A Philosopher's Blog

DBS, Enhancement & Ethics

Posted in Ethics, Philosophy, Technology by Michael LaBossiere on August 15, 2014
Placement of an electrode into the brain. The ...

Placement of an electrode into the brain. The head is stabilised in a frame for stereotactic surgery. (Photo credit: Wikipedia)

Deep Brain Stimulation (DBS) involves the surgical implantation of electrodes into a patient’s brain that, as the name indicates, stimulate the brain. Currently the procedure is used to treat movement disorders (such as Parkinson’s disease, dystonia and essential tremor) and Tourette’s syndrome. Research is currently underway for using the procedure to treat neuropsychiatric disorders (such as PTSD) and there is some indications that it can help with the memory loss inflicted by Alzheimers.

From a moral standpoint, the use of DBS in treating such conditions seems no more problematic than using surgery to repair a broken bone. If these were the only applications for DBS, then there would be no real moral concerns about the process. However, as is sometimes the case in medicine, there are potential applications that do raise moral concerns.

One matter for concern has actually been a philosophical problem for some time. To be specific, DBS can be used to stimulate the nucleus accumbens (a part of the brain associated with pleasure). While this can be used to treat depression, it can also (obviously) be used to create pleasure directly—the infamous pleasure machine scenario of so many Ethics 101 classes (the older version of which is the classic pig objection most famously considered by J.S. Mill in his work on Utilitarianism). Thanks to these stock discussions, the ethical ground of pleasure implants is well covered (although, as always, there are no truly decisive arguments).

While the sci-fi/philosophy scenario of people in pleasure comas is interesting, what is rather more interesting is the ethics of DBS as a life-enhancer. That is, getting the implant not to use to excess or in place of “real” pleasure, but to just make life a bit better. To use the obvious analogy, the excessive scenario is like drinking oneself into a stupor, while the life-upgrade would be like having a drink with dinner. On the face of it, it would be hard to object if the effect was simply to make a person feel a bit better about life—and it could even be argued that this would be preventative medicine. Just as person might be on medication to keep from developing high blood pressure or exercise to ward off diabetes, a person might get a brain boost to ward off potential depression. That said, there is the obvious concern of abusing the technology (and the iron law of technology states that any technology that can be abused, will be abused).

Another area of concern is the use of DBS for other enhancements. To use a specific example, if DBS can improve memory in Alzheimer’s patients, then it could do the same for healthy people. It is not difficult to imagine some people seeking to boost their memory or other abilities through this technology. This, of course, is part of the general topic of brain enhancements (which is part of the even more general topic of enhancements). As David Noonan has noted, DBS could become analogous to cosmetic/plastic surgery: what was once intended to treat serious injuries has become an elective enhancement surgery. Just as people seek to enhance their appearance by surgery, it seems reasonable to believe that they will do so to enhance their mental abilities. As long as there is money to be made here, many doctors will happily perform the surgeries—so it is probably a question of when rather than if DBS will be used for enhancement rather than for treatment.

From a moral standpoint, there is the same concern that has long held regarding cosmetic surgery, namely the risk of harm for the sake of enhancement. However, if enhancing one’s looks via surgery is morally acceptable, then enhancing one’s mood, memory and so on should certainly be acceptable as well. In fact, it could be argued that such substantial improvements are more laudable than merely improving appearance.

There is also the stock moral concern with fairness: those who can afford such enhancements will have yet another advantage over those less well off, thus widening the gap even more. This is, of course, a legitimate concern. But, aside from the nature of the specific advantage, nothing new morally. If it is acceptable for the wealthy to buy advantages in other ways, this should not seem to be any special exception.

There is, of course, two practical matters to consider. The first is whether or not DBS will prove effective in enhancement. The answer seems likely to be “yes.” The second is whether or not DBS will be tarnished by a disaster (or disasters). If something goes horribly wrong in a DBS procedure and this grabs media attention, this could slow the acceptance of DBS. That said, horrific tales involving cosmetic surgery did little to slow down its spread. So, someday soon people will go in to get a facelift, a memory lift and a mood lift. Better living through surgery.


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Getting Up to Speed

Posted in Running by Michael LaBossiere on November 14, 2009
Lateral aspect of right leg.

Image via Wikipedia

As those who are regular visitors to my blog know, I had quadriceps tendon repair surgery on April 3. I had my first post-surgery run on September 4, doing 2.38 miles (distance courtesy of my Garmin 305 GPS watch). I had my first race on September 12, running the course in about 30 minutes-thus setting PW (personal worst) for the 5K. Of course, being able to do a race at all was awesome for me.

I’ve run many races since then and have gotten my average mile down to 7:18. Of course, that is my old 50K race pace so I’m clearly not back up to speed. However, I have been getting faster each week and I consider that an accomplishment.

While I have faced injury before, the quadriceps tear was the worst one. Getting back from it has been a great challenge, but I have managed by setting small goals and reaching them. Based on my experience, that sense of progress is key to keeping on track and, more importantly, avoiding depression and despair. Of course, the trick is setting realistic goals and meeting them-expecting too much and failing can be something of a morale killer. Of course, setting goals that are too low also does not help. So each week I set a goal of running a bit faster, of being a bit stronger going up and down hills (that is a serious challenge for me), and keeping my morale up. So far, so good.

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Ossification Clarification

Posted in Humor, Medicine/Health, Running by Michael LaBossiere on September 5, 2009
Wolverine: X-men Origins
Image by Satsukiame via Flickr

On September 3, 2009 I had what I hoped would be my last follow up visit for my quadriceps tendon repair surgery. Unfortunately, I’ll have to go back again. The following dialogue nicely explains the situation:

Friend: “So, I hear you had your last appointment. Ready to start winning races again?”

Me: “Well, it was supposed to be my last. Now I have to go back for another x-ray and follow up. Also, I won’t be winning anything for a while, unless it is for ugliest running style. Or, rather, hobble-jogging style.”

Friend: “But, you seem to be doing so well.”

Me: “I am, but the x-ray I had today shows that I’ve got  heterotopic ossification.”

Friend: “Your surgery made you gay?”

Me: “What? No. heterotopic ossification is when bones form in soft tissue. In my case, I’ve got some tiny bone nodules in the soft tissue above the knee. Anyway, being gay would be ‘homo’ and not ‘hetero.'”

Friend: “Your knee is gay and has a bone?”

Me: “Okay, that is wrong on numerous levels. Let me try again. Neither me nor my knee are gay. I have bits of bone tissue that grew in the soft tissue.”

Friend: “Does that give you powers?”

Me: “Um, what?”

Friend: “You know, can you extend bone knifes out of your knee, like Wolverine did in X-Men Origins?”

Me: “No. They just sit there and do nothing other than being vaguely annoying. Much like you.”

Friend: “Are you sure you can’t do that? It would be so cool. You’d be like Knife Knee, the mutant that knees bad guys with his knife knee. You could be an X-Man.”

Me: “Errrrr!”

Friend: “What are you doing?”

Me: “Trying to get that knee knife to work so I can stab you.”

Friend: “Awesome! I’ll start designing your costume and your catchphrase. How about ‘knife kneeing evil in the groin’?”

Me: “No.”

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Week 14

Posted in Medicine/Health by Michael LaBossiere on July 13, 2009

I’m now in week 14 of my recovery from quadriceps tendon repair surgery. I have made considerable progress since then: I can walk, pedal my exercise bike (with both legs), and (sort of) do my Tae Kwon Do forms. Oddly enough, I have started feeling  a bit worse about my situation. I suspect it is because now I can do most normal things once again, it makes it even clearer what I cannot do. I still cannot run, I still have problems with stairs, and I’m fairly slow getting around.

In a few weeks I’ll be able to start a pool running program. That is, I’ll be able to put on the Aqua Jogger and run in place in the pool. I haven’t tried this before, but people say that it is excellent exercise…and painfully boring. After that, I should be able to start running again-although it will be on flat ground and very slowly. I’m looking forward to returning to racing-although I’m sure I’ll be wicked slow at the start. Fortunately, I started out as a really slow runner-so this will be a return to familiar territory. Having been there before, I know I can work my way back to speed again. Or so I hope.

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Quick Thoughts

Posted in Medicine/Health by Michael LaBossiere on June 29, 2009

Although the world is awash in events, I don’t have the time to write a proper blog. I started teaching my summer class today and it was great to be back to that. I did teach a while after returning from my quadriceps tendon surgery, but that was at the end of the semester. It even seemed a bit surreal-hobbling about in a brace with my leg wrapped in bandages, talking about Kant, the ethics of video games, truth tables and liberty.

So, some quick thoughts:

Michael Jackson: Cool music, creepy fellow…too bad he’s dead.
Bernie Madoff: 15o years…will they keep his corpse in prison? If so, who gets to be his cell mate?
Iran: A tiny recount that will amount to nothing. Any hanging chads?
Billy Mays: Who will sell us our Oxiclean? Is that ShamWow guy out of prison yet?
North Korea: Still crazy, after all these years.
Firefighters’ Suit: 5 to 4 ruling goes against her, but shows she’d fit in just fine…at least in the 4.
Sanford: Should call William Shatner to negotiate a cheap one way flight to Argentina.

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More Flexion

Posted in Medicine/Health by Michael LaBossiere on May 1, 2009
None - This image is in the public domain and ...
Image via Wikipedia

I am now one month out from the quadriceps tendon repair surgery. Yesterday I had yet another appointment and my brace was opened up to 70 degrees of flexion. I can’t bend it that far, yet. As you might imagine, after a few weeks with my leg locked in place, my knee is reluctant to bend. In fact, bending it feels very much like lifting weight. Or perhaps more like trying to bend my knee with a huge rubber band taped to it. Suffice it to say that moving it ain’t easy.

I suspect that the difficulty is a combination of a few weeks of immobility plus the fact that my tendon is now shorter. The tear is repaired by anchoring the tendon to the knee with surgical thread until it attaches on its own. So, getting it to bend is both a matter of working on flexibility and probably also getting the tendon to lengthen a bit.

Since the lower leg is under tension, I’ve found that if I pull it back it will pop forward like a catapult. Surprisingly, my cats really enjoy being catapulted across the room-I just place a cat on my foot, pull it back and zip, there goes a cat. It did take a while to get my aim and power down right, as a few cat size holes in the ceiling will attest. I’m sure PETA would be thrilled. I’d be happy to give them a ride, too.

I start physical therapy on May 11. I’m sure that will be suitably painful. I’m working at having full range of motion by then so that the PT won’t have to “help” me by applying a winch or something to my lower leg. My prescriptions says I’ll be in PT for six weeks and I have about another eleven weeks of visits to the doctor’s office (although it is now down to a two week interval). It will be good to be back to normal. Well, as normal as I get.

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Quadriceps Tendon Repair

Posted in Medicine/Health by mclfamu on April 21, 2009
Image via Wikipedia

On March 26th I had a ladder go out from me, resulting in a fall of about eight feet. I struck the wayward ladder with my left foot, thus taking all the impact on that leg. The result was a torn quadriceps tendon.

In the course of getting this injury treated, I found that most medical professionals (though generally very pleasant) seem to take the view that informing the patient is a very, very low priority. Since I am rather concerned about my well being, I did a fair amount of research on the quadriceps tendon, the tear, and its treatment.

Before getting to the discussion, you should keep in mind that I am a philosophy professor and not a medical professional. I’m presenting this information with the purpose of sharing my own experiences and not with the intent of providing medical advice or a diagnosis. If you are injured, then you should see a medical professional. Now that the disclaimer is out of the way, on to the information.

The quadriceps is a group of four muscles that link to a single tendon (the aptly named “quadriceps tendon”). These muscles are located in the upper part of the leg and are connected to the knee cap via that tendon. These muscles play critical roles in allowing people to walk, run, jump and squat. The tendon, as I found out, also serves to absorb the shock of landing.

The quadriceps tendon is normally very strong and rather difficult to tear. However, there are a variety of circumstances in which it can be torn. In some cases, age or a pre-existing condition can weaken the tendon-sometimes so much so that it will tear (or rupture) while walking or due to a minor fall. Among healthy folks, a quadriceps tear is usually due to a fall or an impact injury such as suffered by football players or skiers.

To deal with a quadriceps tendon tear, you first need to know that you have one. In general, you only need to worry about this if you have suffered serious trauma to your knee/leg, such as in a fall, skiing accident, or other such accident. However, there are cases in which the tendon tears without this sort of serious calamity.

In some cases you will hear a “pop” when the tendon tears, although you might not. And, of course, there are other injuries that make popping sounds. The following are common signs of a quadriceps tendon tear. First, you might find that your knee cannot bear any weight at all.

Second, you might be able to stand and walk, but find that your knee will “give” way during movement. In my case, I was able to walk after the injury, but fell down twice before I could figure out how to compensate.

Third, you will experience pain (obviously) and swelling of the knee area. Bruising is also likely. Of course, this is compatible with a wide range of injuries.

Fourth, you might notice that your knee cap is now lower than it should be-you might even see a noticeable gap between the quadriceps muscles and the knee cap. If the knee cap is out of position, this might well cause problems with moving the lower leg (mine would lock up at a certain angle).

However, the defining test of a serious tear is that you will not be able to straighten out your knee against resistance and you will not be able to perform a straight leg lift/raise. A straight leg raise is done in the following way: lie on your back on a flat surface and attempt to lift your leg straight up. If you can do this, then you do not have a complete tendon tear (though you may have a partial tear). If you cannot do this, then the odds are good that you have completely torn your quadriceps tendon.

Naturally, you should not leave it at a self diagnosis. If you have had a serious accident, then you should seek professional help. The professionals will, if they know what they are doing, x-ray your knee and also perform a physical examination. While X-rays do not show soft tissue damage, they will show if the knee cap is out of place. You might get an MRI, but you might not-my diagnosis was based on the x-ray and a physical examination.

If you are diagnosed with a quadriceps tendon tear, then you will most likely be going in for surgery. Partial tears can apparently be treated non-surgically, but that is something you would need to discuss with the doctor.

A complete tear, which is what I suffered, requires surgery-the tendon will almost certainly not re-attach to the knee cap on its own. Here is a page that briefly but effectively describes the nature of the injury as well as the surgery for treating it. Roughly put, they will cut open your knee, drill two (or more) holes in your knee and then run suture thread through the holes to the tendon to anchor it in place.

If you are told that you will need surgery, then here are some things that you should do to prepare.

First, you will need to stop eating and drinking at least 12 hours before the surgery, so plan accordingly.

Second, after the surgery you will be even more disabled (you’ll be in pain and in a knee immobilizer, brace or cast) so be sure that you have a ride home and that your home is ready for your return. You will need to keep your leg elevated, so have some pillows set up on your bed for that. In order for the elevation to work, you need to be truly elevated (above the heart). Sitting in a recliner with the leg rest up won’t cut it. You won’t be able to shower normally, so I would suggest getting one of those shower heads that have a hose attachment. That way you can wash your hair by standing beside the shower stall. You should also get some liquid body soap. I’ve had to replace my shower by washing myself from the sink using the liquid body soap in water first and then rinsing with plain water and a wash cloth. Get some baby wipes for areas that you’d rather not use the same washcloth that you use on your face.

You will most likely arrive at the hospital/clinic a few hours before the surgery. After you check in, you will probably be brought to a waiting room. While you wait, you’ll put on a gown, have blood drawn, be hooked up to an IV, and given a pill to keep you from getting an upset stomach (take it). Then you will be wheeled down to the prep area and given an antibiotic (attached to your IV). You’ll meet the surgical team and then its lights out-the operation is performed under general anesthesia.

If all goes well, you’ll wake up in the recovery area, hooked up to a machine that lets the nurses know that you are still alive. You’ll be in some pain at this point. After that, you will be wheeled to a waiting room, given some pain medicine as well as water. Drink plenty of fluids-you will most likely be rather dehydrated from not drinking. I know I was.

The surgery is usually done outpatient, so you will most likely go home that day. If you are having problems, then they will keep you overnight. I went home that day. Be sure to get the instructions from the physician’s assistant who will speak with you. You will most likely get prescriptions for pain killers, muscle relaxents, a blood thinner, and a stool softener. Get them all. The pain killer and muscle relaxant functions are obvious: you will be in lots of pain and will want to kill that. I’m rather tough (I’ve run ultra-marathons and have a black belt) and I used them the first few days. The blood thinner is to keep you from getting blood clots. You’ll also be told to do “foot pumps” to keep the blood flowing. Do those religiously-you don’t want a clot.

While you might be tempted to pass on the stool softener, do not. I repeat, do not. Be sure to drink plenty of water and eat normally as soon as you can. Also, go to the bathroom as soon as you can. Otherwise, you will have some unpleasant problems (just imagine trying to pass packed clay…that should be sufficient motivation to use the softener).

For the next two weeks, your main job will be to rest and recover. Depending on what your doctor says, you can probably move around somewhat, but be careful. Aftter those two weeks or three weeks, you will have the staples removed from the incisions and you will probably have the immobilizer replaced with an adjustable brace. If you are in a cast, then you will probably be in it for six weeks. Lucky you.

The PA will most likely tell you to not remove the immobilizer for any reason for a week and then only to change the dressing a week after the surgery. Heed his/her advice. The immobilizer is there to prevent you from moving your knee because doing so could ruin the surgery. Resist the temptation to take it off-a fall or a moment of forgetfulness can be all it takes to ruin the surgery!

As I write this on April 20, I’m 17 days out from the surgery. My leg is in a locked adjustable brace and is also wrapped in an ace bandage. I can move around well on crutches and, when this blog is posted on April 21, I will be back to teaching.

I’ll write additional posts as I go through the recovery process.

Update (4/11/2011): I’ve written a short book about my experiences with quadriceps tendon repair. It is available at Amazon for the Kindle and at Barnes & Nobles for the Nook. Both versions are 99 cents (and might even be worth every penny).

A Handicapped Unfriendly World

Posted in Medicine/Health by Michael LaBossiere on April 20, 2009

Thanks to my quadriceps tendon repair surgery, I am now among the temporarily handicapped (or “differently abled” if you want to be stupidly PC). I cannot drive (my leg is locked and I cannot fit into the driver’s seat of any available vehicle, including my own pickup truck). I can only move about semi-effectively on crutches (although I suppose I could hop quite a ways on my right leg). While I have been intellectually aware of how difficult it would be for the handicapped to get around, now I have real awareness of this.

One thing I have noticed is that most buildings are not well set up for people who cannot walk about normally. While some buildings do have access ramps, many do not and navigating stairs with one functional leg is a bit challenging-especially when the stairs are rather narrow and steep. I normally loath elevators, but now I notice the absence as I try to work my way up and down stairs.

Doors are also something of a problem. For example, I recently came to notice that most bathroom doors are set to swing shut with a fair amount of power (but relatively low speed). Trying to push open such doors and get into the bathroom required a bit of practice (and speed). Speaking of bathrooms, most older buildings are not equipped for the handicapped. While I could manage to get on the toilet, I’d have to leave the stall door open so my leg would fit out. I won’t be doing that, though. I’m reasonably sure that no one wants to walk in on a dude on the bowl.

Other doors are also rather hard to operate one handed; but I suppose that is how they need to be. Otherwise, they would just stay open and allow bugs, heat or cold into the building. Some buildings do have those handy handicapped door buttons, but most do not.

The buildings on my campus tend to be fairly old and hence they have been exempt from being updated to the current standards for access. Naturally, the building where my office is located is particularly bad.

While I normally liked the hills on campus, now they pose quite a challenge. My school has dealt with the hills by putting in lots of outside stairs. Naturally, to get from one class to another, I need to navigatemany of these stairs. I’m trying to recall some alternative routes that will avoid the stairs-hopefully that will be possible.

I have heard people argue that providing handicapped access is expensive and needless. While it is expensive, it does seem worth having for those who lack standard mobility. Naturally, it could be argued that there are few people who need such access and hence it actually is a waste of money. After all, that same money could be used to benefit the majority of people who have normal mobility.

From my own experience, I can only recall seeing a very few students and faculty who actually needed to use the access features. Of course, it might be the case that people who have such handicaps simply decide that it is not worth the effort of dealing with such a relatively poor degree of access.

While my handicap is not particular serious or permanent, this experience has given me a new perspective on the world and what some people have to cope with on a daily basis.

One Legged Exercising

Posted in Medicine/Health, Running, Sports/Athletics by Michael LaBossiere on April 16, 2009

Before the fall that tore my quadriceps tendon I worked out by running and doing Tae Kwon Do. Unfortunately, both of these activities tend to require two functioning legs (although there are exceptions). Since I have no desire to become fat, insane  and weak during my long recovery, I had to find exercises that I can do that will meet my needs.

In some cases, I can keep doing my old workouts. For example, although I cannot do the proper stances with my leg locked in a brace I can still punch my punching bag. Naturally, I have to be careful to avoid damaging my knee, but I can still get in a decent workout. While I cannot kick properly, I can still do leg lifts with my bad leg. I suppose if I was really ambitious, I could rig a suspension harness so I could kick with my good leg. But that would be just a bit too weird, even for me.

Since running is out, I had to find something that would work my good leg and also help keep my cardio up. I can’t swim yet (no bending the knee and the brace foam shouldn’t get wet). Fortunately, my friend Dave came through for me. He had an exercise bike he was not using and brought it over and set it up for me. It is the type that has the pedals with the toe straps, so I can pedal with one leg. I replaced the factory seat with the nice gel seat from my bike (won’t be riding that for a while) to keep my bits from suffering too much.

When biking one legged you have to be careful not to overdo the leg-after all, it is doing all the work on the down pedal and up pedal. If your leg is immobilized like mine, then you also need to get it out of the way-I prop mine up on a padded stool. I’ve found pedaling a stationary bike to be rather boring-I cannot get into that runner’s groove yet. So, I watch TV as I pedal away. While it is not as good as running, it does help satisfy my need for exercise and it is helping to keep my cardio from dropping too badly.

I have also started using a home gym. I first started with the “Chuck Norris” home gym that my friend Dave loaned me. But, the device works with a slideboard: you provide the weight/resistance by lying on a padded board that slides. I used it for a while, but before the surgery the doctor warned me to avoid hard landings. Looking at the machine, I had a vision of the board sliding off and my foot slamming into the wall (interesting, Dave said that assembling the device scared him out of using it).

So, I bought a Bowflex PR3000 Home Gym. When I bought it, Amazon had a great deal-I got $300 off the base price, then $100 off because of some special and also free shipping. It arrived yesterday and Ron and I set it up today.

It was quite an adventure. While taking me to my appointment this morning, Ron managed to trigger some awful back problem that has plagued him on and off over the years. So, whereas it was supposed to be one disabled person going to the hospital, it ended up being an adventure of handicapped proportions.

After we got back, Ron surprised me by wanting to set up the Bowflex anyway. It was quite a show: I couldn’t bend my left knee and Ron couldn’t bend his back. I also cannot move around without a crutch, so I had to one hand carry things. Although it was hardly sensitive, I couldn’t help but joking that we should have filmed it and put it up on YouTube as “two crips and a Bowflex.” Yeah, I probably bought some time in PC Hell for that remark, but it seemed funny at the time.

Once we got the Bowflex assembled, we gave it a quick try. While I haven’t done a proper workout on it yet, it appeared to be well constructed and seems like it will work well. I cannot do anything with my left leg yet, but the Bowflex makes it easy to work out. Rather than needing to deal with free weights (try moving those around on crutches) I can just sit on the Bowflex chair and do a decent upper body workout. I can also work my good leg, provided that I am careful. So far, I’m pleased with it. Naturally, I know that a Bowflex is not going to turn me into some sort of bulging beast. But, that is not my goal-I want something to do while I wait for my leg to heal. Also, I have been wanting to do more moderate weight training and now I have the motivation to do it.

One Week After Surgery

Posted in Medicine/Health by Michael LaBossiere on April 10, 2009

A week ago I underwent surgery to repair the torn quadriceps tendon in my left leg. That was, as you might imagine, not one of the more enjoyable experiences of my life.

At this point, I’m doing better than I expected. While I do have some trouble sleeping (you would not believe the nightmares I had for a while-most involving my knee cap popping out of my leg) and my leg is immobilized, my outlook is still positive and I have not (as of yet) had any psychotic episodes. Since I’m a running fanatic and haven’t been able to run in a couple weeks, I am worried that it is just a matter of time.

Today was the day I was finally allowed to change the dressing on the wound. Fortunately, one of my close friends, Ron,  is married to a nurse and she agreed to help out. As she peeled away the various layers of bandages, I vaguely wondered what horrors I would see. Fortunately, the bleeding had been very minimal and the incisions were already healing nicely. Of course, it was just a bit creepy to see shiny metal staples sticking in my flesh. Naturally Ron took a picture of the knee-he is a sensitive sort of guy.

Seeing that things were healing up nicely helped keep my morale up and being able to reduce the amount of gauze stuffed under the immobilizer has been great. This coming Thursday I am supposed to get the staples removed (I wonder if I can keep them…) and a hinged knee brace. Since I plan on using a stationary bike (thanks Dave!) to keep my cardio health up, it will be nice to have something that will handle sweat better. The immobilizer handles sweat by absorbing it and then getting stinky. Hardly an optimal solution.

I am supposed to be able to go back to work the week after next-I’m looking forward to that. Grinding through student emails, downloading student papers, and setting up two weeks worth of classes online has made me work way too much for someone out with an injury. On the plus, side, it has kept me busy and given me a continued sense of purpose.