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September 2007

August 2007

An update on my elbow, one month after Platelet Rich Plasma (PRP) treatment

I had my one-month followup visit with Dr. Mishra today, to review progress since undergoing a platelet rich plasma (PRP) treatment for chronic elbow tendonitis (or, based on an earlier comment, tendonosis) on July 12. I'd posted an update at the 1-week mark, and given all the comments I've received on the blog and via email, I wanted to post an update at the 1-month mark (well, the 5 1/2 week mark, technically speaking).

At this point, my right elbow feels pretty much like it did before the treatment - normally very little pain, a dull ache that starts after even light exercise (e.g., just standing / walking around for 20 minutes with the elbow unsupported ... or typing / mousing for that long), and occasional very sharp pain when I pick up something too heavy or otherwise overextend the elbow. I've regained most if not all of the flexibility in my elbow, e.g., I can now touch fingers from both hands with arms crossed diagonally behind my back, and can use my right hand for eating, drinking (though not my 20 ounce coffee mug) and brushing my teeth - though I'm still using the floss sticks. I can also wash and [towel] dry my hair with relatively little discomfort.

I confessed to Dr. Mishra that I had not followed some of the recommendations he and/or his assistant, Amy, had made on both specific activities and general actvities. They had recommended against taking both the dune buggy tour and the jet boat tour on our recent family vacation down the Oregon coast, as well as prolonged driving; I did all of the above. They had also recommended that I slow down on my typing speed (and duration), which I did, but only for the first two weeks - I suspect I'm back up to my normal speed, which is probably somewhere in the range of 80-100 wpm. I also did some vacuuming around the house yesterday, which, although they did not specifically recommend against it, I knew would not be good for my elbow - and Dr. Mishra confirmed that vibration, in general, is bad, and recommended that I not do more vacuuming for a while. I have, however, been diligent about avoiding anti-inflammatory medications and have been pretty good about doing the gentle stretching exercises.

Dr. Mishra said it is not at all uncommon for the condition of a PRP-treated elbow to be at the same level - or even slightly worse - at the one-month mark after treatment as it was prior to treatment. He re-iterated earlier recommendations (especially about the typing - so I'm going to try to keep this short), and I have started some theratube strengthening exercises. I'll have another followup visit on September 24, after which I'll post another update.

I'm glad that what I was interpreting as a lack of progress is not necessarily indicative of failure of the procedure. I have to say that during the vacation, I was feeling sad about not being able to so much ... though in writing this, I'm a bit embarrassed, as I know many other people have far more extensive disabilities (or, I suppose I should say, challenges). I still feel a bit disheartened, but writing this has been therapeutic - as has been the support offered through comments and emails - and so I will do my best to practice acceptance.

Update, 2007-08-23:

Pete sent me a note with a link to a Runner's World forum topic on My Platelet Rich Plasma Prolotherapy Journey (so far), started 24 May 2007, detailing a series of ups and downs with a PRP injection for knee tendonitis - including the ability to run 5 miles 3 days after the injection (!) - and ending with a report of 100% recovery on 15 August 2007. I'm glad to read of both the eventual success, and the ups and downs that were part of the journey, but I am a bit confused about the conflation of PRP and Prolotherapy, which I'd thought were different procedures. Clearly I have much to learn (and experience). [In a followup note, Pete sent me a link to the Prolotherapy Nashville page, along with some commentary that suggests that Prolotherapy is the more general term for injecting a specific substance - which may be saline, glucose or PRP - into the region around an injured ligament or tendon in order to stimulate healing. (Thanks^2, Pete!)]

Mark sent me a note detailing extensive experiences with various treatments that included an overuse of Cortisone; he now urges people to avoid the use of Cortisone. Fortunately, the doctor's I've seen about my elbow problems over the years have all been averse to using Cortisone, but I did have two Cortisone injections, and one of them was effective (for a while). I wanted to pass along Mark's (and my doctors') recommendations to avoid using Cortisone, as it is a complicating factor in the potential efficacy of PRP.

While I'm on the topic of avoidance, I'd meant to include a few recommendations for things I would have liked to avoid more (well, things I might have avoided more ... clearly, these are things I like), in the course of the healing process, if I were a bit more disciplined. I already mentioned [not] avoiding prolonged or fast typing [... he types, quickly]. Another strategy is to not buy a new 10-megapixel digital SLR camera during the recovery period. Holding the camera for shooting photos during our recent family vacation along the Oregon coast, resulted in significant pain, but I kept repeating the procedure many, many times, reveling in my renewed appreciation for [digital] photography. Another thing I wish I was more disciplined about is avoiding handshakes, at least with the right hand. I was pretty good about this during the first week, but the social discomfort I feel in reaching out with my left hand - or giving a less than firm handshake with my right hand - often overcomes my good sense about protecting my elbow. I still feel sharp pain during - and lingering pain after - firm handshakes. Another area in which I've not been able - or willing - to be more disciplined is [elbow] safe sex. I realize there are many, er, variations available, but [for me], it just is not a "hands off" (or "hand off") activity. My wife, of course, is far more disciplined than I am - fortunately, she doesn't read my blog, or I might get some extra, unwanted help, in practicing greater discipline in this dimension. In general, It seems that any activity that involves the use of the right arm in which I typically enter a flow state (typing, photography, sex) is a candidate for avoidance ... or perhaps more mindful attention.

On Hineini, Team Spirit and Recognition

I've been reading a soon-to-be-published book on Digital Dharma: A User's Guide to Expanding Consciousness in the Infosphere, by Steven Vedro, which proposes an integration of spirituality and technology based on the seven chakras. I hope to post an entry on the book after I finish it, but one of the many gems I've encountered in the book so far ties in with some other things I've encountered in other media streams over the past few days, and so I'm going to weave them together in a new stream here.

In a sidebar, Steven recounts Flash Rosenberg's recounting of the true value(s) of Hebrew School, which include a definition of hineini from Rabbi Krinsky that I find inspiring:

The most important duty you have is to be present whenever you are called upon, whenever you are needed, whenever you can help.

My son, Evan's, football coach, Joe Morgan, recently sent around a welcome message to the players and parents of his Woodinville Junior Football team (which has strong, multidimensional team and community spirit, as I've written about before). Joe's message included a signature that offers some related inspiration:

You can have everything in life you want, if you will just help enough other people get what they want.

This strikes me as a fabulous philosophy to articulate and promote, whether the team is oriented toward athletics, business, politics or any field of human endeavor! [Update: this quote is attributed to Zig Ziglar]

On Friday, I heard a story on NPR's All Things Considered about the retirement of Karch Kiraly that relates to all of this. In an interview with KQED's Rob Schmitz, Kiraly, the winningest volleyball player of all time, who may be the sport's pre-eminent bumper and setter (vs. the more attention-attracting servers and spikers), shared his strategy:

If I can help my teammate - or teammates - play at a level they never played at before, then it doesn't even matter so much how I play.

While many organizations talk a good game about valuing such under-the-radar contributions, very few have any kind of mechanisms to more formally recognize and reward this kind of behind-the-scenes facilitation of others' success - systems of encouragement for being a mensch.

I'll finish off with something I used to do regularly, but from which I've refrained for the past 6 months: invoke the wisdom of Kathy Sierra. In this case, I'll simply borrow a photo she posted in a blog entry on Never Underestimate the Power of Fun, in which she shared a fun example of recognizing employees who typically operate behind-the-scenes - a calendar that includes photos of employees of the Water Services Department of the city of Bryan, TX, along with the annual Drinking Water Quality Report they help produce:

Coasting in Oregon: Notes from a Family Vacation along the Oregon Coast

Oregon_washington_coast_map_detaile We spent the first week in August traveling down the Oregon coast, covering 1300 miles in 8 days, stopping in Cannon Beach, Florence and Gold Beach then dipping down into Crescent City, California, before heading inland to Crater Lake, with a stopover in Eugene on the way back home to Woodinville, Washington.

Canon_eos400d The scenery in Cannon Beach was so spectacular that I decided I had to go out and buy a new digital SLR camera (the 10.1 megapixel Canon EOS 400D / Digital Rebel XTi), as my Nokia N95 photos weren't doing full justice to the natural beauty there ... and I knew from a trip along the coast in 1986 (when I also bought some new camera equipment) that we were going to pass through lots of other beautiful places. As a side effect of this purchase, I was taking lots of photos, and the image files are large, so I've upgraded my Flickr account to "professional".  Another side effect is that taking lots of photos with the new camera aggravated my right elbow, for which I underwent a Plasma Rich Platelet treatment a month ago (about which I'll post a separate update on progress - or regress - in the near future).

TripAdvisorYelp_logo Before the trip, I'd made heavy use of TripAdvisor to investigate lodging options. During the trip, I tried to use Yelp to investigate dining and other activity options. TripAdvisor was very helpful; Yelp was [surprisingly] not very helpful (given how useful it's been for assessing options in the Seattle and Palo Alto areas). I decided to post a number of reviews of our lodging, dining and other experiences on both sites. I'm not sure if my reviews on TripAdvisor added much value to TripAdvisor, since my ratings were very closely aligned with the existing averages, and my reviews probably didn't add much new information. My reviews on Yelp may have been more helpful, as I was the first to review several restaurants and a bike shop ... though I suppose I'll leave it to others do decide how valuable those reviews really are are.

Since I've posted so many reviews elsewhere, I'll just briefly review our itinerary here, with 5-point ratings, brief comments and links to the full reviews (by me and others) on the other sites, in case our experience might be valuable to other families planning a similar vacation (the preponderance of favorable ratings is either the result of successful research or low standards ... I like to think it's more likely the former). I'll also include thumbnails and links to a few photos along the way. [A much more comprehensive guide to the Oregon coast can be found at 101 Mile by Mile.]

A New Generation of Proactive Displays

We launched our new proactive display application at Nokia Research Center Palo Alto two weeks ago. The application - provisionally called the Context, Content and Community Collage - situates online content in a shared physical context to foster a greater sense of community, representing a convergence of the core themes of our Context, Content and Community project and earlier instantiations of proactive displays. The content currently consists of photos that are slowly and semi-randomly distributed across one [or more] of the eight HyTek 46" LCD touchcomputers we've deployed around the lab.


We call these proactive displays because they sense who is nearby - in this case, via Bluetooth phone IDs - and respond - by selecting photos from public Flickr profiles that people have explicitly associated with those Bluetooth IDs. Although the displays support interactivity (people can move the photos or delete them via the touchscreen), their primary mode of "use" is for the system to proactively select and show photos when people draw near, without requiring any kind of direct interaction by those people.

This work extends earlier work on proactive displays in interesting and [hopefully] useful ways. An earlier installation of proactive displays at UbiComp 2003 used RFID tags and readers to sense who was nearby, drew content primarily from specially-created web-based profiles, and were only in use for three days (during the conference).  The new proactive displays use Bluetooth phones for sensing, draw content from other sources such as Flickr, and will be in use, well, for the foreseeable future (I hope (!)).

I was fortunate during our earlier instantiation of proactive displays to be working with a team of three fabulous interns, and was disappointed about unanticipated events that disrupted that trajectory of research (at that time and place). At this new time and place, I once again feel fortunate to be working closely with another group of three fabulous interns - Max Harper, Ben Congleton and Jiang Bian - along with the rest of the NRC Palo Alto Context, Content and Community team, following through on some earlier articulated intentions for working on context, content and community, increasingly wholeheartedly enthusiastic [again] about prospects for proactive displays ... and feeling a certain affinity for the myth of the Phoenix at the moment.

At the two week mark now, early responses - by people to the displays - is very encouraging, and our short term challenges are how to keep up with all the cool new features people are suggesting ... and how to effectively evaluate the impact these displays have on the people here. It's hard to believe the interns will only be here another few weeks, but I'm confident we'll [continue to] make good progress. Meanwhile, I posted some slides I presented at a workshop a few weeks ago at Communities & Technologies 2007 that outline some of our initial plans and goals, and will be posting some new slides after my upcoming talk at Yahoo! Research Berkeley Brain Jam on August 17.

[Update: Jeff Johnson posted a video he took of a proactive display in action during a recent visit to the NRC Palo Alto site, embedded below.]

[Another update: embedding my slides from CSCW 2008, which are based on our paper, The Context, Content & Community Collage: Sharing Personal Digital Media in the Physical Workplace.]