New York State Health Care Proxy Form

Similar to a living will, but legally recognized by New York State.

The New York Health Care Proxy Law allows you to appoint someone you trust - for example, a family member or close friend - to make health care decisions for you if you lose the ability to make decisions yourself. By appointing a health care agent, you can make sure that health care providers follow your wishes. Your agent can also decide how your wishes apply as your medical condition changes. Hospitals, doctors and other health care providers must follow your agent's decisions as if they were your own. You may give the person you select as your health care agent as little or as much authority as you want. You may allow your agent to make all health care decisions or only certain ones. You may also give your agent instructions that he or she has to follow. This form can also be used to document your wishes or instructions with regard to organ and/or tissue donation.

Review of Treo 650 Updater 1.08 (Sprint PCS branded version)

Very, very annoying to load. Requires 11 MB of memory -- in other words, lots of deletion and reinstallation. But worth it. After updating, the free phone memory increased from 3 MB to 10 MB.

Hilarious Journal Articles Part 2

Recovery from impaired dark adaptation in nightblind pregnant Nepali women who receive small daily doses of vitamin A as amaranth leaves, carrots, goat liver, vitamin A-fortified rice, or retinyl palmitate.

Am J Clin Nutr. 2005 Feb;81(2):461-71.

Technorati Tags: Hilarious Journal Articles

Swopper Chair Review

No other chair I've found is as flexible (or looks as interesting) as the Swopper. Occasionally if you need a change you can spin the dials on the base to adjust the bounce and tilt. Thumbs up. Blurb:

• Allows you to sit in motion with freedom of movement.
  
• Bounces and moves in all directions to enhance circulation and spinal fluidity and flexibility.
  
• Improves posture, abdominal strength, and lower back strength.
  
• Raises and lowers to work for any height individual or work station.
  
• Stylish design featured in the New York Museum of Modern Art.

Dispatches From the Michael Jackson Trial

Slate's coverage of the Michael Jackson trial is really, really good.

Let me explain just how strung out and godawful Michael looks:

One evening, several years ago, I swallowed two Vicodin in the midst of getting deeply drunk. Then I woke up in my bathtub. I'd passed out while trying to pee, and my fall had snapped the soapdish clean off the shower wall. After staggering to my feet, I caught a wobbly glimpse of myself in the bathroom mirror.

I looked better than Michael looks this morning...

Killer Hospital Beds

From CNN:

FDA orders killer hospital beds to be seized
Warns: Vail Products' beds have trapped, killed patients

LOS ANGELES, California (Reuters) -- The U.S. Food and Drug Administration, citing a public health risk, said Tuesday it ordered the seizure of enclosed hospital beds made by Vail Products Inc.

The FDA said it was aware of 30 people who became trapped in the beds, seven of whom died.

Officials at Toledo, Ohio-based Vail Products could not be immediately reached for comment. The company's Web site says the beds, used for clinical and home care, allow "the patient to move about freely within a safe, padded environment..."

Graphic Novels and Other Media

Point Blank and Coup D'etat by Ed Brubaker; Nip/Tuck - The Complete First Season; Channel Zero by Brian Wood; Far Cry; Collateral; Garden State; and Ministry of Space by Warren Ellis.

Hilarious Journal Articles Part 1

The first in an occasional series. Feel free to email me contributions.

Accidental Anal Intercourse: Does It Really Happen?

Journal of Clinical Forensic Medicine
Volume 12, Issue 1 , February 2005, Pages 1-4
Guy A Norfolk

A postal survey was conducted of members of the Association of Forensic Physicians (UK) to determine whether accidental anal intercourse occurs in heterosexual relationships and, if so, whether intoxication by alcohol or drugs and sexual inexperience were likely to be causative factors. Of the 512 (47.9%) replies, there were 498 individuals who had had a previous heterosexual relationship and may have experienced accidental anal intercourse. Of these, there were 26 (7.2%) males and 14 (10.4%) females who reported at least one lifetime episode of accidental anal intercourse. Amongst those with a history of accidental anal intercourse, 79% reported that they were sexually experienced at the time and 83% reported that their partners were sexually experienced. Personal intoxication by alcohol or drugs at the time of accidental anal intercourse was reported by 43%, with 41% reporting that their partners were intoxicated...

Technorati Tags: Hilarious Journal Articles

Review of Infinite Jest: A Reader's Guide by Stephen Burn

This slim 92 page book is interesting, but far from definitive. Good ideas. Too much unexplored. I'm still betting the drug DMZ was being synthesized by the mold in Hal's intestine that he ingested when he was a kid. I especially liked the timeline at the end. (2005 is the Year of the Perdue Wonderchicken.) Worth the price of admission for Infinite Jest fans.

Review of Treo 650 Bluetooth Headsets

I've used three bluetooth headsets, and the Treo 650 Wireless Headset is significantly better than any of the others. The Jabra Freespeak 250 fit well but had an unacceptable amount of static (a problem others have mentioned). The Sony Ericsson Akono HBH-660 Headset had no problems with static, but the volume was too low (which made it difficult to hear in noisy environments) and the earpiece didn't fit well. The Treo 650 Wireless Headset has no static, is louder than the Akono, and fits very comfortably.

Brain? What Brain?

When your old notebook says "Operating System Not Found," it may be nature's way of saying that you need a new computer.

(To be fair, I'll try reinstalling Windows XP first.)

Final Sleeptracker Review: No Magic Bullet

Disclaimer: Sleep isn't my specialty. My experience may not be yours.

I've evaluated Sleeptracker for one week, and I can't detect any significant difference in my sleep or wakening. To recap: Sleeptracker is a watch which is designed to detect REM or stage 1 sleep and wake you up at the "optimal" time.

This sounds good in theory, but in order for this to be effective the following must be true:

1. REM or stage 1 sleep must be sensed,
   
2. the stages of sleep must be sensed accurately,
   
3. there must be a noticeable benefit to wakening in the lighter stages of sleep.
   

The problem is this: the Sleeptracker website doesn't say how it works. This is understandable, but it means there is no way to verify that #1 or #2 is true. Number 3 intuitively seems true, but no evidence is cited to back this up.

Personally, I have not noticed that I wake easily or feel unusually refreshed when using Sleeptracker. There could be many reasons for this (and again, my experience may not be yours), but for a product this expensive, I would hope for a more obvious benefit.

What's on my Treo 650

The Treo 650 is my only phone. I recently upgraded from the Treo 600 because I had to replace it four times.

These are programs which may be of special interest to nephrologists, nephrology fans, or internal medicine docs.

• Adobe Reader: Can read lots of things now.
  
  
• Avantgo: Indispensable. Channels are New York Times Front Page, Book Reviews, Business, Technology, Arts, International; American Medical News; PCWORLD.COM; and Salon.
  
  
• DatavizTech: The only purpose of this program is moving DocsToGo to your memory card to save space.
  
  
• DateBk5: Because the supplied calendar program is too clunky.
  
  
• DocsToGo: Primarily for arcane spreadsheets.
  
  
• Epocrates: Originally I used MobilePDR but it developed hotsyncing problems so I switched. I like knowing drug prices.
  
  
• eReader: I don't read books on paper anymore if I can help it.
  
  
• FileZ: In case you need to do something like delete all the corrupted files of VersaMail.
  
  
• hblogger: Because I liked the interface better than mo: blog's.
  
  
• HoliDates2: So I put the dates in. Now what?
  
  
• Life Balance: "The word processor of to do lists." Or something.
  
  
• MedCalc: Almost all the formulas I need.
  
  
• PowerRUN: Because of that annoying 650 memory issue that makes Treo users want to kill Palm.
  
  
• Snappermail: VersaMail is very, very, very buggy.
  
  
• Statcoder.com: Everything on this page.

The Gates

My favorite print of The Gates in Central Park (Gates XIX, taken by the Pond):



Link to larger image.

For comparison, this is a photograph of the area:



Link to larger image.

Further thoughts on Sleeptracker

Rather than sensing sympathetic nerve activity in the skin, it's possible that Sleeptracker senses body movement instead (assuming that increased body movement is related to lighter stages of sleep).

Disclaimer: Sleep ain't my specialty. This is speculation.

Other ways of wakening: the Digital SunRise Clock by Bio-Brite wakes you with a light that slowly brightens over 20 - 30 minutes. I've used it for the last year. My review: thumbs up.

Sleeptracker papers

There's some literature on determining the stage of sleep by measuring the sympathetic nerve activity of the skin. I presume this is what Sleeptracker does, but I'm not sure. Two papers:

• Skin sympathetic nerve function during sleep--a study with effector responses.
  
  
• Sleep stage-related changes in sympathetic sudomotor and vasomotor skin responses in man.
  

Sleeptracker

I've been evaluating Sleeptracker, which is a digital wristwatch that is designed to sense when you are "almost awake" (at the lightest stage of sleep) and wake you at that time. I am interested in papers or resources that could answer the following questions:

1. How does Sleeptracker sense the stages of sleep?

2. How accurate is it at determining sleep stages?

3. What evidence exists that awakening during the lightest stage of sleep is beneficial?

No Titles

Since posts emailed by Snappermail take two days to appear on Blogger (and the formatting is screwy), I've switched to using hblogger on the treo 650. The interface is better than mo: blog, which was my second choice. No titles on hblogger, however.

Reviews

Thumbs up to the Treo 650. I had a Treo 600 for two years and replaced it under warranty four times. The Treo 650, so far, seems much more stable, is significantly faster, and has a beautiful screen. The biggest downside is the memory issue (written about everywhere), but a utility called PowerRUN and a complimentary 128 meg card provided by palm seem to have solved this problem reasonably well.

A qualified thumbs up to Snappermail also, which is significantly better than the buggy Versamail. The biggest downside is the annoying habit of laboriously highlighting every link in every email, which makes trying to scroll through quickly a pain in the ass. Snappermail support has been appropriately sympathetic and perhaps they will change the scrolling system in a future release. (I should mention that these entries are emailed to kidneynotes using Snappermail on a Treo.)

Also thumbs up to adobe reader for palm, avantgo, treo butler, datebk5, documents to go, epocrates, filez, holidates2, lifebalance, and everything on statcoder.com.

Begin

So, I am now half complete with Song of Susannah, the sixth book of the Dark Tower series. I have attempted to read all of them using Ereader on a Treo 650. I'm sold on reading books this way.

Also starting Steven Burn's A Reader's Guide to Infinite Jest.

Just finished a presentation on the perils of hyponatremia. Too much water can kill you. Intravenous fluid is a drug. Sometimes the cure is worse than the disease.

Hello, by the way.