Common Programmer Health Problems

http://sheddingbikes.com/posts/1281257293.html

by GVRV • 16 years ago

394 184 16 years ago

carbocation3• 16 years ago

This is an interesting thing for Zed to share.

Sleeping on your back is something that can exacerbate sleep apnea, so I would modify his otherwise quite pleasant sleep suggestions with that in mind.

philwelch• 16 years ago

If you have sleep apnea, go get yourself a damn CPAP machine and wear it when you sleep. Sleep apnea is almost, but not quite, as bad as never even sleeping. That means dozing off during every quiet moment of the day, having waking hallucinations, waking up just as tired as you felt when you went to bed, even sleeping all weekend. Your concentration and mental abilities end up just plain shot. I've known two people with sleep apnea and they both turned their lives around considerably when they had it treated.

carbocation3• 16 years ago

There is essentially a continuous normal distribution of "apneic" sleep features. There is no bright line between apnea and not apnea, though we create lines for simplicity's sake. Of course if you need CPAP, use CPAP. But there are plenty of people who have soft tissue that closes off the upper airway to a significant degree only when supine. These are the people who don't need to deal with the modest but non-zero risks associated with respiratory assistance — all by just sleeping in a different position.

leftnode• 16 years ago

I cannot stress how important it is to stay healthy. I used to be a competitive natural bodybuilder (which isn't the healthiest thing, overall) and a personal trainer, so being healthy was always a part of my life. After I graduated college, I didn't have enough time for them and let myself go. As a result, I get sick more often, and have back pain.

I'm currently in the process of getting back into shape (not as a competitive bodybuilder, but just general fitness). So please, if you can avoid becoming unhealthy, do, and stay fit. There's literally no downside to it (that I can think of).

jodrellblank3• 16 years ago

It's effortful, time consuming, boring, and involves changes of behaviour, self image and thought processes, and involves potentially standing out against peers, family, friends, colleagues and industry culture.

If there were literally no down sides, everyone would do it by default.

joey_bananas• 16 years ago

It's hard to take health advice from a guy who considers martial arts to be a qualification in dispensing them. Especially when he trots out bullshit old wifes tales like caffeine leading to dehydration.

a00021• 16 years ago

>bullshit old wifes tales like caffeine leading to dehydration.

[citation please] - I am genuinely curious about the current scientific consensus on that one, as IIRC I have heard the reverse claim in this talk: http://www.youtube.com/watch?v=dBnniua6-oM regarding Cola being stuffed with caffeine for both its normal effects and the diuretic side-effect (my memory could be failing me, of course).

Cheers,

rue2• 16 years ago

Coffee etc. is still mostly water. One unit of coffee/cola/tea, compared to the same unit of water will A) give you slightly less water up front and B) cause some loss of fluid due to diuretic effect but overall you still gain fluids.

It is by far not the best source of hydration, of course. You are much better off drinking water or (preferrably unsweetened) fruit/vegetable juices - or even just eating said fruit or vegetables. Hypotonic sports drinks have their place too, but not when your exercise consists of walking up to the fridge.

Confusion7• 16 years ago

Well, the advice is all based on experience. You could skip the 'background and qualifications' bit and it still makes sense.

He might want to check with a GP to find out whether these are really problems that are common among programmers. When you've dealt with something yourself, it's easy to confirmation bias your way into thinking the ailments are common in your profession.

zedshaw11• 16 years ago

I've been working professionally for a long time and have seen way too many programmers with these issues. I haven't met someone with all of them at once, but I have met plenty of people who have had one or more during their life. I've just been lucky to have had all of them, but not severe at all.

jrockway2• 16 years ago

Indeed. Studies have shown that those that are used to caffeine don't get dehydrated from drinking caffeinated beverages.

The NYT examine this here: http://www.nytimes.com/2008/03/04/health/nutrition/04real.ht...

pradocchia• 16 years ago

Really, though, you shouldn't need Zed, the NYT or anyone else to tell you whether coffee is dehydrating. You should be able to tell, for yourself, one way or the other.

For myself, it's headaches and feeling "parched" (for lack of a better term), preceded by the usual coffee-smelling piss. I usually don't let it get that far, but once my head starts to ache I quickly switch over to green tea and/or water.

Whether the latest journal reports caffeine is or isn't dehydrating may be interesting, but should mean fuck-all to your daily routine. Don't look for authorization in science. Look for it in careful examination of your own experience.

fmora2• 16 years ago

You do know that coffee causes you to pee more often? Lookup it up in wikipedia. If you drink a lot of coffee those liquids are going to be sent straight to your blader. That is what causes dehydration. Same for caffeinated soda.

silentbicycle6• 16 years ago

That part was him saying, "I used to be in really excellent shape, here is what has worked for me, and I can really notice when I get less exercise," not "don't take health advice from someone unless they're at least third dan.".

And maybe caffeine doesn't dehydrate everyone, but coffee sure as hell makes me sweat more. (Coffee dehydrates me, but tea doesn't anywhere near as much.)

zedshaw11• 16 years ago

It's not the coffee, it's the fact that many people drink everything _but_ water. Coffee's got a lot but you can't drink that much of it, so if that's all you drink, then you get dehydrated. People also drink too much soda which doesn't help, and people also just don't drink for long periods of time.

If you get headaches then try drinking some water. Pretty simple.

Also, man you're a giant douche. Did someone piss in your fucking coco puffs today little boy? Shit.

pjscott• 16 years ago

I'm curious: if someone other than Zed Shaw had written this, would you still have responded so contemptuously?

jacquesm8• 16 years ago

Mental health should be on that list.

Confusion7• 16 years ago

Funny, but not nice and not necessary.

Downvoters: you are aware that Zed lists problems he has struggled with and that his generalization of this list to 'common problems programmers face' is perhaps not warranted for all problems mentioned? If it was a serious suggestion, jacquesm would have included an explanation of why programmers would commonly face mental health problems.

mechanical_fish• 16 years ago

Everyone, and I do mean everyone, with a mental health issue understands the first problem with mental health: People try to laugh it off, or hide it out of fear that others will laugh it off. Since people literally end up dead at an early age because of this attitude, your flippant comment seems likely to be downvoted by folks who have encountered mental illness, and that is a lot of people. Such is the risk of being flippant. Fortunately there's a -4 limit and you'll live.

Do you really need an explanation of why programmers might be at risk of mental health problems? To first order, Zed's list speaks for itself: being in poor health tends to depress you, especially the part about bad sleep. The depression and the health effects feed back on each other in a nasty way.

But I'd add that loneliness is a big factor. These days we have amazing tech like IRC and Twitter and HN, and it's easy to imagine that we can have rich social lives without ever seeing another person except through the medium of text. Well, your brain, designed and conditioned as it is for the presence of actual physical humans, may think differently. I spent eighteen months working as a solo consultant in my office, meeting clients only via email and the occasional phone call, and it eventually drove me bananas. My wife still laughs about the day I took half an hour off to go to the barber and then raved about the awesome social experience.

Even if you work in an office the isolation can be frustrating, because as a programmer you routinely work on problems that nobody else understands or wants to understand - even your fellow programmers, who are trying to focus on problems of their own. To interact with others you need to really break your focus, but that causes you to slow down, so maybe you try not to do it, and before you know it everyone else has gone home and it is dark and you're wandering through an empty parking lot...

Remember, solitary confinement is one of the worst tortures you can inflict on a human.

jacquesm8• 16 years ago

If you though that was in jest then I'm really sorry I didn't make it clear that I was 100% serious.

I don't think an explanation of why programmers commonly face mental health problems is required beyond asking you to read through the last years postings on HN, which include some very sad entries indeed.

jc-denton2• 16 years ago

Fully agree, staying behind a computer for a whole week is not healthy (even if you exercise regularly)

bootload• 16 years ago

I posted a quick note to Zed about this. The mental side is underrated. One thing I've noticed is mental exhaustion occurs much easier than physical exhaustion. With a strong minds you can block the physical. Crack the mind and that's it.

Some discussion on "mental habits of mind" would be good.

Goladus2• 16 years ago

Mental health is partially (largely?) a function of physical health.

Sitting up straight and relaxing your breathing isn't just good for your back it changes the way you think about what you're doing.

jacquesm8• 16 years ago

> Mental health is partially (largely?) a function of physical health.

If only that were true, then the answer for every mental problem would be 'exercise'.

Not saying that people with mental health issues wouldn't benefit from exercise in general, but that goes for everybody, not just for them.

And even if their mental state would improve I'd be surprised to see 'schizophrenia cured by exercise' as a headline. And the same would go for plenty of other mental health issues. Mental health is influenced by physical health to some extent but to claim it is a function of physical health is a step too far I think. You can have perfectly healthy people with a very bad mental make-up and vice versa.

zedshaw11• 16 years ago

I may mention those, but I think people with mental health problems tend to take them more personally than with physical health issues. It's very difficult to talk to someone who is depressed, has schizophrenia, has manic episodes, or is a drug addict. Definitely difficult with a blog.

jarin• 16 years ago

I can definitely see how bleeding out of your rectum might interfere with your programming flow.

barrkel• 16 years ago

I believe a tight bubble (intestine + vein) of blood hanging out of your rectum (i.e. an actual hemorrhoid) would actually be more distracting than the bleeding, which would be a relief.

rb2k_• 16 years ago

Something that really upped my motivation for running is using my cellphone's gps to log data. I coded a small web-app to show a little bit of stats (http://fitness.marc-seeger.de/category/joggen / http://github.com/rb2k/run-a-log) as my first little project with ruby/sinatra. My inner nerd loves to collect data and do stuff with it and my body is probably thankful for it (just finished my 800th recorded kilometer)

p.s. I currently use "cardio trainer" on android which would also offer a webinterface to data. Before that I used MyTracks (android), Nokia Sportstracker (Symbian), jogstats (webos)

SandB0x3• 16 years ago

Another related problem is hygiene. I've met too many programmers that smell. Some people don't wash, don't wear deodorant or just don't realise that their clothes need washing even if they look clean.

It's especially annoying because it's so easy to fix!

jrockway2• 16 years ago

That is a different class of problem. The health problems Zed mentions affect you, not others. Doesn't matter to your coworkers if you have wrist pain or diabetes.

On the other hard, you smelling doesn't affect you in any way (you get used to your own stench), it affects others. So this is not a health issue, it's a generic "getting along with others" issue.

SandB0x3• 16 years ago

It's not exactly the same, but it affects you in that people will start to avoid you as much as possible. Would you recommend someone with B.O. issues for a job?

One big distinction is that people often know they're unfit, but are normally oblivious to hygiene problems. I've never had the nerve to tell anyone myself.

Edit: It works both ways. If someone is unproductive due to their health problems, that definitely affects their coworkers. Diabetes, fair enough, but there's definitely an argument for putting many easily avoidable physical problems in the "getting along with others" category.

Edit Edit: If you're going to downvote, let's have your counter-arguments please.

jacquesm8• 16 years ago

It can lead to other problems though.

weaksauce• 16 years ago

Lack of friends and inability to get along with others leads to mental health problems though.

lkozma2• 16 years ago

A slightly related issue is that keyboards are usually incredibly dirty (especially those in public places). A habbit of touching your face after having typed on the keyboard can cause all sorts of problems.

avar• 16 years ago

Go on, what sort of problems?

matwood4• 16 years ago

I'm very OC about this. Anytime I eat or feel my fingers have become oily or dirty I have to wash my hands before working on the keyboard. Of course my keyboard still gets dirty over time, but not nearly as bad as some peoples I've looked at.

fmora2• 16 years ago

Some of us are aware of this. But it becomes less important if you are stuck in your apartment for a weekend coding and not seeing anybody. You have to take a bath in the morning when going to the office. You will smell otherwise.

coffeejunk• 16 years ago

Honestly I never really understood this. If I don't take a shower in the morning, I'm simply not able to do anything.

The rest is just routine: new day -> new shirt; fresh cloth -> deodorant; sunday -> do laundry..

rue2• 16 years ago

Protip: put on deodorant before shirt.

(Also, get an antiperspirant/deodorant (without aluminium/titanium if possible)).

steve192• 16 years ago

Don't forget new underwear ... you would think it wouldn't need to be said

ruang2• 16 years ago

I prefer baby powder to deodorant. Deodorant clogs your pores while baby (talcum) powder soaks up moisture. Much cheaper too!

matwood4• 16 years ago

When I used to work in an office we had this kid who worked with us who I don't think washed his clothes ever. He would have stains on his shirts and pants and was just generally disgusting. We finally had to tell him that he needed to clean up.

His clothes are now cleaner, but he's still pretty dirty. It's especially noticeable right after a new game comes out that he spends all night playing (WoW, and I'm told now SC2).

yason2• 16 years ago

In the summer, it's not easy to fix. It's been quite hot here this summer, around 25-30℃ through June—August. Hot weather = sweating.

Taking a shower doesn't give you an edge over it for more than an hour: as soon as you've walked for a while or sitting in public transportation for more than five minutes, you're as soaked as before. And then you're smelling again.

wwortiz• 16 years ago

You must live in a rather humid climate because that isn't too hot, it is more of a comfortable temperature.

SandB0x3• 16 years ago

Put on some deodorant after you wash and keep a stick/roll-on in your bag or at work.

If it really is unbearably hot you could even pack a spare t-shirt. An American Apparel Summer T-Shirt will fold up to the size of a wallet if you're short on space.

jim_h• 16 years ago

It's been over 32c (90f) in NYC for most of this summer and with relatively high humidity and I don't stink after being outside and taking the trains. Nor do most of the people here. I would LOVE it to be 25-30C most of the summer! In fact it's hit 37C (99f) a number of times here too!

mistermann• 16 years ago

I use one of the salt crystal rocks for deodorant, you wet it and rub it around on your pits, it works by far better than anything else I've tried for eliminating odor, especially in warm humid climates.

izak30• 16 years ago

Eating better makes your sweat stink less.

jawngee• 16 years ago

Gold bond medicated powder is an absolute must for me in weather > 80F. And the older you get, the more important this is as certain parts of the male anatomy uh drop lower and lower. Sad but true.

grammaton• 16 years ago

You know, in all the time i've worked as a developer, I can honestly say I've never met a programmer who smelled or had obviously bad hygeine. Sure, I've met quite a few who dressed kind of funny, but never any that fit that particular bit of the stereotype.

jc-denton2• 16 years ago

EXERCISE REGULARLY.

Nobody forces you to drink coffee.

Really I don't think it's so hard to do programming w/o becoming a complete nerd.

seshagiric• 16 years ago

Very well written and practical. Thanks for sharing this.

wallflower3• 16 years ago

If you don't read the rest of this, get a styrofoam foam noodle around 12" in diameter and 3 feet in length. Lie on it to relax and stretch your back. Back stores have them. They're expensive but I use mine twice a day.

For those of you who type like madmen with no regard for ergonomics and work breaks, I did that since I was 9. I have systems in place to avoid that now. Through grade school, high school, college. I was a blazing fast slouch typer. After I graduated from grad school, I started getting pains. So I would rest up and be as good as new overnight. There reaches a point where if you ignore the problem long enough it becomes persistent. Finally, it became such that even after a weekend of rest it would (pain, soreness) still remain. Maybe at a level three out of ten. I went to see a physical therapist and he tested my grip strength - my left hand was stronger. And I'm right handed. Leaving out thousands of ergonomics purchases, the best thing you can do is to start a swimming program. Swimming is zero-impact; you're not pounding the pavement. It is excellent for working your full body. Swimming is hard if you don't know how to swim because you're basically putting all your energy into fighting water resistance. Elite swimmers are three times more efficient than average swimmers (91% of energy fighting water vs 97% for average swimmers - meaning they can put 9% towards forward propulsion). Total Immersion has an awesome swim-like-a-fish program (http://totalimmersion.net). For eyestrain, rest your eyes by looking at least twenty feet away every twenty minutes for at least twenty seconds (the 20-20-20 rule). If you wear corrective lenses, ask your optometrist for a computer Rx (that you can use while screen working). WorkPace software from Wellnomics is awesome because it forces me to micro-pause every 4 minutes for 20 seconds and stop working for 4 minutes every 14 minutes. Believe me, I am a very efficient programmer. Also, use the mouse with your non-dominant hand.

For those of you who don't have health issues, realize that you will not take endless, pain-free typing for granted once you have soreness that becomes persistent. The only true rehabilitation would be to stop typing all together for a long time (2 years). Until then, I'm appreciating my job for what it is - something in the short term. Diversify your portfolio of skills - don't be over-weighted in tech. Start creating things that you own.

AgentConundrum7• 16 years ago

micro-pause every 4 minutes for 20 seconds and stop working for 4 minutes every 14 minutes

I doubt that's feasible for anyone working in an office, rather than for themselves.

I ran the numbers a bit, and I assumed: a) that you work 4 minutes, break 20s, then work for - i.e. the clock resets after the break, b) the 14m breaks are wall clock, not non-break time, and c) when you return from a 14m break, the 4m clock resets.

According to this, you're taking 19m of breaks per hour. I'd be fired if I only worked 2/3 of every hour.

Edit: For anyone interested, I did this in Excel and it breaks down like this:

work 4m, break 20s, work 4m, break 20s, work 4m, break 20s, work 1m, break 4m, work 4m, break 20s, work 4m, break 20s, work 2m, break 4m, work 4m, break 20s, work 4m, break 20s, work 1m20s, break 4m, work 4m, break 20s, work 4m, break 20s, work 1m, break 4m

sokoloff• 16 years ago

Presumably most of us are adding value by a mix of activities and not just merely by typing. You can work during the forced downtime.

That said, such software would drive me insane.

wallflower3• 16 years ago

It only counts active time (keyboard activity, mouse movement). For instance, I naturally pause for some time while thinking. If you take a break, the counter will reset automatically. Yes, it has driven my co-workers nuts when they try working on some code but I tell them to relax.

As for being fired, I've proven that I can get more done than others in this setup. It's not quantity of code, per se, but fixing three to four times more bugs than other devs. That's my niche - I love fixing bugs. I don't understand why other developers claim to not like fixing bugs. For me, quality balanced with efficiency is utmost.

Getting laid off would be a nice clean break.

zedshaw11• 16 years ago

Don't let them know. You aren't a factory worker. You can sit there with your eyes closed for a few minutes once in a while.

illumen• 16 years ago

Give up guitar. Write less. Think. Solve problems in ways that use least typing.

zedshaw11• 16 years ago

Well that'd be no fun.

phatbyte• 16 years ago

Why give up guitar ? Playing an instrument can be a very creative process and it's also an excellent way of relaxing.

You can do whatever you want to do, just do it with moderation.

wyclif2• 16 years ago

I'm a bit surprised Zed didn't mention getting a standing desk, or better yet building one (it's simple and cheap to do so).

I think standing desks are an obvious remedy for back pain and discomfort. Your "core muscles" are used more than if you were sitting down, and it reduces the pressure on your spine caused by sitting upright in a typical office chair.

A good, low-tech way to do this is to buy an unfinished door and paint or finish it yourself. If it has a doorknob cutout, just use it for cable management. Then get a pair of adjustable Stanley FatMax workhorses and you're in business:

http://www.amazon.com/Stanley-11031-Telescopic-Plastic-Sawho...

StavrosK3• 16 years ago

I just sit in a 120 degree angle and have never had problems with my back, wrists, neck or anything. Just make sure the screen is high up that you don't have to bend your neck...

carbocation3• 16 years ago

Seriously, or just kidding? For years I have wanted to try a setup like this and would love to know how it actually feels to use one.

zedshaw11• 16 years ago

Unless you have specific support for that, as in a special chair/desk setup, that's horrible advice. I'd almost like to see what you're doing since I can't imagine it being comfortable. You got a picture maybe?

DTrejo• 16 years ago

Do you do your best thinking when you are sitting down, staring at a monitor, or when you are pacing* around the room?

I prefer standing, as it is so easy to take a step away from the computer and really concentrate on the problem at hand. I find the computer can really distract me when I need to think.

* This is part of why I find whiteboards so helpful. They give me tons of space to think, both physically and mentally.

wyclif2• 16 years ago

Walking or standing. I also find whiteboards helpful. What I want now is giant glass whiteboard: http://www.glasswhiteboard.com/

craftsman• 16 years ago

I've suffered from the low back problems he mentions, but mine was not primarily caused by sitting for long periods of time. It was from playing sports when I was younger--I really messed it up.

However, I recently got an ergonomic chair after minor back surgery and it is awesome! It has made a big difference in how I sit and I am much more comfortable with it.

I would also add: don't sit at your desk and eat your lunch and surf to HN. :) Go outside for a 20-30 minute walk. Walk somewhere different every day and look at things you haven't seen before. Not only do you get good exercise, you will spur your creativity and curiosity.

mhd• 16 years ago

But trust me on the sunscreen…

tomwalker• 16 years ago

As a medical doctor, i think its a good article

the hacker community is not thought about in the medical community overall

mattmaroon2• 16 years ago

This is decidedly unscientific and at least in the small part I read clearly uniformed. Eyesight problems from LCDs have nothing to do with fonts. It's staring at something that's bright and at a close range for hours at a time. Even if you were just watching YouTube for 8 hours a day you'd suffer.

zedshaw11• 16 years ago

Yeah, a lot of eye health seems to be voodoo bullshit. But, you got any links to references on this? It might help people who have the problem.

keeptrying• 16 years ago

This is an New Scientist article on an epidemiological study on the causes of myopia. The link is to a blog which copied the content. The original is behind a paywall. The fact that this paper is behind a paywall makes me freaking mad because it could literally save the eyesight of a huge number of people.

Original Article: http://www.newscientist.com/article/mg20427331.100-generatio...

Actual Content: http://www.sunilreddy.com/?p=1429

An excerpt: On average the children in Sydney spent nearly 14 hours per week outside, and only 3 per cent developed myopia. In contrast, the children in Singapore spent just 3 hours outside, and 30 per cent developed myopia. Once again, close work had a minimal influence; the Australian children actually spent more time reading and in front of their computers than the Singaporeans

kilian• 16 years ago

Still, everyone should use f.lux at night: http://www.stereopsis.com/flux/ :)

sigil2• 16 years ago

Laptop ergonomics deserves a special mention. Because it forces your line of sight and wrist level to converge, there really is no ergonomic option -- either you hunch or you scrunch. Elevating the screen and either using an external keyboard or external monitor really helps.

bphogan2• 16 years ago

Actually my Macbook Pro has improved my ergonomic situation. I use the built-in zoom tool, (it's the reason I bought a mac, as I have low vision) and because of the zoom feature, I can put the laptop wherever I find it comfortable but still see things. The zoom keeps me from hunching over or leaning in.

Also, I use my middle finger on the trackpad, as I need to use the middle AND index fingers to "right click", and this slight turn of my wrist completely removed the wrist pain I get from using a mouse or a normal trackpad.

sigil2• 16 years ago

But don't you end up angling your head downward to see the screen? Or angling your forearms upward to reach the keyboard? All the ergonomics material I've read suggests keeping these on the level, or possibly even angling your forearms down a bit into your lap. Almost impossible to do with just a laptop.

gfodor2• 16 years ago

Quit coffee. I ended up in the hospital after being in the heat and being hypercaffinated, so I decided to quit.

After the first few weeks of withdrawl, I've found that it is a net gain overall. No more feeling like crap until the first cup of the day. Better sleep. Clearer, less scattered thinking. I recently went on a trip with a friend who is still a heavy coffee drinker, and it was striking to see him suffer through the first several hours of the day before his second or third cup. Being able to wake up and feel great is well worth it.

The thing you lose is the muli-hour high speed coding marathon. But lets be honest, how often is it that the result of these marathons isn't something you end up needing to rewrite anyway because you jumped in too quickly or failed to think it through?

You could, of course, drink it "when you need it", but I've found that this is the slippery slope back into addiction. So, I just stay away.

Edit: I've also found that a tall decaf from Starbucks can serve as a mental substitute for those days when I really crave it. I even get a slight placebo energy boost. "It's so good when it hits the lips" :)

st3fan• 16 years ago

Well there is drinking coffee, and DRINKING coffee.

I sure enjoy a cup or two a day and I doubt that is excessive. Drinking lattes also has another nice side-effect: you get to drink some milk, for your daily calcium needs.

gfodor2• 16 years ago

Well, it depends on what cup, what coffee, and your body weight. If you're a skinny dude downing a venti from starbucks every morning, you're in a world of difference than if you brewed a lighter blend and drank from a small coffee cup.

I found myself quite addicted drinking a grande from starbucks every morning. Before that cup I was pretty much useless.

bryanlarsen2• 16 years ago

A cup or two a day isn't excessive. But it's more than enough to be addictive.

yason2• 16 years ago

The thing with caffeine depends entirely of the person and the flavor of coffee. A more accurate advice would be to suggest quitting anything you're even slightly addicted to.

zedshaw11• 16 years ago

But, it tastes so good! No! You can't have my coffee! :-)

jsz0• 16 years ago

I'd rather die than quit coffee. The method I use with good success is:

a) Drink coffee without much sugar/milk. I prefer iced espresso drinks that end up being 50% ice or water. Drink it slow so the ice melts as you go.

b) Drink a 1:1 ratio of water to coffee. If I have a 20oz iced Americano I drink 20oz of water before having more coffee.

c) Pay attention to your pee. Easiest way to see if you're getting dehydrated.

Ixiaus3• 16 years ago

I was never even close to being addicted to coffee and I refuse to drink even one drink due to its effects on my body. Stimulants not only fry you a bit, they also fatigue your adrenal glands which is the major cause for midday fatigue, random allergies, and poor sleep at night.

I highly recommend anyone that drinks anything more than green tea to quit - it seriously f's up your adrenals...

savemylife• 16 years ago

Do you have any references to back this up? I'm curious specifically about your claim that caffeine negatively affects adrenal glands.

fgf• 16 years ago

I'm also very interested in more info about this.

eru3• 16 years ago

Why do you think than green tea is especially mild?

bm98• 16 years ago

That tall decaf from Starbucks is not just a placebo; it has 20mg of caffeine.

See: http://www.starbucks.com/menu/drinks/brewed-coffee/decaf-pik...

jacoblyles• 16 years ago

But coffee makes you regular.

bryanlarsen2• 16 years ago

Seriously. Quitting caffeine was one of the best decisions I've ever made.

- I fall asleep within 5 minutes after hitting the pillow.

- I wake up when I want to, without problem, whether I've had 4 or 8 hours of sleep.

- The number of headaches I get has decreased dramatically.

- More importantly, the severity of the headaches I do get is dramatically different: before they were debilitating. Now, they're more like a hangover. Annoying, but easy to deal with.

- Caffeine radically improves the efficacy of medicines like acetaminophen. 350mg of Tylenol + 1/2 of a coke is more effective for me than 1g of Tylenol.

- When you get fuzzy headed because you've been staring at the screen too long, 10 minutes of fresh air works better than coffee used to.

- waking up is a lot more pleasant. It takes about an hour to fully wake up, but you're always partly functional, never grumpy. A little bit of exercise is the best way to shake it off.

Caffeine is a nasty drug to kick. DO NOT GO COLD TURKEY -- the headaches are evil. Slowly titrate off -- I used caffeine pills and a pill cutter.

samstokes• 16 years ago

I've heard several reports of the benefits of giving up coffee from people who were drinking several cups a day. What about moderate consumption? I usually start the day with one double-shot latte, and that's it.

silentbicycle6• 16 years ago

In my experience, the whole caffeine thing works best with small amounts, divided throughout the day, rather than a spike and crash. Besides, for programming you want to be calm-but-alert, not wide-eyed, sweating profusely, and jibber-jabbering.

Whether that means one cup of coffee in the morning and another after lunch, a thermos of green tea over the day, or a couple slightly-caffeinated mints every few hours depends on how your body handles caffeine.

imd2• 16 years ago

A while ago this was posted: http://www.kk.org/quantifiedself/2009/10/the-false-god-of-co...

I found it interesting, if not very rigorous. It shows that one man's productivity did not suffer after quitting coffee.

nileshk• 16 years ago

This will probably be controversial, but I believe that RSI (and typing-related carpel tunnel) is psychosomatic. I experienced what I thought was chronic RSI that I wasn't able to solve through any other means but reading Dr. John E Sarno's "The Mindbody Prescription" which I highly recommend reading.

For 1.5 years I was not able to type without pain. I was able to rid myself of this pain in weeks through a psychological approach. It's been over 7 years since then and I haven't had problems.

I also play guitar, bass guitar, and drums. It can be painful sometimes to play a lot if I haven't been practicing, but that pain goes away immediately, and I don't believe it contributes to a permanent or long-standing problem.

Ergonomics is good for being comfortable and pain-free. And exercise is good for general health. But I don't think not doing so is going to give you chronic pain.

Of course you should see a doctor to rule out diseases like multiple sclerosis.

Here is a document that explains Sarno's ideas: http://www.rsi.deas.harvard.edu/handout.doc Google cache of it for HTML: http://www.google.com/url?sa=t&source=web&cd=2&v...

Keep in mind that this does not mean "it is all in your head"... The problem does cause a physical condition in your body, but the cause of it is psychological.

mmt• 16 years ago

Of course you should see a doctor to rule out diseases like multiple sclerosis.

Autoimmune (e.g. Lupus) diseases are another important set to rule out.

The good news is that, though not curable, many of the inflammatory ailments are easily and cheaply treatable.

My advice: have your doctor consider the old NSAIDs first.Ketoprofen is my favorite, though Wyeth pulled it off the OTC market[1], so the lowest single-pill dose is pretty high[2]. Among friends and relatives who've tried it, it consistently counters inflammation, even though its pain relief varies down to nothing. Being old, it's cheap, too.

[1] shortly after buying the company who marketed it under the brand "Orudis KT". The cynic in me says it's because Advil has a much higher profit margin.

[2] 50mg compared to 12.5mg. Sometimes, 12.5mg once a day is all I've needed. Especially with the recent concerns over the safety of NSAIDs, needlessly quadrupling the dose seems foolish, so I hack the dosages. I could probably get a compounding pharmacy to do this for me, but that would eliminate the "cheap" advantage.

mattchew• 16 years ago

It's definitely controversial--so I feel obliged to mention that Sarno's methods also worked/work for me.

I also ran the gauntlet of standard medical treatments and therapies before trying Sarno's approach.

If you have seemingly untreatable RSI, it's worth giving Sarno's ideas a look.

zedshaw11• 16 years ago

I agree, it is psychosomatic, although that's usually a term used by bad doctors to wave away real problems with people. I think a better way to explain it is that your body is controlled by your brain, and if you control it wrong you can cause damage. Same way if you punch or kick something wrong you can break your hand, if you spend 8+ hours a day typing with tension, poor technique, bad posture, and ignoring pain signals then you'll hurt your hands.

So yes, learning to control you body and how you use it is generally a good idea. In general I think that's all Sarno's method does. It just makes you focus on how the motions should be done in a more relaxed manner, rather than tense and harmful.

Combine that with the wrist exercises and you'll be even better off.

xenophanes• 16 years ago

I agree with you that it is sometimes (perhaps often) psychosomatic.

I myself experienced much improved condition when I stopped being fearful.

Would you agree that in at least 5% of serious cases, the physical not mental problem is the main thing?

mikeklaas• 16 years ago

A repost of my comment from the last time this came up (http://news.ycombinator.com/item?id=1270409):

--------------------

His experience matches mind as well. Horrible RSI persisting for years, with non of the conventional treatments effective beyond a short amount of time.

After doing a _lot_ of research into this, I experienced an almost complete short-term recovery. It wasn't just lack of pain... muscles that felt perpetually taut and ropey were suddenly softened, and I became extraordinarily thirsty for a couple of days as healing started again.

Unfortunately, I only have speculation about what's going on here medically. As a seasoned skeptic, Dr. Sarno's explanation of psychological causes is unsatisfying to me. My hypothesis is that RSI is caused by a problem in the autonomic nervous system (i.e. the part that regulates your body). Sympathetic nervous system activity is provoked when your body is in "danger" mode: muscles are tensed, ready to act, etc. Now, what happens in RSI is that your muscles are being stressed through use (typing). This isn't normally a problem: when you stop typing, your muscles heal the tiny amount of damage that was inflicted. But if you are stressed out, then your sympathetic nervous system activity is heightened and your muscles don't get a chance to heal.

Now this is the insidious bit: the pain and injury eventually becomes a danger signal to your body. The injury thus provokes further sympathetic nerve activity. This negative feedback loop can thus perpetuate without the person feeling actively stressed any more, but is obviously exacerbated by feelings of worry about the RSI. Every time you try to be careful, you make the problem worse.

For a more medical take, some pieces are conveyed in this article: http://www.aapb.org/tl_files/AAPB/files/biof_34_2_pain.pdf . Some people speculate that similar issues underlie more serious problems, like RSDS and fibromyalgia

So that's all well and good, but what about the "cure"? Well, it seems that many people have virtually instantly solved their problems by adopting positive beliefs about the nature of the problem, that it is a problem caused by problematic nervous system signals and NOT an insoluble muscular injury. How does that work, exactly? I have no idea. Obviously, some stress is reduced, but that can't explain the magnitude and suddenness of the change. If anyone has ideas, I'd be very interested in hearing them.

If you suffer from RSI, the advice I would have is to think about this explanation while researching the ideas thoroughly to see if you're convinced. In the meantime, the best thing to do is daily exercise that isn't too intense, but gets your blood flowing for 20-30 minutes. Biking, running, yoga all have good benefits. You can do things like lift weights as well, but it is easy to overdo it, so I don't recommend it if your symptoms are severe. It's worth reading Dr. Sarno's book, but keep in mind that he uses words like "freudian unconscious rage", which made it hard to take anything he said seriously. In my mind, he is inaccurately explaining something which isn't true but corresponds to _some_ true phenomenon.

I've wanted to write this up for a while, but while I'm relatively convinced that I have a better explanation for RSI than most doctors, I don't really understand how "the solution" works (nor for how many people it does). I also realize that it sounds exceptionally hokey, which fuels my reticence. We'll see how it goes over here... ask me anything.

silentbicycle6• 16 years ago

It sounds like a lot of these are symptoms of the real problem: People are so hell-bent on hyper-focusing for long hacking marathons that they ignore warning signs and neglect their bodies.

Also: I did Aikido for a couple years, too, and know exactly which wrist stretches he means. They're great pre-typing stretches.

awolf• 16 years ago

My eyes used to be my weakest link. Then I got a pair of Gunnar Optics computer glasses. They soften the contrast of bright screens with their yellow tint, cut glare, have a slight corrective factor, and reduce airflow around my eyes keeping them more moist.

They work wonders.

MicahNance2• 16 years ago

Seriously? 65 comments and the top voted is about (off-topic) hygiene? With a community such as this, I expected a lot more advice and personal stories. To be fair, I guess this did get posted early on a Sunday.

Many thanks to Zed for bringing it up the topic. I think it is always good for the programming community to hear different views on it. As we rely more and more on computers, mobile devices, etc., we're going to see these sorts of injuries more and more and I'm not sure the medical community knows how to deal with them yet.

I read HN sometimes and there are so many people doing full time jobs, then coding at home, then playing guitar on top of that! It is depressing to read because I'm lucky if I can make it through lunch without my arms hurting some days. I don't think people in my camp speak up enough (partly because we are trying to type as little as possible). I haven't played my guitar in years while I try to cope. I've been to some physical therapy, but found that it didn't improve things much short or long term. If you do visit a doctor (which you probably should), just be aware that they may suggest surgery. Personally, I don't think that is the answer to RSI in most cases.

I weight lift occasionally but I can't tell whether it is helping or hurting. I've always been curious about yoga, I just need a kick in the pants to get started. So, there's my personal story.

As far as advice, I don't have much since I haven't actually found something that works well for me. I read "It's NOT Carpal Tunnel Syndrome" which was an short, interesting read, but ultimately didn't help me with my particular problem. It does have good general advice, a section with stretching exercises and nerve glides, etc.

zedshaw11• 16 years ago

Hey, just from what you're saying it sounds like your wrists have gone a little too far. If you have constant pain in your hands from typing, and you can't play guitar, and this fact is consuming your life, then you should do something about it. I don't know if that's surgery, but you should at least talk to a specialist about your pain (not a general practitioner), and see what they say. Also try to take a week or more off and not touch a keyboard or guitar. If that helps then it may just be you need to change how you do things with your hands.

MicahNance2• 16 years ago

It isn't my wrists; it is my forearms. From my reading and (ortho) doc visits, Radial Tunnel Syndrome is the closest diagnosis to what I experience. It could just be tendinitis, though. I agree I need a week off, but from my past experience I know a week isn't enough. I'm going to try and take several weeks off later this year.

Maybe my writeup sounded worse than it is. It isn't totally consuming my life, but it has been worsening again lately so the topic has been on my mind. I am not always in pain. I go through periods (days-weeks) of relative normalcy, but other periods where the pain is worse. I haven't played guitar because I try not to stress my arms while I'm home. I try to stay off the computer at home too, but you see how that is working out... I need some mental fortitude/willpower, too.

What do you mean by "change how you do things with your hands"? I've tried a few different chairs, chair/desk heights, keyboards, and mice. My latest is putting my MS Natural 4000 in my lap to type. I think that is an alright position for my hands, but I wish its keys had a little less resistance than they do.

mitjak• 16 years ago

I wouldn't get so fired up quite yet: the way HN rates comments is very bizarre.

alexyim• 16 years ago

Another useful thing is http://en.wikipedia.org/wiki/Myofascial_release.

Go pick up the hardest foam roller you can handle and start rolling:

http://www.amazon.com/Foam-Roller-6-x-36/dp/B000Y4W9VA/

It has done wonders for my body.

dylanz• 16 years ago

1. RSI: Take a week off, then, switch to Dvorak (maybe get a Kinesis keyboard if that helps you as well).

2. Back: Standing desk w/ nice architects chair.

3. Eyes: Get a Kindle and read PDF's/etc on it instead of computer.

My quick $0.02 on the problems I've helped resolve from your list Zed.

The other problems, I have yet to tackle, but, I probably should sooner than later! Great detailed post.

sushi• 16 years ago

Most of the problems mentioned won't even happen in the first place if one takes regular breaks.

I recommend WorkRave for this: http://www.workrave.org/

Tichy• 16 years ago

Or follow my twitter bot: http://twitter.com/officeworkout (strictly non-scientific)

silentbicycle6• 16 years ago

Or xwrits (http://www.lcdf.org/xwrits/), on Unix.

msluyter• 16 years ago

I disagree with his advice on vitamin D, especially for those over 40 who have lost most of their ability to synthesize it from sunlight. See:

http://heartscanblog.blogspot.com/2010/01/getting-vitamin-d-...

mathgladiator• 16 years ago

On Vitamin D, you need to be careful because it can also mess up your calcium levels. If you calcium levels change, then it can affect your magnesium levels. If your magnesium levels drop, then your muscles will hurt hard core. If you ignore the pain (and deal with it like a real man), then you will die.

earl• 16 years ago

Zed, you forgot kidney stones. One of the consequences of too much caffeine is it's easy to be dehydrated, which puts you at risk of kidney stones. Which essentially means you get the dubious pleasure of pissing razor sharp calcium rocks out your urethra. It hasn't happened to me, but it has happened to friends; based on their experiences, I wouldn't recommend it.

c1sc0• 16 years ago

Happened to my father & it was the most agonizing experience I have seen him go through. Kidney stones cripple you with pain, you can't sit, you can't lie down. It rips basic comfort out of your life for weeks on end.

grigory• 16 years ago

Something that worked really well for me is having several hobbies outside of work. It prevents me from just coding for 12 hours a day, and makes my life so much more enjoyable.

A really big one for me is mountain biking. I always found it to be a great escape from whatever I had going on - school, work, relationships - you can really forget about all of that stuff on trails. Mountain biking at times feels more like an addiction, to be honest. Indeed, I own a shirt that reads "Mountain biking is as addictive as crack, but twice as expensive". I start feeling bad about myself and getting a bit anxious if I don't go out on trails for several days in a row. It sure feels great afterwards though - really push yourself, have fun, get that dose of adrenalin and be physically exhausted in the end. I always solve my toughest problems after "hardcore" biking sessions :-)

Having talked to some hospital staff during my several biking-related emergency room visits, I can tell you that some forms of it (downhill-type stuff) are very hard on your joints, so don't over do it. If you're really into downhill racing and freeride, mix in several good XC sessions for cross-training. You'll be stronger and healthier.

P.S.: another thing that really helps is having an active S.O., someone who'll drag you out of your work-mode and take you hiking several times a week, and who will want social interactions outside of "reading HN".

sprout2• 16 years ago

I'm addicted to Swing Dancing.

wvl• 16 years ago

When you sit all day with your hands on a keyboard, your shoulders are constantly in internal rotation. Try this quick test:

Hold a couple pens loosely in your hands with the points facing out, and stand naturally with your arms at your sides. Where are pens pointed? If they are pointed forward, then you've got excellent posture. If they are pointed diagonally inwards, you have slight internal rotation. If they are pointed almost straight inwards, then that internal rotation is severe.

The point of this is that pushups, and everyone's favourite lift, the bench press, promote more internal rotation. Most office people would be far better served performing more pulling exercises than push. So deadlifts, rows, pull downs, pull ups, etc.

steve192• 16 years ago

CS departments should make all students attend a short course covering all of Zed's topics and the personal hygiene and mental health issues mentioned in this thread.

shoover2• 16 years ago

Or better yet companies that expect people to sit at computers for 40-60-80 hours should. One good thing about meetings: sitting in them is easier on your hands, if it doesn't drive you crazy...

Qz2• 16 years ago

While we're on the topic of computer use issues, thought I'd share something I discovered for mouse use. I realize lots of us like to go solo keyboard, but for when you have to use a mouse, try this:

Put the mouse (m] sideways pointed left at the bottom left side of your keyboard:

  [Keyboard]
  (m]

Rest your elbow on the desk, so your arm is parallel to the keyboard.

I've been doing this for a few months now, and it's been a huge improvement. It might take a while to get used to the mouse being perpendicular to the pointer orientation on screen, but maybe not (didn't for me). The position is somewhat adapted from the tai chi standing practice posture.

sprout2• 16 years ago

I do this when I'm forced to work at a desk. Though presently I'm sitting- well, reclining across two chairs, my keyboard in my lap. My mouse is sitting on a table to my right, so I actually raise my arm so it's at a 90 degree angle from my body to use the mouse. That works pretty well (incidentally, I'm reclining to spare my knees - keeping them bent for hours at a time is not a good thing, better to leave them straight. )

Encosia• 16 years ago

I can confirm that this setup has legs, long-term. I've been using my mice that way for over a decade now, after accidentally stumbling onto it.

A good cordless mouse makes this configuration much more convenient (I'm still using an aging Logitech G7, for example).

Curious, do you write left handed? I do, and so does the only other person I know of that uses this setup.

Qz2• 16 years ago

Actually no, I'm right-handed. I don't even remember how I ended up with the setup... maybe my mouse just gradually moved leftwards across the desk in search of better comfort!

stretchwithme4• 16 years ago

This article mentions several problems caused by stiff muscles and strategies for coping and preventing them. It may be useful to understand the mechanisms that cause and perpetuate this problem.

There's the muscle sheaths that have stiffened by the lack of use of the full range of motion and the constant deposition of collagen, which literally glues the sheath to itself. This tight sheath can impair blood flow to a muscle, especially when the muscle is contracted for a long time. The contracting muscle presses out against a tight sheath. Blood takes the path of least resistance.

That lack of healthy blood flow can cause the sarcomeres, the contractile unit of muscle, to get stuck in their contracted position. This is how a muscle gets tight and actually shorter.

When a muscle gets very stiff, a trigger point can develop. A trigger point is just an area where many sarcomeres are tight. We certainly notice trigger points, but the muscle gradually hardens for a while before a trigger point develops.

The hard muscles are shorter and thicker and this makes manipulating the sheath to break up the collagen much harder. But if the muscle is softened first, it can be done.

Massage is how you soften the muscle and get the sarcomeres in it functioning again. Massage pushes depleted blood out and then new blood is pulled in from the capillaries.

But there's still one other factor and that is the way muscles communicate with each other to accomplish work. When one muscle is engaged, other muscles receive nerve signals to help. And if there is a trigger point in one muscle, other muscles are engaged via the nerves.

So you may have a tense muscles but it may be another muscle that is the root cause. All of the muscles need to considered and massaged in a systematic way.

AgentConundrum7• 16 years ago

All of the muscles need to considered and massaged in a systematic way.

I wish I had realized this years ago. I developed RSI symptoms, or at least they became severe enough that I took note of them, about two months ago. I did a lot of research after that and ended up booking my first ever massage.

When the therapist started working on my forearms, she explained that I was very tight, and she wasn't surprised it was causing me pain. Oddly, my left arm ended up being the worse off of the two. After the massage, I felt great and could type relatively normally again without pain.

She also told me that my neck muscles were essentially made of stone, and asked me if I regularly got headaches (I did).

I guess what I'm trying to say is that you shouldn't underestimate the value of regular massages. It would probably cost around $1k/year to go once a month, but I think it's worth it to keep yourself at the top of your game. Therapeutic massage is often used to manage chronic pain, so I see no reason why it couldn't also be used to prevent it (or cure it if you're in the early stages).

stretchwithme4• 16 years ago

Massage addresses one piece of the puzzle and to me is primarily a coping mechanism. It does not necessarily addresses the underlying problem.

It depends on the therapist; some are really good and some approaches work much better than others. But this problem is clearly not addressed properly for most people. Many suffer for years with it and a quick trip to a nursing home will confirm that.

jz• 16 years ago

A little late to the party, but I went through a bout with wrist/arm pain for over a year. I did physical therapy for more than 6 months, saw a doctor that said I needed to have surgery on my arms, neither helped (did not have surgery BTW). I then finally saw a myofascial specialist. She identified the cause of my pain from trigger points in my upper back and shoulders. After just one visit and a follow up visit a year later, I've been relatively pian free. She basically taught me how to address the trigger points my self using a tennis ball and 'The Trigger Point Therapy Workbook' http://www.amazon.com/Trigger-Point-Therapy-Workbook-Self-Tr...

I'd definitely give this book a try since it clearly identifies which trigger points are causing the referred pain/numbness along with the ways to treat them.

Also if you are in the Chicago area, check out http://www.myopain.com/. Like I said, they were able to help me with only 2 visits.

joe_the_user2• 16 years ago

Generally very interesting discussion. The point that multiple muscles need to be addressed is important. I've read The Trigger Point Handbook and had some training in a form of trigger point therapy but I hadn't heard that exact discussion of the origin of trigger points - some references would great. Trigger points themselves also can and should be massaged - ideally by someone who knows what they're doing it.

I suspect the narrative is simplifying a bit. In my experience, trigger points develop in a variety of situations following a variety of physical, genetic and psychological factors.

I stretch at least daily and I'm probably more limber than 90% of people but I can certain develop trigger points after some intense exercise - stretching isn't necessarily enough.

ruang2• 16 years ago

Semi-fast once a week. Much easier than trying to calculate your calorie count each and every meal.

I skip dinner and breakfast the next morning, so I'm without food for 24 hours.

stretchwithme4• 16 years ago

Here's an easy way to release some muscular stiffness if you're having lower back pain while sitting.

Stand up and feel your lower back and whether you can massage it easily.

With your arms back at your sides, bend both legs just 1/4 of the way down. Do this 3 to 5 times.

Now stretch the front of each thigh by holding the foot to your butt. Don't use a lot of effort to do this. Just hold in place for 5 seconds or until it completely stretches.

Now feel your lower back again and see if you can massage it. If its much easier to massage now, the source of your pain is your tight thighs. But now you have a way to cope with and reduce the consequences of this tightness.

xom• 16 years ago

What's a door jam?

PidGin128• 16 years ago

http://en.wikipedia.org/w/index.php?title=Door_jamb&oldi...

Depending on the context that inspired you to ask, the literal explanation may not help.

c00p3r• 16 years ago

Run, Forrest! Run!

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