My Right Forearm is Toast

image

I am writing this blog post mostly using a microphone.

I think I’ll try to do this in one shot, clean it up later but keep the original version around, so that the blemishes and problems with voice dictation can be seen.This is not a good sample though, because I am not using a headset: my Turtle Beach microphone has a TRS connector and the Samsung Surface doesn’t have that input.

I am having difficulty using my right hand (lateral epicondylitis) and in an effort to heal I am choosing not to use it for at least 3 weeks. This has led to several discoveries:

Taking things for granted Discoveries:

There are several things built into the muscle memory of my right hand.  For example in Visual Studio, Intellisense.  When a suggestion shows, to choose it is apparently down arrow enter, but when my left hand tried, it tried pressing enter and did not know about the down arrow involved.

I discovered that my brain would output code at the same speed that my hands could put it in. (Perhaps my brain puts it out faster than my hands can put it in and that is why I am having a problem). Now down to typing with one hand, I simply cannot keep up! I get frustrated, and the thoughts that were in my brain disappear leaving me wondering what I was typing.

I have to reevaluate how I am going to be effective at coding over the next few weeks.

Directions and Challenges

I am going to see a doctor whom I trust and see where she thinks I should go. I am hoping that rest will let my body self heal, but if there are major tears in the tendon etc that might need a different level of attention. I am very reluctant to go there. I have heard that once you invade, complications arise.  Bottom line: I need diagnostic stuff, x-ray or something, to determine what the state of things are under the skin.

I have been trying to find resources online that state exactly what the mechanism is for ice and compression leading to healing. I see a lot of sources that indicate that inflammation in the body’s attempt to recover in which case how can I get more inflammation? 🙂 (A: Graston Method is one.)

I have another problem as well: by using my left hand more now, it too is in danger of burning out.  Friday I think my active left arm hurt more than my slinged right arm.

I have watched videos of people using various speech synthesis program to do programming. my reaction was: OMG that is so slow! I am hoping that if I do something like draw onto paper first and get the code out quickly, then I will be able to take my time typing it into the computer in a relaxed and optimal way. I wonder if I could hook up a midi keyboard to something that types in code for me.  lots and lots of macros.

Something very nice about my current employer colon he has had to go to this kind of pain as well, about two years ago.

Tools:

Here are the various tools and tricks that I have learned:

Typing one handed with a living room style small chicklet keyboard: this minimizes travel distance between keys; however I had a hard time finding a small keyboard which also had function keys. Wife and I found one, will try it on Monday.

I am now much more aware of the muscle tension in my forearm while typing.  Normally I would tense up everything and then out would come a burst of keystrokes.  I am now trying to be aware of keeping everything relaxed and returning to zero after every keystroke. 

Four ways of limiting motion:

1. Tennis elbow brace – bad. cut off a lot of blood circulation and ended up being less than effective, because my problem is along the entire length of the muscle / tendon and not just in the elbow region.

2. Sling: a lot better. the first two days using the sling, my hand definitely went into repair and recovery mode. however, the sling dug into my neck of lot and can be very uncomfortable.

3. Athletic Tape:  bind my right hand fingers together to prevent the temptation to use them.

4. Wear a glove on my right hand: this is very effective in stopping me from using it accidentally. However, it is not as healing for my hand as a sling, but it is better on my neck.

I find it very funny that my attempt to say third came out as a turd

Another thing that deserves a metnion is KT tape.   I used it for a week or so prior to becoming serious and using a sling.  It provides a lot of good support, but at the expense of skin sensitivity, as the support comes from elasticity of the skin.   Eventually the skin rebels.

And now I have a cat who is trying to use the microphone as well

Emotion:

So I have this amazing opportunity color to re-evaluate how I work, as well as something that forces me to choose what I do with my time. I am certainly not going to play much Elite dangerous, nor am I going to work on my side project, until this is better – trying to save my hands for generating income.  I could probably get around playing American Truck Simulator with my steering wheel and using my left hand just like driving my car.  However, there’s only two cities left to visit, I’m probably going to wait for the DLC / Arizona to show up before I play it more.

No, I now have an opportunity to catch up on several books that I have not yet read, and to focus on working out and nutrition and things like that.

However, right now I am sad and just want to say cluck it all and watch TV shows and hide. and that’s okay, it’s just part of Grief. I am not sure I am out of denial yet. Maybe I’m near the pyramids. get it? Denial? the Nile? Ed used to make that joke all the time.

The other disadvantage of a voice dictation is that this laptop keeps thinking I am not doing anything, and shutting off in the middle of a sentence

Wish me well! I am now going to go back through this post and use my left hand to edit it so it is readable.  I also had a cat volunteer to sit on my right hand helping me not use it.

Original Text – before lots of editing.

I am writing this blog post mostly using a microphone.

I think I’ll try to do this in one shot and then clean it up later but keep the original version around so that it’s blemishes can be seen. space this is not a good sample though, because I am not using a headset comma because my Turtle Beach microphone has a TRS connector which My Little surface Samsung sing sing thing doesn’t have an input for

I am having difficulty using my right hand insert black muscle Palma and in an effort to heal this hand I am choosing not to use it for at least 3 weeks. this has led to several discoveries hole in the line

There are several things that I take for granted that are built into the muscle memory of my right hand for example in Visual Studio Computing intelligence is apparently down arrow enter, but I didn’t. Know that my right hand you that when my left hand try to do the same thing it tried just pressing enter and did not know about the down arrow involved

Other thing I discovered is that for many years, my brain would output code at the same speed that my hands could put it in. perhaps my brain puts it out faster than my hands and put it in and that is why I am having a problem. Now down to typing with one hand, I simply cannot keep up the mycohl I get frustrated, and the thoughts that were in my brain disappear leaving me wondering what I was typing. I have to reevaluate how I am going to be effective at coding over the next few weeks.

My solution plan is currently very simple: I am going to see a doctor whom I trust and see where she thinks I should go. I am hoping that rest will let my body curious, but if there are major tears in the tendon or something like that color that might need a different level of attention. I am very reluctant to go there. Center Center

I have another problem as well: by using my left hand more now, it too is in danger of burning out.

I have watched videos of people using various speech synthesis program to do programming. my reaction was color oh my God that is so slow exclamation I am hoping that if I do something like hold onto paper first and get the pot out quickly, then I will be able to take my time putting the code in to the computer in a relaxed and optimal way.

Something very nice about my current employer colon he has had to go to this kind of pain as well, about two years ago

Here are the various tools and tricks that I have learned colon um

Typing one handed with a living room style small chiclet keyboard color this minimizes travel distance between keys semicolon however I had a hard time finding a small keyboard which also had function keys

At first using a tennis elbow brace, however. Cut off a lot of blood circulation and ended up being less than effective, because my problem is along the entire length of the muscle / tendon and not just in the elbow region

Second attempt is using a sling, and that has worked a lot better. the first two days using the sling Kama my hand definitely went into repair and recovery mode. however, the slang dig into my neck of lot and can be very uncomfortable align

Turd was to use either some athletic To find my right hand fingers together to prevent the temptation to use them, or to wear a large fingerless mittens on my right hand colon this is very effective in stopping me from using it accidentally. However, it is not as healing for my hand as a link, but it is better on my neck

I find it very funny that my attempt to say third came out as a turd

I have been trying to find resources online that state exactly what the mechanism is for ice and swelling leading to Healing. I see a lot of sources that indicate that inflammation in the body’s attempt to recover in which case how can I get more information? 🙂 New York

And now I have a cat who is trying to use the microphone as well

So I have this amazing opportunity color to re-evaluate how I work, as well as something that forces me to choose what I do with my time. I am certainly not going to play much Elite dangerous, nor am I going to work on my side project until this is better Kama trying to save my hands for generating income. I could probably get around playing American Truck Simulator with my steering wheel and using my left hand just like driving my car. Uline no, I now have an opportunity to catch up on several books that I have not yet read, and to focus on working out and nutrition and things like that.

However, right now I I am sad and Hi just want to say cluck it all and watch TV shows and hide. and that’s okay, it’s just part of Greece. I am not sure I am out of denial yet. Maybe I’m near the pyramids. get it? Denial? the space and I on? The Nile River? Ed used to make that joke all the time.

The other disadvantage of a voice dictation is that this laptop keeps thinking I am not doing anything, and shutting off in the middle of a sentence

Wish me well! I am now going to go back through this post and use my left hand to edit it so it is readable.

Comparing Nutrition Tracking Apps (iOS)

I’ve decided I’m going to track nutrition again.  I tested entering the same day into 4 apps and recorded myself:

Here’s the raw video of all 4 side by side.   Its provided for reference only, I don’t expect you to actually watch it, unless you work for one of the above companies trying to understand what I saw.

[youtube=http://www.youtube.com/watch?v=05zfzKXJlzA&w=448&h=252&hd=1]
4 Apps, Long and Boring

 

Here’s a close up of just the breakfast bits, for only two apps, trying to compare the same item to the same item:

[youtube=http://www.youtube.com/watch?v=cJ7z_74n_GQ&w=448&h=252&hd=1]
2 Apps, Just Breakfast, Almost Watchable

 

Frustrations

These are all my opinions, not statements of fact. 

  • Up!
    • Could not find some restaurant food, so I had to go find something else that might or might not be equivalent.
    • Amazingly wrong values for Orange Juice (45 cal per orange!), and Orange Juice (100 cal per g)
    • While the “just add it and edit the quantity later” seems like a good idea at first, I think there were a lot more touches in the end.
      • One reason why this one had a longer video – I had to go look up caloric values for stuff it couldn’t find, so that I could go back into the app and update things to more reasonable values.  The other apps, I already knew the caloric value I was looking for, so they were spared this embarrassment.
    • Their “slider” for changing quantity took a bunch of fiddling.
    • If you enter food as you eat it, it’s a lot easier, but otherwise, selecting times for meals gets hard.  I like the other apps “Breakfast, Lunch, Dinner, Snack” method better. 
  • MyFitnessPal
    • Looked kinda clunky?  (but it worked!)
  • FatSecret
    • I think I was trying to put in 471g of soup, since my scale tells me its 471g, and wow that was annoying to have to scroll gently from 100 to 471.
  • Lose It!
    • Their selection of foods seemed limited, didn’t find what I was looking for.  Its like they’ve tried to reduce complexity of what is available or something?
    • App crashed during data entry, I had to restart it.

Winner

MyFitnessPal gets my “business”.  I do not remember being frustrated trying to enter anything; everything I searched for came up; they had decimal input; and I agreed with the calorie estimates given the first time around.

Standing Around…

imageLong story short, I’ve started trying to stand almost all the time at work.

It all started when I saw some of this show:

There are two free episodes – about 2 hours worth.  It was awesome enough that the Wife and I bought it, and we’ve been consuming it at home, an episode every few days.  Not through it yet.  However, that took me over to his website and Youtube channel:

He has SO MUCH stuff out there, it’s a bit overwhelming.

At the same time, after a lot of asking the wrong people the wrong questions, I finally got in to see a Urologist, who gave me a diagnosis:  Prostatitis.   Possible cause: sitting too much.   Lots of Truckers get it. 

So, I made the decision to stand at work, as much as possible.

In order to do this, I had to learn how to stand:

  • Tighten up the abs.  Like, lightly punch yourself in the stomach. 
  • Screw my feet into the ground so that my toes would go away from my midline – this also tightens up the butt. 
  • Bring everything back to 10%, 20% tightness
  • This is stable position.

I got (had) some equipment to help:

  • Work had already provided me with a geek desk – adjustable height desk.
  • Get a gel standing mat from Bed Bath and Beyond. 
  • Yoga block – to prop my foot up from time to time.
  • Fancy keyboard
  • Tackball
  • Eye level monitors (monitor stand provided by work)

Also some other habits

  • Walk barefoot most of the time.    Luckily, at my work environment, shoes are very optional. 
  • Switch back and forth from right hand mouse to left hand trackball, every few days. 
  • See a good Massage Therapist.  This guy, Travis: http://elementsmassage.com/louisvilleeast/our-therapists/id/5577/travis   knows his stuff.  
    • Side note: a massage with him, for me, usually involves pain-threshold numbers, and lots of muscle names.  One of these days we’ll work through everything – we’ve already visited the scapulae, the tersis major/minor, and currently working on pec minor and some calves and some hip stuff that I can’t remember the name of.
  • Continue to see a good chiropractor

The Result

  • My right hand is no longer numb
  • My lower back no longer hurts when I stand
  • My belt is tighter.  I don’t know how many pounds yet .. too much variability – but I’m definitely 1 belt notch tighter.  Without any other exercise.

Thoughts

Chiropractory vs Massage Therapy vs MobilityWod:

I used to think that Chiropractory by itself was good enough – I’d just have to go back and get a tune up every few months.   What I’m understanding now is that if I have soft tissue problems going on – and my body adapts around those creating other overly used muscles – my body will try to drag my spine out of position.  Once the spine goes out of position, then other muscle problems happen, and .. pretzel.

Now, with a) using my muscles properly – core muscles to provide straightness rather than relying on soft tissue slump;  b) not sitting – see below, and c) a therapist to squish and crush the lactic acid crunchies in my system, for the first time, after a month away from the chiropractor – I didn’t feel like I needed an adjustment.

I went anyway, and I had a beautiful adjustment.  Lots of crackling.  We started working on shoulder and hip adjustments.

Its not perfect yet – I’m doing something wrong for my Lats and my Hip, there’s a spot that keeps forming there.  And my right shoulder.   But it’s a LOT better. 

Standing, Lactic Acid, Warm Up, Walking

After standing all day, the bottoms of my feet can get a bit sore.  And then I go and see the therapist, and he has to squish all this lactic acid out of my system.   Not right.

Turns out, “warm up” and “cool down”:  Think of the Lymphatic system as a network of sponge.  It doesn’t have any motors.. it takes the body moving to start the squishying process that then moves the stuff around.   That’s the purpose of warm up and cool down – to get the lymph moving.  So If I stand for a while, and then go for a 2 mile walk – the first mile, I’m sore.  The second mile, I’m fine! 

I can’t just stand, I have to move.   And move for a while.

Standing vs Sitting Caloric Burn

Supposedly, a person burns 0.7 calories/minute more while standing than when sitting down.   Or, use this handy calculator:  http://www.juststand.org/Tools/CalorieBurnCalculator/tabid/637/language/en-US/Default.aspx

That adds up to around 1700 calories a week for me.  1 pound every 2 weeks.  That seems about right.

Sitting

What is involved in keeping your body straight while you are sitting?  Not that you keep your back straight, usually people slouch anyway.  According to that dude mentioned above, It involves your Quads (front of your thigh) and your Psoas (behind the 6-pack).   They stay on, like, all the time.   And sure enough, I had these really tight quads, and a lot of lower muscle back pain – I’m guessing the lower back strain was to counter the Psoas?

And that’s the other thing – to keep back straight while sitting, its harder than when standing?   I can’t prove any of this.. but, yah, that’s why we slouch when we’re sitting.  And if you slouch all the time, your body says: here, let me help you:  and it stiffens up the back of your neck with fatty tissue…

Yeah.  It’s a bummer.  Better to squat. Smile Or If I’m going to sit, I’m going to sit back and let my back be supported by the chair.

Do NOT walk Duck-Footed

Very much a side thing – as a result of watching @MobilityWod, I now cringe every time I see somebody walk, or run, or bicycle, duck-footed / knees bowed out.   Its pretty bad for you.    Click over to this article (from whence I grabbed the image) for more awesomeness: http://www.crossfitworks.com/archives/4797

In Other News – my Soylent Shipped!     Time to get that project off the shelf I stuck it on.

PS: That was the BEST picture I could find of me standing.   I have a ways to go yet.

Save the Wrists! Ordered a new keyboard / Code Dictation?

My wrists have been numbing more lately.  At my wife’s suggestion, I’ll bring it up with my GP at my appointment next Wednesday.  Meanwhile:

  • Switch to using the trackball with my left hand.
  • Switch keyboards.

This is the keyboard I’ve been using for the last 2 years or so – Microsoft Wireless Comfort Keyboard 5000.   It has some level of curve in it, however, I still have Ulnar Deviation and Pronation when using it.  The keyboard action is very light, and its been good to me for a while.   It is wireless .. less cords to deal with.

image

This is my older, wired, USB keyboard.  Microsoft Ergonomic Keyboard 4000 v1.0.  I switched back to it, but what I find is that the keys take too much pressure to press.. and my hands are tired.   I couldn’t do it.    The keyboard is also larger, which means I need to stretch my fingers further to press the keys.  However, Ulnar deviation is a bit better.

image

Just for fun, I tried using both at the same time:

image

This worked surprisingly well.  It was fluid, except when I needed to switch to the mouse.   I’m used to my keyboard being a single keyboard, and something about having two keyboards confused me; I didn’t know which hand to move.  I guess I know my “home” position based on the distance between my hands, and if I move one hand, I cannot find home easily without looking. 

I did some research and decided to order this keyboard, it should arrive next week sometime:

 

In the mean time some of the things I can do are:

  • type at a deliberate rate. (not look at keyboard)
  • type with one hand only.   (requires looking at keyboard)
  • I can also just use one finger from each hand.  By doing this the entire hand moves, and ulnar deviation is removed.   It is also quite fast.  (requires looking at keyboard)
[youtube=http://www.youtube.com/watch?v=xLR0Nwh1l6o&w=448&h=252&hd=1]
What did I type?

This is me typing with one hand.

In light of Hanselman’s new app which allows dictation from an iPhone, I wonder if there are any programmer-specific dictation tools?  I have looked at vimspeak, however that mostly addresses the control aspects of using vi.   Think of it:

public int Add(int a, int b) { return a+b; } 

“public int shift A d d paren open int a comma int b paren close curly open return a plus b semi close curly” ?

Other folks have talked about it over here: http://productivity.stackexchange.com/questions/3605/how-can-we-use-dragon-naturallyspeaking-to-code-more-efficiently

The problem is one of lost context.  In programming we are trying to be specific about contexts – usually using parens and curly’s as visual queues – for example, that “int a” and “int b” are parameters of Add.   The solution seems like it would be codifying contexts into spoken word, by adding extra keywords to tell the parser what we are trying to do.  For example:

“function <name>” => starts adding function, puts you in function mode; creates defaults; additional things make sense in this mode:

  • “parameter x”
    • [of type] y
  • “returns [type] ”
  • [visibility] “public” | “private” | “internal”   // keywords can infer that we meant visibility
  • “body”  // go to editing body mode

So theoretically, “function Shift a d d visibility public returns int parameter a of type int parameter b of type int body return a plus b”, or more specifically:

What is said What the code looks like (using underscore to denote cursor)
function object a01() { }
Shift A object A() { }
d d object Add() {  }
visibility object Add()  {  }
public public object Add() {  }
returns public object Add() { }
int public int Add() {  }
parameter public int Add() {  }
a public int Add(object a) { }
of type public int Add(object a) {  }
int public int Add(int a) { }

etc.    Ie, you map the spoke word into meanings that then get applied to the editor.

You could even navigate “into” and “out of” contexts by using clicks and clucks – sounds that are easy to make yet are definitely not letters.   “down” and “up” would apply at the context level – ie, statements, or functions.

It is an interesting problem.  It could be a fun thing to solve.  Any takers?

Saving Wrists

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My wrists have been hurting lately.. especially the right one.  Wife thinks I have carpel tunnel syndrome, she might be right.   I already have the ergonomic keyboard, and a trackball; I can use a mouse in either hand, with either button configuration.    However, when working with code, there’s definitely a “switch hand to arrow keys” and “switch back” repetitive thing that happens.  (at least for me).  So, this journey to save on keystrokes and wrist movements.

Step 1:  Try Not to Use the Mouse

I started by putting the mouse very far away from me.   This forced me to try to find keyboard shortcuts for most of the things I was trying to do – especially switching windows.  Here are some of the ones I use now;  most of these are not the default keyboard combinations, but rather the secondary keyboard combinations, which I was left with after vsvim got installed.

Shft-Alt-L or Ctrl-Alt-L Solution Explorer
F5 Build + Debug
F6 or Ctrl-Shift-B Build
Ctrl-Alt-O Ouptut Window
Ctrl-R Ctrl-R Resharper Refactor
Alt-~ Navigate to related symbol
Ctrl-K C Show Pending Changes
Ctrl-T, Ctrl-Shift-T Resharper Navigate to Class / File
Alt-\ Go to Member
Ctrl-Alt-F Show File Structure
Alt-E O L Turn off auto-collapsed stuff

I also assumed a layout where I have a bunch of code windows, and all other windows are either shoved over on the right or detached and on another monitor.   No more messing with split windows all over the place.  By using a keyboard shortcut, wherever the window is, it becomes visible.  I don’t hunt around in tabs anymore.

image

Step 2: VsVim

History

I first learned vi in 1983, on a Vt100 Terminal emulator connected via a 150 baud modem to the unix server provided by Iowa State University’s Computer Science department.   (I was still in high school, I was visiting my brother who was a graduate student at the time).  There was some kind of vi-tutor program that I went through.    It was also much better than edlin and ed, which were my other options at the time.

Anti-Religious-Statement: I used it religiously till 1990, when learning LISP, I also learned to love emacs.   Yes, I stayed in emacs most of the time, starting shell windows as needed.   

I maintained a proficiency in both vi and emacs till 2001, when I got assimilated by .Net and left my Unix roots behind.

And Now

Having had a history with it, I decided to try vsvim and see how quickly things came back to me.

The first thing I noticed is that every other program I used, whenever I mis typ hhhhcwtyped something, I’d start throwing out gibberish involving hhhjjjjxdw vi movement commands.  And pressing ESC a lot.   I (am still having to) to try to train my eyes to only use vi commands when I saw the flashing block yellow cursor that I configured it to be.

imageimage

I also had to un-bind a few things – for example, vi’s Ctrl-R is a lot less useful to me than Resharper’s Ctrl-R Refactorhhhhhhhhhhhhhhh   I did it again.   vi’s Ctrl-R “redo” I could just do :redo instead.

And where am I now?  I still need to think about it a bit..  but, for example, recently I changed some code from being a static Foo.DoSomething() to a IFoo.DoSomething(), and I had to inject the class in a bunch (10+?) of constructors.   The key sequences went something like this. (R# in Red, vsvim command in blue)

ALT-\ ctor ENTER Jump to the constructor in the file (R#)
/) ENTER Search forward for “)” and put cursor there (/ and ? go across lines, fF are in current line only)
i, IFoo foo ESC Insert “, IFoo foo”
F, Go back to the comma
v lllllllllll “ay Enter visual select mode, highlight going right, to buffer A, yank (copy); cursor back at ,
/foo ENTER jump forward to foo
Alt-ENTER ENTER Use R# “insert field for this thingy in the constructor” thingy
Ctrl-T yafvm ENTER Use R# Go to Class, looking for YetAnotherFooViewModel  (most of the common things I work with have a very fast acronym.  For example “BasePortfolioEditorViewModel” is “bpevm”.  I can also use regexp stuff)
Alt-\ ctor ENTER Jump to constructor
/) ENTER Go to closing brace
aP paste from buffer A before cursor

If this sounds like complete gibberish …  yes it is.  But here’s the thing:

  • I am talking aweZUM s3krit c0dez with my computer!
  • My fingers are not leaving the home position on the keyboard.  Not even for arrow keys.
  • By storing snippets of text into paste buffers (a-z, 0-9, etc), I can avoid typing those things again, which is very useful.
  • If I plan ahead a bit I can save a lot of keystrokes trying to get somewhere in a file.
  • Once I enter insert mode, Its just like normal – can still use arrow keys to move around, shift-arrow to select, etc.

It is geeky, nerdy, experimental, and it might be helping my wrists a bit.   1 week so far, still going okay.

another trick I use:  variable names like “a”, “b”, “c” .. and then I Ctrl-R Ctrl-R rename them to something better later.

I would not recommend trying to learn vi without a vi-tutor type program