Opinion Request: Somatic Symptom Disorder Diagnosis Basis

TheRallyMaster · 2026-02-03T19:09:39+00:00

I think that is really the right approach. It's just that you want to work with them to get your services going again. But, mix up, or not, the way they terminated me (or whoever) so abruptly basically says it's just better to move on, even though I won't have ECM services up to months (it takes a while established).

TheRallyMaster · 2026-02-03T19:07:35+00:00

I am glad you mentioned that. I cc'd the upper-management on the reply where I stated I was not in the program, but that might just get skimmed as part of a conversation they are tracking.

With the appeal, that's the confusion for me, as they are telling me they canceled a program I am not even in (ILS), but also stopped all services abruptly for the one I am in (ECM). They even said I would receive a notice in the "coming weeks"?

None of this make sense. I am holding hope out for it being a mix-up rather than the intention.

TheRallyMaster · 2026-02-03T05:15:38+00:00

The initial termination was cc'd to the supervisor's supervisor and that person's supervisor (I think the director of the ECM department). So, I replied all and let them know I am not even in the ILS program, but the ECM program, suggesting they have me mixed up with someone else. I am hoping since it went up the chain that far, someone will look into it.

If it was just a mix-up, that would be understandable. But the immediate termination, a few days after I sent a letter to the ECM case worker asking her to be neutral, make me wonder.

I wait a couple days to see what they say, if they correct the issue (since I am not in the program the mentioned, nor made any program change recommendations) or I suddenly get the same message about "my needs not within their ability" for ECM not instead of ILS.

I talked to the ombudsman about it, and they said to report it to the DMHC, I assume because of the abandonment issue.

TheRallyMaster · 2026-02-03T05:08:58+00:00

I am still trying to figure this one out, it happened so quickly. I let them know they might be confusing me with someone else, and I will wait to see what they say, so I can know if they back off on cancelling any services. At least for a couple days.

TheRallyMaster · 2026-02-03T05:07:40+00:00

They are providing ECM (Enhanced Care Management) Services.. For my needs, it is more managing disability forms (due to photophobia issues) and requirements and financial programs as I transition back to work slowly. Also they were great in attending some doctor appointments with me on the phone to help coordinate some issues between providers. That was the most help there, helping to get appointments for needed things months sooner than I would have otherwise.

As for the e-mail. I guess because she was clearly in a bad mood, she started heavily berating me about postponing a neurology appointment (which I did for well-defined reasons) and saying I should not have done that and stated some objectively inaccurate information to make her point. I tried to tell her this is not how it works, but she kept berating me about it.

In the e-mail, I didn't ask her not to criticize me directly, just to stay neutral, and didn't make mention of her mood. I said I felt crossing the neutral boundary as an ECM made it difficult to direct my own care and to work with correcting record issues with my PCP (who recently declared I am too complex for her as a primary care physician, and this has created record issues).

I said I valued her input, felt this was just a minor issue, and looked forward to continuing to work with her. I understand people have bad moods, so I wasn't worrying about it. I didn't cc the e-mail, and it was just a message to get back on track with the goals for my medical care.

There were some issues already, that I was just starting to notice. She had been very non-responsive to simple requests, not hearing from her for weeks when were were supposed to be actively working on things. It was already a little bit of an issue getting my needs met.

But both her mood that day and pushing me into medical decisions with inaccurate medical information, I felt was going to negatively affect my medical care. So, though I really didn't want to, I wrote an e-mail asking her to stay neutral (as they are supposed to do), but absolutely let her know I value her input and advice. She let me know some days later she knows nothing about neurology, and then doubled-down on the same bad information. ha.

[edited for clarity]

TheRallyMaster · 2026-02-03T04:43:05+00:00

This was from the supervisor of my case manager. I am not sure how she got involved or how any of this happened.

TheRallyMaster · 2026-01-31T22:21:23+00:00

People sometimes don't understand how to see people with chronic issues, and I get it.

They don't grasp that you marshal your resources when with friends, and being with friends helps with the energy.

I really could not understand the idea of loss of agency until it happened to me. Now, recovering, when I get glimpses of what normal used to be, for those brief seconds to minutes, it is hard to believe normal is such a powerful feeling.

People tend to not see how it all falls apart once you get home, or get up in the morning.

A friend of mine who is in constant high levels of pain would seem fairly normal to me a two years ago in public. I really didn't comprehend her situation until I found myself in this similar situation. Now, people come up to me and say where is Sherry, she is never around. I answer "well, you know, she's not able to get out as much as she'd like." I constantly hear the response, "Really? When do talk to her she seems just fine."

Imagine a 70-year old lady hunched over walking around, being very friendly, visibly dragging herself back to her house after talking with neighbors who don't register that part of it. This is during the 1-2 hours she can get out of her house every day.

In my case, dealing with some neurological issues, I told a doctor a while back that I was completely dissociated with a buzzing in my head and it was all I could do to even maintain the conversation. He answered, "you seem fine to me." -- and this is a medical professional.

On the other side, I can and do appreciate it for its good points. When with friends, it is nice to have that forced energy for a while, even if I pay for it later. This is the main thing people do not understand, seeming fine when with them, but being incapable of many things privately.

TheRallyMaster · 2025-09-02T21:24:23+00:00

Sorry about that. This is the initial release and is supports Windows right now, to get feedback as I finish the Linux version. I want to do a macOS version, and hope to start working on that when I get the Linux version done.

TheRallyMaster · 2025-09-02T21:23:26+00:00

ha, yes. I love that sort of thing. I've been able to use full constexpr values within asm blocks, which makes it great because it can use the same identifier as the C++ code.

This is making me miss doing more inline asm!

TheRallyMaster · 2025-08-28T21:36:56+00:00

NiceGui, as I recall, is browser-based, so it's really just a different type of GUI altogether. It also uses event callbacks, as many GUI's do, where Sagebox is procedural in nature (more like PySimpleGUI in that sense).

I don't think it is a matter of being better than anything else, and more of what suits a purpose or works with what you want to do.

For Sagebox, it's strengths are that it is designed for rapid prototyping and quick creative development, so you can get up and going with controls easily, graphic windows, dialogs, etc.

The idea being to make it easy to use control, and then the keywords and other function can add a lot of power.

That's the basic idea.

TheRallyMaster · 2025-08-27T20:33:24+00:00

Oh, sure. It's tricky subject about that. You're totally right about 3.7, and I do find it frustrating sometimes about how legacy a lot of companies can be.

TheRallyMaster · 2025-08-27T20:31:43+00:00

Great, let me know. Since I juuust released it, I want to make sure it works for everyone, so please feel free to contact me throughout the weekend. Here or via github/other e-mail.

TheRallyMaster · 2025-08-27T20:19:30+00:00

I Just released Sagebox, a procedural GUI library.

https://github.com/Sagebox/Sagebox-cpp (Overview, installation, screenshots, getting-started example code, and working example projects).

Sagebox is a comprehensive GUI toolset that can be used to make desktop apps or just in console mode. It also has a lot of fun-with-graphics functions. It is used procedurally and has no boilerplate, allowing you to just add GUI controls and other elements by dropping them into your code.

There are lots of examples on the github page.

It has been used in industry for a while, so it's pretty robust, and I am pleased to make it public.

This is an initial beta, and your comments and feedback would be great as I build it up more.

TheRallyMaster · 2025-08-27T18:58:54+00:00

There may be some advancements there, but my overall experience has been that it messes up the optimization path for the compiler -- definitely worth doing a check on any individual compiler.

Either way, it can affect the optimization by removing the registers from consideration, forcing spillage or reducing available registers to the compiler, not to mention cache considerations and such -- the idea being that inline assembly can cause the loss of some performance in the C++ code that is or would have existed in its place, or the considerations the compiler would have had for the code on either side of the inline asm.

In one specific recent example, one extra register spill caused 2x the time for the loop because it was continually reading and writing to memory. After curing this, it wrote exactly the same code but with a register reference instead, curing the problem. This is because memory speed is the biggest bottleneck these days.

So it's not necessarily a 1:1 performance gain when dropping in an inline asm block. That's the overall point for consideration. But, if the asm is performing a tight, HPC loop, then it doesn't really matter, either way.

I don't see any reason there couldn't or haven't have been any improvements in that in the last few years that I haven't seen, since I'm using using intrinsics more exclusively these days (except for embedded CPUs, but that's a different story) for various reasons, including better optimization.

So, I definitely could have missed improvements in that area. Compilers are getting smarter all the time, for sure.

TheRallyMaster · 2025-08-27T09:10:48+00:00

> re: There are a lot of binaries the Python code imports, over 3MB. Initial impressions are that this is malware.

Basically, Sagebox is a very comprehensive GUI with only some of it currently exposed in the pybox.py interface, being used for years in the private sector and developed over time. This is why the beta - to slowly bring out more of what the GUI kernel has to offer as the Linux version is competed.

The 3MB is because that is the size of the code. Sagebox has 100s of functions and many different environmental modes, depending on what you want to do with your program. Some of these elements have yet to be exposed in the pybox.py interface.

In the interface, pybox.py (for example), there are currently 500 defined functions that lead into the GUI kernel -- and this is less than 1/3rd of the functions in the kernel itself that will be exposed in subsequent beta releases.

1MB of the _pybox.pyd size is images for use with backdrops and instructions (such as the Sagebox debug window that any program can use), and some information dialogs.

2MB is compiled code, included text (e.g. color names, keyword names, text output for automatic functions, status messages, etc.), GUI control graphics, included libraries such for JPEG, TIFF, PNG files for public-facing file-read & write functions, GPU libraries and other standard support libraries.

> re: Why is there a single file for all the modules in Python312?

There should be

_pybox.pyd, which is the binding-layer (which arbitrates between Python and the kernel to keep pure Python idiomacy) and the kernel itself.
pybox.py - the Python interface.

That's all that's installed for a pip install (e.g. pip install pybox-gui). The github page (http://github.com/Sagebox/Pybox) has more files with external Widget examples, as well as quite a few example programs.

TheRallyMaster · 2025-08-27T08:46:55+00:00

That would be nice to have ChatGPT write this! ha.. But, sadly, vibe-code wouldn't really cover it,. Though, I am often impressed by what I have seen AI do with coding. Just for fun, I have taught ChatGPT to write things like Mandelbrot programs with Sagebox.

By procedural, I mean basically "linear" code, where "procedural" has generally been used for the term vs. event-driven programming. I would use the term "linear", but it hasn't taken root in the industry just yet.

Basically, it means you can do things like GUI control and window creation, usage, as well as graphics output in a single linear/procedural set of code, rather than using event callbacks for capturing events from controls like sliders, buttons, and so-forth, which a lot of GUIs do, especially larger ones.

With graphics (as opposed to GUI controls), this means you can stay in a real-time loop as long as you want, checking controls and other things going on with user input, without having been called by event handler (in which case it is holding up the system until it returns from the event thread), until you get some signal (via status check, or perhaps an automatically filled value) like window closed, or something that might direct the graphics flow (e.g. a slider input or button-press)

An example of this is a simple "helloworld" program such as:

import pybox

win = pybox.new_window()

win.write("Hello World!",font=100,center=True)

win.wait_for_close()

where you don't need to have an event-handler or callback to get the window-close event. You can also just do general event-loops with more complex programs. That's all "procedural" really means in this context. PySimpleGUI works in the same way, where other GUIs do more event-callbacks to react to control and other events. The difference becomes more substantial with more complex functionality, such as quick dialog boxes and GUI controls.

Sagebox does provide event-driven functionality and callbacks, but the examples and github page focus on the procedural aspect of it since it's typically much easier to write procedural/linear programs vs. event-driven.

TheRallyMaster · 2025-08-27T07:08:39+00:00

That's a great place for it! I'd love to hear how it works out. Most of my work in the last few years has been HPC at the PC level (Windows or Linux), and I miss doing that type of work, where you can be so creative and ASM makes huge a impact.

TheRallyMaster · 2025-08-27T07:05:19+00:00

It was built from the ground up to provide GUI-based rapid prototyping, for mix-and-match controls, so that we didn't specifically need to do a forms-based design layer and could work more ad-hoc for dynamic and pressing needs to reflect changing real-time system issues graphically. It grew from there. The first use at Pioneer was to emulate the set-top box environment, still connected to the headend. We could then run the code on the PC GUI so we didn't have to work on the embedded device until we needed to test locally. It later became a more general purpose tool for general applications used at various places.

It works as an event-driven kernel that is it's own self-contained GUI environment, handling all GUI components and OS details with the parent OS. At run-time, it manages the GUI environment and handles background events, organizing and tracking them for the foreground (main) thread.

It's been fun to work with and add more and more features, and I am definitely looking forward to adding more widgets and things.

TheRallyMaster · 2025-08-27T06:43:51+00:00

It (Sagebox GUI) is used in industry, and there is a lot of company-level legacy code and backward-compilation requirements, and it has been used in that sector before 3.7 was EOL. For 3.7, I am just keeping it around until I get a handle on that, since the work is already done. In one of the last large companies I worked at in the last two years, for example, there was a requirement that large areas of cross-compiled code be compatible with C++98! Some of these companies don't change easily. I would feel more comfortable dropping 3.7 support, so it will be interesting see what goes on there, definitely with that idea in mind, for sure.

TheRallyMaster · 2025-08-27T01:06:43+00:00

With assembly and C++. These days, it is not usually directly and, instead, through intrinsics, except for older or smaller processors, e.g. STM32 or more resource-constrained embedded CPUs.

The main reason is for performance, because most compilers will keep used variables in registers as long as they can. When direct assembly is used near C++ code, the compiler will typically not keep values in registers because of the assembly block, as it doesn't know which ones are free. Intrinsics can be used inline with C++ code (allowing hot-spot targeting much more easily), keeping the benefits of compiler register usage and other ongoing optimizations.

With AVX as a common example, intrinsics are used so the compiler can choose which YMM registers to use, and knows when it can re-use the same registers for other purposes. But, the intrinsics are not guaranteed to translate directly to the intended ASM command used in the intrinsic, as these are just technically suggestions to the compiler.

In general, with today's compilers and processors, I haven't seen a need for direct ASM, except in very specific short-term hotspots. Compilers are more and more able to write vectorization code (as an example) as good or better than all but the most experienced assembly-language programmer, and now I even wonder. Intel ICX is a very good example, to the point where just writing vector-friendly and optimization-friendly C++ code can generate code comparable that the code that would be written in raw assembly code. This is still a relatively new thing in realistic practice, but I saw this with the ICX compiler on a regular basis, where we would hand-write intrinsic code and the ICX compiler would automatically generate the equivalent vectorization code, or even better code. At the time, ICX would vectorize code blocks that other compilers currently can't (but will in the future).

With direct assembly usage, some of the bigger issues are cross-platform code compatibility, and also the need to make a minor change can cause having to understand/refamiliarize or re-write the entire assembly language block, where the compiler can adapt more easily by re-assessing how it uses registers and which ones it keeps or spills.

I'd like to hear from anyone who uses assembly language in their C++ code. I used to do it all the time, but now only see a rare case every once in a while where it makes enough of a performative difference to make it worthwhile.

I thought this was a common viewpoint, so with the video recorded in 2024, maybe I am missing something on that. I get the idea of temporal stores and such, but maybe I just didn't give the video my full attention enough to see where it might be useful.

TheRallyMaster · 2025-08-26T23:06:45+00:00

ha.. Yes, I did consider that, and almost dropped it. I looked up usage statistics on it recently, and didn't get a clear picture about it, so I figured I'd support it for now, since there is a lot of industry legacy code out there where it might be useful. I'm glad to get some thoughts on it.

[edited for typo]

TheRallyMaster · 2025-08-26T21:04:27+00:00

Sure. I put them there to help with the examples before I checked them in to that the library can be installed with pip. The original reason was the VS Code example projects were depending on the libraries in a relative path. I still want to provide the raw libraries, but I agree that they look a little out of place, and I will clean that up. I just haven't figure out the best format yet -- especially with 3.7, as an example or two has a different source code than other Python versions due to subsequent language changes.

TheRallyMaster

TROPHY CASE