What a difference a year makes

7 05 2008

Four days ago on a Saturday, I biked 4.5 miles to 7th Heaven Yoga, took a 1.5 hour class, then biked another 4.5 miles home. What a difference a year makes.

A year ago I was coughing up my lungs in a hospital bed at Summit, unsure of what ailment I was suffering and whether it would ever get better. I had been admitted to the hospital on May 6th, one day after my wedding.

I had been feeling progressively weak and sick and asthmatic for months. A week before my wedding, I went to the hospital because things had become more dire: a rash had broken over my arms and head, terrible pain was striking without warning in my back and legs, and the asthma was totally uncontrollable. At the family physicians office, I was told there was blood in my urine and they sent me to the ER.

At the ER, I learned that my white blood cell count was through the roof and that I had thrush in my throat and mouth. Hematologists said it was cancer. Infectious Disease specialists said it was a massive infection. Another doctor suggested that systemic fungal infections cause all manner of strange symptoms. A dermatologist thought the rash could be from a staph infection. I was told it could be anything from HIV to Tuberculosis, and in fact for a couple hours I had been made to wear a mask to prevent spreading the probable infection. At one point, with my fiance in the room, they were ready to admit me to the hospital, which would force us to cancel the wedding or exchange vows bedside. She broke out in tears.

They decided it wasn’t TB and, against their better judgment, we checked out.

The wedding was a blur. Around 11pm of our wedding night, I excused myself, took Codeine and Tylenol, and fell asleep. The next morning at brunch, while trying my best to enjoy breakfast, I went temporarily blind in my right eye. I can still remember watching the blackness surround my vision and close off, literally a tunnel vision experience. I sat down with my parents and sister and casually mentioned that I couldn’t see from one eye. My sister, a nurse in New York, said “I’m taking you to the hospital.”

Eleven hours in the ER, 72 hours in the hospital, and finally a diagnosis. A pulmonologist looked at the collection of symptoms and said matter-of-factly that in all likeliness it was the very rare Churg Strauss syndrome, a syndrome that used to kill people just 30 or 40 years ago, but today which can be treated simply and effectively with Prednisone. A biopsy of my lungs and one on my arm confirmed that my body was overrun by eosinophils (Churg Strauss is characterized by systemic inflammation; the body responds by producing excessive white blood cells called eosinophils).

Apparently, when he uttered the diagnosis, the attending internist slapped her forehead (”duh!”) because “of course” that was it… it’s something every US-trained doctor studies as part of med school, it’s a good textbook syndrome, but rarely do they encounter it (only 3 out of 100,000 people are diagnosed every year). My family physician said something similar: they thought it was Churg Strauss, but because they had never had experience with it they were uncomfortable about making the diagnosis. And now when I look at the cases on the internet, I see photos of people with rashes on their arms that look identical to what I had

There was a time when people routinely died of Churg Strauss. And people can still be damaged by it if it’s not treated early enough. Fortunately, there’s Prednisone, and for those of us lucky enough to be diagnosed early, the disease (syndrome, really) is eminently treatable and rarely relapses. In my case, the doctor believed Churg Strauss was caused by a very uncommon side effect of a very common medication:

In rare cases, patients on therapy with SINGULAIR may present with systemic eosinophilia, sometimes presenting with clinical features of vasculitis consistent with Churg-Strauss syndrome, a condition which is often treated with systemic corticosteroid therapy.

My family members who were unlucky enough to see me suffering in the hospital were astounded to see how my body responded after a single dose of 20mg of Prednisone. I had been literally gulping for air with each breath, and two hours later was breathing almost normally. A day later it was like nothing happened. A friggin miracle drug, my friend.

Naturally, all this has given me a few insights and opinions about hospitals, insurance, and medical care. First, there is such thing as good medical care, but one still has to be vigilant. Summit was awesome, but the quality of nursing care varied greatly from nurse to nurse. One has to be demanding, sometimes, in order to get better care. Specialists are smart people, but myopic. Hematologists, Infectious Disease specialists, dermatologists, allergists, pulmonogists…. After that experience I’m happy to let my family doctor do the coordination and refer me to the right person next time. I have health insurance, and had a couple thousand dollars of out of pocket costs, but thankfully it wasn’t Sicko revisited.

Ironically, I had applied for life insurance right before all this happened. Minnesota Life extended an offer for a policy, then I was diagnosed with Churg Strauss, and then they revoked their policy. Can you say “assholes?” If I’m ever in Minnesota, I plan to jog several symbolic laps around their HQ. We called several other insurance companies. We called an insurance broker. No one wanted to touch me with 10 foot pole. But just last week, a company came through. The policy ain’t cheap; no preferred rates for me! But as we get ready for our son to be born, I’m thrilled to have it. I feel so incredibly lucky.




Meetup after CommunityOne

29 04 2008

A quick message… Atlassian is sponsoring a Javabloggers meetup at Thirsty Bear downtown San Francisco after CommunityOne (May 5, 2008). Free beer from 7:30pm!




Yawn 2.0 Expo

28 04 2008

I’m finding it painfully difficult to write an interesting blog about the Web 2.0 Expo that took place last week in SF. That’s because the show — at least from my vantage point on the expo floor — was painfully plain. Where were the coolest, latest, greatest Web 2.0 technologies? The Twitters, Facebooks, YouTubes? While I’m sure they were being used on people’s laptops and iPhones, they were otherwise invisible on the expo floor. Vassil Mladjov gets it right” “There was not clear innovation that I can see at the show, nothing to get me exiting.  There were a few clever tools in terms of clean UI and well execute ideas, but nothing of a WOW.

Instead, the floor was dominated by B2B apps and infrastructure companies like F5 and Juniper networks, ie, companies that can make your Web 2.0 apps run faster. That’s not to say that there weren’t interesting and cool companies there like Atlassian (the company I work for :) ), Gomez, Sprout, and Automaticc, but they weren’t the ones that dominated the show floor.

To look at it another way… the companies that were exhibiting there were the ones that actually made money and a few VC backed startups. Of the ones I mentioned above:

Gomez is a great company that I had had experience with during the dot com era. They monitor website and network performance. I learned, too, that one of their developers, Patrick Lightbody, was an early contributor to Atlassian’s products.

Sprout had a very interesting Flash authoring tool that I could see us using some day for creating microsites.

Automaticc… needless to say, I’m a big fan of WordPress.




The new face of spam

17 04 2008

Many months back, I got an offer from someone to pay me for posting spam. Today, I receive this email. If it’s not spam, then it’s from a really stupid writer that failed to read my blog (and you know what happens to those people!):

Hi Jon,

I recently started writing work for RN Central as a content writer. I would like to write a guest post related to medical/nursing/healthcare on your site if you’re interested in accepting such a post. If you are interested, please let me know and I can send you an article for you to look over.

The Deal:

I will write a good, useful posts/articles on medical/nursing/healthcare specifically for your website/blog, free of cost. But I will need a by-line to build up my writing career. In addition, there will be a link to the RN Central site in the by-line. So, it will help all parties concerned.

Sample posts written by me:

http://www.rncentral.com/nursing-library/careplans/how-to-get-cheaper-healthcare-without-insurance

http://www.rncentral.com/nursing-library/careplans/20-surprising-ways-wal-mart-clinics-affect-us-healthcare

Both articles were widely read and received numerous links from other bloggers.

Thanks for your time and I am looking forward to your reply.

Thanks,
Heather Johnson

It has evolved!




Fear and loathing of NPS

27 03 2008

Jackie Huba at The Church of the Customer has blogged about Mouthonomics — the financial windfall from word of mouth marketing as measured by a company’s Net Promoter Score (NPS). It was a comforting blog to read, especially after all the snarky comments I’ve read about NPS recently. One thing’s for sure, there are no end of opinions about NPS. For an unbiased discussion of the strengths and weaknesses of NPS, I can’t recommend enough this report (PDF) by Justin Kirby and Alain Samson.

The Ultimate Question

We just ran our first NPS survey and I published the results publicly. My feeling is that it’s a good number to track, but it doesn’t give you all the answers. It’s a metric, nothing more. For what it’s worth, I think it’s a better metric than revenue growth for helping companies to predict future growth; it’s a good bellwether.

More important than the metric is the feedback (we include an open text field and prompt respondents to tell us why they gave us the score), including the feedback from the 7’s and 8’s, the so-called passives. Frankly, many of the passives gave us better praise than the promoters (9’s and 10’s), and many of the promoters had strong criticism. ie, you can’t just look at the number and rest on your butt. The true work begins after the survey to try and address the concerns and issues that customers are experiencing.




Cash for code

25 03 2008

Codegeist banner

Atlassian is running its 3rd annual plugin competition. Apologies to Gandhi for this year’s theme–be the code you seek :) Cash prizes keep going up year after year; six winners will receive $5,000 cash plus other goodies.




I know what they meant, but…

20 03 2008

Seth Godin recently wrote Why bother having a resume? and then went on to argue that job seekers would do better to have a great reputation and extraordinary letters of recommendation. “A resume is an excuse to reject you.” Note that Seth came to this insight after sifting through resumes of interns, ie, people that most likely don’t have enough job experience to write a resume.

I know what he means, at least I think I do — that marketers should position themselves as brilliantly as they do their products or companies — but how many of us are known outside of our companies, in our industries, or outside of our industries?

Cover letters and resumes are vital, in my opinion, for helping candidates stand out from the pack. But to toss out resumes altogether is just bad advice. Good resumes can differentiate candidates. All the other things he mentions, like blogs and letters of recommendation, can fill in the picture.

In other news, GroupSwim chose to insult their customers and their customers’ customers. Here’s the headline on their website:

groupswim tagline slogan

I know what they mean, but… let’s break this down. You’re saying that people are smart but they’re using dumb software. That means they’re dumb, or at best ignorant. And (here’s the kicker), you’re the dummy that picked it for them. You dumb, dumb, dumb IT person. Dummy.

Apologies to GroupSwim. I’m sure they’re smart folks, but they need a smarter slogan.

Rant over.




The photography of Rebecca Rome

20 02 2008

Disclaimer: Rebecca is my niece, so I’m hopelessly biased on the fact that she’s a tremendously talented artist. She was interviewed at myartspace.com.

Need your photography fix? Read the full interview and see some more of her work here! And how in the world did I end up in a family of so many wonderful artists? Links to their sites are in the right column of my blog.




Death, taxes and The Black Swan

12 02 2008

The Black Swan is the #1 highest selling non-fiction book in the US for 2007.

Maybe it’s because I grew up with a statistician for a father — where you learn among other things that certainty is an illusion, life is full of grays (no black and white) and gambling is a dumb idea — but one chapter into The Black Swan, a book about unpredictability and randomness in every day life, and I’m thinking so what?

Benjamin Franklin summed up the point of this book a long time ago when he said, “in this world nothing can be said to be certain, except death and taxes.” For a less compressed version of this phrase see the plays of William Shakespeare. Even just one or two would suffice. And there are many other novelists and playwrights that deal in the topic of irony as illustrated by the tragedies suffered by their stories’ protagonists.

ie, shit happens.

Instead, author Nicholas Taleb spends about 400 pages writing about those moments that fall outside of the norm.

If you want a predictable way to fall asleep, I recommend this book.




Stella!!!! … and Carolyn Kennedy???

7 02 2008