Plaidophile

I guess it's been a while since I've posted, so here it is in brief:

• Job is going pretty good so far. The way computers are set up now is very different than five years ago, so I was able to actually figure out a decent work setup that works well. Also, my coworkers are pretty excellent, and in particular I'm getting along well with one of the engineers who is an old friendly curmudgeon from Syria. I'm also getting a handle on the codebase quicker than I expected, and this team is way more laid-back than anyone else I've worked with.
• My offer on the Firehouse 25 condo still stands, and I just accepted an offer on my condo in SF (whee). The offer I accepted wasn't as high as I was hoping for but it was still above my asking price and makes the timing work out really nicely (and my realtor pointed out that because of labor day and Burning Man I'm unlikely to get more offers in the next couple weeks anyway, and then that means it'll be sitting on the market for a while and that has a way of tainting things). I'm still making a decent profit on it anyway.
• I got sick of not having any guitars with me and I figure I need a better 6-string acoustic, and Guitar Center is just up the street from where I'm staying, so I figured...
• Werner is still going nuts, but hopefully he won't have to put up with this crappy apartment much longer.
• The ISP situation in Seattle proper is pretty dismal. Looks like the only real choice right now is Comcast. Maybe Paul Allen will stop working on his urban-renewal vanity projects and start trying to establish a FTTH provider to improve the city that's already here. But I'm not holding my breath.
• My wrists still suck, my butt still sucks, and I still have anxiety issues, but somehow life goes on.

Today I got my current albatross of a boondoggle of a project to a good stopping point, as in I've completed everything on it that I'd committed to. The rest of it is up to Steve and Andy, assuming they can get it done in the next week (Steve's doing his best to debug a pretty aggravating issue from a perspective other than where I've been attacking it from, and Andy is basically putting tab A in slot B and hopefully not fucking things up too badly, but this is Andy we're talking about so I'm not optimistic).

It's been a while since I've posted anything about my wrists. I've mostly had them manageable, although my left wrist still hurts quite a lot much of the time. But based on a couple of people asking me specifically for what I've been doing for my wrists (hoping it would help them as well), here's some quick, non-professional, I-am-not-a-doctor-or-ergonomoist things I've found that help:

First, exercise with negative resistance is very helpful. Negative resistance is where you're working against a force (such as walking down a steep hill). The best device I've found for negative resistance on the arms is the Powerball gyroscopic exerciser; I got mine (which I'm very happy with) from NSD Powerballs, but there are a bunch of other ones on Amazon that I haven't tried. They're a bit hard to learn how to use at first but it's worth the effort.

Another important thing is to take typing breaks and to stretch during them. These days I use RSIGuard, which costs $65 (and has a 45-day trial). On Windows and Linux there's Workrave which is nearly as good (although it doesn't track actual usage/strain and its stretches aren't nearly as comprehensive or well-designed). The least-terrible free RSI timer I've seen for MacOS is TimeOut, although it's pretty bad (which is why I eventually broke down and bought RSIGuard). During these typing breaks is a pretty good time to use the Powerball.

July 2012 I no longer recommend RSIGuard on the Mac, as it's fragile due to some underlying design flaws (which mostly come down to its Windows and corporate-deployment legacy). Unfortunately there are some issues with Mac OS X which makes it difficult to make a properly-working typing break application (because of some strict "user-friendliness" issues when typing break software must be inherently unfriendly), but the application I use which is the least bad, all things considered, is BreakZ.

A good ergonomic setup is also very important. Most keyboards are way wider than they need to be (pushing the mouse further away than is really comfortable), and most keyboard trays suck badly. I use Apple's wireless keyboard and trackpad (which also work with Windows with a bit of effort, and also in Linux) and instead of a keyboard tray I use Ikea's DAVE laptop desk, which is nicely height-adjustable, easy to place in a comfortable spot, and pretty much stays wherever you put it. It's way better than any of the $300 professional keyboard trays I've used.

July 2012 I've been using a Filco Tenkeyless keyboard (a clicky one at work and a quieter one at home). It's only somewhat better than the Apple Wireless Keyboard, but every little improvement makes a big difference. The price is pretty off-putting, though. As far as a pointing device I've gone back to a normal scroll mouse, although I think that's been detrimental. I still haven't found a perfect pointing device.

Finally, when I sleep, I usually wear a wrist brace. I like ACE's TekZone ones; they're much more comfortable than any of the others I've tried, and are easy to adjust to be tight without being constricting. They're available on amazon although I'd recommend going to Walgreens or CVS or whatever so that you can size them properly.

Of course, I'm not a doctor or an ergonomist or whatever, so if you have access to a professional ergonomist definitely take advantage of it.

When I was en route to Chicago, the battery in my MacBook Pro began to swell, so bad that my touchpad stopped working and when I opened the battery cover, the battery popped out with a great deal of velocity. So I made an appointment at the nearest Genius Bar (which is annoying to have to do), and when my appointment came up (after a few failed checkins) I showed my quite-round battery to the Genius(tm) who immediately just gave me a new one for free, despite my MacBook being about a year out of warranty. It never hurts to ask nicely (although I was prepared to argue for it anyway).

Also, having previously been dissatisfied with a compact Logitech keyboard and a Wacom Bamboo Touch, I bought the Bluetooth keyboard and Magic Trackpad, and while it's weird to spend $140+tax on a mouse and keyboard, these are actually quite comfortable, and I have them on a little Ikea lap desk and it's much more comfortable on my wrists than trying to put up with my horrible keyboard tray. Hopefully this will help a lot. Unfortunately, the lap desk is a bit thicker and squishier than I'd like, so I'll have to try a couple others out, but still, not a bad setup, and altogether costs way less than a proper keyboard tray (and a desk that can hold a proper keyboard tray).

Things I meant to do after my checkup but got distracted:

1. Make an appointment with the referred neurologist to get another nerve conductivity test
2. Make an appointment with the referred orthopedic surgeon to get treatment options, including (hopefully) reputable massage therapists

Not wrist-related but other action items resulting from the checkup,

1. Get the labwork done (fortunately that's a walk-in and I can do it before work on Monday)
2. Make an appointment with the referred dermatologist for the skin cancer screening (my idea since I've been a bit concerned about a couple of moles lately)
3. Also wasn't Walgreen's supposed to call me about my Albuterol prescription when it was ready? It's been well over an hour. I guess I can head over there now (grumble).

So back when I was 18 or 19 I started to develop wrist pain, and that led to full-blown carpal tunnel syndrome (pain radiating up both arms from my wrists, tingly fingertips, reduced grip strength, twitchy fingers, and so on). I got it more or less under control with a DataHand keyboard, but then with my first job out of college it came back full force and I quit and went back to grad school.

While in grad school I got the CTS under control thanks to massage therapy and a significant reduction in typing volume, but I was left with permanent tendon damage (which I later learned was most likely tendinosis). This tendinosis would continue to flare up now and then (every other year or so), but the carpal tunnel syndrome remained at bay.

Today my fingertips got numb again, and I'm showing all the signs of a resurgence of carpal tunnel syndrome.

Of course this would happen two weeks before an important musical event that I've been looking forward to for months.

Hopefully I can get it under control pretty quickly but my suspicion is that I will not be playing any non-drum instruments at SFRR (fortunately I already have a backup band partially lined up, so I guess the rhythm guitarist will simply be the guitarist), my posting frequency will diminish even more significantly, and I won't be able to do comics or music or the like (not that I've been posting music on my sites lately but I've been doing a few side projects). And of course I can't help but worry about, you know, my career. Basically, this really sucks.

Fortunately I have a two-week vacation coming up (starting with Song Fight Live) so maybe I can keep myself away from the Internet enough during that time to give myself time to heal again.

I haven't been particularly posty over here, mostly because I haven't felt like talking about things going on in my life. So, in bullet list form:

Usually my left wrist is more painful than my right (which is the case currently), but lately it's my right wrist which sucks more. It's like my fingers don't want to move correctly sometimes, and sometimes my right thumb twitches involuntarily, like there's a nerve problem or something. I've been drawing a lot more than usual lately so that probably has something to do with it.

My grip strength is still excellent, though, and I don't have numbness in my fingertips, so it's not carpal tunnel syndrome (I did probably have CTS 10 years ago but since then most of my wrist problems have been more likely some form of tendinosis).

Man, why does biology have to suck?

For now I'll try mousing with my left hand, and maybe try to figure out a more ergonomic setup for my Wacom tablet at home (I'm not going to try drawing left-handed though).

So, after an Ars Technica thread about dealing with RSI, I decided to order a Powerball, which arrived a few days ago. I played with it a few times but couldn't figure out how to get it going, until I searched Youtube and came across this useful video.

I got the Techno model which only shows your score after a certain threshold (which I haven't reached yet) but even without that, this thing is great. Just a couple minutes of it feels like I've been working out for hours, and I can barely move my arm afterwards from the muscle fatigue. It finally gives me something useful to do during my typing breaks (and it's certainly more fun than lifting dumbbells while watching TV).

Of course one has to be careful when using one in an office environment.

Hopefully this will finally help me get over my long-term wrist problems. I'm sure I'll keep everyone updated.

For the last month or so my wrists have been getting really bad again, and for some reason I've been in denial. Argh. I guess this is the same cycle I go through every few years. This time around I think it's a combination of bad ergonomics (my keyboard tray at work kind of sucks and I have no keyboard tray at home) and other stress factors.

In particular, over the last couple weeks I've been playing guitar and drawing a lot, which probably has a lot to do with it. Also I haven't been sleeping with my wrist braces for the last, oh, 6 months. So that's something I'm going to have to start doing again. Meh.

I'm having a heck of a time trying to find a decent massage therapist in downtown San Francisco. Most of what I can find are erotic masseuses who advertise their picture more than their credentials, and what's left is mostly practitioners of bullcrap like reiki and reflexology.

I really need someone (preferably a CMT, though the reiki/reflexology practitioners all claim to be CMTs as well so I'm guessing CMT doesn't really mean much anymore) who will do deep-tendon massage for tendinosis. Surely there's got to be someone good and reputable around here?

(I can find a number of decent-looking therapists down in Mountain View, San Jose, etc. and I suppose it's not that big a deal to go down on a Saturday or whatever, but it'd be much more convenient if I could go during the work week without taking a day off from work.)

That's the important one.

There hasn't been a "Dear fluffy" in quite some time, but Chris just writes in with this:

Hello

Googling for leads on what's been plaguing me for the past six months brought me to your site, specifically this post:

http://beesbuzz.biz/blog/e/2006/06/16-tendinosis.php

I've been diagnosed with everything from tendinitis to deQuervain's to nerve damage in my neck with no luck so I still hunt for answers. Since your wrist posts seem to end after that one I'm very curious: did anything in that post work for you? Have you had any improvements or progress? Living with this, I sincerely hope you have

Regards
Chris

I've been going about treating my wrist problems all wrong. I mean, I was doing an established protocol for treating inflammation of the tendons, but cortisone didn't help at all. Reading further I found out it's much more likely I have tendinosis, which is caused by several microtears in the collagen layer of the tendons. In the case of tendinosis, the last thing you want to do is get rid of the inflammation, because that is how the body sends important stuff to the tendons to repair the collagen.

There is an experimental treatment for tendonosis called "prolotherapy" which actually induces inflammation to speed the natural healing process up, but apparently the best treatment is to exercise the muscles in "braking" motions, not stretch, not use anti-inflammatories (instead using painkillers like acetaminophen) to mitigate the pain, and not do the things which cause damage for a month or more. Argh.

So, nerve conductivity tests showed that there's no compression or damage. So whatever I have isn't typical carpal tunnel syndrome. Yay me.

You know it isn't a good sign when a traditional doctor suggests trying acupuncture...

(Well okay, he didn't actually say it outright but he implied it.)

So, managers at work have suddenly decided that now would be a really good time to demo our project to our potential customers, when we're nowhere near ready. So of course they decided that the best way to get us ready is to give us a fire drill by scheduling a meeting with the customers which we can't back out from and if we do it'll be extremely damaging to our credibility. So of course now those same managers are deciding that everyone on the project really should put in a lot of extra time and effort. Everyone except me because of my wrists. Which of course adds to stress all around and jacks up everyone's morale.

Also John has gotten sick of pussyfooting around with a couple more on the team. He's pretty shocked at how much hand-holding he needs to do just to get things accomplished. It's a very different environment than what he's accustomed to. Also different than what I'm accustomed to. He's made it pretty clear to me that he's trying to ramp me up as a manager so that I can take over for him; he's obviously not very happy here. But he's the only thing keeping me sane right now.

I really don't like the current chunk of songs which I'm so horribly late on due to my wrists anyway, at least not Been To China or A Thousand Swords. There's a couple of surprise ones I still want to do, though, and I guess I got a bit less shitty for Birds Of Our Own. Really there's not a lot of worthwhile songs left though.

I actually missed the +5 deadline for "Been To China." I have lots of ideas for it but can't work on it because it hurts too much. Meh.

Hopefully this Friday I'll get cortisone and then I'll be all better.

Because my wrists are teh sukc right now my superiors want me to just do non-typing analysis and demi-management stuff until I can get to the orthopedist, and the one who I was recommended to see doesn't have anything available until next Friday. So, no typing until then. Although I appreciate work not wanting me to kill my wrists, after just one day I've already taken care of all the management-type stuff I can foresee for the next week or so. And so now I'm being paid to basically sit around and not even twiddle my thumbs. And I've also been politely asked to not work on music in my spare time (so of course my sadistic muse has decided to fill my head with song ideas! and I'm just bursting at the seams with songs right now) and to keep my non-work typing to a minimum.

I really appreciate the concern for my physical well-being but I AM GOING CRAZY. And it's only been one day! (Two if you count being sent home on Friday.)

There's got to be something productive I can do without using my hands.

I hope that things are unwinding and that you are feeling better. I think we can come up with ways to reduce your typing load (other than APL ;-) ), so we'll discuss when you feel up to coming back in.

Courtney said she had a really good wrist doctor, and it wouldn't hurt to follow up on that. I don't use the Amazon health plan, but the web sites normally allow you to search for specialists, and I can use our healthplan to at least locate one.

I'm really sorry of the pressure over the last few weeks precipitated this. I'd like to re-iterate that everyone (including Bob) really, really values you, and any flack flying around was not directed at you.

So, let it improve, and let’s review a few ideas to use eyes and brain rather than hands.

TTYS, John