Bed Rest in the Digital Age plus Over-Prescribing Meds

Today I learned:

1. Bed Rest in a Digital Age: Prior to yesterday’s ACL reconstruction, I had two previous arthroscopies on the same knee in the early-1990’s. It was almost 20 years ago but I have two vivid recollections:

  • Dialling my own home phone number from downstairs to make it ring upstairs so I could ask my mom to bring down some ice cream, without getting off my lazy butt. I remember this, partially, because she reminds me of it every chance she gets.
  • Watching ALOT of crappy TV.

As a high-school student who actually attended all my classes, this was my first exposure to the Soap Opera genre. Try as I might I never took to Days of Our Lives and General Hospital, but there just weren’t many other options in those days.

The world is different this time.

I stacked months of reading by my bed in preparation for the down-time but one day out of a general anesthetic and still hooped up on pain meds, my head is not so much into books.  Instead I have watched a few shows recommended by friends on Netflix – The Hour and Justified are favourites so far – and watched a work-related webinar.

As I look at myself now, surrounded by my iPhone, iPad, and macBook Pro, as well as my work laptop and blackberry, I have a sense this round of bed rest will be very plugged in. This blog may in fact prove to be therapeutic as it forces some form of daily creation, rather than consumption.

All the technology comes in handy too – this time I have 4 separate devices that I can use to Skype my mom to see if she can drop by with a bowl if Ice Cream.

2. Over-prescribing Meds:  On discharge from hospital I assumed I would be sent off with a small script for T3’s, but in fact I was given a prescription for a fairly heavy narcotic.  Interestingly, I was prescribed 60 tablets which my close friend (a pharmacist) described as “an awful lot for knee surgery.”

Taken at the recommended dosage of 1-2 tablets every 4-6 hours, the 60 tablets would be depleted at a rate of between 4 and 12 per day. Essentially, worst case I have 5 days of meds, but best case I have 15 days (or more if I don’t need them frequently).

This made me wonder: Why prescribe so many tablets?

Surely if I am in so much pain that I run through these meds at the fastest pace then someone should see me before 5 days to assess the problem. Alternatively it could be that I will have so many tablets leftover when I am done that they end up sitting around in my medicine cabinet long after I need them. This invites abuse by me or someone else.

I trust my doctor – I think he’s great and I am sure he did a good job on my knee – but I wonder how much thought went into the follow-up medications.  It may be that he assessed me and felt a large prescription was safe and low risk. I hope that is the case.

It seems to me though that it is more likely the script size was just a convenience factor for both him and me – an attempt to reduce follow-up visits just to write a new script. If that is the case then I am not too impressed. A smaller prescription would potentially catch and save problems at both ends of the spectrum.

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Chick TV and Addiction to Gadgets

Today I learned:

1. I can’t watch a chick shows: Grey’s Anatomy, American Idol, Dancing with the Stars – they are all the same to me. Intolerable.

I simply can not watch these shows without constantly groaning about the problems I see and providing a sarcastic running commentary. At the same time I am happy to lose myself for a short time in sitcoms that are no more stimulating, like How I Met your Mother or The Big Bang Theory. This must drive my wife nuts.

2. My Addiction to (Useless?) Gadgets is Flourishing: The realization dawned on my today as I clicked “confirm” to finalize my online purchase of a Fitbit activity tracker that will help me monitor both my activities and sleep, syncing wirelessly to the web and – the kicker – allowing me to track the information obtained through an app on my phone.

Don’t get me wrong, this is not buyers remorse talking. I meticulously research these things and only buy stuff that I am convinced works well and I will use. It is just that I seem to have an addiction to these marginally useful products.

The evidence?

A few other things I own, and use everyday to make my life more enjoyable or easier, but I don’t really need:

  • Watch with a vibrating alarm, so that it wakes me up to exercise without stirring my wife.
  • TV remote app, so I can turn my TV on/off and change the volume when the kids lose the remote.
  • Bluetooth car speaker, solely to listen to the Economist from my phone will commuting to and from work.
  • Remote controlled light switches for all the bedrooms. Basically a glorified clapper, and a ridiculous luxury, but they look cool.

Ultimately I think it is good design that gets me. This is also why I have a love-in for most Apple products. If the gadget is simple, works flawlessly and looks good then I am an easy mark. Alternatively, if it doesn’t fit all those criteria and it somehow makes it into my home (e.g.this recent gift, which arguably fails all three tests), it is destined for the garage sale pile.


Serving Feedback in a Sh*t Sandwich, plus The Death of Cable TV

Today I learned:

1. The Sh* Sandwich: I had a great discussion this morning with a few other managers about performance evaluations and the art of delivering feedback. One person came up with a term that I wasn’t familiar with before today – the Shi*t Sandwich.  Essentially this is the practice of framing a piece of negative/constructive feedback with two positive points.

For example: “You did a job great developing that proposal, John. We need to do a lot of work to get your presentation skills up to par, but in the end you are still great at developing rapport with clients.” Although, we know that with many managers the middle part will be more like, “…your presentation skills suck…” Hence the title.

Regardless, I am not a big fan of this approach.

It is an easy way to get across a tough point but the area for growth can get lost in “the bread.”  I prefer to deliver both the positive and the negative separately, clearly delineating between the two. As well – maybe most importantly – I think it is critical to ensure upfront the person is ready to hear everything you have to say.

My preferred approach would be closer to this: “John, would you like some feedback on our work with Customer X?…Great…I think you did an excellent job in some areas but in a few spots we need to work on improvement. Let’s start with what I think you did very well…”

From my perspective The Sh*t Sandwich is a cop out. It’s an easy way to get tough news across, but in the end if the key piece doesn’t hit home you will just need to revisit it down the road. Better to be clear, with specific examples, up front so you can get to work on the road to improvement.

2. The Death of Cable TV: Admittedly it is not dead yet, but its days are numbered.

In the fall we got a PVR, and we now watch about 5-10% of the commercials we previously watched, mostly when we forget to fast forward.

More recently we signed up for Netflix, and in the last month my 4 year-old daughter hasn’t watched Treehouse TV once. She is only interested in Netflix (via TV, iPad or Computer) as she is in control of what she consumes. She can even pause it to pee.

Add in Apple TV a couple weeks ago and we now stream shows, along with our pictures and music.

Interestingly, with more choice we are actually watching far less TV. Flipping on a slideshow or some music is now viable and fast, so we are turning to more laid back evenings with music, pictures and books. All in all, everything is better, faster and in-line with what we want, when we want it.

Reflecting on it today it occurred to me that it all happened very quickly. Our progression – from basic cable to everything on-demand – took us about 3 months. This spells very bad news for our cable account. If every hockey game was free in HD online we simply wouldn’t need it.

How many years will it take for everyone else to follow the same path? 10 years? 5?



Steve Jobs was an A–hole and Robin Sharma is a Genius

I can’t seem to read just one book at a time. Typically I have a few going and I switch back and forth depending on my mood. On the nightstand right now is the Steve Jobs biography by Walter Isaacson, and The Monk Who Sold his Ferrari by Robin Sharma.

From these two amazing books, today I learned:

1. Steve Jobs was an A–hole (and a Genius): From the sounds of it the only thing you could predict about Steve Jobs was that an encounter with him would be entirely unpredictable.

A terrible boss. Demanding, demeaning, insanely detail focussed. I doubt I could have worked for him but I wish I could have.

A terrible customer. He would never hestitate to explain everything you had done wrong. There was no filter. No mute button. I would have hated dealing with him, but I wish I could have.

A terrible listener. Prepared slides be damned. No way would he sit quietly through your presentation. It would have been impossible to present to the man, but I would have loved to have tried.

An utter genius with an unrelenting drive for perfection. I own 6 products with his stamp on them. I can’t imagine life without them – they make my day easier and remarkably more fun. The more I learn about the man the more I find to both like and dislike, and the more I want to buy his stuff.

2. Robin Sharma is a genius:  I just picked up a copy of The Monk Who Sold his Ferrari, and only a few pages in I am fascinated. I already considered one of his other books, The Leader Who Had No Title, the most simple and simultaneously profound book I have ever read, so it is no surprise I am enthralled with this one too.

As a carryover from school I always read with pen in hand ready to circle things that impact me. This is the passage that hit me today:

What I love about Robin Sharma is the simplicity at the core of everything he writes. Stripped down messages not unlike Aesop’s fables. This passage presents such a simple concept in a way that is easy to action. After today I know that the next time I am presented with an idea I will be sure to ask myself, “Is my cup full or empty?”


The only thing my phone can’t do, and more Zig than Zen

Today I learned:

1. Love for my iPhone: By noon today I had read the news, checked email, sent a few texts, looked at the weather, paid two bills, bought a book, listened to the Economist online, updated my wine cellar, paid for parking, watched part of a show on Netflix, and turned off my TV. All from my phone.  Disappointingly it seems the only thing it can’t do is one of the things I need most – repair my ruptured ACL.

2. More Zig than Zen: I recently started reading the ZenHabits.net blog. This morning I reviewed a post by a writer named Jeff Goins. Some great stuff  – I am certainly onboard with his recommended 4 practices to “bring you closer to the life you want.” He suggests you: 1. Get up early, 2. Over-commit, 3. Talk to strangers, 4. Practice Generosity.  I agree on all counts. Ingraining these ideas into your life is a step in the right direction.

That said I strongly disagree with the idea that to get the life you want, planning and goal setting are unnecessary.  Living life like a pinball bouncing around aimlessly might work. It might even lead you somewhere great that you never expected. But it might not, too. It seems to me that marrying the 4 practices, with some goal setting and targeted effort is a better way to lead yourself through life. I guess I am Zig than Zen. To kick of 2012 I am working through Zig Ziglar’s Pick 4 book to help me make this year my best one yet.


I’ll never go to the bathroom alone again, and it’s never good when your daughter says…

Today I learned:
1. I’ll never go to the bathroom alone again: My problems in the bathroom are officially solved. No more awkward balancing of the laptop on my knees. All logistical problems have been flushed away. Now that we have an iPad I really can’t imagine going to the bathroom alone again. The only problem that might come up now is getting me out of there.
2. It is never good when your daughter says: “Daddy, you’ll never find your keys!” Today our pleasant little four year old was laughing and laughing while I madly searched the house for the my keys.  A fun game, apparently.