Coleman McCormick

Archive of posts with tag 'Health'

Scans Update

June 30, 2022 • #

Just this afternoon I finished up another round of scans at Mayo Clinic — my standard regimen of an hour-long MRI of the abdomen and a CT scan of the chest / lungs. Everything went routine and the worry level leading up to it the past couple weeks was as low as its ever been. So that’s a victory.

I was thinking about how many times I’ve actually gone through this process and I’ve lost count. I think it must be around 12 times now, with how often I had to get them done during the first couple years after treatment. I’m sure it’ll be a lifelong procedural activity, so it’s good to make it a routine and get used to it.

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Goal Progress: November

December 1, 2020 • #

We had a hurricane blow up part of a week of productivity around here, but I still limped along with some middling progress on the year’s goals. I’m behind the targets this year late in the game, but I’m still happy with the results. I can still close the gap on the running target, at least.

I’ve been thinking about an idea Patrick O’Shaughnessy wrote about recently on ā€œgrowth without goalsā€ — setting up systems to be able to pursue and achieve personal growth without having hard numbers on a scoreboard. Using this site as a public accountability tool helps me to keep these top of mind for continued effort. I’ll have to give this some thought as we near the end of 2020 as to how I want to set up my personal growth systems for 2021. I’m thinking an evolution is in order that creates more space for discovery of new interests without interrupting growth in focus areas.

Activity Progress Pace Goal Plus-Minus
Running 588.6 miles 597 miles 650 miles -8.02
Meditation 1070 minutes 2607 minutes 3120 minutes —
Reading 24 books 27.53 books 30 books -3.53

Reading seems like one that’s particularly absurd to quantify as num_books_read. The dimensions of depth and breath of a ā€œbookā€ are so all over the place that the metric approaches uselessness as a measurement. I’ve tried to avoid selecting material I choose to read around ā€œmanaging to the metricā€; the last thing I want is to end up reading 11 garbage quick reads just to hit an arbitrary number. The purpose is defeated if I were to fall into that trap.

One idea that comes to mind as I’m writing this is selecting target study areas to read about — something like choosing 4 or 5 topic areas I want to dive deeper in and measure to how many of those subjects I learn more about. A trackable tool to keep me honest would be useful, but I’m conscious of falling prey to simply managing what’s easily quantified.

With the downramp in the previous daily posting regimen, I’ve used that time mostly to catch up on a bunch of new ideas cooking in (and about) Roam, and put out a couple of newsletters, issues 4 and 5 of Res Extensa. (Subscribe here!)

It’s been fun to do so far. I’ve landed on this idea for the last couple of following a theme topic rather than a simple digest of links or interesting things. That could be interesting, but there are a lot of great ā€œcuratorā€ newsletters out there already. Issue 4’s theme was legibility, from James C. Scott’s epic Seeing Like a State, and issue 5 looked at alternate timelines from a couple of different angles.

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Goal Progress: October

November 1, 2020 • #

October is over already?

At this rate, it’ll be New Years in no time flat.

Anyway, let’s check in on the 2020 goals:

Activity Progress Pace Goal Plus-Minus
Running 534.25 miles 543 miles 650 miles -8.90
Meditation 1070 minutes 2607 minutes 3120 minutes —
Reading 23 books 25.07 books 30 books -2.07

I made middling progress in areas, like some better runs in the first couple of weeks. Felt good to have some overachieving progress. But then we did a week out of town up in Georgia last week, and my plan to do some trail running didn’t become reality. Between schoolwork (Elyse was still remote-learning from the Georgia countryside), rain, and a surprise tropical storm, much outdoor activity was a challenge, to say the least. We did get in 1 hike, but 5 and 3 year olds aren’t that compatible with long excursions.

I went a full 7 days without running, the longest gap in probably 2 years. While it wasn’t necessarily intentional, it’s probably good for health to get some air space there every now and then.

On the reading side, I finished Stephen Fry’s Mythos, which is his reimagining of the greek myths. I listened to the audio version which is read by the author himself, and if you know any of Fry’s work, you’ll know this is the proper way to consume this book. An outstanding rendition of the tales, more accessible than Edith Hamilton’s Mythology or something like Ovid or Virgil classics.

Ross Douthat’s The Decadent Society was both thought-provoking in its claims, and occasionally frustrating by its pessimism about the state of western culture. I tend to agree with many of Douthat’s views on his ā€œ4 horsemenā€ of decadence: stagnation, sterility, sclerosis, and repetition. I’m skeptical of, but open-minded to, the theories of technical stagnation that you read about in the works of Peter Thiel and others. There’s a compelling case to be made that something is going wrong, and Douthat has an interesting take on where he thinks the issues lie. My skepticism is less around the presence of decadence, decay, or drift than it is around the severity of the issues. It’s a worthwhile and provocative read. Along the same lines I’d highly recommend Yuval Levin’s takes on institutional decline in his book A Time to Build from earlier this year.

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Goal Progress: September 2020

October 1, 2020 • #

For the month of September:

Activity Progress Pace Goal Plus-Minus
Running 484.26 miles 488 miles 650 miles -3.69
Meditation 1070 minutes 2342 minutes 3120 minutes —
Reading 19 books 22.52 books 30 books -2.52

Good news is I closed the deficit a bit on the running goal, even though it didn’t feel like a particularly productive month there.

COVID makes time fly and crawl simultaneously, through some sort of perverse time distortion. There were just no notable events this month to break up the monotony of online school, Zoom meetings, and tame weekends around the house. Maybe the holidays and better weather we’re entering soon will help get us outside some more.

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Goal Progress: August 2020

September 1, 2020 • #

Another month down of quarantine life.

Activity Progress Pace Goal Plus-Minus
Running 426.44 miles 435 miles 650 miles -8.08
Meditation 1070 minutes 2086 minutes 3120 minutes —
Reading 19 books 20.05 books 30 books -1.05

Outside of widening our circles a little from shelter to family and one or two friends, we’re still spending most of our time at home or in outdoor activities.

The start of Elyse’s kindergarten over the last couple of weeks really put a dent into anything other than work or supporting her online schoolwork. By the end of the day I’ve been too burned out to do much running or reading at all. It’s also been raining like crazy here over the last week.

I just barely kept it together with the running habit. I just picked up some new running shoes that have me excited to schedule some more longer runs the next couple of weeks.

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Goal Progress: July

August 2, 2020 • #

A quick touch on progress for July. I can’t believe it’s already been 5 months since the beginning of the pandemic.

Activity Progress Pace Goal Plus-Minus
Running 371.27 miles 379 miles 650 miles -8.05
Meditation 1070 minutes 1821 minutes 3120 minutes —
Reading 17 books 17.51 books 30 books -0.51

Nothing that notable this month. Steady upkeep on the running goals, but the summer time in Florida is brutal. Really restricts the scheduling if you can’t do early morning or late evening exercise.

I’ve got a couple of side projects going on that I’ve been pleased with the progress on: a couple of things with the website and some work on personal finances that all feel like good progress.

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Goal Progress: June

July 1, 2020 • #

These updates during the quarantine are weird. In some ways time feels like it’s standing still, in others it feels like it’s flying by. Every day feels mostly the same. Even though some has opened up in our area, we’re still basically in isolation from friends.

Activity Progress Pace Goal Plus-Minus
Running 317.49 miles 324 miles 650 miles -6.62
Meditation 1070 minutes 1556 minutes 3120 minutes —
Reading 15 books 14.96 books 30 books +0.04

It wasn’t that interesting of a month from a goals perspective. I’m continuing to close the mileage gap that I fell into early in the year. I’m hoping in July to bring that one into the green. Other than that, nothing notable this month other than powering on through this quarantine. Seems like it’s going to last a while longer now.

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Goal Progress: May 2020

June 1, 2020 • #

Just a quick update this month. With the pandemic still going, lockdown in a state of unknown non-committal from any authority, and the madness going on around the nation the past week, all of this seems kinda trivial. I’m sure we’ll power through past it, but I’m just doing my best to keep the habits going. I’m still fortunate to get to plow forward mostly unimpacted by it all.

Activity Progress Pace Goal Plus-Minus
Running 257.89 miles 272 miles 650 miles -14.58
Meditation 1070 minutes 1308 minutes 3120 minutes —
Reading 13 books 12.58 books 30 books +0.42

I’ve been reading some great books lately. No particular update this time on that front, but From Dawn to Decadence is fantastic, I just started Matt Ridley’s How Innovation Works, and Ra is one of the most interesting fiction works I’ve read.

Meditation hasn’t gotten folded back into the routine yet. I’m going to leave the goal in my updates and plan to get back to it and catch up by year end.

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Goal Progress: April 2020

May 1, 2020 • #

April was the first full calendar month of COVID lockdown. In the beginning of the month I started getting comfortable with the working-from-home setup. I have a decent desk setup and a large master bedroom-slash-office space, which until early March I’d barely used since we moved in. It’s gotten a workout now for 2 months of all-day work. I’ve got one of these adjustable desks that’s nice and wide, with plenty of light in the room, so aside from the zero separation between work and life zones, it’s not too bad.

In this past week though the strain is coming on. Some of it is certainly the 2 months of social separation from anyone (which is especially bad for the kids, which is, in turn, bad for us), but I think working as a distributed company is weird, too. Productivity has still been high, and since we were already about 30% remote anyway, it hasn’t been the huge adjustment for us that it has been for many others.

Let’s look at the goal progress:

Activity Progress Pace Goal Plus-Minus
Running 198.46 miles 215 miles 650 miles -16.54
Meditation 1070 minutes 1034 minutes 3120 minutes +35.7
Reading 11 books 9.95 books 30 books +1.05

So I fell off the schedule completely in the middle of the month on the meditation practice. I went a few days without doing it, and then just fell apart with consistency. There wasn’t a specific reason other than laziness, and not building it into a morning routine as I had planned. I’m not sure what I’ll do with the practice, but I do intend to get back to it. One thing I’ve still got to get figured out is a more solid morning routine to create the transition from personal to work life more smoothly.

I closed the gap pretty well on the running schedule. The weather’s been unpredictably cool out a lot for Florida spring. We typically have the occasional cooler temperature in April, but this year we had a lot of days in the mid- to upper-70s to work with, which was fantastic for workouts. The kids have been along for the ride on many of them, probably most of them. It helps to get them out of the house; we usually go over the neighborhood bridges and go near some of the water and look for any manatees, fish, and whatnot. With that mild weather there have been some beautiful days to get out lately.

I closed out a bunch of books I’d had in progress for a while. I’ve referenced Martin Gurri’s work a few times here recently, and his The Revolt of the Public is one of the most insightful books I’ve read to explain the modern state of affairs with the culture war, political landscape, social media, and more. It was a lot broader than I’d expected, but highly recommended.

Arthur Koestler’s Darkness at Noon is a classic I’d had on the list for a long time. Very glad I spent the time with it. A grim work of historical fiction about Stalinist Russia and the Great Purge.

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Goal Progress: March

April 1, 2020 • #

So March has wrapped, probably the longest month we’ve had in many years.

The shake-up in schedule, work-life patterns, and disruptions in everything from kids, to family, to day-to-day activities played absolute hell with my progress on goals.

Activity Progress Pace Goal Plus-Minus
Running 141.04 miles 162 miles 650 miles -21.01
Meditation 860 minutes 778 minutes 3120 minutes +82
Reading 6 books 7.48 books 30 books -1.48

Let’s start with the ā€œokayā€ news. On the meditation front I’ve been doing alright, but made a decision to switch from using Headspace to Oak. This was partially to shake up what was feeling like a lack of improvement, but I recognize that the tool is not the problem when it comes to disciplined practice of any sort. After reading Tom’s comments on Oak, I decided to give it a shot. I’ve been preferring unguided modes to help work on concentration myself; the cues can actually be a distraction in that way once you know what you’re supposed to be doing. Will see what happens here over the next month with our new normal.

Running was an unmitigated disaster this month. Way too many days off and missed for no particular reason other than the mental disruption in the daily flow. It’s counterintuitive that more time indoors and at home would make less time for running (it really hasn’t), but not having clear breakpoints in the day, plus the kids being home 100% of the time, has made this a difficult adjustment for things like exercise. I’m going to make a concerted effort to do mid-day runs with the kids in tow, even if that means higher quantity of shorter workouts. I’ve got to figure out a way to get a pattern going again.

Books appear behind, but don’t feel that way. I’ve done exactly what I’d intended all along at the start of the year, which was reading longer, deeper books — quality over quantity. I’ve really enjoyed the thread I’ve been following with the history of tech, and I’ve got a few more in the queue I’m looking forward to.

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Things That Will Change

March 25, 2020 • #

This is a weird time.

The COVID-19 pandemic is the biggest global event that’s happened in my lifetime. It hasn’t impacted me personally that much (yet), but the financial and public health implications are clearly already disastrous, and bound to get worse.

Most concerning, though, is how little we know today about what’s in store for the rest of 2020 and beyond.

I don’t use this outlet to make predictions, and I’m generally not a fan of trying to call shots on uncertainties. But as an experiment, let’s set down some open-ended questions to revisit in 6 months to see what’s different.

What will be different by mid-September?

Restaurants and bars

  • Will the restaurant market return to how it was before? If it rebounds, how does the renewed landscape look different?
  • Does the expansion of the food delivery market change the kinds of restaurants that open? Not all food types are equally compelling when jammed in a box. Does that influence what’s available?
  • We were already Shipt customers before all of this for grocery delivery. Is COVID-19 the stressor that shifts more grocery business from brick-and-mortar to delivery?

Hotels

  • Airbnb already impacted the hotel business over the last 10 years. But as we return to normal, what changes? Do people start putting extra priority on personal space?
  • Airbnb has been, generally speaking, cheaper than traditional hotels over the years, but does this balance shift?

Airlines

  • Seems like a fairly irreplaceable business, but does air travel return to pre-COVID level? Do people reduce non-essential travel?

Cruises

  • Already an expendable industry, but not a small one ($45bn annually). After COVID, how does it ever return to normal
  • Where would this spending go if it doesn’t? What form of recreation, travel, entertainment picks up that spending?

Businesses

  • Businesses have gone dormant, people laid off, reduced hours, high unemployment. When things start to rebuild, what returns?
  • For those of us that have gone to remote work with minimal disruption, how many companies return to an office full time?
  • If even 20% of these remote-capable companies decide either ā€œwe don’t need an officeā€ or ā€œwe could downsize to a smaller one,ā€ what impact does it have on commercial real estate?

Schools

  • Schools around the world closed pretty quickly, most moving to remote learning. Universities mostly have some infrastructure in place now for online coursework, even though most traditional ones are still in-person heavy. Given that there was already a trend (albeit small) toward distance learning in higher-ed, and assuming at least moderate success in moving to remote over the next several months, are colleges ever the same again?
  • At elementary and high school levels, the move to remote Zoom-based classes seems shakier. Our daughter is still in pre-school, so we aren’t that impacted (plus the first week of this quarantine spanned spring break, with no school anyway). But I’ve heard from others mixed experiences with their kids trying to ā€œhomeschoolā€ while they work from home. When do the kids return to a normal school life? Will it be back to normal by the fall and start of the 2020 school year?

Entertainment

  • The feature film industry could be done-for. With theaters all closed for a while, what happens to them after? Will they re-open? And if so, how long does it take to reconstitute a business in which many will likely have permanently closed and laid off their staff?
  • Film studios are now forced to release new movies online, jumping the theatrical release completely and dropping movies directly on iTunes for $20. What will these new ā€œvirtual box officeā€ results look like compared to their predicted receipts if they’d been released traditionally? If the earnings are still attractively high, will this new release model be permanent?
  • What happens to film and television production over the next 6 months? Do we end up with a lull in new content similar to the writers strike from 2007?
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Weekend Reading: Chess, COVID Tracking, and Note Types

March 21, 2020 • #

ā™Ÿ Chess

Tom MacWright on chess. Reduce distraction, increase concentration

Once you have concentration, you realize that there’s another layer: rigor. It’s checking the timer, checking for threats, checking for any of a litany of potential mistakes you might be about to make, a smorgasbord of straightforward opportunities you might miss. Simple rules are easy to forget when you’re feeling the rush of an advantage. But they never become less important.

Might start giving chess a try just to see how I do. Haven’t played in years, but I’m curious.

🧪 The COVID Tracking Project

The best resource I’ve run across for aggregated data on COVID cases. Pulled from state-level public health authorities; this project just provides a cleaned-up version of the data. There’s even an API to pull data.

āœšŸ¼ Taxonomy of Note Types

Andy Matuschak’s notes on taking notes. This is from his public notebook, like reading someone thinking out loud (or on a screen at least).

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The 5 Revolutions in Cancer Treatment

March 2, 2020 • #

This talk from Jonathan Lim gives a good overview of how the newest treatments for cancer work — radiation/chemo, targeted therapies, immunotherapy, and ecDNA.

I wrote about my experience with immunotherapy and how it’s different in The Infinity Machine a couple months ago, but this video gives a good animated visual example of how it works.

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Goal Progress: February

March 1, 2020 • #

A quick update for February. No big revelations or movements on goals, just slight progress.

Activity Progress Pace Goal Plus-Minus
Running 97.76 miles 107 miles 650 miles -9.09
Meditation 600 minutes 513 minutes 3120 minutes +87
Reading 4 books 4.93 books 30 books -0.93

I’ve struggled with building longer meditation sessions into my routine. I think the only way it’s going to happen is if I can get a pattern of sitting down in the morning before the kids are up. At night things are just too unpredictable — kids might stay up late, too tired, have to do runs, unmotivated.

Running was a little better than last month. I stayed a bit ahead of the curve through the month to close the deficit a bit, but still had several multi-day-off periods.

As I’d mentioned in my Goals post at the start of the year, I plan to read some deeper books this year so I reduced the total number. A focus on quality material and better retention is the priority. I also have about 6 or 7 in motion right now, which is abnormally high even for me.

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First Race of the Year

February 7, 2020 • #

I just committed to my first race of the year, a 10K in the St. Pete Distance Classic. Sort of a seat-of-the-pants commitment, but should be able to do a competitive personal time (maybe a PR if I feel good enough). I promised to do more races this year, so gotta stick to the plan.

The weather’s cooled down for the weekend, and a 6:30am start time should make it comfortable for a speedy run.

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Goal Progress: January

February 2, 2020 • #

The first month of 2020 is already in the books. 31 days blew by already?

It’s been a rollercoaster of a first few weeks, with some vacation at New Years, shot out of a cannon with a reinvigorated team at work, a trip to Miami, and a trip to Jacksonville.

I already fell behind on the targets with all that’s been going on. Once I can fall into a better rhythm with some normalcy in the schedule (which should be happening over the next couple weeks), I think I’ll be fine to catch up.

Activity Progress Pace Goal Plus-Minus
Running 43.14 miles 55 miles 650 miles -12.07
Meditation 350 minutes 265 minutes 3120 minutes +85
Reading 2 books 2.55 books 30 books -0.55

My running’s been reasonable, if not frequent enough to stay on track with the increased goal over last year.

Reading I intentionally re-prioritized some longer stuff, and I’ve been working through a couple that are great so far, but one in particular leads down all sorts of Wikipedia side trails while reading it.

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2020 Goals

January 2, 2020 • #

Last year was my first serious attempt at setting goals at the outset with structure and plan to hold myself accountable to each one throughout the course of the year. ā€œGoal orientationā€ is not my native approach to motivation, but being able to quantify results in data-driven terms (for good or ill) is something I’m compelled by. If, for example, I can’t track a run with Strava, I don’t even want to do it. The inanity of this compulsion is not lost on me, but the way I think about it is that if any strategy keeps you going (even a superficial one), it works. It’s all about the result after all.

In the spirit of 2019, here are the goals for this year. The learnings from last year’s results showed me some ways I want to iterate on certain of the areas, not necessarily to perform better against a metric, but to get deeper meaning out of healthy habits.

Health

  • Run 650 miles — When I set 500 as a target for 2019, I thought it’d be all I could do to hit that. I ended up landing on 615. With consistent effort (it requires an average 12.5 miles per week) I can definitely hit 650. Feels incremental, slightly uncomfortable, but attainable.
  • Run 2 half marathons — Did one last year, will shoot for one in the spring and one in the fall or winter.
  • Deeper meditation — In my takeaways on this from last year, I mentioned the lack of depth with short, frequent sessions. This year I’m going to try doing 2 sessions of at least 30 minutes per week. I’ve read from multiple sources that anything shorter than about that length doesn’t get you all the way to the ā€œpresentā€ state that mindfulness techniques are targeting. Half an hour will feel like a long time, but only twice a week should be fine.
  • Begin strength training — Shooting for 3 days per week. My plan is to get a setup in the garage to do workouts pre- or post-evening run.

Reading, Learning, and Writing

  • Read 30 books — I’m lowering the number this year, but have no plans to read less. I want to prioritize more long-form, deeper books that I’ve got on the shelf.
  • Continue daily posts — I’d also like to force myself to write posts on 1 book per month.
  • Study finance — With a half-decade of being heavily involved in the business end of a SaaS company, I’ve gotten a ā€œcrash MBAā€ in budgets, finance, and tons more. I plan to spend more time learning about markets, investing, and economics to have a broader understanding.

Professional

  • Host Fulcrum Live 2020 — The name of the event is TBD, but we’ll be doing another iteration of our user conference that we last did (with success!) in 2017.
  • Grow the team — Much of my time this year will be focused on team growth. No hard targets yet, but we have some things in the works that’ll be expanding our team.

Other Things

  • Share more posts from the blog — When I started the daily posting habit in fall of 2018, I made the intentional decision to just put posts out there and see what would happen organically. No expected plan to drive traffic, just post and leave it be — personal journal out in public. One of my main reasons for doing that was to reduce the friction in getting things out there. The idea that every post was getting tweeted or shared could’ve made me overly attentive to perfection and polishing, something I wanted to avoid not only because it’d take longer on net for each new post, but it could make me hesitant about certain things. This year I’ll plan to share more widely the content for feedback and discussion.
  • Take a few local weekend trips with the family — There’s a shortlist of places in driving distance I’d like to take the kids to, like on long weekends.

I’m updating my tracker to include some other things. I’ll be back on this topic with a post-January check-in on my progress.

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Goal Summary: Running Stats

December 28, 2019 • #

Continuing my summaries from a couple weeks ago, this post covers some statistics on running throughout 2019.

I track all of my runs with a Garmin fenix 5 watch synced to Strava, but also have been logging each one to a spreadsheet as I complete them. That way I’ve got an easy dataset to work with for analyzing and charting the results.

Here’s the overall breakdown of stats for the year:

Stat Total
Total Distance 615.55 miles
Total Duration 86 hours, 32 minutes
Total Activities 148
Average Distance 4.16 miles
Average Pace 8:26 minute/mile
Average HR 156 bpm
Total Calories 66,431 cal
Best Month September (88 miles)
Worst Month March (39.6 miles)
Miles by month

September was my big training month for the October half marathon (August was decent too, at about 70 miles).

2019 was my best running year by a wide margin. I got the fitness up to the point where 5-6 milers are pretty easy (when pacing), and the half proved that I can go even farther with a little preparation.

I’ve got new marks I’ll be aiming for in 2020, but probably won’t have time to post about the plan until into January a bit. Next up will be the map showing the year’s running coverage.

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The Infinity Machine

December 22, 2019 • #

This one is part book review and part reflection on some personal experience, a chance to write about some science related to a harrowing past experience.

A couple of years ago I had a run in with genetics-gone-wrong, a life-altering encounter with cancer that would’ve gone much differently if I was older or had the run-in in the wrong decade. The short version of that story (which I still plan on writing more about one day on this blog) is that I made it through the gauntlet. A stage IV diagnosis, 6 months of chemotherapy, and 2 major surgeries, and now I’ve been at ā€œNED,ā€ as they say, for 2 years1.

The fine doctors of the Mayo Clinic were able to navigate me through a treatment plan that had to do with genetics, and what’s possible nowadays with modern treatments that rethink the toolbox for cancer.

Working with the doctors and genetics team there2, I got a crash-course in Lynch syndrome, an inherited disorder that results in increased risk of developing cancers — specifically colorectal, intestinal, liver, and a few others. To say that Lynch is complex is a massive understatement. The geneticist I met with had to draw diagrams and flowcharts to answer the seemingly simple question ā€œDo I have Lynch syndrome?ā€ (see the image below) To cut to the (strange) point, my cancer expressed Lynch, but not me (see, it’s complicated). This meant we could try something different. Genetic oddities like this can serve as targeting tools for specific drugs.

A testing algorithm for Lynch syndrome (Goodenberger & Lindor, 2011.)
A testing algorithm for Lynch syndrome (Goodenberger & Lindor, 2011.)

Thus began my experience with immunotherapy, a category of wonder drug that’s exploding on the medical scene as a weapon for battling cancer. More on this in a bit, but let’s explore the book and how it relates to all this.

The Elegant Defense

An Elegant Defense investigates the power, and sometimes lethality, of the immune system. Through four separate cases — a patient with terminal cancer, one with HIV, and two with autoimmune disorders — it looks at what happens when immunity works like it should, but also what happens when the system goes haywire. This book isn’t about cancer immunotherapy exclusively, it’s an overview of the immune system in general — the adaptive versus innate immune system, T cells, cytokines, inflammation, and much more. As a primer on the amazing adaptive machinery of human immunity, it’s a top-notch read.

Throughout the book, Richtel uses the analogy of a ā€œpeacekeeping forceā€ to describe the immune system, an apt one that I think works well in most of his descriptions. Peacekeeping elements maintain law and order, of course, but sometimes under the wrong conditions, the peacekeepers can incite violence themselves. Instances of ā€œautoimmunityā€ (any time the immune system inappropriately responds to stimuli by attacking healthy cells) he compares to phenomena like nationalism, xenophobia, or even Nazism — cases in sociocultural systems where what starts off as a ā€œdefense mechanismā€ goes on the offensive. It’s a fitting analogy that helps to make a deeply complex scientific topic accessible to a wider audience.

The highlight of the book was Part II, titled ā€œThe Immune System and the Festival of Life.ā€ This section serves up the meat of the story, providing a background on how immunity works, its building blocks, and the history of the science of immunology. B cells, T cells, vaccines, the thymus, inflammation, transplants. Richtel does good work succinctly covering the basics of an incredibly complex system. How did this level of complexity emerge? What is the immune system evolved to respond to?

The Villains

The ā€œFestival Crashersā€ come in several forms. Bacteria, viruses, parasites, and cancers each bring their own deadly tactics that our immune systems have to learn to defeat. The biggest challenge comes from the fact that these enemies know this and do everything they can to blend in, so the immune system has to identify friend or foe:

Survival depends on knowing what is self and what is alien. The immune system must cope with three major challenges: the variability of bad actors, the central circulatory system that sends rivers of blood throughout our body in seconds, and the need to heal.

And the immune system must do all that without so overheating that it kills us in the process. It walks the most delicate path. It succeeds with the help of peacekeepers so effective that their work could be mistaken for magic.3

Faced with this challenge, the body’s adaptive immune system needs to evolve along with its enemies, to get better over time.

Trainable Defenses

Taleb’s notion of antifragility is on glorious display with the human immune system. His central theory holds that for an antifragile system, stressors, shocks, failures, and challenges increase a system’s abilities over time. The stressors serve as information channels to help the system adapt to future ones. At birth, babies have weak immune systems;Ā their bodies haven’t seen the millions of pathogens they’ll eventually run across. Being exposed in manageable doses to mild illnesses gives a child’s immune system the feedback loop it needs to counter future threats.

But what about completely novel threats? How can it, on first encounter, identify and eliminate threats it’s never seen?

How can your T cells and B cells react to a pathogen they’ve never seen, never knew existed, and were never inoculated against, and that you, or your doctors, in all their wisdom, could never have foreseen? This is the infinity problem.4

It’s my favorite part of the immune system story, the part that’s the closest to the supernatural. Proof of the incredible things the ā€œtinkeringā€ of evolution’s trial and error can develop.

It turns out that the genetic makeup of B and T cells is very different from other blood cells:

The antibody-encoding genes are unlike all other normal genes. Yes, I used italics. Your immune system’s incredible capabilities begin from a remarkable twist of genetics. When your immune system takes shape, it scrambles itself into millions of different combinations, random mixtures and blends. It is a kind of genetic Big Bang that creates inside your body all kinds of defenders aimed at recognizing all kinds of alien life forms.5

The system essentially pre-creates trillions of possible random combinations of genetic codes, creating an archive of ā€œguesses,ā€ keys to locks that could exist, but your body has no idea. Human genetics adapted a way to combat intruders by brute force.

Or if you prefer a different metaphor, the body has randomly made hundreds of millions of different keys, or antibodies. Each fits a lock that is located on a pathogen. Many of these antibodies are combined such that they are alien genetic material—at least to us—and their locks will never surface in the human body. Some may not exist in the entire universe. Our bodies have come stocked with keys to the rarest and even unimaginable locks, forms of evil the world has not yet seen, but someday might. In anticipation of threat from the unfathomable, our defenses evolved as infinity machines.6

It all seems impossible to believe.

A Bit of History

The potential to use the immune system as a controllable disease-fighting arsenal was first observed in the 19th century. In the pre-Germ Theory days of medical treatment, however, there was little hope of physicians figuring out what was really going on. True immunotherapy drugs have only been around since the 1970s, with the development of interleukins, followed by the cytokines (like interferon) and others.

In reading more about the history of immunology as a treatment path for cancers, I ran across the ā€œfather of immunotherapy,ā€ bone surgeon William B. Coley. He noticed several cases in which patients with cancers developed unrelated bacterial infections, then had their tumors disappear, so he searched for a link:

Having noted a number of cases in which patients with cancer went into spontaneous remission after developing erysipelas, he began injecting mixtures of live and inactivated Streptococcus pyogenes and Serratia marcescens into patients’ tumors in 1891.

Coley achieved responses such as durable complete remission in several types of malignancies, including sarcoma, lymphoma, and testicular carcinoma. The lack of a known mechanism of action for ā€˜Coley’s toxins’ and the risks of deliberately infecting cancer patients with pathogenic bacteria caused oncologists to adopt surgery and radiotherapy as standard treatments early in the 20th century.7

In the days before antibiotics, Coley was bold enough to experiment with intentionally dosing patients with bacteria, with the theory that this was stimulating the immune system to handle the cancer on its own. Though it was much more empirical and experimental than based on scientific theory, it just seemed to work. This kicked off decades of exploration in how the immune system actually worked, and investigation into manipulating it to fight ailments like cancer.

Changing Tactics

One of the patients followed in the book is a guy named Jason, a friend of the author that throughout is in a battle with a vicious case of Hodgkin’s lymphoma. After every form of surgery, radiation, and chemo, he’s eventually put through trials on an immunotherapy, with incredible response that ravages the tumors (or rather, enables his immune system to do so). He gets the same thing that I had 12 doses of, a drug called nivolumab.

My first few months’ experience in treatment was a crash course in understanding the different options available. I was loosely familiar with chemotherapy and radiation, at least as broad techniques for treating the disease. Immunotherapy was completely new. Luckily the research doctors at Mayo are happy to give their patients crash courses in understanding the detailed science behind how the treatments work.

Oncologists are fond of analogies in comparing treatments:

  • Chemotherapy is like carpet bombing, or even a nuclear weapon. The tactic is to blow up everything in the area and hope the disease goes with it.
  • Contrast that with immunotherapy, which is more like a surgical strike. Find the right target and targeting method, and send in the cruise missile to kill the disease with minimal collateral damage.

Or a better way I like to think about it: compare immunotherapy to code-breaking. Figure out the foe’s patterns and algorithms, then formulate a key that defeats the ā€œencryption.ā€ As mentioned earlier, it’s much like the immune system’s natural solution to the ā€œinfinity problem.ā€ But rather than generating those genetic keys, immunotherapies are only assisting the immune system in doing the job its already got the keys for. Cancer cells express proteins that essentially deactivate T and B cells, causing them to ignore the mutated monsters and turn away. All of the ā€œcheckpoint inhibitorā€ drugs like nivolumab function by ignoring these proteins so the immune system can attack.

My genetic history as diagrammed by my geneticist
My genetic history as diagrammed by my geneticist

It’s hard to describe the contrast in treatments without experiencing them (which no one should have to do). My chemo regimen was one called FOLFOX, which was a cocktail of several drugs delivered over the course of several hours, every 2 weeks. I also had Avastin added to the mix for additional factors8. Total all of that up and you’re under a flood of poison flowing through the bloodstream, leaving a trail of side effects like nausea, high blood pressure, terrible cold sensitivity, neuropathy, and brutal fatigue. My age plus excellent anti-nausea meds helped me work through it much better than I’d expected, and without more than mild symptoms. But toxicity builds up from treatment to treatment, so treatment 1 is bad mentally not physically, and treatment 10 is the reverse, since you feel worse, but your anxiety about the process is much lower.

Immunotherapy had zero side effects for me. I’d go and get my 30-minute infusion biweekly (contrast again with chemo’s 3+ hour infusion sessions), and head home as if nothing had happened. It’s wild to go from such a rough treatment process to something actually easier than most routine visits to the doctor.

Emergent Power

The infinity machines within our bodies are marvels of evolution. Understanding better how these machines work can give us deep insights into the complex and powerful emergent order of immunity, with opportunities to harness those T cells in lifesaving treatments. But the autoimmune story is a terrifying display of what can go wrong if we’re not careful. Toying too much with the infinitely complex immune system could result in the deadly overreactions that can kill in minutes.

The field of immunology research is complex, costly, and fraught with risks of exacerbating problems if trial and error isn’t kept in check or if researchers overshoot the target. But I’m personally thankful for the research institutions and pharmaceutical chemists out there on the edge figuring out new ways to understand disease and aid our bodies in doing magic.

  1. ā€œNo evidence of diseaseā€ in the oncologist’s lexicon. Their way of saying ā€œeverything we can see is gone.ā€Ā ā†©

  2. What kind of institution has a whole genetics division? Mayo Clinic is an incredible place, a marvel of science and patient care. ↩

  3. Richtel, An Elegant Defense, p. 55. ↩

  4. Ibid., p. 85. ↩

  5. Ibid., p. 85. ↩

  6. Ibid., p. 89. ↩

  7. A Brief History of Immunotherapy. ↩

  8. With the fancier generic name ā€œbevacizumab.ā€Ā ā†©

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600 Miles

December 11, 2019 • #

The goal at the start of 2019 was to hit 500 miles running this year. Tonight’s run pushed me up to 602 miles for the year, with a couple of weeks left to go.

150+ miles more than any prior year
150+ miles more than any prior year

Through the mid-summer time I was only averaging 42 to 45 miles a month, which was barely keeping me over the pace mark week to week. I would log my runs and watch the moving plus/minus number I track and see myself float above for a couple days, below for a couple days, hovering around the pace for hitting 500.

In August I made the commitment to run the Halloween Distance Classic half marathon at the end of October, so August through October had me attacking a rough training plan to prep for the race. Mileage increased up to 71 and 88 miles, respectively in August and September. That really accelerated me beyond the pace and I crested 500 before I even finished the half (which I finished with under 10 minute pace).

I haven’t yet decided what I want to target for next year. There’ll likely be a couple of races and some kind of mileage target, but nothing crazy. I’ve got too many other things I want to spend time on. But I’m glad I was able to stay healthy enough to push forward to the best health I’ve ever been in.

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Goal Progress: November

December 1, 2019 • #

This was a busy one. Between the All Hands earlier in the month and the week off for the holidays, those are brutal to maintaining the routine (though great to get a break and spend time with both workmates and family, respectively).

Here are the stats with one month left to go:

Activity Progress Pace Goal Plus-Minus
Running 574.02 miles 457.53 miles 500 miles +120.53
Meditation 3503 minutes 3340 minutes 3650 minutes +163
Reading 51 books 45.75 books 50 books +5.25

Once I hit the 600 mile mark on the running in the next couple of weeks, I’m planning on taking the rest of the year off to see if I can rehab the foot and ankle pain that’s built up. I’m past the goal line now on a couple of these, which feels good.

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Goal Progress: October

November 1, 2019 • #

The big achievement this month was the culmination of the half marathon training, ending October by finishing my first one.

Activity Progress Pace Goal Plus-Minus
Running 520.12 miles 416.44 miles 500 miles +103.68
Meditation 3208 minutes 3040 minutes 3650 minutes +168
Reading 47 books 41.78 books 50 books +5.22

The other notable movement was surpassing the 500 mile goal, which happened on this run and I didn’t even realize it at the time. I was able to knock out the mileage goal 2 1/2 months early. Back in March I definitely didn’t expect to be much over the target at all, let alone a full 100 miles beyond the pace mark. At this rate I’m pretty confident in hitting the 600 mile mark, especially with the nicer weather around the corner. I might do one more race in December, likely only a 10 or 15K.

This month I finally finished The Federalist, which I’d put down for a while. I made extensive notes throughout it. I’m looking forward to flipping back through for a refresher soon. Such a phenomenal work to put together such a deep, thoughtful, still-relevant rationale for strong but limited governance.

The other read this month that definitely made my ā€œbest ofā€ list for the year was Tracy Kidder’s The Soul of a New Machine. A riveting story of a small team developing an early minicomputer. This story had to be one of the inspirations for Halt and Catch Fire, turning rooms full of geeks into a fast-paced drama.

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13.1

October 27, 2019 • #

Today I finished my first half marathon. Felt great until about mile 10 when things got a lot harder. The final mile was painful, but I got it done and even ended up pushing it to under a 10 minute mile average pace (a goal I decided to shoot for around mile 8 when I was still feeling good and thought I could push myself).

  • Finish Time: 2h 09m
  • Average Pace: 9:52 / mile
Halloween Halfathon

Time for a week off!

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Goal Progress: September

October 1, 2019 • #

In September the training push continued for the half marathon. I did a personal record 88 miles in the 30 days, for an average of just about 3 miles per day the whole month. Somehow I’m not dead yet, but the aches and pains were there to prove it.

Activity Progress Pace Goal Plus-Minus
Running 460.88 miles 373.97 miles 500 miles +86.86
Meditation 2893 minutes 2730 minutes 3650 minutes +163
Reading 42 books 33.66 books 50 books +8.34

I think I’ve got the joint, knee, and foot pains to a manageable stage and seem to be turning the corner on that. My post-workout stretching process has been more diligent, shoes improved things, pacing, and proper rest days inserted in there. I’m really looking forward to the weather playing nicely in October and getting the temperatures down, at least a little.

The best books this month were for sure the two short story collections I read: Ted Chiang’s Exhalation and Ken Liu’s The Paper Menagerie. Both of them phenomenal blends of fantasy, speculative fiction, and historical science fiction, with imaginitive and thought-provoking short stories and novellas I’m still thinking about.

We’re moving into the final quarter of the year going strong on all of the goals. By the end of the month I’ll be able to report back on my experiences with the first 13.1 mile race of my running career.

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A Quick Running Update

September 27, 2019 • #

I’m almost at the two-month mark since upping my mileage at the beginning of August. I did about 72 miles in August, up from an average of less than 50 per month the prior months of the year. With 3 days left in September I’m over 80 miles, with a couple of runs left to do:

Running progress September

A few notes on how that’s gone so far:

  • Slowing down my pace has been essential to push the activity durations higher (obviously, to lower the average HR).
  • After the first couple of weeks I started to get foot pain on the sole of the feet. Of course the distance increase is going to add stress all over, but I’ve also tried improving posture by standing up straighter and pulling the shoulders back, while also keeping the cadence more consistent.
  • To help with the foot pain I got some better shoes to help with supporting my very-high arches. Anecdotally so far this has helped a lot. The On shoes I’d been running with are light and speedy, but lack support for my feet.
  • Running while monitoring my HR zone is helping a lot to get in the distances I’m targeting. On longer runs I just get my HR into the range I want and adjust pace and cadence to keep it there.
  • Once I get past the half-marathon, I’ll probably reduce the number of weekly activities but raise my average miles on each one. Back-to-back days are leading to some morning soreness I could avoid with more rest days.
  • At this rate I should easily break the 500 mile goal, and probably reach 600.
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Labor Day

September 2, 2019 • #

The kids had a great holiday — a beach day with their cousins, lunch on the beach together, then an evening playtime slash barbecue over at a friend’s house for dinner. It was the first beach trip here at home since probably Fathers Day of last year. We need to do it more often on the tail end of the summer.

Kids on the beach for Labor Day

I even got a 5-mile run in while everyone was napping and relaxing after the beach trip.

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Goal Progress: August

September 1, 2019 • #

This month I made a concerted effort to kick it into a higher gear with the running. Mid-month was the start of the Strava training plan I’m going to try and follow for race preparation.

Activity Progress Pace Goal Plus-Minus
Running 372.51 miles 332.88 miles 500 miles +39.63
Meditation 2563 minutes 2430 minutes 3650 minutes +158
Reading 36 books 29.96 books 50 books +6.04

The longer mileage is feeling good. I wasn’t sure what to expect when doing longer times with only single days of recovery in between, but it’s really not bad. The latest few runs have actually felt great cardio-wise right up until the end. The limiters at the moment are the heat (nothing I can really do about that) and some calf muscle and plantar fasciitis pains in the left foot. I’ve been doing lots of stretching and foam-rolling after runs, though, to try and counteract that, which I think is working alright so far. I’m trying to pace my mileage increase so I don’t end up with a real injury that really throws a wrench into the plan.

For books this month the most notable was the finale to Cixin Liu’s Remembrance trilogy, Death’s End. I haven’t had the time to write up many thoughts yet on that series, but it’s up there with the all-time best science fiction, for sure. Another pleasantly surprising read was Simon Winchester’s Pacific, which is a broad history of events and places on the Pacific Ocean since the 1950s. It’s one I plan on writing a longer piece about sometime down the road.

So that’s August in the can. Having pushed the running to 40 miles over the pace mark, I think I should be able to get to +60 at least by end of September, perhaps even higher if weather and health permit.

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Elevate for Strava

August 29, 2019 • #

Jason turned me onto this Chrome extension for Strava data analysis called Elevate. It’s a pretty amazing tool that adds deep analytics on top of the already-rich data Strava provides natively as part of their Summit plan.

Elevate fitness curve

In addition to having its own metrics like this fitness/freshness curve, it overlays additional metrics into the individual activity pages on the Strava website. My favorite ones are this (which Strava has its own simpler version of) and the year-over-year comparison graph, which lets you see your progression in total mileage over time:

Elevate YoY comparison

I love to see the consistency this year reflected visually like this. I feel like I’m doing well staying on course for hitting my goals, and this cements it. I was surprised to see how well I was doing in 2017 before the health issues struck. My long term goal is to be able to exceed that trend in 2020 after making progress on the fitness front this year.

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Group Training

August 28, 2019 • #

Our SNI running club on Strava keeps expanding. We’ve got 12 members now and counting. Two people are committed to marathons in the fall, and two of us to half-marathons.

Somewhere in reading about marathon training I read that the community aspect of the training plan is one of the most important: finding a group of people around you for mutual support and motivation along the way. Proper training (aside from the physical effort) is time-consuming and requires consistency to get 4 or more activities in per week, without falling off the wagon. It certainly helps to have the visibility of those around you keeping their habits going as a motivator to push yourself.

When we do our semi-annual All Hands events with the whole team in the office for a week, we now have something of a tradition of doing a group run sometime when we’re all together. I think we’ve done it for 2 or 3 years now pretty consistently. It looks like the upcoming November event we’ll be mobilizing about 15 of us or so to get out there and do at least a 5K. There’s a half-dozen of us that are real active and do this routinely, but it’s awesome to see the communal gravitational pull working, attracting many to join in who are really just trying to get moving on building the habit.

This’ll be right after my half-marathon, so it might be the first recovery run after that race.

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Long Runs

August 15, 2019 • #

When I committed to the half marathon for October, I also enabled one of Strava’s Summit training plans to keep me honest on the times and distances I should be ramping up with as I prep for that race. My personal goal isn’t to hit some target time in the half; it’s mostly to finish in a comfortable time frame. I chose a plan that has a 10-week training course, 4 activities per week with rest days and/or cross-training in between.

Over the last 3 weeks I’ve been trying to manage my activities by duration and heart rate zone rather than just running with no plan. Throughout the year up until now I’ve been doing pretty high paces (sub-8-minute miles), but at that level I can’t keep the times up or the HR in the right ā€œtempoā€ zone. I’ve been consistent with keeping under the threshold zone for my midweek runs for about 30-45 minute lengths. I’m particularly happy that I’ve gone 3 weeks in a row with long runs on the weekend and hour-long continued effort in the right HR zone.

We’ll see what happens tomorrow and this weekend as I kick off the training plan. It’s set to start next week, so my long run this weekend will be the pre-training benchmark for the 10-week program.

I’ve already crested the +20 mile mark over my year’s goal pace with my increased times and efforts this past month. With this lead up to the half marathon, I could be in the +50 territory by mid-October.

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Watts vs. Speed

August 4, 2019 • #

After a long ride today, I was looking at the stats on Strava and wondering how wattage calculations work to determine power. Strava has a built in estimate it uses for your power rating if you don’t have a power meter on your bike. From looking into it, their calculations look pretty sophisticated for estimating power pretty closely, unless you’re really riding in extreme conditions:

The power produced while riding is made up of several components:

  • Power produced to overcome the rolling resistance of forward motion.
  • Power produced to overcome wind resistance.
  • Power produced to overcome the pull of gravity (in the case of climbing hills).
  • Power produced to accelerate from one speed to another.

The total power produced, P(total), is the sum of all four power components.

P(total) = P(rolling resistance) + P(wind) + P(gravity) + P(acceleration)

It looks like the biggest source of error would be the environmentals, particularly wind resistance and elevation change (if the GPS elevation data is poor). My ride today shows an average 103 watts for the 1 hour 20 minute ride. Since it’s almost totally flat and their was only a little wind today, it should be pretty accurate. Seems to me that wind-induced error would sort of cancel itself out on circuitous routes like this one — for every segment of headwind, you get another with tailwinds.

I also found this bike calculator that takes various inputs and adjusts the resulting speed and watts accordingly.

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Half Marathon

August 2, 2019 • #

I’ve committed myself to running my first half marathon, coming up in October. This sort of happened on a challenge from a couple folks at work. I didn’t really intend to throw something like this into the schedule that could interrupt my regular goal progress, but in looking at Strava’s training plans, their half marathon one starts mid August and scales up in a way I think I can tackle relatively comfortably. It starts off with easy runs in the 40-60 minute range, with weekend long runs up to 75-90 minutes. I’ll need to bring the pace down from my recent patterns if I want to build that level of endurance.

August 19th is the first day of the training calendar. Going to grind on until then and see if I can get comfortable with longer sustained times.

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Goal Progress: July

August 1, 2019 • #

I had surprisingly good results on goals this July given how much was going on all month.

Activity Progress Pace Goal Plus-Minus
Running 300.57 miles 290.41 miles 500 miles +10.16
Meditation 2270 minutes 2120 minutes 3650 minutes +150
Reading 33 books 26.14 books 50 books +6.86

On the exercise front, I was able to get the same quantity of runs in even though we started out with the holiday weekend, which always makes sticking to patterns and habits challenging for me. Plus all month long has been exceptionally busy (more than usual) at the office. I’m planning on starting up a more formal training schedule in August in prep for a couple of long races later in the year, so I already tried to incorporate some long runs on the weekend at a lower tempo pace to start building the endurance. I got 46 miles in versus the 42 from June. For the first time this year I officially closed out the month 10 miles ahead of the pace mark.

On a different exercise-related note, I’m trying to bring cycling back into the regimen, mostly for cross-training with the running routine, but also because I enjoy being able to commute to and from the office.

I’ve still been able to squeeze in reading time somehow with a couple of really enjoyable fiction reads in The Dark Forest and Lovecraft’s Call of Cthulhu collection, two that have been in the backlog a long time. Both are well worthy of longer write ups at some point. I’ve just now cracked open Liu’s final installment of that trilogy: Death’s End, which has to be an exciting climax given how original and expansive book two was.

I’m 3/5ths of the way there now on the running target, feeling good. Let’s see how early I can hit all these marks.

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Cycling Commute

July 26, 2019 • #

This week I tried out commuting on the bike, like I posted about earlier this week. It’s a comfortable, nice ride with a dedicated bike lane the whole way from my house, a block away from the Island Loop through Shore Acres and Snell Isle. I haven’t done any rides to the office from the new place yet; it’s a decent morning workout of about 6 miles when connecting up to the North Bay Trail route downtown.

There were some crazy summer thunderstorms all week long. I had originally intended to work in a Tuesday / Thursday plan for bike commutes each week, but Mother Nature screwed that up Thursday. Some weather came through during the day today, but I dodged it for the ride home.

A commute plan like this would add a solid 25+ miles of cycling weekly to my health routine. I want to at least try to keep this up through the summer before Elyse starts back at school.

✦

Garmin fenix 5

July 23, 2019 • #

Wearables have become such a big market these days that there’s a wide variety of options to pick from if you want to monitor activity metrics. From the basic Fitbit step counters to more ruggedized outdoor watches to full-blown smartwatches, there’s a device for everyone.

I’ve been a devoted user of Garmin’s activity tracking watches for years now, starting out with the Forerunner 220. A couple of years ago I upgraded to the fēnix 5 model, one of their highest-end watches.

Garmin fēnix 5

I used the 220 model for about 3 years for run tracking. It was always reliable for me — water/sweat resistant, long enough battery life, and provided accurate GPS data. Because I also wanted to monitor heart rate during activities, I also used to use the chest strap HR monitor to feed that data to the watch. It worked reliably for a long while, but I think the contacts got corroded and the data started to get wonky after a time. I’d see huge surges in HR for no reason that would suddenly drop back down to normal.

I’ve now been using the fēnix for a couple of years and have loved it, one of the better devices I’ve ever owned. After a good experience with Garmin’s Forerunner series, I felt confident enough that I’d get benefit out of one of the higher end models. Let’s walk through some of its best features.

Multisport Activity Tracking

One of the things I didn’t like about the Forerunner was that it only supported recording run activities. The fēnix supports over a dozen activity types, indoor and outdoor, like cycling, climbing, swimming, and more. With the Forerunner it would still log GPX tracks that could be exported and treated however you want, but when synced to Garmin Connect or Strava, it would consider every activity a ā€œrunā€. With fēnix when you select a different activity type, it gets picked up accurately in both sync services and treated differently for metrics reporting.

There are some differences between activity types in terms of instant feedback on the watch display. For example, between runs and rides, you can have different ā€œlapā€ lengths to notify you of progress along an activity. So the advanced features like HR zones, pacing, and other things differ in how they’re fed back to you while you’re active.

I’m interested in incorporating swimming into my workout routine and to see how that would work with the watch.

HR Monitor

Having the HR monitor built into the device has some great advantages: mostly that it’s always on, and always available. I like that I get passive tracking of heart rate all the time to be able to see the resting heart rate during the day and during sleep (more on sleep tracking in a moment). I don’t have a good sense for the accuracy of the measurement with the on-wrist infrared sensor, but it seems generally consistent with what I used to see with the chest strap. To me it’s mostly important to have relative consistency between activities, and that I can see it in real time during activities. When I’m running I usually switch the watch display to view HR, which tracks amazingly closely with how I feel during a run. I can see a measurement of when I’m on the limit, so I typically use that readout to pace myself.

Battery Life

This is one of the best features about the fēnix, to me. Garmin reports 2 weeks of passive usage, 24 hours of active usage, which tracks pretty closely with my experience. What I tell people is that it lasts so long that I usually don’t remember exactly when I last charged it. This is the main reason that the Apple Watch has never interested me. I like the idea of richer apps on a wristwatch (especially with the phoneless-but-still-connected capability of the Series 3), but having to charge something every night is a nonstarter to me.

Sleep Tracking

Given that I wear the watch all the time, the sleep tracking is an easy side benefit. Ever since reading Why We Sleep recently, I’m more interested in prioritizing long enough sleep cycles (which with children simply means going to bed early). The watch reports not only sleep time, but also sleep stages somehow, through some combination of heart rate monitoring and movement tracking it buckets your sleep time into deep, light, and REM sleep stages. I don’t need hyper-accurate reporting, so this is a slick feature to get for free with an exercise tracker.

A rare example of 8+ hours of sleep
A rare example of 8+ hours of sleep

I’ve heard about the Oura ring as well for more detailed sleep tracking, but it’s a bit pricey for something I don’t have a big problem with right now. If I want to get more sleep, the simple solution is to prioritize it (which I don’t do well).

Smartwatch Capability

Through Bluetooth pairing, the fēnix also supports integration with push notifications from the phone. This can be convenient sometimes, but I’ve honestly never used it that much. Probably the most utility for me is quick access to turn-by-turn directions while in the car or on my bike. Quick readout of SMS and instant messages is convenient, too.

Strava Integration

You can set up Garmin Connect to sync with a number of services, including Strava, which is the only one I use for activity tracking. The main feature it has tied to Strava that I like is that with Segments in Strava, any segments you add to your favorites transfer to the watch for live progress tracking. It’s a feature they call Live Segments, and it’s cool because it’ll give you live feedback on your performance against your previous efforts and the KOMs from your friends. I love the ability to challenge myself on my own personal records on common routes.

The syncing works pretty flawlessly both with Garmin Connect and Strava. Never had a problem making sure my data is always up to date.

Any Downsides?

It’s been a rock-solid device for me, overall, with no major drawbacks.

The custom charging connector is probably the only downside, and not too acute because of the long battery life and rarity of needing to charge. It’d be much smarter for Garmin to use USB-C or micro-USB, but I don’t know what would motivate a custom interface. Given that the connector plugs in perpendicular to the watch back, it’s possible that there’s not enough thickness to fit the receptacle for a USB-type connector. Regardless, the need for a special cable to charge is an annoyance. I have keep one at home and a spare at the office so I can charge anywhere.

Overall it’s a very solid device, and I’d consider buying other Garmin devices down the road.

✦

Biking Again

July 21, 2019 • #

Last weekend I got the bike back up and running again. It’s been out of commission in the garage since the move a few months ago. Just had to clean it up a bit and put some air in the tires and it’s good to go. I’ve got a budding plan to start commuting down to the office, thinking I’ll start with a target of doing that two times per week to start. It’s about a 6 mile ride each way, which wouldn’t take much longer than driving, but in the summer heat here it’s plenty to require a shower when I get there. With the unpredictable weather here in the summer, committing myself to more than a couple commutes per week will just mean I’ll come up short on the goal.

My bike is only a single speed (a Takara Kabuto with no bells and whistles. It’s been reliable over the 7 or so years I’ve had it — no problems at all but tire replacement. I’m exploring getting a more serious road bike at some point, but I’ve told myself that’s not allowed until I can build up a good pattern of regular usage on the one I’ve got.

I went out for a loop ride yesterday and it felt good. My regular running has got my cardio up to make a decent pace ride pretty easy.

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Weekend Reading: Rhythmic Breathing, Drowned Lands, and Fulcrum SSO

July 20, 2019 • #

šŸƒšŸ»ā€ā™‚ļø Everything You Need to Know About Rhythmic Breathing

I tried this out the other night on a run. The technique makes some intiutive sense that it’d reduce impact (or level it out side to side anyway). Surely to notice any result you’d have to do it over distance consistently. But I’ve had some right knee soreness that I don’t totally know the origin of, so thought I’d start trying this out. I found it takes a lot of concentration to keep it up consistently. I’ll keep testing it out.

šŸž Terrestrial Warfare, Drowned Lands

A neat historical, geographical story from BLDGBLOG:

Briefly, anyone interested in liminal landscapes should find Snell’s description of the Drowned Lands, prior to their drainage, fascinating. The Wallkill itself had no real path or bed, Snell explains, the meadows it flowed through were naturally dammed at one end by glacial boulders from the Ice Age, the whole place was clogged with ā€œrank vegetation,ā€ malarial pestilence, and tens of thousands of eels, and, what’s more, during flood season ā€œthe entire valley from Denton to Hamburg became a lake from eight to twenty feet deep.ā€

Turns out there was local disagreement on flood control:

A half-century of ā€œwarā€ broke out among local supporters of the dams and their foes: ā€œThe dam-builders were called the ā€˜beavers’; the dam destroyers were known as ā€˜muskrats.’ The muskrat and beaver war was carried on for years,ā€ with skirmishes always breaking out over new attempts to dam the floods.

Here’s one example, like a scene written by Victor Hugo transplanted to New York State: ā€œA hundred farmers, on the 20th of August, 1869, marched upon the dam to destroy it. A large force of armed men guarded the dam. The farmers routed them and began the work of destruction. The ā€˜beavers’ then had recourse to the law; warrants were issued for the arrest of the farmers. A number of their leaders were arrested, but not before the offending dam had been demolished. The owner of the dam began to rebuild it; the farmers applied for an injunction. Judge Barnard granted it, and cited the owner of the dam to appear and show cause why the injunction should not be made perpetual. Pending a final hearing, high water came and carried away all vestige of the dam.ā€

šŸ” Fulcrum SAML SSO with Azure and Okta

This is something we launched a few months back. There’s nothing terribly exciting about building SSO features in a SaaS product — it’s table stakes to move up in the world with customers. But for me personally it’s a signal of success. Back in 2011, imagining that we’d ever have customers large enough to need SAML seemed so far in the future. Now we’re there and rolling it out for enterprise customers.

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Goal Progress: June

July 1, 2019 • #

So that’s a wrap on the month of June. This was my best month so far in terms of a consistent plan and feeling more productive with staying on target. Even with an out-of-town trip to visit the Cape and Jacksonville for a few days, which threw a brief wrench into the running plan, I was still able to climb enough above the target line get to my highest mark so far.

Activity Progress Pace Goal Plus-Minus
Running 253.54 miles 247.95 miles 500 miles +5.59
Meditation 1920 minutes 1810 minutes 3650 minutes +110
Reading 28 books 22.32 books 50 books +5.68

At some point mid-month I was actually about +10 miles over the goal line for running, but a 4 or 5 day break for that trip chopped it back down. It’s okay, though, since that’s exactly the point in overachieving for brief periods — creating the flexibility to go off-schedule if needed. I completed the Shore Acres running project, got under contract with a buyer for the old house, and had an all-clear follow up visit last weekend.

We’re halfway through the year and still tracking on all the goals. Let’s see what July’s got in store.

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18 Months Down

June 24, 2019 • #

I just got back from a trip up to the Mayo Clinic in Jacksonville for the every-three-month scans cycle. MRI and CT scans clear with only a couple minor things to monitor. These weekends are always a bit of a mental ā€œresetā€, and a relief to be done with. Laying in a tube for 90 minutes is never fun, but I’ve done it enough times now that it’s sorta routine. Being proactive about monitoring change is more important than a little discomfort for a couple hours.

Now it’s off my mind til September.

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Run Shore Acres: Complete

June 20, 2019 • #

Earlier this week I finished up my personal challenge to run all of the street segments in my neighborhood, Shore Acres.

Completed Shore Acres

Here’s the breakdown of stats to get there:

  • Total distance: 125 miles — by my rough calculation there are about 39 miles of streets in Shore Acres, but it takes significant overlap running over past ground from my house to hit new streets
  • Total activities: 36
  • Average run: 3.5 miles
  • Longest run: 5.2 miles
  • Started: March 22, 2019
  • Finished: June 20, 2019

This was a fun challenge and added extra motivation for me to keep getting out there consistently. As I talked about in my post on habits, any form of personal challenge or goal-setting (even if manufactured) that forces you to get it done is a good one.

Now that this is complete, I’m planning to move on to Snell Isle to the south. Why not keep painting the streets with GPS tracks?

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Running Kit

June 12, 2019 • #

This year’s annual target for running (pinned at the 500 mile mark) has me trying to figure out my own personal flow — what it takes to get a consistent, comfortable process for building the habit. The number one factor consistency: making the appropriate time and not breaking the promise to myself is the foundation of being able to hit the target.

It’s also important to get your kit in place. One of the great things about running is its minimalistic nature. You truly need nothing but your own body and motivation to get started. As you get into it (and depending on your preferences for style), you eventually figure out a consistent set of gear that works for you.

Here’s my normal setup:

Running kit

This has been my consistent setup now for a few months for every run. I always have the AirPods and my watch on me, so there’s very little required to always have what I need. The headlamp has been a game-changer for night running, which I do a lot. Really makes me feel much safer even when running in the neighborhood.

I’ve really loved the Cloudflashes with their extreme lightweight build, minimal form factor, and still-decent support. Strava reports that I’m approaching the 300 mile mark on the shoes, and the wear is showing in the heel of the sole pretty bad. This week I ordered a pair of their new Cloudrush shoes that I should get in a couple of days that I’m excited to try out.

If you told me 5 years ago I’d be running 5K distances routinely like it was nothing, I’d have thought you were crazy. Now it’s a habit I thoroughly enjoy and look forward to. Just goes to show that (for me) consistency, good gear, and some stretch goals can really change that perspective.

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Goal Progress: May

May 31, 2019 • #

For the second half of the month I got into a good rhythm with every-other-day running. I was even able to push almost 5 miles beyond the pace target to end the month. I started running with the kids again in the jogging stroller, which I haven’t done really at all since Elyse was little (2015-16). It’s good because it gets them out of the house, adds some cargo to push for additional workout, and gives Colette a nice break if I take them when I get home at the end of the day.

Activity Progress Pace Goal Plus-Minus
Running 211.61 miles 206.85 miles 500 miles +4.76
Meditation 1595 minutes 1510 minutes 3650 minutes +85
Reading 22 books 18.62 books 50 books +3.38

I was able to do more of what I’d talked about doing in previous months with more frequent, shorter runs rather than having to force the longer ones to stay on pace. Consistency is everything when working on a long-term goal like this. The last 8 sessions have been in the 3-4 mile range, which I feel works well right now — a good balance of exercise without taking too much time, so I can still squeeze them in later in the evening.

With my reading I’ve got too many threads open at the moment. I’m bad about getting 5 or 6 books in progress simultaneously, so sometimes it takes me longer to finish them up. This month I read Matthew Walker’s excellent Why We Sleep1, which is an excellent scientific deep-dive into how sleep works and all of the interplays between sleep quality and other health factors. I’m looking forward to writing up something longer about it here sometime in the next few weeks when I have time.

June has quite a bit lined up both personally and professionally, but I don’t see anything in the way of plowing through on the goals all month.

  1. Check out the 3-part interview series he did with Peter Attia for a good summary of much of his book’s material. ↩

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Neighborhood Run Progress

May 26, 2019 • #

I’m making quick work of the streets of Shore Acres. Yesterday I set up a quick and dirty local database that I could load the tracks into. I’m just using the GPX export feature on each activity and the ogr2ogr command line utility to import each one.

Run Shore Acres progress

Now I can see the streets get painted as I complete the job.

I ran a quick calculation on the street centerline data to estimate the total distance of roadway and counted about 37 miles. Once I’m done with each section I’ll tabulate how much total running it took to cover all the combined distances.

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Forming Habits

May 23, 2019 • #

This year has been an experiment for me in how one goes about forming habits — at least those of the healthy, positive variety.

We’re all familiar with falling into negative habits and how easy that can happen. There are automatic gravitation-like forces pulling us toward unhealthy habits all the time. Eating junk food, lazing around the house watching TV, not exercising, not reading, spending too much time with social media. What all of these things have in common is short-term gratification. In fact, I struggle to think of any easy traps like this that only have a delayed, long-term payoff. If eating that extra snack late at night or staying up 1 more hour to continue your Netflix binge didn’t give you instant gratification, you’d just skip the snack or go to bed.

On the flip side, positive habits are those that everyone wants to do more of, the stuff of New Years resolutions. They have the opposite common trait: you don’t see a result right away, sometimes not for months or years. Not only that, for many types of long-term investments it’s actually painful in the short-term. All forms of exercise fit this model. Running an 8-miler involves some suffering today and doesn’t knock off those pounds right away. It takes months worth of them to make a dent. This short vs. long idea is not a secret to anyone, yet it’s hard to defer those immediate satisfactions for the big win down the road. Often very hard.

I’ve never been a particularly goal-oriented person. Putting big numbers on the board to hit isn’t required for me to stay motivated. My personal motivators tend to be more intrinsic; I don’t need an externally-set objective target to stay on track. Often the act of the work itself is enough of a motivation to keep building. I can’t put my finger on it exactly other than that my motivation tends to come from within rather than without. That said, I wanted to figure out how I could manage to work in some new productive habits in a consistent, accountable way. Would setting a goal and staring at it every day actually make a difference?

I took a new approach this year by picking some things and tying numbers to them to see how it’d go. So far at about the 4+ month mark, results look promising. Because I’m such a data-driven person, I knew that not only was it critical to have the target mark set, but to be able to measure the progress toward those marks over the course of the year. Building this spreadsheet to keep track of my pace against the trendline has helped. I look at it all the time to keep up with it:

Goal tracking

One of the keys was to pick only a few goals and focus on them — running, meditation, reading books, and blogging. Those are what I’ve got on the board that I’m measuring. Trying to also add weightlifting, getting an MBA, or swimming to that list would overload the available resources and none of it would happen. I intentionally picked things that fit a specific class: not too time consuming, still enjoyable activities in their own right, fit my day-to-day pattern of life, and healthy over the long run.

Keeping it limited to things that are both good and enjoyable seems like a sound approach so far. It strikes me that this could be part of the problem with people consistently breaking their New Year promises by the time February rolls around. Creating habits around things you actually despise doing is extremely difficult. It also doesn’t hurt to have some sort of precedent of success first before committing to an every day routine. If you want to run a marathon before the year is over but you’ve literally never run 100 feet in your life, it’d be a good idea to start with some progress first rather than setting up for failure.

It’s a work in progress for me. I have a better sense now of how hard it is to get things to the point of being automatic. It’s getting close! I definitely think about getting my meditation session or running in each day without having to be reminded. It’s not on autopilot and may not ever be. My goal is to test these waters with myself on how to reprogram my own motivations so good habits become routine.

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Night Running

May 19, 2019 • #

With all my commitments each day between work life, kids, and other things, it’s hard to fit exercise into the schedule. Combine that with the struggles I have personally with rising before the kids to get running in, and the only option left is running at night.

For the past 9 months or so I’ve been pretty consistently running at night time after the kids are asleep — anywhere between 9 and 10:30pm. I actually enjoy it, even though it took a while to get comfortable making that commitment to still get out of the house that late. It’d be easy to be lazy and ā€œtoo tiredā€ to go. That does happen occasionally, but I’m usually pretty good about keeping myself honest if I mentally commit to doing it earlier. As we move into summer, night running is also essential to help keep good pace and avoid the brutal Florida sun and heat.

Most of the miles I’ve done late were down on the waterfront toward downtown St. Pete. There’s a nice set back trail down there which is well-lit, so safety and visibility never worried me that much. After the move though I’m running mostly in the neighborhood where the street lighting is a lot less consistent and the sidewalks aren’t always great. I posted last week about the headlamp I got, which I tested out last night:

Headlamp for night running

It worked great — comfortable to wear, plenty bright without being overkill, and adjustable to point down in front of me for good visibility. Today was a 90 degree heater, so it feels good to have an added level of safety for keeping up the night runs where I can get in miles without melting in the sun

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Run Shore Acres

May 12, 2019 • #

For no particular reason I decided to try and run every street segment in my neighborhood. A while ago I saw this project from ultrarunner Rickey Gates where he ran every single street in San Francisco. Of course my neighborhood is a fair bit smaller, but attempting it will keep things interesting. You can already see the progress zigzagging through the street spurs of waterfront property, with canals in between each row of houses.

Running Shore Acres

I’ve been doing a route regularly out onto Venetian Isles. This will mix it up and give me a chance to see the rest of the neighborhood. If I get it done soonish I’ll extend to Snell Isle to the south. My plan is to also download all the track line and point data and create a custom map.

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Foxelli Headlamp

May 5, 2019 • #

Since I do so many of my runs at night (even as late as 10-10:30pm), I’ve always been mindful of being visible for safety. Until we moved last month, I used to drive down to the Coffee Pot Bayou area and run on what’s called the North Bay Trail, since runs in my old neighborhood were boring. That whole route was on a dedicated trail set back from the street, so visibility was less of an issue. Now that I’m doing most runs in the neighborhood, even though the sidewalks are good, there are plenty of crossings that can be sketchy in the dark. So I bought a headlamp to try out.

Headlamp

I haven’t gotten to use it yet, but will likely be doing some runs in the evenings over the next week.

One feature I do really like to make it a multitasker is it’s got a red light mode. Really meant to be used in outdoors activities to preserve night vision when doing things like checking maps or looking around in your tent, I’ve already found it useful for reading in the bed at night. Usually I’ll only read my Kindle Paperwhite in the bed since it’s got a nice low power backlight, but this is great because it allows be to read paperbacks in the dark, as well.

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Goal Progress: April

May 1, 2019 • #

I was able to stay on track this past month toward my 2019 goals.

Activity Progress Pace Goal Plus-Minus
Running 164.51 miles 164.38 miles 500 miles +0.13
Meditation 1285 minutes 1200 minutes 3650 minutes +85
Reading 19 books 14.79 books 50 books +4.21

We’re still in the throes of prepping our old house for sale, so between that and work at the new house, that’s occupying a good bit of time. I have a goal to have the house listed in the next couple of weeks, so that’ll be a relief to have successfully behind us. With our All Hands early in the month and a trip to San Diego right after, staying the course was a challenge to make the time. I mentioned last month wanting to do a higher volume of shorter runs. I did a bit better, with 11 runs instead of 9. With a more regular schedule I’m sure I could improve further.

Meditation practice has been steady. I’d still like to work in longer sessions, but I feel the only way I’ll get that done is to wake up early and get started before anyone’s up. I’ve tried 20 minute sessions in the evening once or twice, but by then I’m too tired to focus properly and I end up dozing off. Practicing early in the morning will be a challenge, but I’ll give it a shot a few times this month if I can and see how that goes.

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Moving to Three Months

April 25, 2019 • #

I still haven’t published the long backstory on my cancer battle from 2017. It’s still a work-in-progress. There’s a draft going, but I want to make sure I do justice to the whole story properly, and it’s a little hard to spend time on. One day soon I’ll get it out there.

I mentioned a bit about my immunotherapy treatment a few weeks ago. Long story short is that there’s been good news recently, uneventful scans and visits (other than those 90 minute sessions in the MRI tube — not a good time there).

A quick update from today’s visit with the oncologist: I’ve graduated from a monthly schedule of checkups and diagnostic bloodwork to a 3-month cycle. After having multiple visits over there per week, to only a couple per month, then monthly, spending less time in that office is a welcome change.

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Weekend Reading: Running Maps, Thinking, and Remote Work

April 20, 2019 • #

šŸƒšŸ»ā€ā™‚ļø On the Go Map

Found via Tom MacWright, a slick and simple tool for doing run route planning built on modern web tech. It uses basic routing APIs and distance calculation to help plan out runs, which is especially cool in new places. I used it in San Diego this past week to estimate a couple distances I did. It also has a cool sharing feature to save and link to routes.

šŸ”® As We May Think

I mentioned scientist Vannevar Bush here a few days back. This is a piece he wrote for The Atlantic in 1945, looking forward at how machines and technology could become enhancers of human thinking. So many prescient segments foreshadowing current computer technology:

One can now picture a future investigator in his laboratory. His hands are free, and he is not anchored. As he moves about and observes, he photographs and comments. Time is automatically recorded to tie the two records together. If he goes into the field, he may be connected by radio to his recorder. As he ponders over his notes in the evening, he again talks his comments into the record. His typed record, as well as his photographs, may both be in miniature, so that he projects them for examination.

šŸ‘ØšŸ½ā€šŸ’» Best Practices for Managing Remote Teams

I thought this was an excellent rundown of remote work, who is suited for it, how to manage it, and the psychology of this new method of teamwork.

Let’s first cover values. Remote work is founded on specific core principles that govern this distinct way of operating which tend to be organization agnostic. They are the underlying foundation which enables us to believe that this approach is indeed better, more optimal, and thus the way we should live:

  • Output > Input
  • Autonomy > Administration
  • Flexibility > Rigidity

These values do not just govern individuals, but also the way that companies operate and how processes are formed. And like almost anything in life, although they sound resoundingly positive, they have potential pitfalls if not administered with care.

I found nearly all of this very accurate to my perception of remote work, at least from the standpoint of someone who is not remote, but manages and works with many that are. I’m highly supportive of hiring remote. With our team, we’ve gotten better in many ways by becoming more remote. And another (perhaps counterintuitive) observation: the more remote people you hire, the better the whole company gets and managing it.

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The Breakthrough & Immunotherapy

April 2, 2019 • #

I’ve been listening to the audiobook of The Breakthrough, Charles Graebel’s book about the origins and effectiveness of immunotherapy for cancer treatment.

There’s been a draft post in my archive for months to tell a longer version of the story on my cancer diagnosis and treatment. It’s been something that’s hard to write up in detail — hard to muster the motivation to spend time on the topic any more than I have to. I’ve had good news since late 2017, but still dwelling on it too long is not something I’m interested in. Usually would rather move on to other things.

But reading this book I couldn’t help but post about my experience. I did so today on a Twitter thread (mostly since I have more reach there than here), but here it is for posterity, assembled in a format easier to consume for those not on Twitter.

Here’s the full thread:

I’m currently reading ā€œThe Breakthroughā€ from @charlesgraeber, a story on the background of immunotherapy treatment for cancer. A few thoughts on this from a patient, survivor, and receiver of one of these treatments. (1/x)

2/ In late 2017 after my second surgery for stage IV colon cancer, I got permission to receive an immunotherapy (nivolumab, AKA Opdivo) near the end of my chemo regimen.

3/ My 2nd surgery had removed what they could see on any of the scans prior, but I wasn’t out of the woods yet — after surgery I had about 4 more rounds of chemo and a year of the immunotherapy treatment ahead.

4/ I always had an okay response to the chemo until some neuropathy set in toward the end. Only mild nausea along the way. I was on FOLFOX, which can be rough for many patients, but probably my young age & good health made it easier to take.

5/ But once that was over and I was only on the immunotherapy, the contrast between the treatment methods of the last 100 years — the triad of ā€œcut-poison-burnā€ (surgery-chemo-radiation) — and IT was enormous. I had 2 of those, and of course, neither was a comfortable experience.

6/ Immunotherapy is a completely different thing. Rather than acting on the mutated cells, it acts on your immune system. Cancer cells do what they do by duping your immune system into not attacking them.

7/ Immunotherapy treats your immune system (to activate, in the case of nivolumab) — blocking this signal from cancer cells so the T cells will attack.

8/ I got a dose of nivolumab every 2 weeks for 30 minutes via IV, with zero side effects. I would get an infusion w/ an hour visit to the clinic, then head to work like nothing happened. My blood chemistry would fluctuate a bit, but not enough to create noticeable side effects.

9/ An eye-opening moment that highlighted my own good fortune was learning how new this treatment really is. Nivolumab wasn’t FDA-approved for colon cancer until late July 2017 — nearly a month after I was initially diagnosed.

10/ The timing was perfect, and I have a world-class treatment team at @mayoclinic that were up to speed on the latest treatment options, trials, and genetic testing strategies required to fit patients to options.

11/ Here we are about 6 months beyond my last round of immunotherapy treatment. Two sets of follow up MRIs were all clear. Back to normal life with a renewed respect for how quickly it can go south on you.

12/ I wanted to call attention to this book and can attest to first-hand experience with immunotherapy. It’s a generational medical breakthrough that’s not well known enough when it comes to cancer treatments.

13/ It should be celebrated & reinforced, with more public success stories. There’s a chance that this is the treatment methodology that shatters this disease forever.

14/ Last thing: If your doctor recommends a colonoscopy, do NOT avoid it. It’s not that bad a procedure and can find all sorts of bad early signs well ahead of an advanced stage. It’s much, much, much easier than what might happen down the road if you avoid early detection!

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Goal Progress: March

April 1, 2019 • #

Month three is in the books. A seriously eventful month for us, so I’m surprised I was able to stay ahead of the curve.

Activity Progress Pace Goal Plus-Minus
Running 123.65 miles 123.29 miles 500 miles +0.36
Meditation 975 minutes 900 minutes 3650 minutes +75
Reading 15 books 11.1 books 50 books +3.90

We closed on the new house on the 15th, had an out-of-town trip to Jacksonville right after. Plus there was packing, moving, and child-management throughout. With all that going on I’m surprised I was able to stay on track, particularly with the running. I know last month my main observation about my performance was the fewer, longer runs I was planning to avoid. Turns out I didn’t do a great job. This month I’ll chalk that up as intentional — all of the time commitments this month made me push harder on the days I could run to make sure I could get in the miles and stay on track.

There’s still plenty to be done on the house front, but we’re past the worst of it. For April, I’m going to target more frequent runs in the ballpark of 4 miles and see how that works.

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It’s Not About the Number

March 5, 2019 • #

As I’ve been pushing onward with daily meditation practice on Headspace, the ā€œstreakā€ number has been climbing higher and higher. I have mixed feelings about this in terms of driving motivation. Is the desire to increase a number a healthy way to motivate positive mental health? Is it pushing the right buttons for the right reasons?

Headspace meditation streaks

Headspace founder Andy Puddicombe recently wrote on exactly this topic:

Some people love this feature, viewing it as a source of motivation, a record of accountability, and a badge of honor that reflects their commitment in building a meditation practice. Others can’t stand it, viewing it as a source of anxiety, a reminder of days missed, and an unspoken judgment of their dedication, passion, or priorities.

I’m glad to see them thinking about this, and not just gamifying everything because every other consumer product does. It’s already crossed my mind that the temptation to meditate for the purposes of incrementing a counter rather than for health benefit alone can’t be a healthy one. But Andy (who trained in Tibet) says this structure of practice is common in the Buddhist traditions:

The romantic version of meditative training is often portrayed as one in which time is forgotten, routines are abandoned, and goals are immediately relinquished. Having trained as a monk, I can tell you firsthand that this is anything but the case.

The reality of that lifestyle is a commitment for a certain number of years, and a daily routine set by the clock. We even had a fixed amount of time to complete meditation exercises — a number to which we had to commit. Within this context, we used the concept of run streaks all the time, but it was never about the number; it was a tool to help us deliver on our intention and direction, ensuring we wasted no time and worked towards a singular point, in a clear and steady way.

When I started to think about my personal motivations, I’m definitely motivated by gamification systems and stat tracking. It’s just wired into my brain to feel compelled by data. Sitting here now almost 90 days into a streak, was the outcome of the motivation, whether inherent for its own sake or motivated by being a ā€œgameā€, worthwhile? Am I at a better place now than I was 3 months ago with the practice? I would say the answer is a resounding ā€œyesā€. When I compare the patterns and results of practice now with some time in December, I notice a few impactful differences: it’s always on my mind to remember to sit down and do it, I can get into focus mode more quickly, and I don’t feel the same resistance to practicing I once did — that voice that says ā€œI don’t feel like itā€. The routine is much more like clockwork now. So regardless of the means it took to get there, it’s begetting the desired results.

One good reminder is to not get hung up on the number, to not treat it like the front-and-center measure of success:

As long as we are doing our best, that’s all we need to know. We all miss days, and that’s okay. In fact, some people don’t even want to meditate on a daily basis, and that’s okay, too. The important thing is to realize when we have missed a planned session and then continue with the next, a little like noticing when the mind has wandered off before returning to the breath.

While the streak counting does drive me to do the behavior to some degree, what I’d actually rather see is a measure of aggregate momentum — like a score that indicates the ā€œconsistencyā€ of practice. It could rise in increments with each session, and decrease slightly when skipped, but wouldn’t drop to zero immediately when a chain is broken. I think that’d be a better balance of keeping the positive driver there. Not deflating the balloon, but still exacting some negative feedback when you fall off the wagon.

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Goal Progress: February

March 1, 2019 • #

We just crossed month number two of the year, so here’s another pulse check on how I’m tracking against some personal goals for 2019. I’m tracking on all fronts, slightly better positioned against the pace marks than I was at the end of January.

Activity Progress Pace Goal Plus-Minus
Running 84.06 miles 80.82 miles 500 miles +3.24
Meditation 660 minutes 590 minutes 3650 minutes +70
Reading 10 books 7.27 books 50 books +2.73

With meditation practice I’ve widened my plus gap more than last month through some longer sessions. Experimenting with longer 15 or 20 minute sessions has been positive, but I don’t want to push that too far and demotivate the daily routine. I’m also still working out how to best fit that practice into my schedule in a consistent way — inconsistency in the timing (sometimes morning, sometimes night) makes it challenging to do longer sessions.

I came out ahead on the running this month. Not losing a week to illness like I did in January certainly helped, but I was able to do a week-long trip out west without disrupting the routine too much. One thing I’ve fallen into over the last couple weeks is fewer, longer runs rather than frequent, shorter ones. It’s been okay for the most part, but I could see that irregularity breaking up the pacing too much, so I need to do better about an ā€œevery other dayā€ general goal. Having 2 or sometimes 3 full days off in there requires 10K+ distances to be able to keep on pace (Bill actually wrote on this topic recently, also). Every so often I have an evening where I go out with an intent to do 3.5 to 4 miles, but end up stretching to 6 just because I feel good. It’s fine for that to happen occasionally, but I don’t want to risk injury. Yesterday I did a 3.5-miler with a half-numb mouth (I had just gotten a filling at the dentist less than an hour before), so that was interesting. But I kept on pace!

There were a couple of great books in my reads for the month. In particular John McPhee’s Coming Into the Country is one I’m looking forward to writing about soon.

I haven’t had much time lately to spend on my cartography projects, but that should change in the next couple of months. I’m still rolling with the daily writing routine. There’s no sign of a shortage of topics to write about. I thought this would be much more challenging than it is, but I guess (like any habit) the key is routine. I tend to write longer-form things in spurts where I’ll add to 3 or 4 posts in one sitting so I gradually can build a backlog of content. Post ideas come to me at all times of day, so having a ubiquitous capture method to always log those somewhere is helpful to keep track. Making the time for writing each evening definitely takes commitment. Getting a bunch of it done while I’m ā€œin the zoneā€ helps to lighten the load on other days where I don’t have the mental bandwidth to write very much. For example, on a long flight a few weeks back I wrote about 3 or 4 posts in one sitting.

In other personal news, we’re under contract for a new house in Shore Acres, which is exciting. Will post more here as that develops!

On to March. We’ve got a visit to Jacksonville, Elyse’s spring break, Disney on Ice, and some other fun things planned.

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Goal Progress: January

February 1, 2019 • #

This is the first year I set some goals on a few things. I’ve never been strongly goal-oriented, so I thought I’d put some stuff down to hold myself accountable and see if it helps build some healthy habits into my routine. Also, I thought it might be fun, as long as the goals were aggressive but attainable.

For the month of January, here’s how things stack up with each area. We’ve got my progress in the first column, the pace mark I should be at to keep on target, the total goal, and ā€œplus-minusā€ is where I net out against the goal:

Activity Progress Pace Goal Plus-Minus
Running 41.77 miles 42.47 miles 500 miles -0.7
Meditation 340 minutes 320 minutes 3650 minutes +40
Reading 5 books 3.82 books 50 books +1.18

I ended January technically behind on running, but caught back up with a 4+ miler today.

I’m ahead of the pace on the other fronts. After 1 month it didn’t feel like a stretch to achieve any of them. Meditation is all about building it in and making the time. Running is about committing and not backing out even when I don’t feel like it. And reading more or less comes naturally, but it leaves little time for things like TV and whatnot. The running target has definitely felt the hardest to keep up with. Part of it was getting behind with a head cold the first week, but even without I’ve got to put in about 10 miles per week to make it happen. What that first week did was demonstrate how hard it is to catch back up after going 8 miles or so into the negative. Too many days missed (vacations, illness, other commitments) could really screw me up.

Pushing on into February.

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Peter Attia and Zubin Damania Conversation

January 23, 2019 • #

I’ve listened to a few of Peter Attia’s The Drive podcast episodes. This one was a stand-out conversation between him and Dr. Zubin Damania. It’s a wide-ranging discussion about the health care system, diet, creativity, and meditation (among other things).

I’ve spent a lot of time right in the thick of the health care system the last couple of years (thankfully with a good experience). Insightful thoughts on what’s wrong inside that ecosystem that ring true from first-hand exposure.

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2019

January 1, 2019 • #

With 2018 in the rear view, it’s time to set some goals for 2019.

Here are some things I want to focus on, and some markers to aim at by year end.

Health

  • Run 500 miles — At just under 10 per week on average, this feels achievable, but will require consistency. A fall off the track will be hard to catch up from. I’d like to do some races in here, also.
  • Eat better — Nothing specific here. More cooking at home, more plants, less grease/fat, less quantity, more fish, more variety.
  • Meditate 10 minutes per day, 5 days per week (a total of 43 hours) — I’m enjoying this so far, want to get it closer to an automatic habit. It’s always something I enjoy having done once it’s done, but I don’t always look forward to it yet. As I’m learning, mindfulness practice can be frustrating once you know what you’re supposed to be doing.

Reading, Learning, and Writing

  • Read 50 books — I did almost this many this year. It’s doable.
  • Learn and do some work with R.
  • Get better with SQL.
  • Keep working on cartography and keeping up with open source geo (QGIS, PostGIS, OpenStreetMap)
  • Continue writing every day, 365 posts. Combining this with the reading habit is working well. I like using the process of writing ā€œreviewsā€ of books as a way to digest and think about what I read. If I could put together a full year streak, I’d be elated.

Professional

  • Go big with Fulcrum Community — We have some plans in store for this. Exciting to think about; time to execute.
  • Launch two new products — Good progress here already, will be bringing them public probably midway through the year.
  • Improve our product narratives all around — This goes for internal and external purposes.

Other

  • Take the kids on a trip, just the family — Not sure where, but somewhere out west would be fun.
  • Buy a new house — Working on this now. Kind of a big deal, but we’ll see!

I’m planning on putting together a tracking tool so I can keep myself honest on progress. I’ll publish something on that in the coming weeks once I get it figured out. I’ll also put some reminders on the calendar to revisit my progress here on the blog once a quarter.

Now time to go read.

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2018 in Review

December 31, 2018 • #

2018 was a good year, both personally and professionally. Rather than a long-winded post about everything that happened, here’s a brief summary of accomplishments, major events, family stuff, and travel.

Personal

  • Read 43 books. Check out my favorites of 2018: part 1, part 2.
  • Traveled to NYC, San Francisco, Atlanta, Buffalo, Niagara Falls, Toronto, St. Augustine, and Boston.
  • Ran 214 miles in 66 separate runs. (This one is particularly special to me. Since I had two major abdominal surgeries in August and October 2017, with a 12ā€ scar running down my belly, I’m glad I’ve been able to push and get back up to pre-surgery pace.)
  • Completed immunotherapy treatment in November. Clear scans mean I’m on ā€œmaintenanceā€ for the foreseeable future, with scans every 3 months for now. Probably the best ā€œaccomplishmentā€ of the year!
  • Wrote a post per day here since October 4th. 88 days in a row.
  • Began practicing mindfulness once a day. Going strong the last month and enjoying it.

Family

  • Everett turned 1, started crawling at 8 months, climbing at 10 months, walking at 11 months (yes, he was climbing ladders and stools before walking šŸ¤·šŸ½ā€ā™‚ļø).
  • Elyse turned 3, started school 3 days a week, and switched to a new school 5 days a week. She loves every second of it.
  • Colette and I celebrated our 10th anniversary!

Professional

  • We reached over 1800 customers of Fulcrum. It’s been used by customers in 180 countries. Zooming back to when we launched the platform in 2011, I never thought we’d achieve what we have so far (and it feels like we’re just getting it figured out).
  • We brought on 33 new people — now up to 53, across 11 states.
  • I wrote 7 posts on our blogs — my favorites: on the benefits of SaaS, our DroneDeploy integration, and on creating lookup tables with Fulcrum.
  • Late in the year I’ve been getting back into cartography. Hoping to keep that effort alive in 2019.
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Thanksgiving

November 22, 2018 • #

Things to be thankful for, 2018 edition:

  • Good bill of health, finally
  • A beautiful little guy turning 1 yesterday
  • A 3 year old that loves school, makes us laugh, loves us and her brother, and I’m proud of every day
  • An amazing wife that I couldn’t have made it through the last year and a half without, no chance
  • A family that’s been there for support all along the 2017/18 roller coaster
  • A phenomenal workplace that provided the flexibility, respect, and space to value personal health and family over the day-to-day work

Happy Thanksgiving to everyone. :turkey:

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Veterans Day

November 12, 2018 • #

I’m blessed to work with a large group of veterans these days. I’m thankful for the service of all veterans for making that amazing sacrifice. It’s easy to get wrapped up in nonsense, shortsighted, heated politics — Twitter these days is nearly unbearable with its tribalistic bickering. It’s worth taking a moment to zoom out and see the bigger picture; to see how many out there are playing their part and putting skin in the game for something larger than themselves.

My Veterans Day was made even better thanks to some excellent news on the health front. I’m overdue for a post to document my health ā€œadventuresā€ of the last year and a half. Now that so much time has passed, I think it’s time to take a look back at that for some perspective. Maybe some time in the next couple weeks I’ll try to get something up here.

To all of our current and former service members: thank you.

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Running Update

November 4, 2018 • #

After a tumultuous 8-10 months since last summer, I’ve gotten regularly back into running the last few months. I did over 50K in distance during August. I haven’t checked, but that must be a personal record. There were 2 weeks in a row with 3 10K runs a piece in there. Running late in the evening has turned out to be good for multiple reasons; I can always guarantee the freedom on the schedule and the weather is more manageable at 10pm in August and September.

But I think all those long runs in that spell screwed up my right knee. None of those runs that month felt bad — in fact quite the opposite. Each one felt great, during and after. But a week or so later I had a really uncomfortable morning run, only a few miles and every bit past the first felt terrible. Fatigue in the calves and ankles, higher-than-normal heart rate. I think a combination of overwork, dehydration, and poor warm up combined to mess me up. The next several activities felt better, but the knee pain would be noticeable each time — not so much during activities, but the next morning.

On the advice of Caleb, I bought a wobble board and a foam roller to do better with my post-workout routine. The foam roller to avoid fascia injury and loosen muscle fibers, and the board to work on ankle and knee stability. I’ve only been using them for a week, but we’ll see how that cool down activity helps the joints feel better.

The last 3 weeks or so have been busy, with the All Hands week, tons of personal family events, and other various things. I’m hoping to get back on a consistent pace through the rest of the year as the weather gets much more tenable and enjoyable.

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A Comparison of Activity Trackers

July 16, 2014 • #

The concept of activity tracking is getting ever closer to ubiquitous nowadays with the prevalence of dozens of mobile apps, wearable wristbands, and other health monitoring tools like Bluetooth-enabled scales and video games based on exercise. Now the world’s largest tech company is even rumored to be working on some form of wearable hardware (and software APIs), at which point the whole concept of ā€œlife trackingā€ will reach 100% penetration. Everyone will be tracking and recording their lives like characters in cyberpunk literature.

I’m a casual runner and cyclist, and started testing a handful of fitness tracker mobile apps to map my activity. Since I’m a stats and data junkie, I did some extensive experimental testing with these four apps to size up the advantages of each in terms of technical capability, as well as the feature-set of services provided by each within their online social systems:

There are dozens of other options for wearable hardware for tracking activity, location, and more, but I still think most of them are either too costly or not mature enough to invest my money in. I seriously debated buying a Fitbit or Up, but I’m glad I haven’t given Apple’s potential push into that market.

Let’s run through the details of each and compare what they have to offer.

Basics

Each of these apps has its focus, but they all promise the same basic set of features (with the exception of Moves, which I’ll get to in a moment):

  1. Allow user to log an activity of specific type — running, walking, cycling, hiking, kayaking, skiing, etc.
  2. Calculate metrics about the activity including time, distance, map location (in the form of a GPS track), speed, pace, calories, elevation, etc.
  3. Share your activities with friends, and join a social network of other active people (including professional athletes)
  4. Compete against others in various ways
  5. Set goals and measure your progress toward said goals

Moves is a different style of app. It’s a persistent motion tracker that runs continuously in the background on your device, mostly for calculating steps and distance per day for all of your activity. No need to open the app and record independent activities. I wanted to include Moves in the mix primarily for its deep data recording and mapping capabilities. I’ll revisit Moves’ data quality later on when discussing data.

Mobile Apps

I’m an iPhone user, and iOS has matured to the point that serious, veteran app developers have ironed out most of the annoyances and kinks of basic app design concepts. Most of the conventions around app UI have arrived at general consensus in presentation, using a couple of well-known paradigms for structuring the user interface. Both RunKeeper and Strava use the home-row tab button UI layout, with standard ā€œ5-buttonā€ options list across the bottom. MapMyRun uses the sidebar/tray strategy to house its options, like most of Google’s iOS apps.

Activity trackers

The basic interfaces of all three of these apps are nice. RunKeeper and Strava are almost exactly level on features on the mobile side. They both have a basic social presence or feed of your friends’ activity, activity type selectors, and big ā€œStartā€ buttons to get going with minimal fiddling. MMR’s look is a little cluttered for me, but it does include other functions on the mobile side like weight entry and nutrition logging.

All of them support configurable audio announcements of progress during an activity. A voice will chime in while you’re running to give you reports on your current distance, pace, and time since the start. Each also can be paired up via Bluetooth with an array of external sensors like heart rate monitors, bike speedometers, and others. Strava even has a nice capability to visualize your heart rate metrics throughout the course of your activities if you use a monitor.

Reliability

In my testing, the reliability and consistency of all of these apps has come a long way since the early days of the App Store, back to iPhone 3G and the first devices with GPS. The only one of the group that I’ve been using that long (since 2009) is RunKeeper, and its reliability now is in another class than it was back then. Since the introduction of multitasking with iOS, apps run silently in the background when switching between apps while a tracking activity is in progress. I tested tracking with all three simultaneously without any issues.

During a couple of my test runs, Strava inexplicably stopped my activity for no reason, but didn’t hard crash. When I’d switch back to the app, the current activity was paused mid-way, which is an annoying bug or behavior to encounter when you can’t recreate your activity easily. RunKeeper still seems the most reliable option all around, including the mobile app dependability and the syncing operations with the cloud service. Multiple times I had trouble getting the activity to properly save and sync on Strava and MapMyRun, though usually it was just a delay in being able to get my data synced — didn’t involve data loss except for the paused activities and couple of app crashes.

Services

All three of these apps function as clients for their associated web services, not just standalone applications. They’re not much different; each of them shows a feed of activity and a way to browse your (and your friends’) activity details. Stacking up your accomplishments against your friends for some friendly competition seems to be the main focus of their web services, but the motivators and ability to ā€œplus upā€ friends’ activity might push some to work out harder or more often. The differences here are mostly minor, and deciding on the ā€œbestā€ service in terms of its online offerings will come down to personal preference. One of the features I like with Strava is the ability to add equipment that you use, like your running shoes or specific bikes. Doing this will let you see the total distance ridden on your bike over time.

Each service offers a premium paid tier with additional features. Strava and RunKeeper have free-to-use mobile apps with fewer features, while MMR goes with advertisements and in-app-purchase to remove the ads.

Data Quality / Maps

My primary interest in analyzing these services was to check out the quality of the GPS data logging. I ran all three of them on the same ride through Snell Isle so I could overlay them together and see what the variance was in location accuracy. Even though iOS is ultimately logging the same data from the same sensor, and offering that up to the applications via the Core Location API, the data shows that all three apps must be processing and storing the location values differently. Here’s a map showing the GPS track lines recorded in each — Strava, MapMyRun, and RunKeeper. Click the buttons below the map to toggle them on and off to see how the geometry compares. If you zoom in close, you’ll see the lines stray apart in some areas:

Each app performs roughly the same in terms of location data quality. The small variances in precision seem to trend together for the most part, which makes sense. When the signal gets bad, or the sky is slightly occluded, the Location APIs are going to return worse data for all running applications. One noticable difference between the track geometry (in this example, at least) is that the MapMyRun track alignment tends to vary in different ways than the other two. It looks like there might be some sort of server-side smoothing or splining going on to make the data look better after processing, but it doesn’t dramatically change the accuracy of the data overall.

I did notice that using these apps without cellular data enabled results in severe degradation of quality, I think due to the fact that the Assisted GPS services are unavailable, forcing the phone to rely on a raw GPS satellite fix. When using any location logging app without cellular data switched on, the device has to take longer to get a position lock. A couple of runs from my Europe trip exhibited this, like my run along the Thames in London, and one in Lucerne.

Run on the Thames

Since these motion trackers rely on the GPS track and time series data for calculating total distance (which is obviously way off with this much linear error), you end up with massively incorrect pace and calorie-burning metrics. This jagged-looking run activity in London reported itself to be 4.7 miles, and in reality it was only about 3.5. Soon I’d like to pair my iPhone up with an external GPS device I’ve been testing out to see what the improvement in accuracy looks like.

If you want to export the raw data straight from the web services, Strava and RunKeeper are the only ones that will give you a full time series-enabled GPX track file for each activity. MapMyRun only exports the track point data, which without the timestamp info for each point can’t be processed to calculate pace and other metrics with elapsed time as a variable.

The location data captured by the Moves app works a little differently. It splits your persistent movement activity up into day and week views, with totals of steps taken and calories burned, by type of activity. It does some cool auto-detection of activity type to try and classify car transport, cycling, running, and walking automatically. Because it’s always running in the background, though, the location data isn’t quite as granular as from the other three applications, probably due to less frequent logging using the location APIs.

Moves app examples

One caveat important to note is that Moves was acquired by Facebook back in May. That may turn a lot of people off to the idea of uploading their persistent motion tracking information to the Borg.

Wrap up

Strava and MapMyRun also support pulling the track info from external devices like mountable GPS devices, watches, and bike sensors.

Overall, my favorite is Strava as the app-of-choice for tracking activity. It performs consistently, the GPS and fitness data is high quality, and the service has a good balance of simplicity and social features that I like.

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