machines. Why didn’t I review any? Because these devices are expensive and have mixed reviews. Some websites like them, but Consumers Reports felt that they weren’t terribly accurate. However, some people may enjoy this All-In-One concept and may be willing to pay for it.

-Cuff Material. Cuffs are made of various materials, but the ones that used standard cloth are a bit easier to position properly than those made out of nylon (as it can be stiff and/or slippery). With that said, most of the nylon cuffs were still easy to position, and they get easier to properly place over time, as they become more supple.

-Bluetooth/Smartphone apps. If you are a techy person you may want this feature. If you are not techy, you probably won’t use it. Bluetooth allows you to directly connect your HBPM to an app on your smartphone. The app can automatically accept your blood pressure readings and do other useful things, like graphing your blood pressure values over time. This is a great way for both you and your physician to longitudinally track your blood pressures. You will need to download the appropriate app to your phone for this feature to work. Many brands also state that you can automatically transfer data to the phone’s native health app (Health for iPhone and Google Fit for Android).

Note that if you don’t have a Bluetooth enabled HBPM you can manually enter your values easily into all of the smartphone apps that I tested and reap their number crunching abilities.

The Omron Connect app is very good at presenting a lot of data at a glance. The app allows you to export a nice summary sheet or a CSV file.

The Welch Allyn Home app graphs its data in a format that would be very familiar and easy to interpret by most health care providers. It exports its data as a CSV file.

The Greater Goods Balance Health app is useful, but the graphing function is not quite as sophisticated as some of the other apps.

The A&D Heart Track app has many positive features, but it won’t let you delete erroneous BP values. This could be a problem if you entered a number by mistake.

The Beurer app is useful, but slightly less flexible than some of the other apps.

Walmart and Walgreens rebrand this HoMedics app for use with their machines. It does a nice job, but its graphing isn’t as sophisticated as some other apps. Also, it won’t allow you to delete an erroneous BP value.

How I chose my test devices.

I used a variety of factors to acquire my HBPMs. Some were gifted by friends who had upgraded to newer monitors. Also, I bought some very inexpensive off-brand devices to see how they stacked up against more expensive name-brand machines. In addition, I purchased some HBPMs that I frequently saw as Recommended products. Beyond this, I bought housebrand devices from Walmart, Rite Aid, CVS, and Walgreens, as I felt that those brands would be commonly purchased by others. Lastly, I consulted recommendations from the sources listed below.

-Amazon reviews: I tried to buy devices that had high ratings and many reviews. Unfortunately, the same machine could have both rave reviews and terrible reviews. When a purchaser says, Very Accurate, what does that mean? It was common to see one person say that their machine was Spot on with their doctor’s device, and then have another review say that the same model was Way off their physician’s machine. There are rumors of manufacturers giving gift cards for good reviews-which can cause an explosion of synthetic positive reviews.

There is one off-brand unit that has over 27,000 (mostly) rave reviews. It costs $47 and is an Amazon Best Seller. There is nothing wrong with the unit, but you can get a clone of it under a different name on Amazon for $28. Also, at that $50 price point you could buy name-brand HBPMs that are validated and have sophisticated features like Bluetooth. So why is that unit so expensive? Reviews drive sales, which can make a product an Amazon Best Seller, which can then drive up the item’s price (my personal opinion).

This graph shows that the Lazle HBPM was selling for around $35, but has now jumped to around $48. That is a quite the increase!

The $48 Lazle is on the left, and the $28 DrKea+ is on the right. Can you tell the difference? I can’t.

–Top 10 or Best websites/videos: These websites don’t always list their rating criteria, and some seemed like outright shill sites designed to sell a particular device. I would advise caution.

-Reputable sites: Sites like CNET and Consumer Reports put more thought into their reviews and may provide a better source of information. However, they only review a small number of well known HBPMs, and often don’t cite their judging criteria. Consumer Reports did say that their testing criteria was based on several established protocols (like the one used by the British Hypertensive Society). Still, they didn’t give any more details than that. A number of their monitors were listed as 5/5 for accuracy based on their criteria, but remember that a machine with a +/- 10 point accuracy error could still get a “A” rating.

It doesn’t take much accuracy to get an “A” grade validation, and even less to get a respectable “B” grade.

How good are super cheap off-brand home blood pressure monitors?

Both Amazon and eBay are replete with no-brand or brand-X HBPMs. I was curious to see how well they performed, and so I bought three very inexpensive HBPMs that had good customer reviews. I purchased a Belifu HBPM for $20, a BSX513/Sweet Alice HBPM for $20, and a Topffy HBPM for $23 all from Amazon.

The Belifu, Sweet Alice, and Topffry HBPMs. These very inexpensive machines all worked surprisingly well.

Although their features varied, they all allowed two users, had large memory banks, some type of averaging function, and a BP classification indicator. Two of the units had backlit displays. One featured audio prompts, and one came with a very nice nylon carry case.

These units had many more features than entry-level brand-name HBPMs at a fraction of their price. But how good were they? Construction quality was adequate but a cut below the brand-name offerings. Their plastic cases were lighter in weight, and their buttons felt a bit cheaper. Also, their cuffs were slippery nylon. However, the machines’ actual performance was very similar to brand-name monitors.

Should you buy one of these machines? That is a difficult question as I only sampled one unit per brand, and I have no idea what their long-term reliability will be.

In general, I would go with one of the recommended HBPMs listed below. However, I understand that there may be some of you who read this post who have very limited incomes. Perhaps you are surviving on Social Security, and you have to count every penny. The good news is that it certainly seems that you can get a HBPM for $20 that will do the job.

eBay Anyone?

You can buy recognized brands at significantly lower prices, and many no-name HBPMs at rock bottom prices on eBay. I tried to purchase a no-name machine from a seller with 45 “reviews,” all very positive. The machine never arrived and it turned out that the reviews were fake. Right after I bought the machine bad reviews flooded in and the seller shut down. I did get a refund from eBay, but this is apparently a common scam so some caution is advised.

I would only buy from a seller who has both an excellent rating and many previous sales. In addition, I would only buy a new machine; you don’t want a HBPM that fell off grandpa’s kitchen table a dozen times. Remember that it may not be possible to exchange (or even return) an eBay procured device, but you can easily do either when you buy from a local store. What is more important to you, price or convenience? The choice is yours.

I’m waiting to receive this YMT-Life HBPM from eBay. It only costs $9.99 and I’m very curious to see how well it will work. Sometimes you get bargains or eBay, other times you get trash. Addendum: I have done some initial testing on this machine and it works surprisingly well. How someone manufactures and sells a working HBPM for less than $10 is beyond me.

Conclusion.

Home blood pressure machines (HBPMs) have different characteristics based on their feature sets, algorithms, and construction quality. I strictly followed the American Heart Association blood pressure taking protocol and averaged my results. By doing this, I discovered that the machines that I reviewed may vary by features, but they were similar in their blood pressure reading ability.

At times I saw significantly different consecutive readings with all the HBPMs that I tested; occasionally, I would get a large difference between readings taken only minutes apart. However, at other times the same machine would deliver three readings that were reasonably similar to each other.

There could also be differences between different machines. On one run Machine A could give me a higher average than Machine B, but that could reverse when I ran the two machines in a second competition.

When it came to actual numbers the machines fell into three general categories. The Beurer, Walgreens, and Beliful monitors tended to give slightly higher than average readings. Many of the Chinese no-name brands gave slightly lower than average readings. The Omrons, A&D, Welch Allyn, Walmart, and some no-name brands (for instance the LotFancy, Hylogy, and Greater Goods) monitors gave readings in between. This middle group most closely matched the numbers that I got using reference machines (a mercury sphygmomanometer and a professional Omron HPB 1300). Note that all of the machines worked well enough. However, you may need to slightly adjust your numbers up or down depending on the particular algorithm that your monitor uses.

Despite terms like Validated and Clinically Proven Accurate, it is known in the medical literature that HBPMs are not very accurate. You may think that this makes them useless, but that is not the case. Doctors understand that the blood pressure taken in their office is often suspect as it is a single reading compounded by many variables (did the patient just have a coffee? Did they run up the stairs? Are they anxious?). If you were sitting on the edge of an exam table when you had your blood pressure taken the reading was not done using the standard American Heart Association protocol.

Regularly taking your blood pressure at home will give your doctor a much more realistic picture of your blood pressure over time, and this data will allow him/her to more precisely adjust your medications. Home blood pressure monitor readings give generalized blood pressure results and show trends. Both factors are important enough to justify their use.

When taking your blood pressure, use a cuff that fits your arm. Always use the blood pressure-taking technique advised by the American Heart Association (see standardizing section). Take three readings (done about a minute apart) and then average those numbers. List the average as your recorded blood pressure along with its time and date. Lastly, note any medication changes on your timeline.

As a minimum take your blood pressure daily for two weeks after any medication change. In addition take your blood pressure daily for the week prior to a doctor’s visit. In some situations your doctor may want you to take both an AM and a PM reading. Naturally, always follow your doctor’s advice, which may be different than my suggestions.

When I looked at all of the various machines’ readings as general indicators rather than absolute values their results became more usable, as they all gave me a reasonable idea of the general status of my blood pressure. In my case, all of the machines indicated that my blood pressure was in a borderline hypertensive zone. I didn’t need to start antihypertensive meds, but it wouldn’t hurt either. So in the end, they all did what they needed to do.

When it comes to presenting your blood pressure data to your care provider, it is imperative to do so in a way that they can quickly and accurately digest. If you hand your doctor your BP machine, they will likely scan through a few readings in memory and skip the rest. Slowly clicking through a series of screens makes it difficult to visualize the big picture. Instead, give them a hard copy, like those that I listed above, or provide them with BP data from a smartphone’s health app. These methods are more likely to provide your doctor with the longitudinal information needed for them to make an informed decision.

Popular brands usually have several different models that sell at various price points. Generally speaking, a brand’s cheapest model will be as accurate (or inaccurate) as their most expensive one. More expensive models have more features, such as a larger memory bank, fancier displays, and the ability to connect to smartphone apps via Bluetooth.

Even if your machine doesn’t have Bluetooth you can easily enter your blood pressure readings manually into a phone’s health app, and reap all the app’s number crunching abilities.

If you decide to go with a no-name HBPM, choose one with many reviews and an overall excellent rating. However, in many cases, I would suggest buying a known-name device as their overall quality control is likely to be better. I would also consider a validated model, as this indicates that the company is invested in making a quality product. Expect to pay a bit more for a model that is validated as this process adds an additional cost for the manufacturer. In theory, a name-brand product may have a longer useful life as you may be able to buy a replacement cuff if your’s fails.

With that said, I didn’t see significant differences between validated machines and well-rated non-validated ones as far as accuracy or reproducibility were concerned. If you are happy with the device that you already own, there is no reason for you to run out and buy a new one.

No-name brands do have their own advantages. Most are inexpensive, and they often have features that name-brand HBPMs reserve for their premium offerings. Options like multiple users, expansive memories, data averaging, and backlit displays can be found at bargain prices. Some no-name brands include extra-large cuffs. Others have audio prompts making them more desirable for the visually impaired.

House brands from big box stores and pharmacy chains appear to have good construction, and the ones that I tested worked fairly well. No house brand that I tested was validated, but they often stated that they had undergone some sort of clinical accuracy test.

Model recommendations

Despite the location of a company’s headquarters, many manufacture their machines in China.

Models are listed from lowest to highest price. All are upper arm machines.

Equate 4000 upper arm blood pressure monitor.

At $28 from Walmart, this single-user machine is a good value. It includes many useful features like 60 memory readings, A WHO classification indicator, a time/date stamp, and averaging of the last 3 BP readings. Construction is good and it comes with batteries and a storage bag. It has over 600 ratings on Walmart’s website, with most owners loving it.

You can manually enter your blood pressure numbers into the Equate Heart Health app, which is not quite as sophisticated as those from other manufacturers. Naturally, you can always use other health apps like Apple Health or just write down your values on a calendar or in a log.

The Equate 4000 is Walmart’s basic unit, but it has enough bells and whistles to make it a good value. Construction quality is also good.

Greater Goods Blood Pressure Monitor.

I paid $29 on Amazon, but this machine’s price seems to change every time I search for it. I have seen it selling for $39, $32 (with coupon), and $29. I think it is a good bargain if you can get it for $32 or less. If you are interested in this unit, I would recheck it if the price is too high. This machine has a slightly lower build quality and somewhat shorter tubing than some other models. However, it is compact and cheerful. It has a delightful backlit display and supports two users with 60 memory slots for data. It has a time date stamp, does last three averaging, comes with batteries, and has a lovely case. It runs on 4 AAA batteries and includes an AC port and adapter. It has over 19 thousand reviews, with over 90% of them giving it 4 or 5 stars.

You can manually add your data into the Greater Goods’ Balance Health app, which was slightly less sophisticated than some of the other apps. You can always add your data into Apple Health or write your numbers on a calendar or in a log.

The Greater Goods HBPM is a good value at $32, but there are other choices if you have to pay more.

If you can’t find the Greater Goods HBPM for a good price, consider the LotFancy upper arm blood pressure monitor which sells for $25 on Amazon. It is very well constructed, supports two users (180 total memories), averages its last three readings, has very large digits, and comes with an AC port and adapter (batteries were not included). Its nylon cuff is a bit stiffer than others, making it slightly more difficult to properly position. However, the cuff softens quickly over time. The LotFancy’s only drawback is that its initial set-up is slightly more obtuse than other machines. However, setup is still easy if you follow the included instructions. LotFancy does not have a smartphone app, but you can always manually enter your values in a third party app or your phone’s native health app (for instance, Apple Health). Naturally, pen and paper work too.

The LotFancy unit is well constructed. Set-up was slightly different from other machines, so keep your manual.

A&D UA-651 blood pressure monitor.

This blood pressure machine is $30 on Amazon. Like Omron, A&D is a well respected Japanese company. The UA-651 is one of their basic devices, and it is validated. It is similar to the Omron Series 3 but has 30 memories, a jack to connect AC power (adapter not included), and a WHO classification indicator. It does have an averaging feature, but it appears to average its entire 30 memories rather than the last three readings. If you want to go through the mild hassle of clearing your machine’s memory before your daily readings then you can still use the averaging function for your daily average (as those will be the only numbers in memory). There is no time/date stamp.
You can download the A&D Heart Track app, and manually enter your blood pressure and pulse into this program. The app will give you a daily, seven day, and 30 day BP average. Naturally, you can also write your numbers on a calendar or in a log.

The A&D 651 is a basic validated unit that offers more features than the Omron Series 3 at a somewhat lower price.

Omron Series 5 Wireless blood pressure monitor.
The Omron Series 5 Wireless can be purchased for $50 at Walmart. It has 60 memories and a host of features, including a time/date stamp, last three averaging, an AC jack (adapter not included), and a high blood pressure warning indicator. It links to the Omron Connect app via Bluetooth. It functions as a single user machine. Its features description says it is possible for multiple people to use it via the Omron Connect app. However, this functionality isn’t explained in the user manual. The Omron website says that you have to delete all of your entries on the machine to have a second party use it. That would be a mild hassel. This is a validated machine.

The Omron Series 5 wireless is loaded with features. It is best for a single user.

Omron Series 10/Omron Platinum blood pressure monitor.
At $70 and $80 respectively on Amazon, these are Omron’s premium HBPM products. The Platinum version is an Amazon exclusive and offers a few extra features and a nylon case. You can program this validated machine to automatically take three consecutive blood pressure readings and then send the average to the Omron Connect app via Bluetooth. The device has memory banks for two users, a dual display, and an AC jack with an adapter. The Omron Connect app is pretty slick and will graph your readings in an easy-to-read format that would be useful for your doctor. Downsides are a higher cost, and the units are bulkier than others.

The Omron Series 10 is a full feature HBPM with a dual display.

Welch Allyn 1700 blood pressure monitor.
$99 from Amazon. This was the most expensive HBPM that I tested. I did not find this validated machine significantly more consistent than other devices. However, its construction is top drawer. The display is gorgeous, its very compact case is high quality, and the tubing connector and tubing are similar to those used on professional machines. The nylon cuff is easy to adjust, and the velcro is just “sticky” enough. It is very gentle when it inflates, and it is faster than other machines when taking a reading. The device has only one button, and more advanced functions rely on the Welch Allyn Home smartphone app. This Bluetooth app worked well and does an excellent job at curating data for easy review. This is a single-user machine. It can also be powered with an AC adapter, but that is a $20 upcharge.

The Welch Allyn 1700 is well constructed and has a useful app. However, it was also the most expensive device that I tested.

Honorable Mentions

Omron Series 3 blood pressure monitor.

At $33 on Amazon, the Omron Series 3 is a well constructed and validated HBPM. However, it is extremely bare bones. It has a tiny memory bank that holds 14 readings, and it doesn’t include averaging or a time/date stamp. However, it does what it needs to do, and you can get the brand that Doctors Recommend Most at a low price.

You can download the Omron Connect app to your smartphone and manually enter your readings. This will give you the data integration (like daily averages) of a more expensive HBPM at a fraction of the price.

The Omron Series 3 is bare bones, but it is validated and works well.

Beurer BM76 blood pressure monitor.

The Beurer BM76 is from a well known European company that makes quality products. Their blood pressure machines are not validated in the US, but they are validated using similar European validation protocols. The BM76 supports four users (each user gets 30 memories). Its design is sleek and has a gorgeous display. The unit’s case is a lighter weight plastic that I found a bit slippery. It does data averaging, but not the typical last three readings that many other machines do. The Beurer comes with a nylon case and costs $50 at Costco. There is no AC port.

Many consumers won’t need four different memory banks, and some may prefer two larger ones instead. The BM76’s memory/averaging functions are useful but different from other machines. You can average all of your 30 entries or do seven day averages of your AM or PM readings. This monitor will only recall your last reading (you can’t scroll through all 30 memories on the machine-although you can review them on the Beurer Health Coach app).

The Buerer Health Coach app was a bit tricky for me to set up on my phone. I was not alone as there are scores of complaints about this app on both the Apple and Google app stores. The app itself is not quite as user friendly as the ones from Welch Allyn or Omron, but it does the job. The app’s designers made odd choices, like listing data using grey on a lighter grey background. That may look modern, but it was hard for me to read.

Lastly, in head-to-head competitions with other machines the Beurer BM76 has a tendency to give readings that are slightly higher.

The Beurer BM 76 had a lot of features for $50, and can handle 4 separate users.

Equate 8000 Premium Blood Pressure Monitor.

At $58 at Walmart, this is a pricey housebrand machine, but it has excellent construction, and it is loaded with features. The backlit display has colored bars and icons, and the numbers are large and clear. It has voice prompts (that you can turn off), which could be helpful for the visually impaired. It has a WHO classification indicator that lights up in color, and memories for two users (60 memories each). The Equate 8000 will average a user’s last three BP values. It will also automatically take three blood pressures readings at the touch of a button, if set up to do so. Its cuff inflation is so gentle that when I first tried it I thought the machine was broken. The device has an AC jack and comes with an adapter. It has Bluetooth and can transfer data directly to the Equate Heart Health App. It ships with batteries and a nice case.

The Equate 8000 had all of the characteristics needed to have won the mid-price listing on my Recommended List. In fact, it has more features than the Omron Series 5 wireless that did get that spot. Why didn’t it win? The Omron is a brand-name. I feel that a housebrand should offer a significantly better price than a brand-name machine. In addition, the Omron is a validated machine and the Equate is not. Lastly, the Omron Connect app is more flexible than the Equate Heart Health App. However, that is not to say that the Equate app is bad.

As an aside, I bought the Equate 8000 as a NIB item on eBay for $35. At that price, it is an outstanding value.

The Equate 8000 is a nice HBPM with many features. If you can get it at a good price it is a good value.

Can’t find the Equate 8000 on eBay? The Walgreen’s Premium Cuff Blood Pressure Monitor sells for about $70 in stores, but I picked one up for $18 plus shipping on eBay. It is similar to the Equate 8000 in features and could be an alternative pick if you decide to go the eBay route. I did find that the Walgreen machines (I tested all three current models) tended to give slightly higher readings than others.

The Walgreens Premium Arm Blood Pressure Monitor is a full feature device.

Peace

Dr. Mike Kuna

_{Images by MAK or from Amazon, Walmart, Costco, Walgreens, eBay, and manufacturers unless otherwise stated.}

#COVID-19, Filling retirement time, Life after retirement, retirement, secret to success, Uncategorized

Retirement, Third Year Anniversary

March 6, 2021 Dr. Mike

The end of February brought another anniversary. I have now been retired from Genesis for three years and from Rosecrance for two.

On my 68th birthday, Julie noted that I had retired well, and I agree with her assessment. COVID has undoubtedly impacted me during this last year, but it hasn’t all been negative. As I have said many times, events are neither bad nor good; they just are.

So, where is my life, and how is it different from what I imagined?

When COVID reared its ugly head Julie and I had just become empty nesters. We had gone on a few trips, and we were coming to terms with our changing roles. Julie was now the worker, and I was the stay-at-home partner.

A real Saturn rocket, the largest rocket ever built. — Touring the Johnson Space Center in Houston with Julie.

Friends and family had voiced concerns that it would be difficult for me to transition from a high-stress professional career to a suburban homemaker’s role. However, that change was not at all difficult for me. I had never had a problem doing domestic tasks—my life before I remarried required that I have a comfort level with cooking and cleaning.

I have no problem doing domestic tasks, like. grocery shopping.

Just as I was fully embracing our new couple’s life, COVID hit, and our three youngest children returned home. I was delighted to have them back in the safety of Naperville. Still, I now had to adjust to having a family of 5 adults living under one roof.

I was strictly compliant with the stay-at-home mandate for its first few weeks. Surprisingly those restrictions harmed my mental health. I say surprisingly, as our house was full of people, plus I’m an introvert. However, it was clear that I needed to gently and safely broaden my social circle, and that was precisely what I did.

This year I continued to hang out with my friend, Tom. Here we are transporting white oak logs to a sawmill in Michigan where they will be turned into flooring for a project that he is working on. I always love learning new things.

I also started to challenge myself with my endless lists of shoulds I “should” be more productive. I “should” continue hobbies that no longer interest me. I “should” tackle odious home projects. I reached a point during this last year where I decided that my life could be about more than always working towards goals. Especially when those goals had little real meaning.

I did focus on things that had new meaning-like learning how to fix my dishwasher.

During this last year, I continued to accept that I’m an obsessive person who comes from a long line of driven people. I like hyper-focusing on a particular topic. I love becoming an expert on trivial things. Such actions excite me. In the past, I viewed my behaviors with a certain amount of shame. Shame that my obsessiveness was odd or different. However, I now celebrate that difference. My actions harm no one and enrich me.

A recent visit to my primary care physician resulted in his suggestion that I monitor my blood pressure. This launched an obsessive interest in home blood pressure technology that has occupied me for the last few weeks. Others may think that such actions are crazy, but why should that concern me? I am in the process of compiling my findings in a post that may be helpful to others, and that is enough of a reason for my continued attention. I know that this short-term interest won’t last, but there is always something new on the horizon to catch my eye.

I was able to do some limited testing of HBPMs, comparing them against a reference Mercurial Sphygmomanometer. The results suggest that HBPMs give a reasonable “ballpark” blood pressure reading.

Some of my obsessions last much longer, but COVID has forced me to temper them. My passion for photography continues, but many of my photographing opportunities have not. COVID has robbed me of my small town visits, family get-togethers, and professional gigs. However, I continue to take photos for my friend Tom’s blog, and I genuinely enjoy helping him.

I love traveling to small towns to take photographs.

I continue to take a lot of construction photos for my friend, Tom.

An architectural shot that I did for one of Tom’s finished projects.

My passion for camping and minimalism has also been altered because of COVID. Before I go any further, I understand that those who know me are probably snickering that I connected myself with the term “minimalism.” I freely admit that I am an owner of things. I am a collector who is fascinated by the difference between similar objects. I am a person who has a house that is full of junk. Dear reader, I am a complex human, not a one-dimensional caricature. There is a part of me that likes stuff and a part of me that wants simplicity. When I am camping, I travel with very little, and I love the freedom that this brings me.

Making pancakes while camping in the Medicinebow National Forest.

A deer stops by Violet the cameprvan to say, “Hello.”

I did go on a few trips, but less than what I had hoped to do. I also spent a week of urban camping in Violet the campervan. Julie had a COVID quarantine, and I was concerned about my health. Despite what you may hear on YouTube hipster channels, urban camping sucks. I am grateful to have experienced it so I could sensibly develop that conclusion.

I mentioned that my three youngest kids returned home as soon as I had become comfortable with our empty nest. I am happy to report that I did adjust to my kids’ return. They came back to us as adults, but all of the shelter-in-place restrictions brought back a bygone time when our family was less diluted by other social obligations. We played games again, binge-watched TV shows, and (my favorite) cooked meals together. It was such a delight to go on long “adventure” walks with my kids. Something that I used to do with them when they were in elementary school. These times were wonderful gifts from COVID.

Cooking with my kids is one of my greatest joys.

We made Christmas dinner together-our first immediate family only Christmas dinner ever!

Going on adventure walks with my kids has been a wonderful replay from the past.

My Kathyrn left home when she was a sophomore in high school to attend IMSA. She then matriculated to the University of Arizona. When she graduated college, she joined the Peace Corps and moved to Africa. When COVID hit, she was evacuated back home. I have always had a good relationship with Kathryn, but it was still a bit distant. She connected well with Julie, and for that, I was grateful.

Over this year, my two youngest returned to college, and with Julie working, it was often just Kathryn and me. Over time we have become a team and a good one at that. Kathryn helps me clean the house, we grocery shop together, and we make and eat many meals together. I am a good teacher but a terrible driving instructor, but Kathryn needed to get her driver’s license, so we worked that out. Along with doing the tasks of life comes conversation, and along with talking comes connection. I don’t think that I have ever felt closer to her—another COVID blessing.

The year continued to educate me about my need to be connected with others. I am definitely not a person who needs to be the most popular kid on the block. I don’t need to have a million friends. I don’t need to be the center of attention. However, I do need connections. This last year I have strengthened many of my existing relationships. Naturally, that includes Julie and the kids. It also includes my relations with my extended family.

During much of my marriage, I was solely concentrated on my immediate family and my professional life. Over the last years, I have realized the importance of having male friendships in my life. This last year, I have strengthened my connection with the handful of men I call real friends, and I have been rewarded by their wisdom and caring. It has been a tremendous growth experience.

Asking my friend, Tom for help when I screwed up a faucet repair.

Hanging out with my friend, Ralph on his farm.

Has this year of COVID retirement impacted me? In ways opposite of what I could have expected. Many people have suffered because COVID has isolated them and diluted the connections they had with others. For me, it has had the opposite effect. I find that fact both interesting and remarkable.

This last year has allowed me to slow down and to stay in the moment. It has shown me how significant relationships are in my life. It has allowed me to rely on others and to ask for help. Something that I would have found impossible to do even a decade ago. Miracles can happen.

Pausing to see the beauty in simple, everyday things.

This has not been a “lost year,’ as some feel. It has been a different year. Remember, different doesn’t mean bad.

I move into my next year with anticipation and excitement. I wish the same to you.

Peace

Mike

Uncategorized

Pause

January 22, 2021 Dr. Mike

I wrote a post today, but I’m not publishing it. It wasn’t that it was terrible; it just wasn’t me.

During the pandemic, my daily experiences have been reduced to a pattern of routine activities. I’m not complaining, and I know that my life is fuller than many. I have things to do, people to connect with, and new knowledge to learn. These make me happy, but they have not provided me with new stories to tell you, dear reader.

When I started this blog, I had great ambition. I thought it would be a way to hone my writing into an honest and direct style. In a grandiose way, I thought of it as a platform for my next career. That was not to be.

I realized that my talents are best utilized on the small screen of individuals rather than the big screen of being an influencer. My blog mission changed as I sought to convey my ideas to this smaller group.

I hope that some of my writings helped others. Also, I know that I have former patients who read this blog, and writing it was a way to stay connected with them. I have worked with some patients for years, and I continue to think about them. I am no longer their doctor, but I want them to know that I still care about them. I want them to have successful lives.

The most important group that I write this blog for is my children. I want them to have a record of who I am and what I stand for.

At this time, I will pause the blog with the hope that time will allow me to gain inspiration of where it should go next. I plan to stop publishing the blog for the next six weeks-although I may write if I’m struck by something.

I’m thinking about ways to freshen my content. One idea that my daughter, Grace, suggested was to have theme weeks. One week might be a story with a message; another may be a trusted recipe, a third may be a useful review or tip. Others have suggested that I write only when inspired to do so. I don’t that will work as it would be too easy for me to procrastinate.

I want your ideas of where I should go with this blog. You can reach me at mike_kunaSPAM@hotmail.com. (remove the word SPAM from the address-it is there to confuse email gathering robots). List “Blog ideas” in the title. I promise to read every suggestion.

Goodbye for now. I’ll be back during the week of March 7th.

Peace
Dr. Mike

changing behavior, exercise, Making Change

My Secret

January 14, 2021 Dr. Mike

I have a secret that I want to share with you, but you have to promise to not tell anyone. Do you promise? If the answer is “No,” stop reading now.

Before I reveal my secret, I want to tell you a little bit about my wife, Julie. When I met Julie, she was an avid runner, and that habit continued throughout most of our marriage. You may have noticed that I used the word “habit” rather than “hobby.” My choice of words was not random. A habit implies a repeated behavior incorporated into one’s psyche, where a hobby is a pleasurable leisure activity.

Julie loved to run. Running gave her energy and made her feel emotionally happy. Several years ago, she had a knee surgery that resulted in a bad outcome. That ended her running career. This was devastating to her, and she grieves the loss to this very day. To understand why that is the case, you need to learn just a little about how the brain works.

A structure in Julie’s brain, the nucleus accumbens (NA), becomes more active when she runs. The NA is part of the brain’s reward pathway. This is a pathway that is activated to reinforce behaviors that are necessary for species survival. Have you ever eaten a great meal and had a sense of ease and contentment afterward? When someone gives you a genuine hug, does it feel wonderful? Do you feel happy and mellow after a positive sexual experience? What you are feeling is an activation of the reward pathway; all of these activities are directly or indirectly necessary for our species’ survival.

There are ways to corrupt this pathway. Drugs of addiction, including cocaine, heroin, and alcohol, abnormally activate the reward pathway. Process addictions, like shopping and gambling, also activate this connection. The reward pathway doesn’t have logic; it is reflexive. When a drug like cocaine activates it, the brain assumes that cocaine is necessary for survival. Your brain seeks out cocaine, and an addiction is born.

The reward pathway’s sensitivity is governed by several factors, including a person’s genes, and different brains are likely activated by different things. Alcohol may over-activate one person’s brain but not others. Likewise, exercise may be triggering for one individual but not so much for someone else.

Why would one person’s NA be highly sensitive to exercise when another person is not? Is physical exercise necessary for species survival? As a species, we need physically active members. However, exercise is less important than eating or procreation. If you have more active and less active individuals, your overall species survival may be enhanced. Individuals who like to exercise could become warriors and builders. Those who prefer a more sedentary lifestyle would be content serving in other important but less physically demanding roles.

Our automated lifestyles are very recent in our evolution; everyone had to exercise to some degree in the past. However, over the last decades, the physical demands of humans in developed countries have diminished exponentially. We can order our groceries online, drive to our appointments, and even use a “robot” to vacuum our carpets. Our increasingly sedentary lives have had increased health consequences ranging from obesity to dementia. Since we don’t have to toil in the fields, some go for a run or spend time at the gym. For someone like my wife, it is easy to adopt an exercise program. Why? Because she has direct emotional and physical benefits from exercising. Who doesn’t like doing things that feel good?

Here is my secret, I don’t feel good when I exercise. In fact, I feel sort of lousy when I do it. I used to feel guilty that I hated exercise. I thought that there was something wrong with me or that I was just plain lazy. However, I now know that my brain just operates differently than some. Yet, I know that it is essential for me to be physically active. How does someone like me exercise regularly? How do I turn a negative into a positive?

When I married Julie, I was carried away by her exercise enthusiasm. I outfitted my basement with thousands of dollars of gym equipment. Every day I would force myself to go into the cellar and exercise. Every day I hated it. Despite my feelings, I exercised for over a year until I had a minor injury. I then stopped altogether.

Many years ago, my friend Tom encouraged me to join his gym. I would meet him at 5 AM most days before I worked with my personal trainer. Afterward, we would have coffee. I looked forward to going to the gym and reaped the benefits of all of my physical activity. After some time, Tom’s schedule changed, and he stopped coming. By then, I had established myself with some of the other gym rats who welcomed me into their fold. However, I found myself getting bored, and soon I came up with reasons to sleep in. The new reward didn’t offset the pain.

I knew that I had to do something physically, so I came up with another plan. I would get up very early and walk to my local Starbucks-a round trip of 3.5 to 4.5 miles, depending on my chosen route. I do enjoy walking, thinking, and meditating. At Starbucks, I formed friendships with some of the customers and had good relationships with the baristas. As a bonus, Tom would visit me on occasion. However, the real draw was that I used my time at the Starbucks to write, and I even had a dedicated table at the coffee shop. I was motivated to walk every day and did it one day when it was -27F outside. Unfortunately, all of that ended with the onset of the pandemic.

Walking and hiking are my favorite exercises, as they have many sensory dimensions. Movement for the sake of activity doesn’t do it for me. Exploring nature is motivating, but unless the scenery is incredibly engaging, it is still insufficient to get me out of bed every morning. I have found that I must combine my walking with another activity. Tom bought a townhome closer to my home, and I’m motivated to walk there to visit with him. My kids like to walk, and it is enjoyable for me to walk and talk with them. I also like to walk somewhere with a purpose. For instance, I don’t mind walking to our local market to pick up a few groceries. I have found that combining exercise with something that I enjoy reinforces my desire to be active.

I have also come to realize that some exercise is better than no exercise. In a perfect world, I would do various exercises that increased many aspects of my physical well being. However, I don’t live in an ideal world. Instead of constantly feeling guilty that I’m not doing enough, I am committed to celebrating what I am doing. Such an attitude promotes the continuation of a behavior. Guilt often has the opposite effect.

If I can pair a positive with something that I don’t want to do, it is much easier for me to accomplish my goal. This has been the case with exercising regularly, and I also do this “combining” technique for many other things that range from making dinner for my family to paying bills.

I pass this idea to you. Are there things that you need to do in your life that you procrastinate around? Consider pairing them with something that you do like, and you will probably have more success in accomplishing your goals.

Peace

Mike

I like to walk in nature. I can enter a walking path very close to my home.

Walking with a practical goal motivates me. Here I walked to my local market to buy a few things for dinner.

It is important to plan ahead. A shoulder bag makes the return trip home easy-hauling a number of plastic bags would be a drag.

I love looking at scenery when I walk. Here I’m spying some graffiti on a viaduct.

Here I’m walking by our carillon. It serenades our downtown on the hour.

The only exercise equipment that I need is a decent pair of shoes.

changing behavior, getting rid of bad relationships, Good relationships, Making Change

The Cabinet Under The Sink

January 9, 2021 Dr. Mike

“Dad, it’s dripping.” I looked towards the sink and witnessed a single drop of water form and fall from the kitchen faucet. “Maybe the handle isn’t all the way off,” I commented. I went to the sink and tapped both the hot and cold handles. They were already closed, but I was hopeful. A minute later, another drop was perched and ready to dive.

Our faucet had been replaced 10 years earlier when we did a partial remodel of the kitchen. I had long forgotten the faucet brand, or even where I purchased it. Also, I had no idea how to fix a leaky faucet, although cloudy images of washers and O-rings danced in my head. It was time to visit YouTube.

I quickly found several fix-it posts. Like most DIY videos, the process looked simple enough. “I can handle this,” I thought. Those of you who are regular readers of this blog may be thinking, “Why not call your contractor friend, Tom?” Dear reader, I am privileged to have a talented friend, but I don’t want to abuse his goodwill. Besides, I was already encouraged by my recent dishwasher repair. But as George Bernard Shaw said, “Beware of false knowledge, it is more dangerous than ignorance.”

Armed with a Phillips screwdriver and a pair of channel locks, I faced my foe. With a MacBook by my side, I played the first segment of the video. “Make sure that you turn off the water valves under the sink.” That sounded like a reasonable step. I reached into the chaotic mess in the cabinet below and blindly felt for the rough metal oval that functioned as the shutoff valve. Grunt! Grunt, grunt, swear… more swears….more grunts. The valve was frozen. Defeated within 5 minutes of starting! With my head hanging low, I pressed the FaceTime icon on my iPhone and then hit the button labeled “Gizmo” for my friend Tom. He answered, and I asked in earnest seriousness, “How can I close a frozen water valve? Can I hit it with a hammer or something?” “No, don’t do that; you could have a flooding disaster! Hold on, I’m coming over,” Tom replied.

Ten minutes later, Tom was at my front door, his toolbox at the ready. He reached under the sink and found the offending water valve. Tom was able to close the valve without difficulty. Dear reader, you have to understand that my hands have only had to grip objects like pens. My digital muscular strength was developed to accurately hit the keys on a computer. Tom has a definite advantage as his mitts frequently turn wrenches, carry heavy objects, and twist bolts. I can only feel so ashamed about my inferior gripping and twisting ability.

With water off, it was time to remove the faucet’s handle and replace the defective water flow cartridge. This involved releasing a special retaining nut. The nut was where my problems escalated. The thin metal was calcified by being subjected to years of Chicago’s hard water. When we tried to loosen it, the nut disintegrated. …more swearing ensued.

The planned obsolescence reality is that it is easy to buy a replacement faucet cartridge, but it is impossible to purchase its companion retaining nut. This latter fact was confirmed after visiting three different hardware stores and talking to two “plumbing experts.” My only option was to buy and install an entirely new faucet. Now I really needed Tom’s expertise.

I also had to tackle the mess in the space below the sink, and that cabinet is the central metaphor for today’s post. I apologize for my long preamble, but I needed to provide you with some context for today’s story.

The region under my kitchen sink has long been the equivalent of a junk drawer. A place where nearly empty bottles of cleaning chemicals live. A zone that collects never to reuse grocery bags. A region of specialty cleaners that I buy but then forget that I have. Four different granite cleaners and at least three different types of glass cooktop polishes were only two of many categories found.

The cabinet was bursting and chaotic because of its massive overflow. I found two brand new buckets of dishwasher packets even though I thought we were completely out. Three different glass cleaners were also located. There were enough unused sponges that, if “real,” they could have repopulated a small coral reef.

Confusion ruled. Empty products had equal status with unopened new containers. The space was so disorganized that it was easier to buy a new bottle of something rather than to look and see if one already existed.

The first category to be tossed was my massive collection of useless plastic grocery bags. I then categorized the other items. One pile became a mountain of sponges, another zone had powdered cleaners; still, another region was designated for granite products. Nearly empty items were discarded, as were those that had broken sprayers or cracked caps. I then organized the groups into plastic bins.

With a small amount of effort, years of disorder were transformed into a neatly organized and functional space. My life had instantly become simpler by applying a little time to the problem. Why did I wait so long?

In many ways, the lazy behavior that I exhibited was no different than other actions that have hampered me in my life. It was simpler to go with business as usual than to take a little time and change a bad habit. It was easier to maintain broken relationships than to admit that it was time to move on. Having to deal with life’s clutter made it impossible to enact simple solutions to make beneficial changes.

Just like cleaning my “junk” cabinet makes sense, it also makes sense to evaluate my life’s situations regularly. What should I keep? What should I get rid of? What should I reprioritize? Items that entered my cabinet with the promise of making a task simpler often just made things more complicated, and it made sense to recognize their false promise and rid myself of them. The same can be said of my life; some situations that promised benefit actually delivered the opposite. It is my personal responsibility to make sure that my life is uncluttered so I can see the forest for the trees.

Once I had emptied out the cabinet, it was simple for Tom to replace the errant faucet. Another lesson can be learned here. I probably could have completed the repair myself, but it would have taken me much longer, and the outcome may have been worse. Yes, you need to solve your own problems, but sometimes it makes sense to call on an expert to assist you. Their knowledge can turn a difficult job into a simple task.

Do you need to clean your metaphorical cabinet?

Peace

Mike

With a small amount of effort disorder became order.

Sometimes it makes sense to call on an expert.

Changing Christmas, Christmas Past, COVID Christmas, Dealing with Christmas stress

Merry COVID Christmas

December 29, 2020 Dr. Mike

I created this blog for several reasons, one of them was to develop my writing style. To accomplish this I committed to a few rules, including to be wholly honest and transparent. I felt that this stipulation was necessary to give validation to what I was writing. Unfortunately, I have been only partially successful in meeting this goal.

I am honest when I write about my past, my fears, my ideas, my successes, my failures, and just about anything related to me. However, I have been conscious to not write about situations that those close to me may find awkward. I made this modification early on when I wrote something about a family member and was told, “You embarrassed me.” That event brought back memories of Erma Bombeck, a newspaper columnist from my youth who wrote a hilarious column that often featured the antics of her children. Decades later I found out that her writings caused her kids untold grief as they hated having their exaggerated dirty laundry aired to their neighbors, teachers, and peers.

I am able to see both the good and bad in people and situations, but my nature is to focus on the positive. Some have accused me of being too Pollyanna-ish, but this is just who I am. I had a concern that my more positive view of this holiday season could be upsetting to some readers who felt punished during this time. I don’t want to be the guy who is rubbing joy into someone else’s face. Should I not write about Christmas because it might be a “trigger” for someone? Editors note: I really am starting to hate the word trigger, and its overuse… but here I am using it myself.

I know Christmas was difficult for many, as most normal get-togethers had to be shelved. The same can be said for my family as we had to forgo a variety of celebrations on both sides. Despite these losses, I enjoyed Christmas a lot.

In many ways I am privileged. I’m retired and have a retirement income, most of my kids were home for the holiday, and I am generally healthy. I’m sure these factors impacted my Christmas experience. Could being truthful hurt some of my readers who have less?

After weighing all points I decided to write about my Christmas. Why? Because I understand that the way that we think about a situation has a direct impact on how we experience that situation. This is an important rule that is worth writing about.

One theme that I have repeated in my blog posts is that events and situations are neither good nor bad, they just “are.” As you read this some of you are thinking of exceptions, and are likely muttering something like, “How can you say that the coronavirus is neither good nor bad? Millions have become sick and hundreds of thousands are dead!” You would be correct in your assertion that this virus has inflicted terrible consequences on our world. However, its total effect won’t be known for decades. Believe it or not, some positive may result from this plague. It is possible that the lessons that we have learned from this pandemic will save us from an even more deadly one in the future. -Sadly, there will be more pandemics.

Back to Christmas.

Here are some of the things that I chose to view as negative:

I missed not seeing my close family, friends, and relatives.

Here are some things that I chose to view as positive:

I didn’t have to travel long distances in terrible weather conditions. I have had to make many white knuckle drives during whiteouts and blizzards to attend past Christmas get-togethers.

How did I redesign Christmas for 2020?

There are many unrealistic expectations around Christmas. Is it any surprise that so many are stressed before Christmas and disappointed afterwards? My goal was to extract what my family found significant and to focus on those events. I used a broad strokes approach instead of trying to micromanage everyone’s individual experience.

There are general themes that we focus on at Christmas time.

The reason for the season-

As Christians we use December 25th as a day to honor the birth of Jesus.

Decorating-

We don’t have a showplace Christmas house. In fact, our decorations are a bit on the soft side. We decorate our living room and family room. In recent years I have backed away from doing a lot of outside decorations-I hate taking the stuff down in the bitter cold.

The most significant holiday artifact is our Christmas tree. It is an old artificial one, that seems to lose more “needles” than real trees do. However, we love putting on the tree’s decorations as they all have significance to us. Many ornaments were given as gifts, while others were made by our kids in preschool and grade school. Each placement feels like a little visit with an old friend.

We all decorated our tree, which was filled with memories from the past.

Food-

Food is a major part of any celebration. We usually have our main meal on Christmas Eve. This year I was chief cook and decided to make a beef tenderloin, tossed salad, glazed carrots, scalloped potatoes, and freshly baked yeast rolls. Julie acted as my assistant, easing my responsibility. I was terrified that I would ruin the tenderloin, as its overall cost was akin to a small mortgage payment. Thankfully the meal turned out great.

Our Christmas Eve dinner table was simply set with some very old and much loved Fiestaware.

I was in charge of making Christmas Eve dinner. Happily, it turned out well.

Traditionally Julie makes a brunch on Christmas Day which always includes an egg casserole dish which we refer to as “egg dish.” It is a combination of eggs, bread, ham, and cheese that is prepared the night before to allow everything to meld together. When baked on Christmas morning it turns into a combination of a souffle and a casserole. It is a holiday must-have in Kunaland.

Julie made our Christmas Day brunch. Here she is dusting some Monkey Bread. You can see the “egg dish” far left.

You may be wondering what we had for Christmas Day dinner. Frozen pizza! It is great to make special meals, but none of us wanted to spend the entire holiday cooking.

Desserts-

Another Christmas tradition. William decided to make Grace a favorite dessert and Grace decided to do the same for William. It was their gift to each other. Personally, I love the idea of a gift of service. Both William and Grace shared their dessert gifts with the rest of the family. A sweet holiday for all.

William making Grace some ice cream cone cupcakes, a favorite memory from childhood.

Grace making William a fresh strawberry pound cake, a recent favorite of his.

Gifts-

For decades Julie and I have tried to deemphasize gift giving, but we have been only partially successful. We have come to realize that it is an important part of the holiday, and we now focus on finding things that have meaning rather than things that are just expensive. For instance, the kids know of my love of camping and gave me items like a book on the National Parks. I gave Julie a variety of things, but I also fixed a long-broken lamp that she loves. For us, it is less about the thing and more about the idea behind the thing. With that said, it is a wonderful feeling when someone is thinking about you. Kindness does not have a monetary value.

The kids know that I love camping. Here I have some camping lounge pants!

My Godchild, Jenny had this special “camping style” mask made for me!

Will wanted some flags for his dorm room. Here he is getting in-touch with his inner Slovak.

We had a power outage that lasted several hours on Christmas morning. Julie was disappointed as we couldn’t listen to music. However, I had a wireless bluetooth speaker in Violet the campervan. The speaker plus some Spotify beamed from my phone did the trick!

Julie got a card game that she played as a child. It was a happy memory.

Together time-

We enjoy spending time with each other. Most of our Christmas time together was centered around meals, watching the end of a TV series on a DVD (which was also overdue from the library), and gift opening.

Alone time-

One of the advantages (for introverts like us) was having more alone time this year. There is not much more to say about this as each of us like doing our own thing.

Extended relationships time-

We had a long ZOOM call with Julie’s family on Christmas, and I made sure to contact people during the holiday season via the phone, ZOOM, Facetime, email, Facebook, and texting. As the pandemic has lurched on socializing options, like a group ZOOM call, seem more natural.

We had a long ZOOM call to Julie’s side of the family.

If I summarize what we did for Christmas, it wasn’t much. We remembered why we were celebrating the day, put up simple decorations, had a few nice meals, opened some gifts, and connected with people who were important to us. So why was the holiday special? Because we choose to make it so. Importantly, we focused on what we had instead of what we didn’t have.

I would also like to emphasize that I wasn’t trying to artificially replicate our usual Christmas. Instead, I took important elements from past Christmases and created a new celebration. I did this to avoid the agony of comparison. I didn’t want us to dwell on why we didn’t have X, Y, or Z. Instead, I wanted us to focus on what we did have.

I understand that some of you may be more fortunate than me, and some of you may be less fortunate. However, it is possible for all of us to approach important events in our lives with what we have, or what we can create, rather than what we don’t have or what we are giving up.

When I was working I would often hear tales of miserable Christmas holidays. Some would vacation, but their friends went to more exotic places. Others gave fabulous gifts, but they then had to deal with debt. Still others tried to orchestrate a “Norman Rockwell” Christmas and were upset when things weren’t as perfect as what they imagined. People can be disappointed during the best of times when they choose to focus on what’s missing. It is up to us to make our lives the best that they can be.

Christmas 2020 will only happen once in a lifetime, I refuse to throw this day away in the hopes of a better 2021. Each day is precious, never to be repeated.

Uncategorized

Dr. Fixit At Your Service

December 24, 2020 Dr. Mike

The little boy in me has always liked building and fixing things. I have done limited repair jobs in the past, but I have been hampered by a lack of knowledge, tools, and time.

On occasion, my interest level would overcome these restrictions, and over the years, I have tackled a few projects. I crafted a desk, hand-built many computers, attempted basic home decorating, and completed some other small projects.

When I moved into my house 30 years ago, I subscribed to a home repair “book of the month” club. Every 30 days, I would receive a glossy covered book highlighting a particular topic, like heating and air conditioning repair. When a fix-it task came up, I would dig into that collection, but I often found that I didn’t have the right tools or that the instructions were too generic to help a novice.

Let’s face it, when you are working 60-70 hours a week, it becomes easier to call someone to do your repair work. Also, I have been fortunate to know my friend, Tom. Tom has both the tools and the talent. He has always been happy to help me, and I rely on him for those jobs that are well beyond my pay grade. However, I don’t want to take advantage of Tom’s goodwill. He is busy enough without my demands.

When you have lived in a house for 30 years, appliances break. In fact, they seem to bust more frequently as their technology advances. I still have the basic 1984 electric stove and fridge that came with my home; they now live in my basement. However, the same cannot be said of their much more expensive replacements. Currently, I’m on my third new range, fridge, and dishwasher. These devices promised miracle features, but they were less forthcoming when it came to reliability.

Replacement stove #2 was a technological marvel with a convection oven, bread proofing drawer, induction stovetop, and enough colored LEDs that it could have been mistaken for a Christmas tree. Over the 10 years I had it, the device was repaired at least 3 times. Each service call was more expensive than the last. The Fourth and final repair attempt happened a few years back. The oven had gone nuclear; I would set it for 350F and come back to a meal that had been reduced to charcoal briquettes. The repair guy’s consultation was $150. “I can stay and monitor your temperature rise, but that is going to cost you a lot more,” He said. The man kindly told me how to reprogram the oven’s micro-computer but informed me that if my efforts failed, it would make more sense to buy a new stove, as it was unlikely that they still made the logic boards for my model. I re-calibrated the oven’s thermostat, and I was able to get a few more months of life from the stove, but soon it was back to its old tricks and failed right before Thanksgiving 2018.

Thanksgiving is a big holiday as we have guests arriving from multiple states. Many stay for several days, and they eat all of their meals at our house. The logistics of making Thanksgiving dinner for 20 plus numerous breakfasts, lunches, and dinners are always daunting but felt impossible without a working oven. That year we pulled it off with a microwave, toaster oven, and our old basement range. Basement cooking is not a sustainable option, and we bought another stove the following Monday. Kitchen appliances may be more energy efficient than they were in the past, but that doesn’t offset their additional repair and replacement costs. I can’t say that my life has changed for the better now that I can tap in 350F on a stove’s keypad instead of turning a simple dial.

Julie shouted from the kitchen, “Mike, I don’t think that the dishwasher is working.” “Oh,” I replied. “What makes you think that,” I said. “The dishes don’t look washed,” was her rational reply. “I think you need to fix it.”

Editor’s note: In today’s world of equality, why is it assumed that males are magically endowed with appliance repair knowledge?

I came into the kitchen for a visual inspection. “Yep, they still look dirty,” was my sage response. At this point, I would normally say that we needed to call a repair service. However, the dishwasher is around 10 years old, and I knew that a repair person would charge $150 just to come out. Any repair would likely be several hundred dollars more. In this COVID era, did I really want a stranger in my house, and did I want to spend $300 to have an old machine fixed? It was time to put on a metaphorical hard hat, assume my manly responsibilities, and attempt to fix the appliance myself.

I went to the fount of all knowledge, and I typed into YouTube’s search engine. “Whirlpool dishwasher not cleaning dishes.”. Up popped several videos with titles containing words like “Easy fix” and “Simple repair.” A chill went up my spine. I have gone down “Easy” and “Simple” paths in the past, and I have learned that these words are really code for “Difficult” and “Demoralizing.”

One Christmas, when my girls were small, we purchased an entire play kitchen whose box loudly proclaimed, “Easy assembly, only requires a common screwdriver.” The kitchen had a pretend oven, stove, microwave, and sink. There was a little counter and several cabinets for pretend food and plastic pots. I knew my kids would be thrilled on Christmas morning.

It was Christmas Eve, and both Julie and I were involved with various tasks designed to ease Santa’s burden. By the time I got to the kitchen toy, it was well past 10 PM. I was tired and irritable.

The panels that made up the “kitchen” were made of a molded plastic. The hollow kind that has a waxy candle smell. I scanned the incomprehensible instructions and started to snap Tab A into Slot B. The process was not smooth. Some problems were due to my fatigue and unwillingness to interpret Chinese English into English. I would accomplish one portion of the assembly to discover that I needed to do something else first. Also, the kitchen had at least 100 stickers that had to be precisely placed. Despite all effort, I found that I was putting some stickers in the wrong spots and placing them askew in others. However, this was the least of my problems. The various panels that made up the kitchen’s structure simply would not snap together. In fact, two were almost ¼ inch off. I pushed, swore, and pushed some more. I tried banging the large panels with a hardcover dictionary and even incorporated Julie’s muscle help. It was now well past midnight, and I was in a panic. This was their major gift, and it lay in ruin on our family room floor. I felt wholly inadequate as a father. I couldn’t put together a simple toy that proclaimed that it was easy to assemble. I was a failure.

I was physically agitated, my heart was pounding, and I was sweating. I needed to calm myself. I leaned back in my Lazyboy and popped up its footrest. I closed my eyes and meditated to calm my mind. My breathing started to slow, and my palpitations quieted. “Breath in through the nose, count to 5, exhale slowly from the mouth,” I repeated to myself. I took myself to a quiet place and opened my mind up to new possibilities. Immediately, an answer came to me, but it had to be the wrong answer. “Go into the garage and get your sledgehammer.” “What!” I thought. “Am I supposed to wack this piece of… with a sledgehammer? I’m not that angry!”

I couldn’t run to the store and buy a new present, it was the middle of the night. “What good is all of this meditation if all I can come up with is a ridiculous solution. Universe, give me another answer!” “Get the sledgehammer” was my reply. “You win, but I’m blaming you when my kids are crying tomorrow morning!” I informed the little thought in my head.

I had Julie hold the two offending panels, and I made sure that she was as far as possible from my intended point of impact. I tried a few light taps, nothing happened. I focused again on the target zone. I drew out my arm, and with both energy and intent, I swung the hammer. I momentarily closed my eyes… I didn’t want to see the toy shattered and destroyed. CRACK! And click, the two errant panels mated. The hammer worked! I completed the rest of the job feeling a combination of exhaustion and exhilaration.

My kids played with that “kitchen” for many years, and they have served me countless plastic donuts and pretend cups of coffee that were heated to perfection on decal burners. The kitchen was one of their favorite toys of all time. However, the build experience left an indelible stain on the words “Easy” and “Simple.”

You can now understand why I shuttered when I saw those mocking words on the YouTube videos. But what choice did I have? I had to submit myself; like Princess Leia’s plea was to Obi-Wan, YouTube was my only hope.

The first video told me what to do but didn’t show me how to do it. “Remove the plastic retaining clips,” it commanded. I wondered, “But how?” The second video was more explicit but just made me more confused. “Use your number 20 star driver to release the filter assembly.” To me, screwdrivers only come in two forms, flathead and Phillips. I went digging through my little toolbox and came up with some bits that I thought would fit. Amazingly, I had bought a generic set that had the required star driver. “Victory is mine!” I erroneously thought.

With my MacBook propped up on the kitchen table, I approached the dishwasher and faced another realization. All of the videos that I watched had a freestanding dishwasher, and some even had the door removed. My dishwasher was stuck in the crook of our L shaped counter, which allowed access only from the right side. Just placing my screwdriver required the flexibility of a 14-year-old Olympic-level gymnast. I conjured up ideas of me wearing a Speedo as I attacked the dishwasher’s screws. I quickly and permanently put those thoughts out of my mind. I stretched, made a lot of manly grunting sounds, and stretched some more. I was able to reach the two screws that attach the dishwasher’s pump to the upper sprayer with effort.

Rats, they were not “star tips”; they appeared to be rectangular. I dug into my bit collection and found another bit, and with more grunting (and a little colored language), I removed them. I twisted the column ¼ turn and pulled it out of the dishwasher. This revealed the 4 star screws that held the filter assembly in place. I removed those screws and pried the unit from the dishwasher. With a little more banging and swearing, I was able to dislodge the actual filter from the unit for a close inspection. There was a little grease on the filter, but it didn’t look too bad. I washed it off with dishwashing detergent and started the reassembly process. This time I employed the help of my son William to re-screw the upper sprayer water supply tube. His youth gave him a flexibility advantage.

I found some dirty dishes-an an easy task in our house and loaded them into my newly fixed machine. I dropped in a little packet of detergent, pressed “Normal Cycle,” and hit start. The dishwasher sprang into action, and I could hear the sound of water churning in its chamber. I checked the results an hour later with hopeful anticipation and discovered… That the cups were as dirty as they were when I placed them inside. “Crap and double crap!” I muttered to myself. After a little investigation, I discovered that water was not getting up the mid and top-level sprayers. It was time to revisit YouTube.

Several videos later, I determined that the likely problem was a defective “food chopper,” a part of the dishwasher that chops larger bits of food into ones that can be flushed down the drain. This repair would require going to a level deeper than my “filter clean.”. By now, I was committed and convinced myself that I could tackle this new level of complexity. I logged into Amazon and ordered the chopper assembly for a reasonable $11. I also purchased a real set of screwdrivers for another $35. “The right tool for the right job,” I said to myself. Secretly, I was hoping that the shipment would be delayed.

Two days later, the part and the new screwdrivers arrived. My Kathryn informed me that Julie told her to tell me that the dishwasher needed to be fixed. In a world of email, texting, and FaceTime, we can still practice indirect communication at our home. “Well, then you are going to help me,” I informed Kathryn. “Sure,” was her reply.

The food chopper repair starts with the removal of the same parts as in the filter cleaning job. I approached this portion of the project with the hubris that came from my earlier disassembly successes. The next stage was more challenging but still within my skill level. I removed the plastic housing around the food chopper and pulled out the part. Holy cow, this had to be the problem. The chopper blade was frozen, and there was at least a quarter-inch of super disgusting greasy slime plugging the blade’s mesh plate. No water could get past that mess.

I made the repair, this time utilizing Kathryn to screw in the upper rack feed tube. In went dirty dishes; I programmed in a wash cycle and pressed the start button. After about 30 seconds, I heard the machine fill with water-a hopeful sound. Then it happened… the sound. A sound similar to that of a 747 taking off from 10 feet away. I looked at Kathryn, and Kathryn looked at me. We both raised our eyebrows. “Maybe the chopper needs to work its way in,” I said hopefully. But the sound didn’t go away; in fact, it seemed to get louder. At one point, I thought that the dishwasher was going to take off. “Crap!” I thought. I hit the cancel button to drain the machine.

I pushed down the door, removed the dirty dishes and the racks, disassembled the washers innards, and examined my installation. Honestly, it looked just like it should-at least it looked like the YouTube example. I pondered my options and called on my past experience. I reached up to the counter and located my little tool kit. I felt around until I found it. Yes, this is what I needed… a hammer. I took aim and gave the chopper assembly a good wack. I heard a “click.” Having disassembled and reassembled the unit 6 times, the reassembly job went quickly. I put my dirty dishes back in the machine, pressed buttons, and hoped for the best.

I heard the water enter, then a relay clicked. I held my breath in anticipation. Joy of joys, the 747 had left the runway, and I was greeted with the sweet, sweet sound of my dishwasher humming. I patted myself on the back for my mechanical expertise and felt very manly indeed. It was fixed!

They say that if all you have is a hammer, everything looks like a nail. How true, and in this case, I “nailed” the repair with a hammer. From plastic play kitchens to large kitchen appliances, never doubt the power of a blunt object.

Peace to you, and Merry Christmas!

Mike

This is a real screenshot from one of the videos that I watched. What kind of sick person says this and then tortures me!

I could only approach the dishwasher from its right side.

The base of the dishwasher with many of its innards removed.

Excited about my new deluxe screwdriver set. It’s magnetic, a choice made after I dropped several screws into the washer’s guts.

Watching YouTube videos for guidance. You can see the new food chopper assembly on the right.

Here is the old chopper assembly. It was frozen and thick with disgusting gunk.

Changing Christmas, Christmas newsletters, Christmas Past

The End Of An Era For Me?

December 17, 2020 Dr. Mike

Everyone has an opinion of these iconic fixtures of Christmas. When I was younger, they had a negative reputation, but I never saw them that way. What am I talking about? The Christmas newsletter.

Most of us have memories of families who would create a story so fantastic that their lives glowed brighter than the sun. Some of us have remembrances of tragic letters filled with negatives that left a sour taste in our mouths for days. However, I feel that these extreme correspondences are the outliers. The vast majority of Christmas newsletters are vehicles of connection. They join us with a relative or friend and keep us abreast of the essential milestones in their lives.

Take a person’s Facebook posts and combine them with the posts of other members of their immediate family. Remove all of the junk, the reposts, the cartoons, and the lame jokes. Get rid of the majority of the selfies, and add order and cohesion to the storyline. Then condense all of that information into one or two typed pages. If you are successful, you have created a Christmas newsletter. An amazing document.

Julie’s family has farmers, and their newsletters would educate me about farm life. I always looked forward to reading about their trials and triumphs. Newsletters allowed me to keep up with my college friends. They provided a summary of missed information from those for whom I had more regular content. Newsletter gave me a window into some of my cousin’s lives, individuals with whom I only connected once a year.

Those who send newsletters adopt their own styles. I have received half-sheets of copy paper roughly typed and without adornment. I have also gotten elaborate stories carefully margined onto fancy bordered linen. Every newsletter has its own charm and purpose.

A newsletter shows effort on the sender’s level and provides a level of intimacy with the receiver. This is in contrast with those who only send a signed card. The only information that such an offering gives me is that a person can still sign and stamp.

I have been writing a Christmas newsletter for around 30 years. My initial interest in creating one had more to do with computers than it did with communications. I was fascinated with the ability to do desktop publishing, and I was in the practice of creating brochures and other items for my medical group, Genesis Clinical Services. Initially, the Christmas newsletter was an extension of that interest. For me, it was the perfect “modern” vehicle to connect with those with whom I wanted to stay in touch but was remiss.

I always structured my newsletter with three main categories. Naturally, there would be news of the year. This was standard newsletter fare. Highlights, trips, illnesses, successes, and failures. I wanted the story to be readable and engaging instead of a bulleted list of pros and cons. I always included at least one family photo. Lastly, I would provide a recipe that my family made and enjoyed. This last part was a way to share something of value with my friends and family. Think of the recipes as e-cookies or an e-casserole. In my Eastern European tradition, food is love.

Over the years, I have made many equipment purchases for the Christmas newsletter. I bought my first laser printer and my first color laser printer specifically to produce a better product. My first home scanner was bought to scan photos for the newsletter, as was my first-ever digital camera, a $750 Kodak model that could record a photo in VGA resolution (a tiny 0.3 megapixels). That mid-1990s camera catapulted me into the world of digital photography, a passion that continues to this very day.

Over the years, the Christmas correspondence scene has changed, or at least it has changed for our household. Every year we get fewer cards and even fewer newsletters. The majority of cards that we receive arrive after we send out our newsletter. I have never been sure if the sender’s lateness was due to procrastination or social reciprocation. In other words, they sent us a card because we sent them one.

For years I have asked myself if I wanted to continue the practice of sending out 80-90 newsletters at Christmas. The cost has been a consideration since I have professionally printed them for the last few years. Time is also a factor, as every newsletter requires many individual steps. I have to chronicle the yearly events of 5 people in less than two pages, come up with a recipe, and find (or take) a photo or two. I have to coordinate this information with Julie, who also serves as my chief proofreader. Despite all efforts, I usually find a typo in my final product-not surprising as I have dyslexia, but embarrassing none-the-less.

The creation of the Christmas newsletter has remained important to me, but not for the obvious reasons. The newsletter has become a summary of my family’s history, and a copy goes into our Christmas book. This is the most important reason why I will continue to write the newsletter. It is the same reason why I write this blog. I want those who come after me to know me as a real person, not just a faded image on an ink-jet printed photo. I want the generations that follow mine to understand our family and see its members as individuals who had real lives. So often, I look at an old family photograph and ask, “What was this person really like? What did they have a passion for? What made them angry? What made them happy? How am I like them? How am I different?” A picture can be worth a thousand words if properly executed. However, most snapshots provide only the smallest window into the past.

It has become less relevant to send a physical copy of the newsletter over the last few years. I can publish it on Facebook or email it instead. Yes, there are a few folks where those types of communications are not possible, but in most cases, it is clear that they have little interest in catching up with the Kunas of Kunaland.

This year I finally cut the cord with snail mail. I wrote and formatted the letter and posted it on Facebook, and sent a few select emails. This simplification was a relief. I didn’t have to go to Staples, or get confused with how to mail-merge labels, or coerce my kids into stuffing and stamping envelopes. Those friends who want to catch up on our lives can; those who would prefer to scan past the post are welcome to do that too. I’ll print up a couple copies for our Christmas book and a few for Julie to send to specific people. My plan is to continue my newsletter writing into the future, but gone are the days of stamp and stuff.

I don’t see this year as the end of an era; I see it as the beginning of something new. Times change, and it is OK to change with them.

Merry Christmas to you. Peace on earth, goodwill to all.

Mike

Changing Christmas, Christmas Past, COVID Christmas

It Won’t Be A Norman Rockwell Christmas

December 11, 2020 Dr. Mike

Christmas is coming, but it won’t be a Normal Rockwell Christmas this year. Let’s be honest, Christmas has never been a Norman Rockwell Christmas, as that day is only a construct in an American illustrator’s mind.

It seems like we fall into two Christmas camps. Those who recall stories of disappointed children and drunken uncles, and those who try to create Christmas magic- sometimes by overbuying, overdecorating, and overeating. Before you think that I’m a cynical scrooge, I am here to proclaim that I’m not. But you will need to read further to understand where I’m coming from.

December 25 is a day that has been co-opted over the millennium to serve the needs of a variety of distinct groups. Christians would tell you that it is the day that the Christ was born. However, any informed Bible scholar will admit that Jesus came into the world in the spring. Early Christians appropriated December 25 as it coincided with the pagan festival day that celebrated the sun’s birth (not Son).

The Christmas tree was borrowed from pagan traditions as well and dates back to Egyptian and Roman times. Evergreens reminded the ancients that spring would come.

The concept of Santa Claus references the real Nicholas de Myra (St. Nicholas). A monk who lived around 280 AD. His kind acts to others catapulted him to become the patron saint of children. His birthday is in March, but he is celebrated on December 6 (St. Nicholas Day) by many European cultures. Through literature, movies, and advertising, he was bound to Christmas Day and renamed Santa Claus. His new significance lies in his ability to sell products (gifts) more than anything else.

Advertisers are always looking for ways to increase sales. One way to do this is to introduce a new character or tradition on top of an existing holiday or event. These efforts continue to this very day. Carol Aebersold’s household spy, “The Elf on the Shelf” is a successful product born out of a childhood memory. Kentucky Fried Chicken has had phenomenal success in promoting KFC chicken on Christmas Day in Japan. Their efforts are more remarkable as Japan is not a Christian country.

Other “traditions” abound, including lavish lights and outside decorations. Every corporation gets on the Christmas bandwagon with their products. A walk through my neighborhood revealed not only dazzling light displays but also Christmasfied objects from companies ranging from Volkswagen to Disney. Nothing says Christmas like an AT-AT wearing a Santa hat.

If you are Jewish, there is also a place for you at the Christmas table. You can erect a Hanukah bush instead of a Christmas tree and adorn your house with blue lights in place of the traditional white ones.

Christmas has always been a day to sell. In its earliest incarnation, it was designed to sell Christianity to pagans (by tying Christ’s birth with one of their holidays); more recently, it is used to push consumers to buy things that they don’t need or can’t afford. They are manipulated to feel shame when they can’t give their kids the products that they see on TV, or when they can’t create a day as magical as what they witnessed in a Hallmark movie.

Advertisers sell by creating a problem and then offering a solution. The bigger the problem, the more expensive the solution. In the past, a new pair of boots could be an excellent Christmas gift; now, it is a new car or a fabulous holiday vacation.

By now, you are likely thinking that I’m not Scrooge; instead, I’m Satan. An evil entity who wants to take Christ out of Christmas by being so cynical of one of the most important Christian holidays. Stand down; that is not the case at all. My point is that December 25 is just a marker, a moment in time that can be used as we see fit. It can be a day to celebrate the birth of Jesus, or a day to gather as a family, or a day to sell fruitcakes and game consoles-or all of the above. Since this day is a synthetic fabrication, we don’t have to attach preconceived ideas of how we have to experience it. We have the right to use it as we see fit.

Our family considers it a Christian holiday, and we use December 25 as a way to celebrate the birth of Jesus. It is a day to reflect on the meaning of Christianity. For me, Jesus’s message has never been one of damnation or exclusion. Instead, it has always been one of redemption, acceptance, forgiveness, inclusion, and love. He may have come to us in March, but I’m OK telling him Happy Birthday in December.

Our family usually celebrates many traditions during this time. We play holiday music, we bake cookies, we sing carols. Mostly, we try to let those close to us know that we love them. We typically socialize more and go to a variety of Christmas get-togethers. Those won’t be happening this year for obvious COVID reasons. This saddens me, but it upsets my wife more. We have traveled to Minnesota to see her family every year since 1992, and it has been a time for her to reconnect. A ZOOM call is a poor substitute for game playing, conversations, and her mother’s Christmas cookies.

I talk to my sisters daily. They are very close to their children, but they won’t see them this Christmas. Both of my sisters won’t put a tree up this year, “What’s the point?” they tell me.

I’m here to tell them that there is a point. No, I’m not telling them that they need to put up a tree- remember that it is just a construct. However, I am telling them that there is a point.

I told you what Christmas means to me; no one or no virus can take that away. In some ways, COVID can give me a better Christmas. This year we set up our tree as a family. It is an old artificial one that is missing a few branches. We conceal its shortcomings in the traditional way, by hiding them against the wall. By doing so, we emphasize the tree’s positives, and we negate its negatives. (a point made here).

Julie put on some of her Christmas CDs (yes, we still have CDs) and we all fluffed and assembled the tree. We then went around the house, putting up our other decorations. Most have been used for decades. However, there are always one or two new items coming in and a similar number going out. This year, I printed a smiling photo of Mercury the cat to be used as the insert on her Christmas stocking holder. I also did one of my kids for a photo holding ornament that we found in our ornament box.

Our tree is decorated with memories, and we all relish the thoughts that each object brings. There are many ornaments made by the kids through the years, some with a little photo. There are ornament gifts from past “tree trimming parties” that we held for so many years. We have other ornaments gifted by friends, and some that are so ridiculous that we had to buy them; a bronzed “Q” from Star Trek and a light-up Mustang convertible comes to mind. Some of my favorites are those given to me by patients-a mouse dressed up as a doctor or a handmade Christmas stocking ornament with real pills glued on the red felt sock. We laugh, gasp, and remember. Our tree will never win a decorator’s prize- but it is highly prized by us.

We emphasize kindness during this time. Yesterday I heard a little knock on my bedroom door, it was my daughter, Grace. In her hand was a napkin, and on the napkin were some warm cookies. My sister Carol had reminded me about CPS (Chicago Public Schools) butter cookies, and I had mentioned that memory to my kids. The cookies are simple, made from only four ingredients, but they are delicious.

I attended kindergarten and 1st grade at a CPS school and have fond memories of snack time when a few pennies could buy a little glass bottle of chocolate milk and a cookie. Grace wanted to surprise me and made me some. A pure act of kindness.

This Christmas Day, we will do some of our usual activities. We will read the Christmas story from Luke, or do we do Matthew’s version? -As always, I will need to rely on Julie’s better Bible knowledge to sort that out. We will eat special foods, and open the gifts that we bought each other. It will be a low-key day, but hopefully, one filled with love. Love and kindness are free, but I believe they are much more valuable than any bought thing. It surprises me that many people are afraid to express either emotion as if they indicate weakness rather than strength.

I suspect that the day will end without a lightning bolt from heaven or a divine revelation. However, that is not to say that it won’t be a memorable and significant day. It will be those things because we will make it so.

Dear reader, I hope you can find some peace, a bit of happiness, and perhaps a dollop of joy in this holiday season. Please focus on what you have, and turn your Christmas into what you need it to be. Try to find the positives in your situation instead of wasting energy on what you don’t have or reliving sad thoughts from the past. December 25 is just a day that we have designated to be unique. We have done this for different reasons, some a bit suspect. However, we can take the good from that day and wrap it around ourselves. We control our feelings, not an advertising agency, past memory, or unrealistic expectation.

Peace

Mike

Grace made me some CPS butter cookies. A pure act of kindness.

Here is the CPS butter cookie recipe, we used salted butter in ours.

Our old tree, its deficiencies hidden its beauty emphasized.

Our tree is filled with memories from the past. You can see the “pill sock” in this photo (far left).

I printed this up for Mercury the cat’s Christmas stocking holder. This will assure that Santa fills it with a cat friendly Christmas treat.

As an aside, not everything during the season has to be family oriented. How about taking a peaceful walk where you try to find the hidden beauty of winter?

family, Family and Covid-19, Family relationships, podcast listening, spending time with family

Serial

December 4, 2020 Dr. Mike

Grace asked me if I wanted to try it on the long drive from her Ohio college. It is about a 5-hour trip, so I said, “Sure.” She said that she had heard good things, but was as naive about it as I was.

Grace was referring to an old podcast called “Serial.” To be more specific, she was referencing the first season of that show, which was streamed in 2015. “Serial” hit the podcast world like a storm. It remains the most downloaded podcast ever produced. Naturally, we were years late to jump on the bandwagon. It is common for me to find a great show or program years after the rest of the world has extolled its virtues.

Season One of “Serial” chronicles the case against Adnan Syed. He was convicted of murdering his former girlfriend, Hae Min Lee. When the crime happened he was only 17 and an honor student at a tough Baltimore high school.

The podcast is skillfully narrated by Sarah Koenig, who spent thousands of hours researching the case. She has the gift of pulling you in one direction, then dragging you from that comfort zone. One moment you are convinced that Adnan is innocent, then you are not so sure, then you think he is guilty. This cycle repeats throughout the series. Clearly, Sarah is a master of the plot twist; her skill is more impressive as she is doing this sleight of hand with a real case that has a known outcome. I won’t spoil the story for you any further.

We listened to the first 5 episodes on our trip, the 5th one ending as we pulled into the driveway. Gracie said, “Dad, we can finish the series when we go on walks.” This sounded like a great idea. When Grace is home we often go on long walks together.

Like many things in the Kuna household, we scheduled walk times. Then, we would download a given episode on our iPhones, insert our earbuds, and head off on our hike. Inevitably, we would hit glitches and have to re-synchronize our listening along the way. We knew when we were off when one person was laughing or gasping, and the other walker had no idea why.

These have been a different kind of walks for me. The majority of the time, I’m a solo walker, but when I walk with someone, we converse. I wasn’t sure about sharing a walk while isolating in an earbud cacoon. In some ways, this seemed even too introverted for me. In reality, it is similar to watching a TV show with someone. You are connected with them but differently. We interact during our walks, and we talk about the show afterward. I would never want to give up regular walks, but I do enjoy the added pleasure of these enhanced hikes. It feels like you are going to the movies. You have to plan the event, and you must leave the house. When you return home you reprocess the experience.

Grace and I like to take different routes when we walk. One day we may go downtown, the next day, we may venture into the forest preserves, and on another trip, we may meander to my friend Tom’s home.

When we finished the series, Gracie asked me if I wanted to continue our walk and listens. “Sure,” I said. She picked another 2015 podcast, “Limetown.” We just started this fictional series, which is more akin to a radio show from the past rather than an investigative documentary. I love old radio shows that stretch my imagination, so I’m all in.

We are now accompanied by Will. He has decided to join our “Walk and Listen” experience. We listened to the first episode of “Limetownm” which chronicles the disappearance of over 300 scientists from a utopian communal village. During this inaugural walk, we traveled into the forest preserves, then through a couple of neighborhoods. Our altered path due to Will’s need to be back home for a ZOOM meeting of his research lab group.

I have been enjoying this new activity, and I mention it here to highlight the fact that there are new things that you can do during the pandemic. Sometimes you can creatively come up with a brilliant new idea, or (as in this case) you can do a little remodel on a tried and true one. COVID is creating barriers, but the only thing that is imprisoning us is ourselves.

Early in 2020, many felt that the pandemic would last for a few months. We now know that this was folly. I would urge each of you to expand your horizons in safe ways. “Walk and Listens” may not be your thing, but use our idea as a springboard for your own.

Peace

Mike

Dr. Mike Kuna's Blog

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