One small step for man

I went to the Doc yesterday with the hope of being freed of my post-op restrictions and to discuss my various arm pains. Good News: He says: “You may do anything you can do.” (Note the careful grammar). I think we both know that I can do less than I want to do, so off to strength training. I see the PT Monday.

Cautionary News: There is a cyst the size of a pea inside the ball, under the area where the rotator cuff work was done. This may go away as the joint gets more load, or it may require a bone graft to fill the void. Right now its internal to the bone, but we took Xrays and I go back in mid-November (3 mo) to see how its progressing. [Late note: Xray was "good."]

Regarding popping: 30% of people experience this. Its not the surgery, its age related.

Regarding pain in right bicep and shoulder: That is rotator cuff disease. Doc  recommends going as long as I can before treating it. (You bet, given what treating it in the other arm just cost!)

Regarding pain in the left side: Doc shrugs. I’m pleased with your repair. The Gritman Radiologist reports that he doesn’t see anything there (ie, can’t tell it was damaged or repaired). These things take a year to heal.

I’m learning a new thing about my iPad — I knew it about my iPhone, but now it’s becoming really significant. Its my username with an underscore and the way I use special characters in some of my passwords . I’ve been thinking about switching my identity to my Gmail and away from my WSU one, and now I’m going to start. This is going to be a big annoyance, but I think it will make the iPad more useful.

WSU teaching and courses are all above average! I got into a conversation on the bus with a faculty member in Economics about assessment of teaching and learning.

In Fall 2009, as in many semesters past, the College of Ag, Human and Natural Resource sciences asked two questions at the end of its course evaluations. Here is the data on 282 courses with 5756 student ratings spread among them:

What is your overall rating of the instructor in this course?
What is your overall rating of this course?
With possible responses: Outstanding, Above Average, Average, Below Average, Poor

Comment below on the quality of these questions, or on the meaning and utility of this data.

Week of
March 15. March 18 – Just back from the Doc and starting the next 6-week phase which is Physical Therapy to increase flexibility, but not strengthening.  Doc’s two simple rules: 1) keep hand where you can see it 2) don’t lift anything heavier than 12 oz can of pop.

The latter will be hard. The mode of failure will be silent, there will be no pain. The failure will be degradation of the developing new cartilage from the micro-fracture treatment, which will eventually flake, slough off, and I’ll be a candidate for shoulder replacement. (Might have been nice to know this before now as I have progressively begun to cheat, both in and out of the sling.)

Week of March 22: First visit to Physical Therapy Monday 7am. This guy measures rotation from a different zero point than my chair uses. Rather than getting 60, he measures me at 25. So machine – 35. I managed to do mt chairs 160/60 this AM, and am now trying to do wider rotation w/o elevation (faster cycle time). I got to 130/80. Going high and wide was harder than just going wide at elevation 30. I’d need to push the chair to 160/95 to match the Doc’s goals with the PT’s measurement scheme. The PT also gave me non-chair way to do the same exercises. I’ll go to PT Mon & Wed for next 6 weeks.

Tues 23rd Pretty stiff and sore this AM after pushing yesterday. I’ve relapsed. Just did 115/80 by building up from 80/65. The chair goes away today or tomorrow, unless the Doc gives a reprieve. I got the reprieve to March 31 and I’m regretting pushing because the relapse Tues aft is worse.

Wed 24th This AM my PT encouraged that 60 to 80 was a big jump, and that elevation was more important now than rotation. We agreed I’d attempt to get back to 160/60 and then use the next week of CPM machine to move from 60 upward, perhaps 4 degrees for each of 5 days. This AM I got back to 160/60.

Week of March 29: PT this AM helped me not relapse in the chair. I’ve regained the desired elevation, and intend to expand the rotation slowly this week until the chair goes away. Small personal victory, I can now carry a small bar of soap in my left hand to wash my right arm pit.

Criteria for Progression to Phase 2

• At least 6 weeks of recovery has elapsed
• Painless passive ROM to (see data here)
  • 140° of forward flexion
  • 40° of external rotation
  • 60-80° of abduction (swing arm out from side) (not sure if I can do this, its not part of the machine)

Shoulder Motion

Goals

• 140° of forward flexion – progress to 160° (see graphs below)
• 40° of external rotation – progress to 60°
• 60-80° of abduction – progress to 90°

Exercises

• Continue with passive ROM exercises to achieve above goals. (looks like I can get there in one day)
• Begin active-assisted ROM exercises for the above goals.
• Progress to active ROM exercises as tolerated after full motion achieved with active-assisted
• exercises.
• Light passive stretching at end ROMs.

Restrictions

• No strengthening/resisted motions of the shoulder until 12 weeks after surgery.
• During phase 2, no Active Range of Motion (AROM) exercises for patients with massive tears.

Immobilization

• Discontinuation of sling or abduction orthosis.
• Use for comfort only.

Pain Control

• NSAIDs for patients with persistent discomfort following surgery.
• Therapeutic modalities
• Ice, ultrasound, HVGS.
• Moist heat before therapy, ice at end of session.

NOTE: Blue data is first 6 weeks, red data is 2nd 6 weeks on new regime

Finally, recipe below. You seem to need to sign in to Wave first.  Wave below here:

I’m using the Wavr WordPress plugin which I installed in this 3rd party hosted instance of WP. My WP hosted (free) blog does not support Wavr.

waveid is of the form: googlewave.com!w+JPxpNCpvA

I added Embeddy  (embeddy@appspot.com) to the wave, as well as public (public@a.gwave.com) (both set to read only)

Embeddy puts a blip into your wave, with code snippets. This will include a line that shows you the Wave ID, so you don’t have to get it from the URL.

I tried Bloggy, didn’t seem to help, perhaps it works from Blogger only.

I have now removed Embeddy

In Learning, Working & Playing in the Digital Age, John Seely Brown outlines some work at Xerox on training for copier repair technicians (the story starts half way down the page)

First of all, what happens is whenever a tech rep gets stuck he calls in another tech rep and then, standing around the problematic machine, they start to weave a story, a story that starts to explain some of the particular symptoms of the machine. And then some fragment of the initial story reminds them of something else which suggests a few more measurements to make which in turn produces some more data that reminds them of another fragment of a story, and so on. Troubleshooting for these guys is really just weaving together a narrative, a narrative that eventually explains all the symptoms and test data of this machine. And when they have made sense of all the data, the narrative is finished and the machine is diagnosed.

…

To make a long story short, what did we do? What kind of system did we design, because of course as a technologist I was expected to build a system? We created a beautifully simple system, one that involved using two-way radios and no computers. We gave everybody in our tech rep community-of-practice test site a two-way radio, a radio that was always on, with their own private network. Because it was always on, they were always in each other’s periphery. When a tech rep needed help, other tech reps in his community-of-practice would hear him struggling and if one of them had an idea he could move from the periphery to the (auditory) center, adding his fragment of “story” which usually suggested a new test to run or part to replace, and so on. And so basically we created a multi-processing, multi-person storytelling process running all across this initial test site. It worked incredibly well. In fact, it also turned out to be a powerful way to bring new people into the community since a novice could, as I mentioned earlier, lurk on the periphery and hear what was going on and in so doing could be a virtual cognitive apprentice. He could also move from the periphery to the center when he had something to contribute, very much like today’s digital kids are doing on the Web.

Another story comes from the description of George Hotz’ work in summer 2007 to hack the Apple iPhone. He blogged the work, but one can glean from the narrative that he was also on IRC with a group of fellow hackers.

In each case, there is a community of practice and it is communicating with a high bandwidth tool. In Hotz’ case, there was also a following on his blog, getting a lower bandwidth experience.

So contrary to the recent Doonesbury cartoons, the point of the examples above seems to be to have a community of practice and to use Twitter as a way to have your radio always on. So, Twitter’s tag line should be more like “What are you doing that matters to your community?” And in all likelihood, you won’t have a following of thousands, but a small read-write group, that links via its members to other small groups.

Had Twitter been a phenomenon when I did my analysis for Pandemic Flu preparations, I think I would have added it as another of the recommended tools for keeping track of the class during the diaspora.

For the record I’m NilsPeterson on Twitter.

Theron pointed me to David Parry (Univ Texas-Dallas) posting about offering his course online to folks outside the university. Its a graduate class called Networked Knowledge

He says about his proposal:

What I hadn’t anticipated was interest in taking this class from people in my twitter network, mostly grad. students at other universities where a course like this is not offered. So, then I started thinking, why not give the class away for free to those who want it?

It made me think of David Wiley’s venture into the same territory. Some of the assumptions is Wiley’s class about the relationship of traditional teacher and student led the course into some difficulties with the “volunteer” students in week X.

Parry’s post suggests

Grad students who are currently enrolled at another university though could arrange with their home institution to take a directed reading on this material, with a professor at their university signing off on it, perhaps by writing a seminar paper which that professor would evaluate.

Which would require those students to write an extra seminar paper. Seems like busywork for a credential, I’d much prefer to see the course designed starting from ideas in Downes’ Open Source Assessment . I wonder what assessment Parry could set for this course and how he could facilitate the diverse group working toward accomplishing that assessment, how they might provide feedback and guidance to one another, how they might bring in other expertise and perspectives — in short, how they could act more like 2.0 Learners. (this last post was written thinking about elementary ed, but see latter paragraphs for application to higher ed.)

My question would be, in a course on Networked Knowledge, taught to a diverse online group, why not do the Full Monte — strip this course down to an open assessment that the community can engage in.

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