Sick?

Maybe I am? By “sick” I mean “undergoing an infection driven physiological shift”. I’ve been so tired, so early that it seems unusual. Zoe was sick earlier in the week. I’ve had a bit of throat irritation (Zoe had a bad sore throat). There’s been a bit of phlegm. Today, I walked home a bit early and thought I was going to collapse along the way. It wasn’t as bad as one time last year when I thought I was going to have to lie down on the sidewalk, but it bore some resemblance.

I’m hoping it’s a transient infection, but of course it could be the mysterious thing plaguing me for quite some time now. Since that tends to fluctuate, either way I can reasonable hope to feel better soon.

Zoe news tomorrow…

 

Advertisements

Continuous Blood Pressure Monitoring

I watch my BP both because of family history and because it has tended to be a bit on the high side. I use a Withings (now Nokia) wireless cuff and it’s ok. Unlike any other system I’ve used, it fails to take a measurement maybe 20-30% of the time.

This paper describes a very cool method for doing truly continuous monitoring. Cuffs can’t do that because you have to go through a compressing cycle which is uncomfortable, takes time, and needs a recovery period. The pulse transit delay approach takes two measurements: one at the heart using an ECG and once at the wrist (measuring wrist pulse). The time between these two events correlates with arterial wall stiffness and thus with BP. You still need to wear a ECG but that’s gotten a lot easier. It’s not something you’d want to do all the time, but it’s clearly much easier than current best practice.

And it just seems neat.

Arthritis (a poem)

This was in my inbox today.

…I look down now
at my knuckly thumbs, my index finger

permanently askew in the same classic
crook as hers, called a swan’s neck,

as if snapped, it’s that pronounced.
Even as I type, wondering how long

I’ll be able to—each joint in my left hand
needing to be hoisted, prodded, into place,

one knuckle like a clock’s dial clicking
as it’s turned to open, bend or unbend.

I balk at the idea that we can overuse
ourselves, must parcel out and pace

our energies so as not to run out of any
necessary component while still alive…

…So much

I still want to do with my hands—
type, play, cook, caress, swipe, re-trace.

It’s that sort of day. Or life.

Against sedentary habits and silent harms

Another Monkeyfist rescue post! I found the book this December when I was hewing out boxes from Zoe’s dad’s attic. This was from June 2000.

Some reflections: Thanks to my activity trackers and physical situation, I’m a lot less sedentary (yay!)! The Egan quote remains amazing. The Ivory trilogy is well worth your time. The evidence of the harms of sedentary lifestyles has become more and more voluminous. OTOH, stretching and flexibility beyond a certain point isn’t considered as critical. The evidence is that stretching e.g., before running doesn’t reduce injuries, for example. Indeed, for runners, stiffness of various bits can make them more energy efficient, e.g., you store more energy in a stiff leg than a loose one which means that you need to expend less to maintain your stride.

“He said you don’t get enough exercise. He also said that you don’t live in your body enough.”

“What’s that supposed to mean? Where the hell do I live, if I don’t live in my body?”

Doris Egan, The Gate of Ivory

I’m a sedentary fellow, no doubt about it. Aside from my obsessive reading, I was a TV zombie as a kid. I wasn’t only sedentary, of course. I loved roaming the woods along the creek near my house. As I grew older, I had the odd flirtation with dance, an on-again off-again steady relationship with T’ai Ch’i, and a passionately settled long-term affair with rambling about. Though I was a soft little wimp (which had more to do with my parents, peers, and personality than with my intrinsic physique), there were times, over the years, where my body surprised me with strength, skill, and flexibility.

People who work with their bodies—dancers, athletes, manual laborers, and so on—acquire knowledge with a content and a form generally inaccessible to many, if not most, people in industrialized countries. But “body literacy” is an important skill…as important to our well-being and overall integrity as reading is thought to be to our citizenship.

Schools teach body literacy even more poorly than they do anything else. Aside from the absurdity of most “physical education” programs, most of the school day is devoted to ossifying pursuits in uncomfortable and anti-ergonmatic situations. Movement is discouraged, stretching frowned upon, and comfort almost completely eliminated.

(My high school resembled nothing so much as a prison, increasingly so as various gates and barriers were installed over the years. I visited it a few years back and was revolted to see that my memories were of a much milder oppressiveness than that of the new reality. No, there weren’t any metal detectors, but you could film a scene set in a minimal security prison with ease there.)

(Is this what we want for children? How are they to learn to touch and interact? To simply be with each other as friends and classmates? How can teachers stand as mentors, friends, advisors, and models if they are, almost literally, guards. This is in a nationally respected, bleached white, rich, suburban school!)

As I said, I’m a sedentary fellow, made more so by my arthritis and occupations. However, my physical therapist finally convinced me to use a kitchen timer and get up every twenty minutes to stretch and get some movement. (Also, to sit up straight!) I’ll even do this in class now, and damn the funny looks.

image-1

This book, Stretching at your computer or desk, provides a slew of stretches and exercises tailored to the office, and other sedentary habitats. You can sneak them in at the copier, do a stretch while a document opens, or make crashing the computer a relaxing, rather than stressful, experience. The book is nicely illustrated, and one can get large posters of the postures to hang in the office or in the classroom.

If we taught our children to stretch sensibly and move wisely frequently, yet unobtrustively, they wouldn’t need kitchen timers. They would learn to feel when a muscle needed relaxing or a joint wanted articulation. And they would take care of it instead of ignoring discomfort as a matter of course.

We just don’t live in our bodies enough. Many of us are more or less imprisioned in them, and we respond the way we respond to dirty dishes piling up—ignore ’em until we need a clean cup or get evicted by the health department. I suspect that living well with others requires that we live well with, and in, ourselves. If we are trained to ignore discomfort, indeed, to shun comfort, in ourselves, how can we learn to care for the discomfort of others?

A Couple of Weeks with a Vivosmart 3

My Fitbit One gave up the ghost (again) and they don’t make them anymore. (Vicki has donated her unused one so I’m looking forward to that!) I have a Withings O2 whatever, but I didn’t really feel it. I went for several months without an activity tracker and…my activity went down. Since I’m fighting some sort of fatigue thing and exercise is the prescription, that’s bad.

The Vivosmart 3 claims to estimate heart rate variability which is the physiological marker for stress. (Robotic heartbeat happens when your stressed, at all heart rates, and is thought to be what damages the heart.) I’d read a bit about it for a 3rd year own project I’d supervised and was skeptical it would work. But why not experiment? I wanted to try continuous heart rate monitoring anyway.

Here’s some first impressions.

  • I can sorta live with in on my wrist thought I’d prefer nothing on my wrist.
  • The display triggers are flaky. Twist and lift is meh but so is double tap (you have to pound it). There’s no way afaict to have only double tap or easily sleep the display. (Reviews warned me.)
  • If you pick the watchface with heart rate you don’t see battery life. The phone app doesn’t show battery life. You don’t get an email warning (the way Fitbit gives you). To find battery life is a double tap, press and hold, at least three swipes, a tap, a couple of more swipes. I mean, fuck you Garmain. This is some grade A extra large bullshit. Forum responses which say that it’s technically impossible to display battery life in the app are filthy, trumpian lies.
  • It seems “generous” on steps, calories, etc. even more so than many. Conversely, it’s stingy about floors climbed (as a review warned me) and if you’re going to show descents…try to avoid flaking when I climb and descend an equal number of floors. (I mean, I climbed 6 and descended 6 and it said maybe that I climbed 8 and descended…3. I’ve never seen a climb estimator that flaky before.)
  • Activity detection is meh. I’m still not sure whether it includes the “trigger time” (i.e. the period of elevated behavior that indicates a defined activity). It’s real quick to stop those so if I interrupt a walk to buy something at a store I get…two walks. Not sure that’s helpful.
  • Sleep detection was good until last night when it failed. UPDATE: it figured it out 15 hours later. Some server hiccup I guess.
  • They don’t let you add, merge, or otherwise manipulate activities. Which is super dumb!
  • They don’t let you add, merge, or otherwise manipulate sleep (except to trim the ends of the one sleep period they allow). Hello, naps? Or just adding my sleep. All these events do is trigger certain kinds of analyses of a period of data. Let me trigger that for whenever.
  • They have some sort of heart rate zone stuff but unless you’re happy to pick a zone for your activity and stick with it, the reminders are annoying. There’s no *analytical* presentation of zone data (i.e. For this power walk how long was I in zone 2 and zone 3). UPDATE: if you swipe to the heart rate screen during an activity it will also show you the zone. That’s something! Why it doesn’t show me zone info post facto (e.g. you spend x minutes in zone 1, y in 2, etc.) eludes me.
  • There’s no heart rate recovery analysis. Which is super dumb. That’s something trivially to do in software and a PITA to do manually. It’s an important indicator!
  • I never ever want to see “pace”. Just show me MPH, ok?
  • The app is demon spawn. Pretty enough but space wasting, a twisty maze of screens and menus and weird things placed weirdly. Setting a silent alarm is an adventure. Finding the heart rate zone stuff is a nightmare. I have no idea how to add distance in miles to the app (it’s on the device! Maybe it’s like battery life?!)
  • Continuous heart rate monitoring is awesome. It seem accurate. I have just started experiencing some flakiness.
  • The stress stuff is probably bogus.
  • Either accelerometers can’t measure treadmill steps correctly or my treadmill isn’t well calibrated. (I believe the latter which conceptually bugs me. How hard is it for a treadmill to get distance right?!? And yet it gives me a pretty tough workout for me.) This borks any VO2max calculation, I’m pretty sure. Oh well. UPDATE: So, on the one hand, there’s definitely a mismatch between the treadmill and the tracker to the treadmills detriment. I mean the 4mph doesn’t feel like what the tracker wants 4mph to feel like and the tracker wants something closer to the GPS. Even 5mph treadmill is pretty slow. OTOH, 6.5-8 require actual running. Soooo…. The amusing side effect is that my computed VO2Max has gone down as I’ve clearly gotten fitter. It took a nose dive today (my fitness age went from 60 to 66 ;)) in spite of my handling a tougher workout well (i.e. same treadmill distance in 15 rather than 20 minutes). Now maybe it’s just getting better data? over time? Could be, but it seems worthless. I can do a specific effort to measure it but I don’t want to do it on that treadmill if it’s going to be this off. It’s amazing to me that they offer this and not simpler measures like heart rate recovery. Track that over time!!

Just to give you a feel, here’s what the app looks like when you open it:

They really really want you to scroll, swipe, and click. A lot.

UPDATE: The “collapse view” is actually reasonable:

But only if you don’t have any activities! Activities remain non compact and are on top which is why I thought collapse didn’t do anything.

Calling someone “crazy” as an insult can contribute to stigmatisation of the mentally ill (probably)

I’ve been meaning to write something about the use and abuse of the conceptual framework of mental illness, esp in the current US presidential election, for a while now. There’s been a uptick in the past week with Trump behaving erratically and then accusing Clinton of having various sorts of mental illnesses. Also, on one of my favourite blogs (where I comment a lot), one interlocutor has adopted a systematic gaslighting (among other things) strategy to try to shut down my criticism of them. So, it’s on my mind!

This is not that writing, but rather a response to a Kevin Drum blog post entitled “Calling Someone Crazy Is Not an Insult to the Mentally Ill.” He writes:

No. Just no. There are lots of words that have both ordinary meanings as well as technical medical meanings. When I say that Donald Trump is a cancer on our society, it’s not an insult to people with leukemia. When I say that Donald Trump is stupid, it’s not an insult to the mentally retarded. And when I say that Donald Trump is crazy, it’s not an insult to people with mental illnesses.

No. Just no. (Sorry, couldn’t help it.)

How should we evaluate these sorts of claim? Before I present what he’s responding do, let’s consider some prior probabilities.

  1. Are people with mental illness stigmatised? Yes, of course they are. In all sorts of ways.
  2. Is there a lot of derogatory language which uses the idea of being mental ill as a disqualified for various activities (e.g., jobs, relationships, etc.). Yes! I trust we all agree on this.
  3. Historically, have complaints about derogatory or biased language been met with
    1. derision,
    2. nonsense claims about language (i.e., it’s not derogatory or it’s a joke or..), and
    3. hyperbole about the harms that come from opposing such derogation?

    Yes. Are there any exceptions?!

This should establish a burden of proof. 1 and 2 alone show that if you want to argue that some use of mental illness inflected derogatory language is harmless, you have work to do. 3 should make one very cautious about particular arguments for harmlessness. How does Drum’s fare? We have 3.a right off the bat. 3.b is there in the first paragraph as well. (Words have different meanings! By implication the derogatory use of “crazy” has NOTHING AT ALL to do with the “technical” meaning!!) How about 3.c?

This is the kind of thing that helps power people like Trump in the first place. Sure, a lot of people who gripe about political correctness are just upset that people get on their case these days if they call blacks lazy or Asians inscrutable or women hysterical. There’s not much we can do about this except keep fighting the good fight and wait for them to all die off.

But there are also people who aren’t especially racist or sexist, but nonetheless feel like they have to walk on eggshells around us liberals. Call someone crazy and you’re insulting the mentally ill. Talk about someone “suffering” from an illness and you get a stern lecture about not making assumptions. Ask any number of possibly dumb but innocent questions and you’re committing a microaggression. Wear a sari in a music video and you’re engaging in cultural appropriation.

This kind of hypersensitivity does little good and plenty of harm.

We can agree that people like Trump use the “PC” charge to rile up their followers. That’s evidently true. I’m more skeptical that it nudges people of good will off the ranch. After all, the core of Trump’s use of PC isn’t to attack PC per se, but as an amplifier and defence of being racist, sexist, etc. Trump, in particular, is very naked about his repugnant behaviour. It’s hard to see how people who are predisposed to find Trumps e.g., racism horrific are going to be turned back by mild requests not to use mental illness terms.

Notice as well that there’s nothing specific about mental illness terms in this litany…it immediately segues into a general PC complaint and a mishmashy one at that. (For example, if micro aggression theory is correct then there are real harms associated with those “dumb but innocent questions”. If micro aggression theory is wrong, then those complaints are misguided. But notice that Drum isn’t questioning anything here. There’s a just a presumption.)

Now, I did a super brief look at some research (via a simple Google Scholar search) and there’s at least prima facie evidence that use of terms like “crazy” as derogatory terms contribute to stigmatisation of mental illness which leads to lack of treatment or support. So, what claims was Drum fulminating against?

What I do know is that we ought to stop casually throwing around terms like “crazy” in this campaign and our daily lives….When that language is commonplace, it becomes that much harder for those experiencing mental illness to openly seek treatment that works. It discriminates, in subtle and overt ways, and extends its reach into schools, workplaces and the health-care system, where we still don’t provide routine mental health exams. When we use that word the way we have, we perpetuate the dangerous, “separate and unequal” treatment of these illnesses, and continue to pretend that the brain isn’t part of the body.

This is a pretty modest claim (by Rep. Patrick Kennedy) that seems congruent with the literature. But, let’s note that Drum cherry picked the quote. Right before it we have:

Is Donald Trump experiencing a mental illness? That’s the question making the rounds these days. The answer is: I don’t know. And neither do the commentators, tweeters and psychiatrists — both licensed and armchair — who’ve diagnosed him from afar as “crazy,” a “psychopath,” not “sane,” having “narcissistic personality disorder” and a “screw loose.”

So while Kennedy uses “crazy” as a synecdoche for the general derogatory misuse of mental illness talk in the campaign, it’s clear that he’s not primarily talking about minor positive uses “crazy weather!” “That’s just crazy awesome.” It’s not unreasonable to wonder where the tipping point is in cost-benefit for language campaigns (though people just assuming that the cost is always out of wack with the benefits are often those who don’t stand to benefit), but the mental illness talk we’re seeing in the campaign is extreme and worth opposing.