Monday, September 20, 2010


Adaptation has never been something I've been particularly adept at; take one look at my nutrition plan for race day and you'll realize I try and figure out every variable known to man and prepare for it. It's one of the reasons why I manically studied metabolism and nutrition when I was first diagnosed with nutrition, the inability to control my fate has been something that has always bothered me - that may be one of those reasons I always work so hard.  But I think my move to California may just hint towards a more mature Ed, an Ed whose willing to flow with things a bit more and not freak out over time zone changes, an inability to find things 100% organic and a workout schedule that has been schizophrenic at best.

The first year after my diagnosis I had tried to control every variable that went into my blood sugar management.  I would freak out if a friend made me eat an hour later than I had planned, would all but lose it if someone wanted fast food instead of something healthy and god forbid a workout started 20 minutes late.  I had tight control over my A1C but probably wasn't the most pleasant person to be around.  During my first season of triathlon I was so worried about hitting my nutrition protocol to a tee that I kind of forgot to have fun during alot of my races.  Fast forward a year and I was still pretty nervous about my pre-race routine but started to loosen the reins on other parts of my life.  Then at the start of IMCDA I had lost that gel, a year earlier and I wouldn't have started the race - this time around I had a super solid swim.  Baby steps towards the willingness to adapt added up to a huge change.

Tonight after work I was planning on going for a run; I had no idea the exact time I'd start or even how far I would go for (I know, shocking).  I left work at about 6pm, and turned my basal rate down to 40%, when I finally got on the N to head to my super sweet new pad (more on that below), I opened up my Clif Bar wrapper and munched away then got home tested, tossed on my running shoes took a swig of Odawala Super Food and off I went.  At some point during the run I decided a 7 mile Monday night jaunt was solid enough.  No planning, no fuel belt, not even a heart rate monitor!  I did wear the Garmin though - I mean I can't just go technologically nude!

And now about the place.  In year's past I was terrified to live with people I knew, let alone people I had only met for 10 minutes!  But on Sunday I moved into my humble new abode with 2 roommates whom I've spoken with a total of 30 minutes, maybe.  I have none of my own stuff here (that comes the first week in October), am making due with the food I could find at the local market and am just enjoying my first place in California.

So how's all that relate to diabetes?  I've switched time zones 8 times in the past month, that hasn't been great for blood sugar management - but rather than freak out about it I'm adapting.  Yes I have to take in a bit more insulin than usual and yes it has been frustrating that my blood sugar is bouncing more than I would like.  But... freaking out about every second of every day isn't going to help my A1C.  I think I'm finally at a place where I can sit back and know that I have tight control of my disease and know that I'm taking the steps necessary to control diabetes as best as I can.  The learning continues - or maybe I've just become mellow since I'm off the East Coast!

Thursday, September 16, 2010

Mobile Health & Diabetes

Through my awesome new job I'm going to have an opportunity to attend some great healthcare related conferences.  Last week I was in San Diego for the MHealth conference which focused on how mobile technology can improve the efficacy of medical treatment, adherence to protocol at home and improve the overall heath outcome of a patient.  One of the subjects that came up alot was home biometric devices.

To aid in adherence biotech companies have come up with an idea to attach band aid like sensors to people to monitor everything from blood sugar to cholesterol to hydration.  I love the idea of body sensors and to have a ton of metabolic information at my finger tips.  I'm a data dork and the more information I can get about my metabolic rates the better I can manage my blood sugars and the better I can perform everyday activities.  However, this technology relies on one huge assumption - that it's accurate.

A few presentations I saw talked about constant glucose monitors, and Dexcom was mentioned!  I love my Dexcom, having the CGM gives me much tighter control over my blood sugars - but it's not accurate all the time.  A while back I talked about the night time low alarms that were occurring for no reason; for home medical technology to really drive great care those problems need to be resolved.  Accuracy needs to improve to a point that shows true trends and presents actionable data in the absence of a manual confirmation.

I do believe that home biometric devices will be a large determinant of improving medical outcomes in the future.  However, the accuracy of that technology needs to increase a great deal before home biometric monitoring becomes a driver of health.  For a pretty healthy 31 year old who understands data a false alarm on my Dexcom is no big deal, for a 70 year old on blood pressure meds a false alarm could be deadly.  Once the technology improves home biometric devices will be awesome; hopefully that day comes sooner rather than later.

Sunday, September 5, 2010

California Dreaming

After close to five years of trying to move to the west coast I'm finally following the advice of Horace Greeley and heading west.  Prior to leaving Manhattan for Darden I was emphatic about working for a small start-up on the west coast where I had control of my own destiny.  Over the course of my 2 years in business school that plan shifted and bent at times but when I returned for my second year in VA I had a firm resolve to make it out West.  One characteristic that has defined who I am is perserverance - my path to a healthcare technology start up demonstrated that quality ten fold.

At the start of b-school there were two career paths I was considering, both slightly non-traditional for a post-MBA career.  I was trying to decide if my skills and passions were a better fit for socially sustainable international development or if following my love of athletics and wellness along with the nerdiness I bring to data analtyics made healthcare technology a better fit.  Since my resume is pretty strong in financial services it was easier to figure out if the buy side of finance would let me pursue a msision that satisifed me both professionally and personally - by the end of the summer that answer was a resounding no.  So when I returned to Charlottesville I was hell bent on getting into health and wellness no matter what.

Over the course of my second year at Darden I tried to start my own healthcare technology company that could be implemented in a corporate envrionment.  I did this with a small intent of getting funding but mainly to gain experieince in the industry.  Creating my business plan and value concept gave me enough cache to get on the schedules of executives at various healthcare firms around the country and demonstrated a passion to actually work in the field.  The hours I spent laboring on my idea proved to be one some of the best time I spent academically at Darden.

From September until August I talked to anyone who would listen about my ideas behind health and wellness and what I could bring to the table.  There were tons of bumps in the road, a start up that had flirted with me lost their funding, a large medical group misled me during the recruitment process, a research grant was refused (still slightly bitter about that one), and I turned down a couple offers that wouldn't have let me fulfill my career aspirations even if the I loved the personality of the companies.  Then this summer hit and I had informational interviews with Microsoft, in person interviews with Amazon.  Those discussions continued to fortify my desire to work for a small start-up who got my ideas so our mutual passions could create growth.  My continued outreach finally paid off in late July.

On a whim I e-mailed the head of the Pioneer Portfolio of the Robert Wood Johnson Foundation to pick his brain about the industry and to find out if they needed an intern for the summer (I was starting to need cash in a bad way!)  The Pioneer Portfolio is RWJ's investment arm that funds disruptive technologies in healthcare innovation - totally the type of stuff I wanted to be doing; although my ultimate goal was to get on the product side of things.  After pitching my ideas behind Perform Wellness and asking Paul about his thoughts on the industry I swung for the fences and asked him to name some firms he thought were really pushing the envelope on healthcare innovation.  One firm he named was Keas.

After doing some google searching, Keas seemed like a totally kick a** place to launch my career or hell to become a lifer at.  At its core Keas is a technology platform that transforms content from healthcare experts into actionable care plans that are personalized for the patient's disease, lifestyle and personality needs.  Keas and my ideas behind Perform Wellness had so many similarities that I thought I was dreaming when I first read their product descriptions.  Not only is the product awesome but when the company launched they made the front page of the NY Times and were recently recognized by Time Magazine as one of the 50 best consumer websites out there - tops in healthcare.  At this point I was pretty much salavating like Pavlov was ringing a bell in my ear then I came to learn that their founder was the previous head of Google Health. 

I calmed my nerves, collected my professional thoughts and shot an e-mail to the career address for Keas.  Within a few hours I heard back from HR asking some clarifying questions; our dialogue led me to the Director of Business Development.  After a quick e-mail the DBD and I had a close to 2 hour conversation about our thoughts on healthcare technoogy, my ideas on corporate strategy and on competitive intelligence - by the end of the conversation Ms. DBD asked me to come out for an in person interview.

The following Wednesday I was on the first flight I could find to San Francisco, had my game face on and knew it was now or never to break into the industry I was dying to get into for a firm that I thought I could really crush it at.  From 9am until 3pm I met with the CEO, COO, DBD, Head of Product Management, and HR.  Each conversation had me more impressed with the firm, not only did I love their thoughts on the industry but I felt like it was a fit; I felt like the people involved in this company really wanted to create change, not just talk about it.

The wait that weekend was agnoizing, I had sent them my references and knew they had contacted at least one, but I was dying to know if I had finally landed the gig I was dreaming of.  All signs were pointing to yes but after more than 9 months of hard core job searching I was starting to lose faith in the process and confidence that I would ever find a job outside of finance.  Then finally at 7:30 pm on Thursday August 26th, Ms. DBD called me to offer me the position of Manager of Business Development!  I started on Monday remotely from NY and spent the last half of the week working in San Francisco for what was without question the best first week of work I have ever had.  Working for a start-up is totally different than the buttoned up culture I come from, but I freaking love it; I'm free to think how I think, be creative and just get after it - there aren't floors or ceilings to navigate, simply a hunger to get the job done lets you feel empowered to take on the challenge. 

It's funny, without having been diagnosed with type 1 in 2007 I'm not sure I would have ever realized that health and wellness was the way my career should go.  I had always thought I had so much freaking fun playing football because I was pretty good at the sport and loved the competition.  It turns out helping my teammates become better and challenging myself to be a better athlete were the things that got me going.  As I continued to write this blog and continually applied my analytic geekiness to sports nutrition and blood sugar management that I was deveoping some intresting ideas on how to help people become healthier.  Since 2007 I've been on this crazy quest to figure out what stuff meant for me, where I fit in and how to become succesful not defined by the amount of money I had in my bank account but by the level of personal satisifaction I felt from my job.  I think that quest got alot more clairifed on August 30th, that whole perserverance thing turned out to be pretty important in all of this.  The next chapter begins in San Francisco, I have no idea what this book will look like but if it's anything like the journey I went on the past 4 years I'm in for one hell of a ride.