August 24, 2008

When Doctors Disagree: Toe To Toe

The mistakes made by doctors are innumerable. They err habitually on the side of optimism as to treatment, of pessimism as to the outcome. --- Marcel Proust

As a kid, I thought of doctors as gods, practitioners of a noble profession. Experience shows these experts in health care have limits. Like everyone else. I just had a strange experience. A molehill got misdiagnosed and became a mountain.

Pain Without Gain
The pain in my left foot started months ago. Like Snake Plissken in Escape from New York, I paid no attention. Until I had difficulty walking. A growth on the side of an inner toe caused pain and swelling. To compensate, I burdened my other toes and other foot with extra weight and unnatural movements. That caused side effects.

Time for medical treatment.

Doctor 1
I went to a neighborhood walk-in clinic, waited and eventually saw a doctor. He diagnosed a callus. He cut away the top layers of dead skin ("tell me when it starts to hurt") and advised me to return if the pain remained.

A few days later, I went to IKI Canada, the centre for pain-free living. I go every 4-6 weeks for a general tune-up. My therapist, Julian Hirabayashi used Ki energy, acupuncture and other techniques to remove the swelling and rebalance my body weight.

Doctor 2
I wasn't cured, though. I returned to the walk-in clinic where a different doctor was on duty. She confirmed the growth was a callus. She poked from the top and sides ("does it hurt here?") but provided no treatment. My condition seemed too minor for her. I was to get a pumice stone.

Something was wrong. The pumice stone caused more pain. Progress was slow. I tried a special file. This worked faster but caused bleeding since too large an area got treated. I waited for the foot to heal before continuing treatment.

Doctor 3 (Specialist 1)
Because of other issues, I was getting orthotic shoes. When I went for foot impressions, the doctor looked at my aching foot and confirmed the earlier diagnoses.

Doctor 4
To reduce the pain, I'd been limiting my walking and wearing looser footwear. I wasn't getting better, though.

I went to a different doctor. He said I had a wart!?! This made more sense. He cut away at the top and applied cold to start killing the virus. He advised that I go to a specialist to get treatment with uber-icy liquid nitrogen.

I got an appointment about three weeks later.

Doctor 5 (Specialist 2)
The health centre could treat me but would not: I lived outside their zone. Something to do with how the province funds them. I should been screened out when I called for the appointment. Three weeks wasted. Plus an hour waiting and filling out forms.

As a courtesy, the doctor examined my foot and gave me a list of private foot care facilities. I got an appointment the next day.

Doctor 6 (Specialist 3)
After filling out paperwork that even asked for ages of children, my foot got examined. The recommended treatment? Surgery. No one mentioned this option before. It seemed ideal based on the location and advanced stage of growth. I paid $300 and got treated right away. That was a few days ago. I return for a checkup in a couple of days. Months of agony and misdiagnosis are ending.

Three Lessons Learned
I'm no doctor. I'm barely a good patient. Still, I'm dismayed that a minor ailment got misdiagnosed three times. If there were doubts, why not refer me to a specialist. I learned three lessons.
  1. good advisors are hard to find
  2. a bad diagnosis means a bad prescription
  3. you suffer when mistakes get made (time, money, inconvenience, pain)
Health = wealth.
Stay healthy.

August 17, 2008

Getting Things Done: Three Big Lessons

Often times, the more limited your parameters, the more creative you'll become because you have to. David Allen
We've looked at scheduling your priorities using an approach from the Seven Habits of Highly Effective People. We've looked at using a scanner to turn paper into searchable, electronic files. This time, we'll look at improving your workflow using ideas from Getting Things Done (GTD) by David Allen.

You can only feel good about what you're not doing when you know what you're not doing. — David Allen
Three Big Lessons
You'll find many similarities among different approaches to organizing your life. GTD gave me three new ideas
  • capture everything (which validates my approach)
  • get things out of your head and into a system you trust
  • misfiling is fine if you follow a simple alphabetic system: your phone bill could be under Utilities, Phone, Telephone or Bell (the name of your phone company) but you can easily find the file
Your Brain's Brain

Your head's for having ideas, not for holding them. David Allen
When do you remember that the batteries in your flashlight are dead? Probably when you need the flashlight, not earlier when you were standing in front of the batteries in your favourite store. Your mind doesn't have one.

If you can't get things out of your head, you burden your brain by having it keep track of too many things. You'll left with an uneasy feeling that you've forgotten something even if you haven't. With things on paper (for example), you can easily see what you need to do. You can then use your brain to set priorities.

What you can do depends on where you are and what you have. If you need a computer to view an email attachment and you're not at yours, then don't worry about that task. Four factors help you pick the ideal task at a given moment.
  1. context (e.g., you may need a phone, a file or a computer)
  2. time available
  3. physical energy available
  4. mental energy available
Suppose you've got a conference call in 8 minutes and you returned to your desk from a lengthy, unscheduled meeting. Your time is limited and so is your mental energy. This may be time to refill your stapler or get a drink of water.

Five Steps
There are five steps to Getting Things Done
  1. Collect: gather and
  2. Process: decide on the goal (successful outcome) and the next action step
  3. Organize: use lists that you can create and review quickly
  4. Review: ideally weekly
  5. Do
You can get more details from the links at the bottom. As you'll guess, the secret is implementation.


Planning brings the future into the present. — Brian Tracy
In Eat That Frog, Brian Tracy recommends that we work from lists. This lets us separate the vital few from the trivial many (in essence a 20/80 rule). Checking off completed items gives a sense of positive forward momentum.


August 10, 2008

Saving Paper, Time and Space

Where are the paperless offices and homes projected for years?

We're drowning in a sea of paper. If you're organized, the paper may be nicely organized in files. If you're like me, they are stacked on most flat surfaces. Can you find what you want when you want? Maybe. Can you find what you want from where you are? Unlikely unless you've stored files electronically.

Electronic records have five key advantages
  1. searchable
  2. save trees
  3. save space
  4. reduce clutter
  5. easy to backup
The problem is creating the electronic records. I got a fancy flatbed scanner with a sheetfeeder years ago (HP ScanJet 6250). It got little use because it's too temperamental. Pages would jam. The process was slow. Organizing the resulting files became a chore. So the scanner has been sitting beside my desk for years doing little more than gathering dust.

The Perfect Scanner
I want a scanner with the following characteristics
  • effortless to use
  • scans both sides of the page at once
  • scans directly to PDF, converting to searchable text along the way
  • good for business cards too (I've got stacks and stacks)
  • automatic file naming
  • compact (ideally portable to allow use while travelling)
Luckily, technology has improved and prices have dropped.

After searching, I found the Fujitsu ScanSnap S300 for Windows (there's also a Mac version). This scanner is portable and can be powered from a USB cable (using two ports in total).

For ease of access, the scans are going to be stored on a computer and backed up to a shared drive on our home network. For extra redundancy, they'll be stored online (not sure where). Try doing that with paper.

In Action
The scanner arrived yesterday. It's well-constructed (feels solid), surprisingly compact and works extremely well. It's easy to move from one computer to another, which allows each of us to scan our own stuff. I've already scanned dozens of pages and fed the originals to the shredder. That's a good start.


August 5, 2008

Google Locks This Blog As Spam ?!?

I'm a big fan of Google and their approaches and rely on many products:
  1. Google 411 at 1-800-GOOG-411 (free directory assistance; now in Canada)
  2. Google GrandCentral (your own free phone number which people can call without even knowing your number)
  3. Google Search Engine (to find stuff)
  4. Google Mail (where you can save every email you get forever)
  5. Google News (for news selected by algorithms instead of editors)
  6. Google Blogger (where this blog is hosted)
  7. Google Analytics (to track web traffic)
  8. Google Feedburner (to send you new posts by RSS or email)
  9. Google Notebook (to capture snippets of the web)
  10. Google Maps (to verify directions from my GPS navigator)
  11. Google Picasa (for photos)
These products are getting increasingly integrated, which makes them even easier to use. And there are others that I don't currently use much.

What Went Wrong
I ran into my first ever problem with Google on Friday night, the start of a long weekend. I got an email saying this blog might be spam. I checked message to make sure it was real. It was. Here's an excerpt:
Your blog has been identified as a potential spam blog. To correct this, please request a review by filling out the form at [link].

Your blog will be deleted within 20 days if it isn't reviewed, and you'll be unable to publish posts during this time. After we receive your request, we'll review your blog and unlock it within two business days.

We find spam by using an automated classifier. Automatic spam detection is inherently fuzzy, and occasionally a blog like yours is flagged incorrectly. We sincerely apologize for this error. By using this kind of system, however, we can dedicate more storage, bandwidth, and engineering resources to bloggers like you instead of to spammers. For more information, please see Blogger Help:

Thank you for your understanding and for your help with our spam-fighting efforts.
The message is pleasant enough, but still unnerving. I clicked on the link and waited impatiently for reactivation.

While Waiting
While you wait, you can draft blog posts, but not publish them.

The Issues
The reactivation, took place two calendar days later on Sunday. This is faster than the commitment of two business days (which would have been Tuesday). However, I missed my schedule of posting early on Sunday morning. Surprisingly, Google didn't send an email to say my account was reactivated. I only found out by logging in.

Here's the scary part. What if you're on a long vacation and can't reply withing 20 days? Your blog gets deleted!!! You could have your blog hosted on your own site, but there are other issues
  • requires technical knowledge
  • may be less robust
  • costs money (your credit card might expire or get suspended while you're away)
Why Use Google?
There are many reasons to use Google products. Since they have the most popular search engine, using their other Google products may give higher rankings in searches (certainly can't hurt). There are ongoing enhancements and since Google's offerings are web-based, you skip the hassle of installing upgrades. What's more, Google's tools are completely free. There's no obligation to show any advertising.

What does Google do about potential spam blogs hosted elsewhere? Maybe they get removed from Google web searches without warning. At least I got a friendly email. So I'm sticking with Google until I decide to start spamming for real!