Health

What I wish I knew before getting LASIK a month ago

October 16, 2023

tl;dr as a middle aged bloke with subtle near-sightedness, the juice may not yet be worth the squeeze getting LASIK!

I walked into a LASIK exam room just over a month ago and in a comically short time I walked out again with different curves in my eyes. If I could go back, I would probably not go through with it.

This isn’t the story of an operation that went shockingly wrong. I’m not blinded. The outcome was a success, but it oddly feels net neutral or worse.

I’m writing this as something I wish I had found when researching the procedure, as I feel a lil sheepish that I didn’t understand where I would be on the flip side. The information is out there, I just didn’t see it.

I will walk though:

What was the state of my eye sight before?
What was the state after surgery?
What about now?
What do I hope for?

NOTE: I am obviously not a professional and this is just one account from a layman on his experience in the hope that it may help someone go a lil deeper on their knowledge gathering!

What was the state of my eyesight before?

I have been wearing glasses since I was a kid. I was nearsighted (right eye: -1.00, left eye: -2.25 at my worst) with a slight astigmatism to boot.

While I wore glasses, I was far from blind without them. If I wasn’t driving or reading I would be fine without them. On vacations I noticed that I would go without glasses for a significant amount of the trip.

My eyesight changed over the years, and most recently it improved when I lost weight. I would see changes that mapped to my blood glucose levels. I fluctuate here, but the range is much smaller so my sight has stabilized along with it. As a bloke in his later forties, I knew that I had a future where I would need reading glasses, before I hopefully get to the cataract period where I get lenses put in. Or by then maybe something even cooler? 🙂

I have had friends and family get Lasik surgery over the years, and they (almost) all raved about it. So many of them spoke on how much of a game changer it was to their life.

I was waiting for some stability with my sight, and then when yet another friend had it done and bemoaned why they waited so long I decided to look for a great surgeon and see if I was a good candidate.

After being checked out, I appeared to be a great candidate. The changes needed were minor, and I have a thick cornea which seemed to be a good thing (and would allow for potential fixes after the fact). Monovision was briefly mentioned, where one eye is correctly for long and the other for near. This seemed interesting, but I was somewhat pushed off of this as an option saying it compromises driving and other situations.

So, I ended up signing up. On the day of the surgery there was one concern that my brow projected and the neaderthal genes that 23andme told me about may mean that it would be hard to get the suction cup in place. I was told that if that was the case they could switch to PRK instead of Lasik, but I wasn’t ready to make an audible on that given the length of time it takes to recover from PRK. I do note that in the pre-op setting I was often told how many of the surgeons themselves opt for PRK and think that it’s a much safer option (no flap and all that). But still, Lasik or bust for me.

They were right about my eye socket, and had to really push it in there to get the suction. This was the only part of the experience that hurt at all… and it wasn’t that bad. 30 seconds of suction and then I got to see the light show for just a couple seconds… it was nothing! Then to the other eye. After taking the chill pills I found myself outside and ready to go home and sleep for a few hours as I had been instructed to do.

What was the state after surgery?

After a lot of sleeping and eye-dropping I noticed that my long range eyesight was amazing already. My eyes were a lil scratchy but really not bad at all. Already! I was excited.

But then I picked up my phone and realized I couldn’t see a thing unless I used my arms to make the phone and my eyes be as far apart as possible. I also had the halo scattering around lights at night time. Oh well. It’s early. I went to my optometrist for the “day after” check in.

This one day check up told me that:

My left eye was over corrected, and I may have to go back and have a change done in that eye
It’s only day one, so be kind to myself, and let me eyes heal
It’s dry in Colorado. Keep those eye drops coming!

I then started on the purchase of what would become many different eyeglasses. I got some readers, so I could …. read again. I then went on to order sunglasses, bifocals, progressive multifocals, halfmoon glasses, computer glasses… thank god for these websites with great cheap glasses to try, such as Zenni!

What about now?

I am now just over a month into my new eyes. I have been to my one week, and one month appointments.

As my eyes healed, they have continued to change. My far range is like 20:10 and I feel like an eagle. My left eye changed and isn’t over corrected, so I won’t have to go back for any changes (hopefully!).

My short range? It’s improved, but it’s still a bit of a frustrating experience.

Before, I could pop out my phone and read it without my glasses. Everything was kinda OK, even if blurry, and then my glasses were progressive enhancements. When I go for a swim, I don’t need my glasses so I just swim away. I put on my glasses for the day and everything is good… until I fall on my arse playing pickleball and my glasses fall.

Now, whenever I reach for my phone I need to plop on some goggles. With progressives, I can flip back to wearing glasses most of the time, but then I am back to where I was? Ok.

I knew that I wouldn’t be done with glasses for ever, and that my age would soon resort in reading glasses. I just didn’t appreciate that my near-sightedness was helping here, and that DUH by getting that taken care of would zoom me into a future of not being able to see things close up as well as I could before!

So, I kinda wish that I had either:

a) gotten LASIK a long time ago and thus had more of the benefit before my eyes were old

b) not gotten it yet, and just kept going… and bumping up progressive lenses with age.

What do I hope for?

It’s still one month in. Maybe my near sightedness will improve a lil (as it has done over the last month). I have ordered some killer progressives that I am excited to try… and will probably back up to wearing them most of the time, but also changing to readers and computer glasses when doing deep work, and at least I can go without when I play sports!

I will consider monovision in the future, either using my thick cornea… or maybe at that cataract time, and will learn more about the true pros and cons.

All in all, it’s obvious, but you really do often end up jumping between far and near… especially with phones in your pocket?

/fin

I will update this a few months in if something has changed!

Taste and Nutrition on the Web

January 24, 2021

We need to talk about taste on the Web. There has been a lot of talk about nutrition, and making sure that you have all of the tools you need to understand the nutritional content of your website, which we call Web Vitals.

Web Vitals numbers are certainly vital, but they don’t tell the full tale, just as a nutrition labels don’t tell the full story of the meal that a customer will consume.

These two extremes on the spectrum do not result in an appealing Web at all:

The Web is fast (nutritious), but bland.
The Web is tasty, but makes everyone sick.

I am excited about a fun, vibrant web that manages to offer a plethora of tastes, but takes users health seriously, too. I think that we have seen a Web that is fun and creative. Some of us even miss corners of the Web that were possible due to the ingredients of Flash and its editor tools. We don’t want a Web that is as bland as the constraints of some social networks (MySpace certainly had some crazy fun though! 🤪)

A tortured analogy of my health journey

I have had quite a journey with my health. I thought I had cracked it, but have continued to learn a lot more, especially with access to smart tools that give me access to data. For example, I use a continuous glucose monitor that tells me roughly how much glucose is in my system. This is like running Lighthouse CI for human vitals, and frees me to run experiments on my body.

I have been able to test the effects of almond flour (doesn’t spike me, whereas regular flour does), or replacing sugar with allulose (also doesn’t spike me), or how exercise (even a brisk 10-20 minute walk) right after eating brings down the post meal glucose.

I can use many other tools to take other vital measurements, such as tracking if I am in ketosis or not via a breath monitor, tracking my heart rate variability (HRV) when sleeping with an Oura, and with integrations that bring together all of the data via Levels.

Continuous measurement is key

I made some lifestyle choices, and the first one was to measure. If you aren’t tracking the health of your body or your website, you are destined for drift…. and trust me it can start slow and then you wake up having a large hill to climb again. I recently had to jump back and have lost 60 pounds with 10 more to go to reach my goal BMI (NOTE: BMI and weight aren’t great measurements, and I look at my blood work as the gold standard, but they are helpful proxies to progress).

Enjoy and live life!

I grew up seeing the Jane Fonda aerobics era, and seeing many people in my circle basically starving themselves and eating rice cakes that tasted like cardboard. This isn’t sustainable, so it doesn’t work, and it’s a really tough way to live. Crash diets don’t work in the long run, so you have to make a choice on what you want your long term sustainable lifestyle to be.

I want to enjoy food. I want to enjoy the taste of food. If I am hungry all the time this is the sign that there is a bug in the system. This all lead me down the path of acknowledging that I fatten easily, and carbs don’t work with my body. They flip a switch that has me go into fat storage mode, and also put me in hungry mode all the time. I can’t have one chip….. I scoff the entire bag. Moderation doesn’t work for me. I had to own it.

Gary Taubes helped educate here many years ago with his books on Good Calories, Bad Calories, and he has a new one that hit home once again: The Case For Keto.

I am going to enjoy food, but use a well-lit path that helps me do that, and keeping out of a restrictive world of how much I can eat. I want to eat to satiety. This puts other constraints on me…. I can’t eat certain carb-heavy foods that I love. But then I remember that I CAN enjoy certain berries with heavy whipping cream. Not too shabby!

Once in mostly-ketosis, I am never hungry. This has enabled me to test out tactics such as time restrictive fasting (TRF). Keeping to 16:8 is simple, and I have also enjoyed simply one meal a day. I also kicked things into gear by taking on some prolonged fasting (3 to 4 day fasts) and was amazed with how, other than boredom, it wasn’t hard to do…. but it would be impossible for me to have done this in carb mode.

I mentioned almond flour earlier. Since I am tracking everything, it allows me the freedom to experiment and find the balance of: something enjoyable and tasty that contains the right nutritional profile. The Almond flour crepes and scones that I have had this weekend aren’t THE most yummy I have ever had, I will admit that, but they WERE enjoyable. That’s the bar for me…. get me 80% there. If the result isn’t enjoyable then why eat it? It’s off the list and I am on to the next experiment.

Back to the Tasty, Nutritious Web

Let’s bring this back to the Web 😅. I know that it sometimes feels like we are always talking about nutrition, and shoving the label in front of your faces. I apologize if it comes across like this at times.

What I ask of you is to consider the balance of taste and nutrition. You are the chefs of your experience, and you should feel the creativity of making amazing meals that acknowledge users needs the hidden costs.

It’s a mind shift. Instead of “Eek, I can only use Xk of JavaScript, and I should keep the experience simple!”, think “I have some constraints, but I want to use all the tools and ingredients I have to deliver something tasty!”. Sure, maybe don’t shove a few MB of JavaScript and have it run on the main thread, but how about thinking about other loading strategies?

Do work in a worker thread that isn’t as expensive for the UI (allulose bypasses the liver!)
Delay loading some of that JavaScript (preload, prefetch, tree shaking, etc)
Start fast (maybe server side render the initial payload), Stay Fast (using service workers and loading)

Constraints are always part of the creative process.

Now, what about the role of the Web Platform? We want to make our PLATFORM tasty and nutritious for you the developer! What does that look like?

Give you new ingredients that are performant, and you can wield in new ways (e.g. new declarative primitives such as constraint layout, various worklets)
Have some of the ingredients be low level (primitives) so you can put them together in new and interesting ways, but ALSO offer higher level ingredients (components) so it doesn’t feel like we are handing you a cow and saying “make a meal from that starting point… THANKS!”

This is where I am very interested in engaging as the broad and diverse web community that we are. We have a general purpose platform, but we have room in zooming in and delivering purpose-built solutions. You don’t need the same ingredients and tools to build a blog as you do building a rich productivity platform…. or a commerce experience…. or a game.

We have a broad tent on the Web… or maybe a broad kitchen. I am excited to see the tasty meals you build for users, and learn how you made them.

Have you seen or built something tasty recently? If so, please let me know… we want to highlight it!

Almond Flour Crepes… don’t look too bad, right?

Our Web Obesity Epidemic

June 8, 2016 Leave a Comment

We have a digital obesity epidemic that is mirroring the real-world obesity issue facing many of our civilizations around the world.

These things creep up, and a subtle misalignment in the balance of the force lets one side run away. In the case of our diets there are arguments over the cause: sugar? carbs in general? The science seems pretty clear that the “fat” boogey man was just that. It had a poor name and Ancel Keys happened to do too good of a job selling it as the enemy.

On the Web our page weights keep growing. With more pixels on our screens we use larger assets. With richer applications we throw down more JavaScript. Business threw in more JS SDKs to show more ads.

We looked at South Korea and their fiber lines, and kept eating away thinking that the network and desktop machines were such that our pants were stretchy and we would be AOK.

But then mobile happened and we found ourselves trying to squeeze into our wedding dress or tux from 10 years ago. Oops. It doesn’t work.

Now we find ourselves as a population looking to get back to a stable healthy midpoint. Now, we aren’t all in the same camp, and it is important to empathize with the fact that every person is on their own stage of the journey to their ideal weight, optimized for their health.

For those who are obese and are ready to make a change, they are looking for the right path. So many of us look for a quick fix when it comes to weight and a pill to save you.

AMP is a prescription drug and vitamin all in one. It does give you a quick path for certain use cases. You will have real constraints, but it can be a great choice to get going. Start taking the pill and you will have content that is bonafide fast. Chances are that you will want to add a richer experience for engagement, and that is where you will want to go beyond AMP. Fortunately, Alex Rusell laid out the connection on how to put AMP and PWA together.

If AMP is the pill, PWA is the path to a healthy web lifestyle.

Whether you take the pill or not, today is the day to start a healthy lifestyle, making sure that your entire experience is fast, safe, resilient, and engaging.

When someone is on this journey it is important to encourage and support them. This is another reason why we set a bar with PWA and Lighthouse, but we cheer on every step in the right direction. We cheer Flipkart for coming back to the Web, making a great experience that has fantastic business metrics, and they keep going by growing the reach. Was it ideal that the first version didn’t support iOS? Sure. But they came through and supported UC, then Safari, and we will soon see support added for Firefox and Edge.

If someone stops on the journey, that is the time that we need to step in and keep pushing them. If they finish up with a pwa.foo.com side that only works on mobile, we push them. But if they are still moving and progressing, we shouldn’t pre-judge.

That being said, if we see someone taking the wrong path, such as going all in on a low-fat diet that we know is a hoax, we should step in. We should do everything we can to educate people and help them make the right choices.

The best way to fight this is to start early. If we can get our youth on the right path from day one, they won’t have to go through the legacy pain to get back on track. To this end we need to setup the green field projects so they are fully responsive, on http2, and follow the best practices that we have to offer. There is still a lot of work to do here.

When a developer starts a new project, which diet do they choose? Which one is The Right One?

There will always be choices, which makes it more important to use data. We need to set the bar and hold choices accountable. If your framework choice ends up with something that passes lighthouses tests, GREAT! These diets and frameworks are a means to an end, not the end itself.

The measures that you choose are then very powerful and important. Is BMI the perfect metric? No. But it may be a nice general measurement for the masses, and for the individual you should go deeper. Once you get to a decent BMI you can then go deeper and get more measurements that tie to yourself. These will be very different depending on your goals. Are you looking to be good at a certain sport or lift heavy weights? Or are you a long distance runner? Are you looking to be a high engagement entertainment site, or a transactional market that wants to help users get in and out as fast as possible? Measure what is right for you.

We are in interesting times. I think we all acknowledge that we have a serious problem. Fortunately, we have the capabilities in the platform to be healthy, the masses just aren’t there yet.

As someone who has been on the literal health journey, and is still fighting that fight, I know that it isn’t easy…. but it is life and death. Let’s do this.