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I recently started to use a tablet in my exam room.  I am not big on change and making this transition was not easy on me.  Adjusting to Windows 8 did not simplify matters at all.  The worst part was every time I started the computer somehow I would turn on a narrator that would start reading my screen for me.  Sometimes when working with patients this was far from ideal as my computer contains information that patients would probably prefer to remain confidential.  I finally figured out that there was an icon in the lower left corner of my screen that I was hitting with my thumb.  For the life of me I could not figure out why it was there but I learned to avoid it and forgot about it.


Last week I had a long time friend and patient come in complaining of difficulty using his computer.  He is in his early eighties and has Camera and Eyemacular degeneration which is the cause of his difficulty in seeing the screen.  He teaches the 14 year olds in Sunday school and it is becoming hard for him to see well enough to prepare his lesson for each Sunday.  Any eighty year old who is willing to take on a classroom full of 14 year olds deserves my respect and help.  I did the best I could to find a glasses prescription that would solve this difficulty for him but just could not make it clear enough because macular degeneration causes the central retina or macula to break down.   An eye is a optical system just like a camera.  Both are made up of a lens system which focuses an image onto a surface.  In a camera the lenses focus the image onto film or a digital sensor, in the eye the lenses focus that image on the retina.  When you have macular degeneration it's like having a camera with bad film, no matter how well you focus the image,  the picture just is not that great.


As I searched for some way to help this great man I asked if he had tried to change any accessability options on his computer.  He said, Ease of Use Icon"the what?   I have no idea what you are talking about".  Now I am not very techy so it took me a moment to figure out how to turn on these options.  As part of figuring out how to turn on these options I figured out what my mystery icon was.  It provides access to the options that could help my friends.  I showed him how to go onto his computer and turn on the Magnifier option which increased the font on the screen by 200% or even more if needed.  We pulled the lesson for the coming week up online and he was thrilled.  Not only was his life benefited by this simple change but also the lives of a bunch of 14 year olds who have one heck of an awesome teacher.


As I mentioned above the accessability options or Ease of Use options and are incredibly easy to access on computers. In fact, I was doing it without even trying.  If your computer has Windows 8, simply touch the icon that appears in that lower left corner when you start your computer up and it will allow you to access a lot of options that will make using the computer a whole lot easier for many people with impaired vision and other difficulties.  Options include;

Narrator-  Reads text on the screen outloud and allow individuals to choose options as they are read by simply pressing the space bar.

Magnifier- Increases images and text on the screen to make them easier to see.

Voice Recognition- Will learn to understand voice commands making seeing the screen or using a key board unnecessary..

Filter Keys-  Will ignore mutilple key strokes so  unsteady fingers will be less of a problem.

And a lot more.  


I have included links to tutorials that can teach how to set up and use all of these wonderful tools that can make using a computer alot more easy and enjoyable for your loved ones who may be facing challenges.  Take a look and give them a try.  You just might improve their life.

I am unfamiliar with Apple but here is their info.




I had the pleasure of climbing a Mountain on the 24th of July.  My brother in-law Steve and I each took one of our daughters and climbed the North Peak of Nebo.  Eight year previous he and I had climbed the South Peak with his oldest son Joey who was six at the time and my second daughter Kara who was nine.  It was an awesome experience.  On that climb I had to keep encouraging my daughter that she could do it, and she did, and she was proud of what she had accomplished.  That was eight years and 30 less pounds ago however.  This climb it was my 14 year old daughter Megan who was encouraging me as I was sitting in Wolf Pass looking at a 1,500 of  shear scree slope that seperated us from our goal.   


Belle my grey muzzled companion.

February is the shortest of the months from an actual length stand point, but to me it can seem like the longest when I am tired of driving in snow and scraping windows.  For me there is a cure however.  Emerson wrote in his book," Nature"; "Give me Health and a day and I will make the pomp emperors ridiculous".  This is all I need!  A day spent stalking a stream with fly rod in hand and dog in tow will revive me from the deepest of the winter doldrums.  In the last week of February I found such a day.  A day with a beautiful forecast and an empty schedule.  I will never say that a February day on the stream is better than July with its green, its heat, its multitudes of insects hatching and the fish chasing any fly on the water with reckless abandon, or late September with its incredible oranges and reds lighting the banks and fish anxious to find nourishment before winter.  A February day can be their equal however, with its brilliant white, intense quiet and ice forming winters works of art on the logs and stones.  A stream I have fished a hundred times becomes new again with each change of season.  Sorry to quote Emerson again but he says it better then I ever could.

"I please myself with the graces of winter scenery, and believe we are as much touched by it as the genial influences of summer.  To the attentive eye, each moment of the year has its own beauty, and in the same field, it beholds, every hour, a picture which has never been seen before and which will never be seen again".

Shapes never to be seen again.

And so it was with this day, the snow was on the ground, the late winter light fell soft, my grey muzzledcompanion of thirteen years was by my side and the ice forming in shapes on logs and rocks that would never be seen again.  The stream flowed low, gentle and clear over the amber stones.  The temperature was slightly over forty which was cool enough to remind you that it was still winter, but warm enough to encourage me that spring would in fact come.  The first blue wing olive mayflies of the year were beginning to ascend to the surface of the stream.  When I was quiet and patient enough I was rewarded by the sight of a nose gently breaking the surface of a quiet pool and sipping one.  That is the sight that, for the moment, breaks the serenity.  The sight that causes  my pulse to quicken as I strip line to cast.  The fly lands silently on the water and slowly drifts down

shimmering gold accented with scarlet

to the trout who rides the current up to meet it.  A circle of ripples replaces the fly on the otherwise smooth surface,Iraise the rod tip and the line goes tight.  The darkness of the pool is replaced by flashes of gold as the trout struggles for the safety of the depths.  I see crimson deep in the water as his gill plates flair.  The trout leaps clear of the water spraying droplets across the surface.  My dog Belle has spent most of her life retrieving game and has never quite gotten the idea that retrieving is not required or helpful now.  She plunges in after the fish, never able to quite grasp this slippery creature.  Despite the best efforts of the fish and Belle the battle is soon over and the trout is in my wet hand.  Its not large, 9 inches at most, but beautiful.  Shimmering gold accented with

beauty is where you find it

scarlet, sleek and perfectly designed for its environment.  I slip the small spun dun from its jaw and slid it back into the stream.  The trout steadies itself for a moment as oxygen washes over his gills, it regains its strength and with a powerful thrust of its tail it becomes a shadow deep in the hole and then disappears.  The ripples disappear from the streams surface and serenity returns.  The shadow of the hills cross the stream signaling it’s time to begin my hike back to the car.  Peace fills my heart, I am full and my spirit is restored.  Truly, health and a day have made the pomp of emperor’s ridiculous and I am grateful for both.

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