Tag: Health

Apple Watch and Health

( )

Photo by Tanja Heffner on Unsplash

Having that thing go off, it's less about it going off every hour and asking me to stand for a minute, but of reminding me of the passage of time, that as a human being, I feed off of motion the same way that I feed off of food.

How often will the watch ask you to stand or move? If standing and moving intrude on my focused work effort which should win out? The stand/move or the focused concentration? What do I do if I am merely a participant in a 2-hour meeting with high-level executives? Do I just stand up in the middle of the meeting and walk out because my watch told me to?

Then linking that into, wow, I actually have more pain today. Tomorrow, I'm going to make more of a conscious effort to really pay attention to when the watch tells me to get up and move, and maybe have a walking meeting.

How do walking meetings work in practice? How easy is it to convince a group of people (or a single person) to go outdoors in very cold or very hot weather and work (think) while walking? What if one member of the group says no (perhaps they have a medical reason)? Does the other members of the team pile on in convincing that person to do a walking meeting?

My wife just walked by while I was reading this article and suggested we go for a walk. I asked her if we could go in about 30 minutes. My Dexcom indicates that my blood glucose is 50 mg/dL. I need a glucose gel. If this had been a request for a walking meeting at a specific time I would have had to decline. For medical reasons that I would not want to explain to anyone.

Were you mindful when you were eating? Did you eat things that, at the end of the day, are going to balance out to cover all of the different nutrients you needed so that your body and your brain can function?

Yes. Sure. I have type 1 diabetes. I already do way more testing and monitoring and daily nutritional analysis than most people.

When we're talking about health and wellness with colleagues, with patients, or with clients, one of the things that we definitely do talk about is it's a buffet. It's rarely going to be a one-size-fits-all. It's really about paying attention to what it is that you need, and finding that best fit.

Truth!

A few of my friends and family have asked why I don't have an Apple Watch. They read some hyperventilating article about how Apple is working on a blood glucose monitor for diabetes. My Dexcom G5 CGMS is helping me do 24⁄7 blood glucose monitoring because of the ever-present risk of hypoglycemia because, like most people who have lived with Type 1 diabetes for a while, I have hypoglycemia unawareness. It's not a quantified lifestyle device toy.

Even if the Apple Watch could accurately monitor my blood glucose, it would need to be connected to me 24⁄7. My Dexcom transmitter battery last three months. Snapping in a new pre-charged transmitter takes two hours. The Apple Watch is good for 18 hours and needs to be connected to a charging stand to re-charge. This is nowhere near to being a replacement for my Dexcom G5.

Luxturna

Gene therapy for inherited blindness sets precedent: $850,000 price tag (Washington Post)

The pricing conundrum of long-lasting treatments

This topic is complicated, but I think it comes down to working out the answers to some questions.

  • If the discovery/production of something exceptional has costs that can't be recouped by the group expending the effort how do we incentivise doing the thing?
    • How do we reward exception individuals who put in exceptional effort to produce something extraordinary?
    • How do we reward exception individuals who put in outstanding effort to create something extraordinary that only serve a few?
  • If shiny rocks (diamonds, gold, etc.) have a financial value that outstrips their actual utility to the many, then why do we want to financially undervalue something with an exceptional utility to a few?
  • In other words, what is the financial value of a single human being? Should we expend every and all resource for the health of any single human being?

I think your answers to the questions will depend on what life means to you (individually and communally) and your belief system (religious and non-religious).

  • Do you believe life should be fair?
    • What does fair mean to you?
    • What does fair mean to your community?
    • Who gets to decide on the definition of fair?
  • Do the needs of few warrant the full blown attention and effort of the many?
  • Or do the needs of the many outweigh the needs of the few (or the one)?

I'll let the comments say what I want to say.

There is no way this can - or should - be free. I don't have the exact numbers but estimate it costs $100,000 to $250,000 just to manufacture and deliver the therapy. These are not tablets that can be mass-produced for pennies per unit and stored for three years in a plastic bottle in a pharmacy. Second, this is not a therapy being marketed by 'Big Pharma' with its supposedly huge advertising and marketing expenses. Spark is a small company, and this is their first product. They do not have the luxury of writing this off as goodwill. Third, if you think $850,000 is expensive, have you looked at how much it costs to be blind? The lifelong medical expenses, accommodations, lost productivity/human potential, and caregiver burden is enormous. Spark did not pull this number out of the air. People just are not used to seeing all that cost avoidance rolled up into one price - but they will after the wave of gene and cell therapies comes to market in the next few years.

Some sarcasm in the comment section:

Excuse me.

breathes heavily through mouth

Look, I don't mean to be controversial here, but have you guys thought about making this drug that possibly cures an illness that affects only 0.00033% of the population FOR FREE?

I know no such cure has ever existed in the entire history of the planet or anything. I know it must have taken time and effort of multiple researchers, not to mention the time that went into their education, clinical trials, etc. But when you think about it, none of that stuff is really special, this should just be free.

We should just make it free so that whoever developed the treatment can eat the cost and magically come up with more cures for other bad stuff because curing things doesn't cost them anything they just magically make up cures. They go to a whiteboard and scrawl some garbage and say, "Beep boop!" Then they wave a magical wand and sprinkle pixie dust in a beaker. Next, Neil DeGrasse Tyson and Bill Nye recite some scientific incantations backstage of an episode of Tonight with John Oliver. What's it to them, reciting some incantations is simple stuff.

So now, I hope you all understand, why this should cost nothing to patients or insurers. Because it costs nothing to create the cure! It's true. Also, reading through other comments, it's evident that if patients don't get treated for blindness, they will die! (It's true, no blind people have ever existed before this drug, they all died immediately upon birth. Now that this drug exists, there is a moral imperative to stop said deaths, but the greedy corporations have once again screwed over the little guy.)

I'll add, I think this drug should be SO FREE it should cost less than a subscription to the Washington Post.

Thanks! dr mcrib

I don't think it's enough to throw out empty platitudes and endless shoulds. For each every shoud, I would want to hear a plan on how to make it work so everyone's benefits and everyone sacrifices. I am bored with hearing about how it should be in theory. I want to know how it will work in reality. And I don't care how it worked in the past. The past does not equal the future.