Knee Surgery (ACL Reconstruction) Journal

17th June 2009

In an unfortunate event of mugging and assault, I severely damaged my left knee.There are four ligaments in and around a knee: ACL, PCL, MCL, and FCL. ACL and PCL corss each other and are at the center of the knee. They help prevent excessive forward and backward movement of the knee. MCL and FCL are around the knee and prevent sideways movement of the knee. Lastly, there is a meniscus that acts as a shock absorber and prevents rubbing of thigh and shine bone and, thereby prevents arthritics.

In my case, I completely broke ACL and MCL. Also, the lateral meniscus got displaced but the extent of its damage can only be determined during surgery.

19th June – 25th June

I saw four orthopaedic specialists, each having a different opinion, suggestion and a rational. Below is a table comparing their suggestions and arguments.

Specialist	Saw on	ACL Reconstruction	MCL Reconstruction	Fixing Meinscus	Surgery Time	No. of Surgeries
1st	19th June	Yes	No – grows naturally	Yes	After swelling goes down – difficult to operate	1
2nd	23th June	Yes	Yes	Yes	After swelling goes down – difficult to analyze and operate and let the knee heel by itself for sometime	1
3rd	24th June	Yes	Yes	Yes	After swelling goes down	2: ACL surgery should be followed by leg extension physiothearphy. Whereas MCL surgery should be followed by giving a knee rest for two-three weeks. Thus both cannot be operated at the same time
4th	25th June	Yes	No:  grows naturally	Yes	As soon as possible. The major concern for him is lateral meinscus. If not treated soon, lateral meniscus might get more damaged increasing chances of arthritics	1

Jun 26th 2009

I decided to go with the fourth specialist. However, If one goes with the above table, the fourth specialist has a very unconventional beliefs. In contrast to all other specialist, the fourth specialist has suggested for a surgery as soon as possible. Nevertheless, my decision to stick with the fourth specialist is based on the fact that he is affiliated with big sports team and specializes in ACL reconstruction. Another big motivation is that I wan’t to get rid of this knee pain as soon as possible and getting surgery quickly done will help with alleviate this problem.

June 30th 2009
Follow up meeting with the fourth specialist. To reduce swelling, the doctor took out some blood from the knee. This helped both in reducing the pain and swelling

July 1st 2009
Surgery started at 1:15. Doctors gave me general anesthesia and bored three holes in my knee. A cadaver was used to reconstruct ACL. Doctors were able to salvage lateral meniscus.

July 2rd 2009
Follow-up meeting with the specialist. The specialist saw the knee and asked his assistant to take out some more blood from my left knee to reduce swelling. Gave me some instructions and asked to visit him again after a month

July 3rd 2009
Started using CPM. The other machine, ice-therapy machine, was not so useful. I found using regular ice pack to be more convenient.

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30 Day Workout Challenge

Challenge: Go for 30 days workout streak.
Motivation: They say it takes 30 days to make a habit.
Starting Date: 17th May 2009
Rules:

1. Keep track of thoughts. Especially note down all the positive and negative thoughts.
2. No breaks. Although, on some days I can go for easy workout such as walking only. However, break days should be at-least 3 days apart.

Contestants

Meet the two contestant of this challenge.

The Procrastinator	The Achiever

The Procrastinator: He is one powerful evil and the master of rationality and logic. But the problem is he uses rational and logical argument to procrastinate things. He is very active only in building logical arguments to procrastinate important things in life. The very existence of this challenge is because of this powerful procrastinator.

The Achiever: He is a weak humble soul who wants to achieve lot of things in life. He believes in hard work but often losses to the procrastinator.

Ever since I existed, the two have struggled to gain control over my mind. Generally, its the procrastinator that wins.  Let see who wins this challenge.

Score board

Scoring mechanism: if I go to the gym, the achiever gets a point. Otherwise, the procrastinator gets a point

The Achiever:   6
The Procrastinator: 1

The Debate

Day 6 – Friday May 22nd

• bummer….so finally procrastinator got a point. Yesterday I thought I will go to gym after in the evening. However, in the evening got busy in party and came back home at 10 PM. I could have still gone to gym as the gym is open 24 hrs and is just one block from my apartment. But, influenced by the procrastinator, I started watching a movie.

Day 5 – Thursday May 21st

• I guessed today the procrastinator worked silently. Although I went to the gym I was not able to enjoy it.I skipped cardio, but did following exercise
  • 3 sets of compound exercise ( lift, balance, curl and shoulder press)
  • 3 sets of cross-cycle
  • 3 sets of shoulder press (sitting on a ball)
  • 3 sets of triceps extension
  • 3 sets of tricep press.

• Most likely it was procrastinator working silently because of which I was not able to enjoy today’s workout. But it might be also possible that I need to allow my muscle relax. Hence, tomorrow I am planning to do only cardio and stretching exercise. Actually there is a free yoga class in the gym. I should try that.

Day 4 – Wednesday May 20th

• 11:56 AM – you are so close to completing your thesis and you are running out of time. Skip today’s gym and focus on your thesis. Right now, your thesis is the most important thing. Work on it. You have already worked all major muscle group, take a break for a day and work on your thesis. Don’t listen to him. He just want to procrastinate. Going to gym will make you active and will increase your productivity.
• 9:40 PM: I must confess that today it was one of the most intense battle that I have ever seen between procrastinator and achiever. The procrastinator even went to the extent of suggesting giving a point to the Achiever without going to the gym. But don’t worry, The achiever is not here to win only this challenge but the whole life long challenge. Finally, the achiever convienced me to go to gym
  
• 10 PM: went gm and did
  
  • Running – 25 min / 2.25 miles
  • Elliptical – 15 min / 1.25 miles
  • Sit-up 2 sets of 12 rep.
    
• 
  

Day 3 – Tuesday  May 19th

• 5:50 AM: Man, you have just gained 3.5 lbs in just one day because of exercise. You should stop going to gym.  You lost 3 lbs last week by not going to the gym.  See exercise is not meant for you. Weight gain can be due to many reasons. May be because of water retention and you just read that 3-5 lbs fluctuation is normal. Just keep on doing. Let complete this challenge and see. But by then, you might gain lot of weight. Exercise cannot cause weight gain as long as you are controlling food, which you are doing I know. Just keep on doing. Do it three more days and on friday take a yoga class. That will stretch your muscles and will allow lactic acid to go. Keep on doing and we will analyze the results after 28 days.
  
• 3:15 PM – went gym.
  
  • 15 min running ( 3 min walk + 6 min @ 6 mph/1 inclination + 6 min @ 7 mph / 0 inclination)
  • Inclined chest press – 3 sets of 35 lbs, 12 repetitions – next time reduce to 30 lbs
  • Push-up – 3 sets, 12 repetitions
  • Chest Extension – 20 lbs, 12 repetitions, 3 sets
    
  • Chest Press using ball – 20 lbs, 3 sets
  • Rowing – 1000 m in 4 min 30 seconds
  • leg raises
    

Day 2 – Monday May 18th

• 10:30 AM – lets go to gym after weekly meeting (which is at 1:30 PM)
• 3:01 PM - lets go to the gym around 4:30 and use this time to work on some new ideas
• 5:22 PM – went gym
  • 10 min elliptical
  • leg press (4 sets of lbs, 12 repetition)
  • calf press (4 sets of 55 lbs, 12 repetitions)
  • hack machine (4 sets of 45 lbs, 10 repetitions)
  • cross cycle (for core – 3 sets of 25)
  • 10 min cycle
  • Missed – Lunches with rotation & Squats
    

Day 1 – Sunday May 17th
Mind at work:

• 7:02 AM -  Will go Gym in the afternoon. Morning time is good for studies and I can effectively use it for writing my thesis.
• 7:04 AM – man 30 days is too long. Probably I should start with one week or two week. My two cents go for two weeks. Also, doctors don’t suggest working out for 30 days. Take one day at a time and forget about 30 days
  
• 10:41 AM - oh man, today is so hot. Just saw the weather and according to the report today afternoon temperate will be around 90 F. Do I really want to go gym in this hot weather and that to in the afternoon. Let’s go in the evening. Talking as if you will be working outside. The gym has controlled environment and you will be never exposed to the sun. Go and get some workout. You will feel good after workout. Don’t your remember that exercise regulates stress hormones and promotes the release of endorphins that make you feel good
• 7:30 PM – So what happened about the challenge. I got some new ideas about my thesis. Let me just put them in writing otherwise I will forget it. Will go to gym around 9 PM ( ) . Achiever mind  ( )
• 9:oo PM  – Common body, get up and move. Anyway you are not able to write any new sentence (for thesis) and just moving statements from here to there. Go to gym. Oh!!. its already 9 PM. If you will go now, you will get late for bed and tomorrow you will be late for office. Lets forget about this challenge and we will start it again sometime later.
  
• 9:15 PM: Ahh, finally I got a chance to win.
  
  • 5 min walk (3.5 mph) + 7 min running (6 mph / 1 inclination) + 3 min walk (3.5 mph / 0.5 inclination)
  • Lower T-Row (4 sets of 90 lbs and 10 repetition)
    
  • Back Extension (4 sets of 10 repetition)
    
  • Upper Back T-Row (3 sets of 80 lbs, 12 repetition + 1 set of 95 lbs, 10 repetition)
  • Lift & Swing (Squat Raises ) – (3 sets with 30 lbs and 10 repetition)
  • Sit-ups (3 sets at 2 inclination, 10 repetitions)
  • 5 minutes elliptical
    
  • Missed Chin-ups, 10 minutes of elliptical, 1 set of situp and 1 set of lift & swing
    

Releasing Reference Manager (Beta) For Word 2007

What is Reference Manager ?

Reference Manager is an “Add-in” for Word 2007 that enhances Word 2007’s inbuilt bibliography feature. It essentially makes it possible to import and export articles using standard formats such as BibTex, RIS, etc. Currently, Reference Manager has four features:

1. Import from Website: Given a URL, this utility will automatically pull all the reference details. Check below for the list of compatible websites

2. Import from text file: If you have citations in BibTex, RIS or any other standard format, use this utility to import your citations into word.

3. Export: Export references in Bibtex and other standard formats

4. Search & Import: Search and import new articles. Currently, search functionality is limited to Memento Search. Thus, it can only retrieve those articles that are present on Memento

Checkout the  video to learn more about reference manager add-in

To download, click here

Is Reference Manager free?
Yes, Referece Manager is complete free. I developed this tool mainly to streamline my thesis writing process. I am so used to word that I wasn’t able to adopt any other writing tool such as LaTex. However, lack of ability to import articles made my life a hell. Finally, last month, I decided to write this add-in.

What are the system requirements to install this add-in

1. Internet – Reference manager calls Memento, an online bibliography manager, to import and export articles. Essentially, all the back-end process is done by the Memento server and the Reference Manager (or Memento) add-in simply provides a nice interface to integrate Word 2007 and Memento’s web-service.
2. Windows XP or Vista – I don’t know whether you can *.exe file on Mac
3. Microsoft Word 2007 or later – Of-coure !.  :)

How to Install
Note: I don’t have any other windows machine than my development machine. Hence, I can’t guarantee that installation will work perfectly. Try it and let me know if you are having any problem. I can, then, work on getting a cleaner installation file. In general, the installation process should be simple.

1. Download the zip file from here
2. Unzip the downloaded file and place it at some secure place such as under your documents folder.
3. Click on setup.exe. Depending on your system’s configuration, you might also have to install VSTO 2008. In any case, the setup.exe will report any problems. Just follow them. Also, if you find any problem, please let me know so that I can take appropriate actions so that other users won’t have to deal with the same problem.
4. Once everything is install properly, Open Word and check if there is a “Memento” tab or not. If there is, you are good to go. Enjoy

List of Compatible Websites

• Amazon
• African Journals Online
• ASM Journals
• Blackwell Synergy
• CiteSeer
• HubMed
• IEEEXplorer
• IngentaConnect
• InformaWorld
• Wiley InterScience
• Lawrence Erlbaum Associates (LEA Online)
• Nature
• ACM Portal
• PubMed
• PLoS Jounals
• PLoS
• Pubmed Central
• Sage Journals Online
• SciELO
• SciELO Health Public
• SpringerLink
• Google Scholar

A point about Latitude/Longitude

With the increasing proliferation of GIS Technology and GPS enabled devices, it is increasingly getting common for everyone to deal with latitude/longitude (lat/lon) on a daily basis. However, a simple, yet important, about lat/lon is often missed by users of GPS devices and also by the developers of mapping application. Most users and developers assume that lat/lon of a point (or landmark such as building) is sufficient to find that landmark on a map (such as google map). To some extent this is true, but not completely. For instance, consider these two geographic coordinates (latitude, longitude) : (1) 47.62054, -122.34947 and (2) 47.62054, -122.34947. If we try to plot these two geographic coordinates, the two points are separated almost by 95 meters (see google map below). The two points are reference for Space Needle building in Seattle, WA but using different datums. Simply speaking, a datum defines shape and size of the Earth and also initial point of reference from which all lat/lon measurements are made. The first coordinate is based on NAD83 datum and the second is based on NAD27. However, since google map doesn’t have the option of specifying datum, both were plotted assuming that both the coordinates are based on same datum. As a result, the two markers (each referring to one of the above geographic coordinates) are separated almost by 95 meteres on the map. However, in reality, two markers should overlap.  

Geographic Coordinates for Space Needle, Seattle, WA 

1.  47.62054, -122.34947 (based on NAD83 datum)
2. 47.620719, -122.348646  (based on NAD27 datum)

Space needle (different datums)

 

Over the centuries, many researchers have proposed many different datum, each suitable for different model of the Earth. For instance, in 1927, US started following NAD27 for which the reference point was located at Meades Ranch in Kansas. NAD27 is based on elliposidal (Clarke Ellipsoid) model of the Earth. A elliposidal model assume that the shape of Earth is similar to an Ellipse. But with improving technology, researchers had access to better tools and technology, which led to more accurate models of the Earth. Most researchers now follow GRS80 model of the Earth. Based on GRS80 model of the Earth, a new datum, NAD83, was proposed in 1983 for use in US. Research on an accurate model of the Earth and most suitable datum is still ongoing and many changes to NAD84 have been already proposed. But these changes are still not in use.

The crux of all this discussion to emphasize the need for specifying datum when reporting lat/lon. However, if datum information is missing, below are some guidlines on what to assume:

1. By default most GPS uses WGS84 datum. Thus, if you are getting data from GPS equipment and no datum information is available, assume it is WGS84. 
2. By default use WGS84 datum if your mapping application can be used by anyone for any geographic region. WGS84 is based on GRS80 model of the Earth, which is most accurate model of the Earth. 
3. If you’re mapping application is only for US then use NAD83. All USGS data is reported based on NAD83 datum and is the best for US. 
4. If the geographic data is for US, but very old (such as historical data), it is better to assume that it is based on NAD27 datum.  

Enjoying mapping.

 

References:

1. NADCON – to convert geographic coordinates between NAD27 and NAD83
2. GRS80 (wiki)
3. NAD27 / NAD 83 (wiki)
4. WGS84
5. Simple explanation of datum

Urban shock

Wow, finally got my Internet connection started. I have been waiting for it for quite sometime, as I wanted to share my ‘Urban Shock’ experience. 

Image Source: Amazon
was modified by the author

Last month was terrible as I moved from State College, a small university town and home of Nittany Lion and Joe Paterno, to Bay Area or SFO, an urban city. After spending six years as a graduate student and living in small university town, I got used to certain things in life such as to live frugually, shopping at Walmart,  sharing apartment, spend less than 10 minutes on commuting, etc. However, as I moved to San Francisco last month, I was suddenly gripped by an Urban shock. My urban shock came in the following ways:

1. Paying more than $1000 for a 1BHK apartment. In State College, I was sharing a 3 bed-room apt and the whole 3BHK apt. cost less than $900

2. Commuting more than 1 hour each way. Wow..this was something I never imagined. Everyday I spend more than 2 and 1/2 hour commuting and this is not unusual for people working in San Francisco city. I regularly meet many people in BART (Bay Area Rapid Transit) that have been doing this for generations (figuratively). In university, I hardly had to walk more than 15 minutes to get to college from my apartment.

3. Home alone. Well, for time-being I am enjoying the solitude. But, I am sure soon the same solitude will get onto my nerve.  

4. 8 hours are too-much: In college, I often thought that I am working more than 8 hours. However, I guess, that was only my false belief. For last two weeks, I have been working continuously 8-5 and now realizing that 8 hours is too-much. Every-day, I just wait for the friday 5 PM, so that I can go home and relax the whole weekend. 

5. Ironing clothes: Wow, this was another big shock. In the last 6 years, I don’t remember a single day when I ironed my clothes. I am even not sure whether I had a iron . However, now, I have to iron my clothes everyday.

6. Day starts at 5:30 AM: In college, my day used to start at noon (even those were good days). But now I had to get up at 5:30 so I can get time to iron my clothes, have breakfast and leave for BART station by 6:30 AM so as to reach office by 8 AM. 

the list goes on..Nevertheless, SFO is a great place and I am enjoying its fast-pace life. It has a energy that I never experienced in any other big city.