After about a year of waiting, my senior project exploring 3D Patient Records for Dentistry has been published as the cover story in the Journal of the American Dental Association (JADA)! I had no idea our work would end up getting published let alone in a journal like JADA. I’m also very excited that our group was able to get a 2 page attachment explaining what user centered design is to an audience that is not very familiar with the field but will hopefully want to push for more exploration of it in medicine.

I’d like to thank the professors at the University of Pittsburgh Center for Dental Informatics, Titus Schleyer and Thankam Thyvalikakath, and the head of the Carnegie Mellon HCI undergraduate project course, Jason Hong, for making this all possible.

See the research write-ups and video demo for the paper.

Microsoft is shaking up the consumer health technology landscape today with their launch of HealthVault. The site allows anyone to sign up and store and share all of your health information and the health information of your family (even pets). The most intriguing part of the application is how Microsoft has offloaded much of the data entering, viewing, and manipulating work to third parties. Organizations like the AHA build blood pressure trackers and hardware companies like Johnson & Johnson allow data from the devices to feed into the HealthVault.

So in a way Microsoft has offloaded much of the user experience of storing health information to third parties. While this probably helped them get a jump on Google and other players in getting the product out, I think it leads to a very disjointed experience. I need to go to the AHA to enter my blood pressure and to another program with another set of visualization tools to look at another type of health measurement. A good move would be to create a Facebook style hosting platform where these third parties could host the front ends of their applications within a section of the HealthVault, or at least have a place where viewing and data entry are accessible.

The thing that I like most is the downloadable Connection Center application. It syncs the data from a variety of hardware monitors and uploads them to your Health Vault account. In the end, it’s this kind of usefulness and ease of use that is needed for people to make the leap to use a system like this. Privacy is always a concern, but time and time again we see the initial privacy scare fade away with every new technology. Remember when online banking seemed like a gamble? There’s a threshold at which the usefulness of the new paradigm mitigated our privacy fears.

But here’s where Microsoft’s partner strategy takes a twist. By having you give access to a third party to enter data, your information is always going through another party besides Microsoft. This seems a bit strange, akin to Citibank making me funnel all my transactions through Paypal. Because of that Health Vault really should have at least some basic information entry and editing so that it can work in a complete silo.

I saw Sicko yesterday which is Michael Moore’s new documentary about health care in the United States. I thought the film made its point very well and Michael Moore is definitely a master of using irony and sarcasm to make powerful points.

Many accuse any public personality that uses irony, sarcasm, or humour to make their point as being unethical. I believe these persuasive techniques are completely valid and almost necessary in today’s world. The average consumer of information recieves more quantities of information than they can ever process or research the validity of. Much of this information comes from profit seeking organizations that are not completely aligned with our interests. You better believe that every company profiled in Michael Moore’s film has a very large team of professionals who’s job is to persuade the public in the exact opposite direction of what Michael Moore is preaching. The only difference is this type of persuasion gets nice shiny names like “public relations”, “marketing”, and “educating the public”.

In a way, irony, sarcasm, and humor are some of the most powerful persuasive tools of our day for individuals who do not have extensive resources. I’ve seen stand up comedians make some of the strongest statements about our society, going into subject areas that would be unacceptable in any other situation.

So this is a bit late, partly due to being away at a conference and other stuff. But just wanted to make the official announcement that my company’s site, RevolutionHealth.com has had its official version 1.0 launch a few weeks ago.

There’s been quite a design overhaul from our preview site that launched in January. Most of the effort went into cleaning up the navigation and visual design. Check it out and let me know what you think!

So we just got the wicked cool Door Gym in our apartment. This has got to have one of the highest cool-to-complexity ratios ever (ie very cool and so simple). You literally just put it through your door frame and once in position you can hang your whole weight from it. The device just stays there on its own weight and it’s shape. I’ve been slacking off on the physical activity side lately, but I think having this thing right on my door will be great motivation.

Oh yea, it also is great for pushups and situps when you put it on the floor.

I’m so glad to see New York City looking out for their citizens and cutting out transfat from restaurant foods. Transfat is a terribly unhealthy substance used as a cheap substitute for natural saturated fat sources, and a large part of the cause for the unhealthy image saturated fats have gotten.
Some argue that banning transfat is going too far and is really paternalistic. I believe this move is more clearly warranted than antismoking bills due to the relatively undetectable nature of transfat. While smoking does harm the health of others around the smoker, at least they are aware and can make the choice to move. When restaurants sneak transfat substitutes into food, it hurts everyone in the restaurant (unfortunately there’s no ‘transfat free’ seating area in most restaurants) and it is difficult for the consumers to avoid the substance short of not eating out.

This is a case that I think it is good to have the government intervention. Free market competition is forcing restauranteurs to use the cheapest health harming substances to compete.
The consumer side of the market is unable to demand transfat free food through their eating choices and purchasing decisions because they are unable to discern who is using transfat substitutes. The government’s action here is good to provide protection of consumer health where the consumer market is not able to do so effectively.

I watched this video before my Epi-LASIK procedure. It’s a closeup view of the actual procedure in all it’s glory. You can now see Exactly what I went through. I can’t speak for how you will respond to it, but I think watching it helped me get a little more comfortable with the procedure. Believe me, I was squirming massively while watching this video (don’t say I didn’t warn you). But by the second viewing I was a bit more comfortable (just a bit). But my philosophy is the more information you have the better. Hard to beat an actual video of the operation. Good luck getting through the video if you decide to hit play…

Note: In this Epi-LASIK video, you’ll see that the surgeon cuts an epithelial flap and then replaces it afterwards. According to my surgeon, this is being phased out in the Epi-LASIK procedure. The consensus among leading surgeons is that recovery is actually better if the flap is not put back. So the surgery is actually completed significantly faster than seen in this video. That’s good news for you!

It’s no secret that I am not a fan of recommendations for people to eat large of amounts of “Healthy” or “Clean Burning” grains in their diet. These recommendations come more from economic forces than anything as the huge US grain industry pushed lots of research and for it’s insanely high contribution to the original USDA Food Pyramid (you’ll notice the recommended grain consumption on the new pyramid has dropped greatly in the new version).

However, attacking grains as a whole is for another day, but I think the latest health findings are coming to agreement that refined grains (white rice, white bread, most pasta) are not good for you. But I don’t think the message is really getting out. A visit to any grocery store will still reveal that whole grain products are a very small minority. This is really unfortunate as refined grains have been linked to a whole host of health issues from obesity to cancer. I think that effecting change in people’s eating habits is a matter of how we present this food to the public. Refined grain should be called what it is, Junk Food.

Refined grain is grain that has had its outer bran shell removed, as well as the germ. The bran has certain vitamins and fiber contributing that “heaviness” to the grain, both in weight and that feeling of satiety after eating a smaller amount. The germ contains some protein and good fats and other good nutrients. What you have left after removing these are nutrient void calorie bombs that do not fill you up (low satiety). What other food can you think of that can be described as nutrient-void-calorie-bombs -that-never-seem-to-fill-you-up? Junk food. Chips, popcorn, cookies, and other processed unholiness. Besides the extra toxic chemicals in traditional junk foods (coloring, preservatives), both foods offer you a boat load of easy-eating calories with little nutritional return. The worst part is the lack of satiety. Just think about how much white rice or white bread you could potentially pack away before achieving that same fullness of a few bites of chicken breast or beans. That and the refined grain will make you hungry again much sooner because your body digests refined carbs just about as fast as pure sugar, another similarity to junk foods. We often make the differentiation between “fattening sugar” and “healthy carbs”. However, when you really look at these two, it’s all just Junk Food.

Been a while since my last eye update. My vision has stabilized since my last post, and my bandage contacts were taken out a few days after my last post. This time, I made sure to keep them really moist the first few days after taking them off to avoid any more bits of epithelium from detaching. There was probably little chance of it happening again after giving my eyes a few more days under the bandages, but I just wanted to be sure.So the big question you probably have is, how is my vision? Well, at my last visit, my eyes measured 20/20, so by most accounts, that’s “perfect” vision! However, in my opinion, I think my vision is a little less than perfect still. While I could see the 20/20 line, the letters were kind of blurry, so I’m probably more around 20/25 or 20/30 (I have no idea what those actually look like, just guessing here). I feel like I was able to read those last lines just through extra focusing power, but unless I look hard, things aren’t completely sharp without me having to try to focus on something. My vision still varies a bit, though, sometimes when I get some tears going everything gets a bit sharper, and other times I don’t focus quite as well. I think this is what they mean by “quantity comes first, then quality”. For the most part, my prescription is right now, but it takes a bit longer for everything to “smooth out”.

So how about those stars and halos in the night you always hear about? Not to bad at all. Not really much worse than before. I’m thankful they turned off the light and flashed a light at my eyes to show me how much I had before, because comparing it now, I see that the level of starring and haloing is about the same, just a slight bit more now. But again, this varies, too. However, I was able to drive home just fine from Pittsburgh with the last few hours of the trip at night.

The freedom is amazing. For a non contact wearer, it doesn’t seem like a few seconds putting contacts in and out matter much, but it does. It adds up every time you do it, having to clean your hands, put them in, experience that constant feeling of something in your eye, the end of the day gunkiness, carrying around gear when you travel. Contacts are just an overall hindrance. The best thing is the “get-up-and-go” ability I have. I can just sit up in the morning and do stuff, and I can jump into bed when I want to pass out late at night after writing a long blog post. Plus, with pretty severe myopia like I had, there’s a nice psychological component of not being totally reliant on contacts and glasses. When I went to Pittsburgh, I felt “lighter” as I packed and lived out of the bag. Just one less thing to worry about in a busy life.

I doubt I will go for a correction if it does turn out I’m not quite at 20/20. I’m pretty much fully functional now (except I can’t cut onions without crying profusely, still a little sensitive I guess) with the level of sharpness I have, though it’s a little less than what I had with my contacts (which apparently got me to 20/15, so I was a bit spoiled). Maybe I’ll try some of those natural vision improvement exercises. I have a book on them and I do believe they work for small corrections. They were out of the question for me when I was -7.0 diopters, but I hear they work wonders for people with a less than a couple diopters off.

All in all, the freedom is worth it. That’s all there is to it. The cost is totally worth it as it comes out to about the same over the long run. The safety is great these days with a good surgeon. It’s arguably better for your eyes than wearing contacts on top of your eyes for years. The pain of Epi-LASIK is a bit tough for the first few days, but is nothing really unbearable, and if you are not into contact sports, you can go for the more common, less painful, LASIK operation. So what it boils down to for me is the lifetime of freedom and “lightness” you get for those few days of discomfort. I feel it’s a good choice, and I am pleased with the results.

Kudos to Dr. Rubinfeld (surgeon) and Dr. Davis (post op care) at Washington Eye Physicians & Surgeons. They have my full recommendation. I will probably post some more intermittent updates from here on my vision, but I just wanted to leave you with a quote from Dr. Rubinfeld at my last visit regarding my new vision: “Now make sure you use your new powers for good, not evil!”

So the last few days haven’t been too hot for my eyes. It seems my epithelial layers weren’t quite ready for prime time. After removing the bandage contact lenses, my eyes were scratchy. This was expected as the surface of your eyes are sensitive. However, they got more and more scratchy and irritated as the day went on.

The next morning, I woke up and this same spot on my eye was still hurting. It felt like one single grain of sand stuck under my eyelid. When I looked into the mirror, there was a red spot with blood vessels kind of swollen around it. I got pretty scared as I thought I had some kind of ulcer in my cornea or something. I called the eye center and they told me I could come in right away. I got there and Dr. Davis looked at my eye and told me a little patch of epithelium had been lifted off. He said it was no big deal as some people’s epithelium are still loose for a while and come off if your eye gets too dry. He put a contact lens back in and said to stay on the drops and come in two days later.

Fast forward to that night, and my other eye started to have the same scratchy feeling in the same spot. I went to sleep early so it wouldn’t get any worse, but the next morning it was still hurting. It wasn’t as bad but I couldn’t really work well, so I went in again. He was a bit surprised to see me back again, and even more surprised to see the same exact thing had happened on the same spot in the other eye. He put another contact lens in and sent me home.

So apparently these little incidents won’t really have any effect on my vision or healing. I just need to use my antibiotics and wear the contacts a bit longer and I may get some more viscous drops next time around.

On a better note, my vision has really gotten a whole lot sharper in the last couple days. My right eye is probably about 20/20 at this point. However, my left eye seems to be lagging and is blurrier. It’s kind of annoying having an imbalance and I really hope they even out.

So I went into work today and got asked plenty of questions about my Epi-LASIK procedure. It definitely takes some extra explaining when you have Epi-LASIK because most people expect you to have perfect vision already and they aren’t as familiar with the Epi-LASIK procedure. It’s definitely fun when you can gross someone out with all the gruesome details of the operation.

Today is the Tuesday after my surgery, 5 days after the operation. I was able to read fairly comfortably at work and could do some work, but probably not super detailed work (not that comfortably at least) quite yet. However, I had to go in to the eye doctor for another checkup at noon. There, he checked out my eye again for any infection and tested my vision. I’m apparently 20/25 now, though I was straining to see the last line of text. I think I’m still worse than that. Apparently my vision is great forthe 5 th day. I’m not really sure if they say that to everyone, as it really is quite comforting to hear.

At this checkup, they finally removed my bandage contact lenses. Dr. Davis put some anesthesia in before doing so. After taking them out, I was expecting things to get clearer, this haze I felt like I was looking through to disappear. That didn’t really happen, if anything, things got slightly blurrier. I guess that’s just how my eyes are for now and only time will get rid of the blurriness.

However, after leaving the office, and the drops started wearing off, my new epithelial cells and their brand new nerves were exposed to the elements. The surface of my eyes were definitely really sensitive and scratchy. The rest of the day wasn’t much fun. It wasn’t the same burning and tearing as before, but more like a dry annoying set of contacts that are ready to be taken out all day. I hadn’t had any dry eye, but now I was yawning to get my tears going all day and putting in drops. I guess this new layer of cells needs to come in and toughen up.

So in my last post I mentioned that my left eye was really blurry and I was getting quite worried. Well, I took a nice long nap and when I got up, I realized that my left eye was as sharp if not sharper than my right. I guess there’s just a lot of variability in your vision quality as you heal from Epi-LASIK. My vision has really improved a good bit today.