I wrote the following informal report to send to my supervisor and payroll department at Twin Rivers:
Often in research, there is a need for further research, and many medical treatments do not immediately work for various reasons. I feel this is the case with my first month. There were some major successes:
- I was diligent about getting a daily blood pressure check from Kaiser, as a medical appointment. This fulfilled my contract requirements, and has given me a good set of data points that I should be able to soon analyze.
- I did an excellent job of logging all the food I ate for the month with MyFitnessPal which I can now download to a spreadsheet using my scraper.
- I worked out at least 3 times per week.
- I attended several classes to help learn more about my health.
- I measured my weight fairly accurately and fairly regularly.
But, my medical progress was not as good as hoped:
- I was making progress on losing weight, and then backslid, so my weight is only slightly lower than when I started.
- While I tracked my food intake well (see below about some minor GIGO problems), I also tracked that there were many days that my calorie intake exceeded the limit that I aiming for, and also a few days that really exceeded that limit, and thus was probably responsible for having weight gain after losing weight.
I also have had several GIGO (Garbage In, Garbage Out) / problems with imprecision & accuracy:
- I have had problems knowing how large my portions are when entering data into MyFitnessPal, and while I have usually tried to overestimate, I really need to at least for a week, use measuring spoons, and a cooking scale to determine how much I’m using when eating, so that my subsequent estimates are more likely to be correct.
- My pedometer has had issues sometimes starting in the morning, and I have not always put it on the charger in the car, or done something else that would pause it, so I am not sure how accurate its data is.
- I do not trust my heart rate monitor’s accuracy. I need to find out how to place it on my body in such a way that it is most likely accurate, and to test it with another heart rate monitor, like one at the gym, to ensure that I’m getting accurate results.
I also still need to complete two more medical diagnosis process that will more precisely measure my fitness and metabolism:
- A Resting Metabolic Rate check from Kaiser
- A Hydrostatic Body Composition check from my Gym
If I wish to truly get valuable data, write a paper of worth about this, and actually get results in my personal life, I need to keep moving forward, and I can’t stop. I must recognize the first month’s successes, but to not stop, and instead to systematically solve the issues that I have discovered, so that I can do an accurate analysis of my health and draw accurate conclusions about correlations and possible causation of different variables with my health.
I just sent the following to my doctor about the proactive medical appointments I had in May:
Per our conversations, I have been working proactively on my chronic medical conditions, specifically obesity, my cholesterol, and my pre-hypertension (since previously I briefly had blood pressure in the hypertension range). As you should be able to see, I have attended the Move to Thrive and other health education programs several times in May, and I will also let you know that I attended the gym regularly. I also got a daily blood pressure screening from Kaiser, as you should be able to note. For my personal records, and for my employer, I’d like to get a printed copy of all the days I went in for my blood pressure screening in May, along with the other appointments, such as health classes, I have had with Kaiser Permanente in May. Could I pick these up on Monday afternoon? Thanks!
Yesterday, I stayed under my 2,000 calorie target that I set for myself!!! (And that was even with it being a fairly stressful day!) Now I will try to keep this going for a streak of several days.
Part of my proactive medical plan is going very well. I have been very consistent about working out with the Kaiser fitness group and getting my blood pressure checked, although I’m still consistently at a blood pressure that is pre-hypertension, I am getting closer to being in the normal/good range.
I have also continued to track my diet well, and I think I’m eating less most days, than I have before, but tonight I went to an all-you-can-eat sushi restaurant with my daughter for her birthday (she is the only other person in my immediate family who likes sushi), and I ate all I could, and thus I went about 1,000 calories over my target of 2,000 and so I’m sure that is going to hurt my weight loss progress. But, I rarely do this type of thing any more, so it will likely be an “outlier” of a day, but since diet is cumulative, it doesn’t matter that it is an outlier, it will still have a potential long-term effect. At least now, I’m starting to really understand that at more of a “gut level” (pun slightly intended).
I also will be able to track to see how this affects my weight, and that will probably help me make the more direct connection to help my will power over the next week.
I have been using Wii Fit Plus (Off and on) for several years, and thus it has some the best longitudinal data about my fitness (especially my weight). I would like to export the data from the Wii and be able to analyze it in Excel. Several people have worked on doing this, and one person started to put an easy to use converter on the web, but it looks like it has been taken down. So, basically at this point, it looks like all the components exist, but that it will take a little coding to get them together for myself.
So given this fact, I’m starting a new scraper on ScraperWiki that will ultimately extract My Wii Fit Plus Data, and allow others to extract their data also. To create this scraper, I’m going to try and use the code from the wiifit project, along with other code.
So far I’ve been overall very happy with Digifit’s iCardio app for Android. I realized that it had the GPS feature I was looking for, so I didn’t need the JogTracker app. I am especially impressed that its CSV export includes a large amount of data of snapshots of the workout session, so there is a lot of data to be able to analyze with a very fine granularity. I also like that the app has a Notes section for each workout, which allows the entry of some good qualitative information including a place to write notes, an overall rating of the workout (1 to 5 stars), the feeling of intensity of the workout (Easy, Moderate, Medium, Hard, or Intense), mood during the workout (as a set of faces from frowning to very happy), and an icon to represent the weather. I only wish that this qualitative info was also part of the CSV export. The only other improvements that I think would be really useful are:
Critics of personal science and self-experimentation might try to argue that because personal science deals with a sample size of one, that there is no ability to generalize the results of experiments. But, there is a fallacy in that logic. While it is clear that experimenting on a single subject cannot prove that the same results will absolutely occur for others, by inferential statistics it does clearly show that there is a high probability that it could work for at least some other people. Further, it should be noted that most health science and social science research also never shows that something will absolutely work for everyone, but instead shows a statistical probability that a result will occur. Using this concept of generalizing the result of personal science by determining the possibility that it may work for others should become part of most personal science research methodologies.
There is another vital area where personal science and self-experimentation can lead to generalization, and that is by having personal science being a component of traditional science. Because, while an experiment on only a single subject may be able to show the possibility of the same results occurring with someone else, if a sufficient number of people follow similar methodologies in their self-experimentation, then the group of their results can be used with traditional scientific methods to determine a statistical likelihood of how the results might occur across a broader range of people. This in effect becomes the crowd sourcing of science, which some are now calling “citizen science”.
This use of personal science may be especially valuable in the repetition of experimentation after initial professional scientific studies. This is because there is a sociological bias towards having scientists wishing to do “groundbreaking” work of discovering new knowledge, but not as much desire to do the ongoing work of continuing to test initial results. But, if the results of a professional scientific study shows something that may be beneficial to individuals, then there is a motivation for individuals who are aware of the results of the study to attempt to implement the results in their personal lives, and if a sufficient number of people do this in a sufficiently rigorous manner, this data can be used along with the initial research and follow-up research in a meta-analysis to create an improved statistical model.
Thus personal science has at least two major areas that it can help add to the general body of scientific knowledge, which in some ways are the “bookends” to professional science. On one side, initial self-experimentation can show the possibility of results potentially occurring for others, which can spur a fuller study with more subjects to occur. And on the other side, from the results of professional science, the crowd sourcing of personal science can help to improve the accuracy of knowledge derived through the professional studies.
I learned a lot this first week, with some successes and a few mistakes. First, as I will also discuss in more detail in an upcoming post, I now have a deeper understanding of how my proactive medical plan can work with conducting personal science. Specifically, I recognize that this month of work is not really sufficient in duration to state whether it has resulted in improvements that are likely to last. But it is a month that can start the necessary habits, gain preliminary data, and test out methodologies on a small scale to “kick-start” a full year-long self-study. I also believe that I will be able to use a methodology that is replicable, so that my data point could be combined with other people who choose to follow the same methodology so that each of our personal experiments can contribute a small portion to the collective knowledge about health and fitness.
This week has also been one where I have narrowed down what part of my health I am going to focus on measuring for the month. My current “ongoing health conditions” as diagnosed by my doctor with Kaiser Permanente are obesity and hyperlipidemia (high cholesterol). Both of these conditions have a correlation to potential heart disease and other cardiovascular problems. Although there is a question of causality with body fat, as from what I understand, there is evidence to suggest that people who get fat removed via liposuction don’t necessarily have a lower risk of heart disease than they did before the procedure. With high cholesterol, at least with LDL, there is more evidence to suggest a causality to heart disease. I also previously was starting to have signs of having hypertension (high blood pressure), which also correlates to getting heart disease.
But, whether there is causality or not with these, the correlation is very strong, and I believe that it is highly likely that by improving my diet and getting more cardiovascular exercise that these will reduce my weight & body mass index along with lowering my LDL cholesterol and also improve my chances of not getting various forms of heart disease and/or other cardiovascular conditions. I also want to work in the future on my strength and balance, but for this first month, while strength and balance exercises will be part of my activities, my major focus and rigorous measurements will all be about my cardiovascular health.
Regarding the implementation of my plan, I feel have been tracking my diet very well, although every day thus far I have gone above my target caloric intake. I have found MyFitnessPal to be an excellent app to help track this, and its bar code scanner is very helpful, and I find it kind of fun to use.
I have also worked out every day this week, with 4 out of the 5 weekdays being with the Move to Thrive program with Kaiser, except Thursday when I worked out at California Family Fitness. I will be measuring my exercise workout by looking at the total steps & estimated distance I’m going through the workout, and throughout the day, and also through measuring my heart rate during the workouts.
To measure my steps, I’m using the Accupedo pedometer app for my Android phone, which seems to be the most accurate pedometer application, that works to have an algorithm that filters out “false positive” steps (for example if I am sitting in a chair, and move a little, Accupedo will generally not show that as a step, while most pedometers would.)
To measure my heart rate, I purchased a Scosche IPTM myTREK – Wireless Pulse Monitor, which while it has had mixed reviews on Amazon, it has won several awards, including Design and Engineering Showcase Honors at the 2011 Innovations International CES, being a Best of Show Finalist for 2011 with iLounge.com, being the Best of Show for 2011 at Macworld, and being the Future Tech Winner for Best Mobile Device with CES 2011. It was also reasonably priced through Amazon.
Several reviewers said that the problem with the myTREK was the software it came with, and recommended Digifit instead, so I purchased Digifit iCardio, and it seems to be presenting results inline with other heart rate monitors I’ve used on the exercise equipment at the gym, and has some good tracking and exporting features. It also has an excellent GPS system to track speed and distance of walking, etc. Digifit iCardio also allows tracking of other self-quantifying information about the workouts (although it doesn’t appear to export this additional information right now.)
To measure the results of my work, I am measuring my weight (and thus deriving my body mass index) via several sources. To see my historical weight/bmi, I’m using Kaiser’s data and also the data from a few old driver’s licenses that I have kept, including my first one from my 18th birthday. I also am using the data from the Wii Balance board as entered into Wii Fit Plus, which I have been using off and on for a few years, and which I am now using on a nightly basis to record my activities (as fit credits), my weight, my balance, my waist size (every few days), and will be storing my pedometer entries. I am also getting my blood pressure screened daily through Kaiser, and I had that done every day this week. I also plan to get a body fat test done with California Family Fitness, and will get my resting metabolic rate tested with Kaiser (see below about how I couldn’t get it done this week). In addition, after my month of working on my diet and exercise, I think my doctor will let me take another Cholesterol test to see if there has been any effect with my hyperlipidemia.
My biggest mistake this week, was that I wasn’t able to get my Resting Metabolic Rate checked, because the morning I was to go in, I forgot not to take my wake-up caffeine pill (I will explain more about my daily caffeine, and how it has really improved my sleep schedule in a future post). So since I took the caffeine pill, and even though it was 5 hours earlier from the appointment, and I had followed all the other guidelines, they felt I shouldn’t take the test then. I rescheduled the test, but I really would have liked to have been able to get my results already. I also didn’t get my myTREK until late in the week, and when I first was going to use it at one of the Move to Thrive chair exercise classes, I forgot to actually tell the Digifit software to start recording the data.
So, overall, a good first week of the proactive medical plan. I am working on continuing my work on my diet over the weekends also, and may or may not do the additional exercise on the weekends.
I am now in my third day of my proactive medical plan, having completed another session of Move to Thrive and getting my blood pressure screened. I feel that these proactive medical appointments along with the proactive medical appointments for health education through Kaiser are all a good and legitimate use of my medical leave from Twin Rivers, given that I have current health problems of obesity and high cholesterol that can lead to a shortened life span, and I don’t have any direct classes to teach at the moment, while I wait for my lay-off to finish. So I would mostly be just twiddling my thumbs at work, not being productive to the tax-payers, if I wasn’t doing something. Further, by using the medical leave now, it lowers my future CalSTRS retirement, thus reducing the tax burden slightly to the state.
But because I am using medical leave to complete my proactive medical plan, and I’m getting paid for the time I’m spending on doing the plan, I am treating it and getting results from it as my job, especially since from the teaching contract I can only use medical leave for either being sick or for medical appointments, if I missed a day of doing my preventative medical appointments, I would be out of compliance , and could jeopardize getting paid. (This is especially concerning to me, as I know my use of medical leave for this purpose is innovative and pushing the boundaries of what may be considered a “medical appointment”) I also know that I am giving up part of my retirement for taking this leave, so I need the long-term benefit of my health being improved to outweigh the loss of retirement funding that it will cause.
So far, I am doing well at this new job. While I feel I am not yet fully competent, as any new worker isn’t, I am putting in the time and practice to become experienced, and this should set habits for my future. And as I will discuss in a blog entry coming soon, this motivation and mindset of being work (combined with my good work ethic) , along with other psychological motivators (that I will also soon write about), are all working together to making sure I will get the health results I want.