Posted by: Nancy | August 21, 2011

Measuring Life

I’ve lately been intrigued by the developing technology to help us measure and manage so many aspects of health and wellness  — on a personal level. I’d started gathering an assortment of brilliant apps and new tools that bring the measurement out of laboratories, hospitals and professional offices and into the hands of individuals.

In larger terms, I believe (naively and idealistically) that this kind of self-monitoring and management can do a lot to change our health care thinking. Shift our focus from sickness to health, push us to take control.

Then, suddenly, I was overcome by disparate happenings — events also oddly resonant with this question of measuring life.

Uncomfortable surprise #1.  My sister came to visit. It had been eight months since her last stay here, and we had both been looking forward to her return. She would play music, set up her work desktop in the kitchen, help with chores, work on art projects and look forward to exercises at Curves. We’d tell stories, play with the cat, go swimming and laugh a lot.

But this time, she was different. She was remote, anxious, uncomfortable. Her mental capabilities had diminished. None of our expectations were met. With great sadness and a sense of such tremendous loss, I made arrangements for her to return to her most comfortable setting. For her benefit.

How to measure the changes? I made note of new behaviors and counted the incidents. I remembered the Dementia Assessment exercise that I’d completed on her last visit; I answered the questions again, in light of her current state here. The scoring told of a change — it was 10 in December, and 44 this time.

But what do the numbers mean?

Uncomfortable surprise #2: Sadly, interpreting the scale is secret and can only be done by a licensed professional who has the code. I’m not sure what’s served by the secrecy. I’d like to know what I could do differently to help her.

Uncomfortable surprise #3: My beautiful husband had a major surgery recently, and was a model patient in working toward getting back to full health. He was dutiful in his exercises, medication schedule, careful in all aspects of his recovery.

Yet he developed a pain in his calf. “It feels just like a sprain,” he’d said. But it got worse, and when he felt short of breath and clammy, we called a nurse for guidance. When she advised checking it out, we went to the emergency room. He was sheepish, apologetic, noting that it’s probably just a sprain from the therapy.

But ultrasound, X-rays and a CAT scan revealed a very large clot, the length of his long leg, with dangerous fragments already in his lungs. Both sides.

He is better now, thanks to the medical monitors that tracked every change in his status. They measured blood pressure and clotting strength, they thinned the blood and reduced the clotting tendency to a specific therapeutic level: 2 to 3 on the Prothrombin Time/International Normalized Ratio.  There are repeated measurements now, with adjustments as needed, to keep the reading at the appropriate level. Over time, with the right readings,  the clots are expected to dissolve or dissipate or somehow disappear.

Now we watch the lab report numbers with intensity. I wonder how long before we’ll be able to do simple checks via a home analysis?

I like this trend. I like demystification. I like being able to measure, baseline, set goals and monitor actions that change the score. I prefer knowing the status and having some control, the ability to take actions to change what I can.

Some more examples of where this is headed:

  • Quantified Self: “Self Knowledge through Numbers” is the tagline for this online resource for measuring and monitoring personal health. It’s a forum, an association, a group that holds Meet-Ups in 27 cities and conferences, and produces a great Quantified Self Guide to help anyone start tracking and measuring … anything.
  • Jawbone: A new wristband sensor and app that helps measure and manage personal health. In addition to monitoring, it pulls from best practices to make suggestions for improvement. It’s a small scale and personal model of the evidence-based medical best practices tied to real-time monitoring data, like the large scale EMRs deployed in hospitals.
  • See Technology Review, The Measured Life, for more details on the trend and links to other cool stuff.
  • I love Daniel Kraft’s vision of the coming health care transformation.

The trade off might be that it makes us a bit more self-centered and self-focused, but if it leads to better self-awareness (not narcissism), I’m all for it.

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