When your passion becomes your bane.

Cate Twining-Ward from L.A. Times:

The first thing I do each morning is check my watch — not for the time but for my sleep score.

As a runner, when the glowing red letters say my score — and my training readiness — are poor, I feel an instant dread. Regardless, I scroll on, inspecting my heart rate variability and stress level — snapshots that influence the tone I carry into the day.

What does dreading my smartwatch’s interpretation of my athletic competence say about me? That I have become a pawn in the gamification of health data.

Last year, electronics represented one of the largest proportions of total Black Friday sales, according to Deloitte. That’s when I bought my first smartwatch, a Garmin.

This year, I’m throwing it away.

I was the perfect target. For several years, I had been preparing to run my first marathon. I watched fitness influencers, ultramarathoners and Olympians optimize their training with meticulous tracking and high-tech devices. I wanted in. I got the watch and joined Strava, a social media network for athletes.

Once I had a tracker on, sleep became sacred. I traded late-night socializing for it, confident that I’d cash in on race day. I built my day around my nights, transfixed by a false sense of control over my circadian rhythm.

Sleep, just like my running routine, had slowly morphed from a bodily function into a technological token of productivity.

I was hooked, emboldened by the illusion that I was training intuitively. I pushed hard when my Garmin nudged me, and even harder when I wanted to prove its metrics wrong. I began to run more for the PR (personal record) badge and “your fastest 5k!” notifications than for mental clarity and solitude.

I ran because I loved it, and because I loved it, I fell prey to the Strava-fication of it. Suddenly, I was no longer running for myself. I was running for public consumption.

I realized this only when it literally became painfully obvious. An MRI found that the lingering pain I’d been ignoring in my heels — something my watch hadn’t picked up on — was caused by four running-induced stress fractures.

Recovering from the injury forced me to be sedentary, and during that time I’ve thought a lot about the app-ification of exercise culture.

I’ve realized that health optimization tools — the ones marketed as necessary for better sleep, a lower resting heart rate, higher VO2 max (a measure of how much oxygen your body absorbs) and so on — are designed to profit off our fitness anxiety. We track ourselves this way and that way, obsessing over our shortcomings to no apparent end. In doing so, we are deprogrammed from listening to innate physiological signals and reprogrammed to create shadow experiences such as posting our detailed workout stats or running paths on digital walls that no one is looking at.

I’ve also learned that if you stop tracking, you will feel marginally but measurably better.

I don’t deny that today’s fitness gadgets are incredibly alluring, and in many ways tracking can be useful for training. I am convinced, however, that overreliance on the data collected by devices and apps — and the comparisons we draw from sharing it — can quickly corrupt and commodify what I find to be the true essence of running: being present.

When we aren’t tracking, when we are just doing, we can begin to reap the dull yet profound psychological benefits of endurance sports — the repetitive silence, the consistent failure — that can’t be captured in a post or monetized.

And when we endure the mundane and difficult aspects of a sport, over and over, we often make gains that are mindful as well as physical, becoming more aware of how and what we pay attention to. This is no small task. It takes discipline to remain aware, present and undistracted.

Exercise is a rare opportunity to allow our bodies’ movement to color our thoughts from one minute to the next. When we’re in motion, we don’t need to analyze our health metrics. We can learn to accept the moment and be humbled by our limitations.

Gift-giving season will attempt to convince you that you need devices to make your exercise more effective and efficient. There will be bright and beautiful advertisements featuring famous athletes. There will be a sleeker smartwatch and a cutting-edge GPS tracking shoe sole like that one Instagram keeps showing you. Be skeptical.

Freeing yourself, even temporarily, from the smartwatch or smartphone or smart-fill-in-the-blank that is tracking your every move is a challenge worth taking on. Because every walk or run or ride is a new story, and without fitness devices the path remains ours to choose.

I pasted the whole article here, because it has a nice flow and also describes something that a lot of people go through.

A phase many people have known too well for too long:

When your passion becomes your bane, to the point where you’re harming your body instead of helping it.

This is one of the reasons why I don’t track my health to an absurd amount. As a matter of fact, I don’t close my rings most of the time because I work in a sterile lab environment, and you can’t even wear your Apple Watch, or any jewelry for that matter.

I also don’t track my sleep with it because I work the graveyard shift 35% of the time, and 65% of the time I work a normal 9-5 routine. If I were to track my sleep and vitals obsessively, I know I would feel worse about it because objectively, it would be considered “non-optimal,” even though I have my own routine that works for me and my body.

I only track my rings on days that I formally workout, since I know I can hit my goals. I could pause my rings or change my daily calorie count which Apple allows with watchOS 11, but that is just too much work and too much tracking.

I’m not trying to turn my life into stats and data and be dictated by it.

The same thing goes for even writing on this blog and my passion for Apple products. There could be moments of excitement when new hardware gets announced, but if I was trying to beat the other websites for content, I know it would be a losing battle because I’m one guy vs teams of people.

That excitement would turn into a form of exhaustion since I can’t keep up with everybody else.

New Apple announcements would turn into a flurry of, “what should I write about to increase my view count?”

I’ve realized that it isn’t about the clicks and views, but it really comes down to writing because you actually care about the subject and you actually want to help people make good decisions, even if it is just one person.

Or maybe you just want to write about something that interests you and others who like your hobby, as a form of entertainment or nostalgia.

If you want to follow your passion and build something out of it, you need to take it easy and at a pace that is sustainable, or else you will get burned out.

You need to find that balance of passion, purpose, and consistency.

Testing Apple's Drug Interaction Checker - How Accurate is it?

Note: These features were tried on iOS 16.5, and on iOS 17 Developer Beta 1. 

I tried to put Apple’s drug interaction checker to the test, and let me start off by saying that overall it does a good job of catching interactions. It’s not perfect though, and can even be dangerous. That is why you should always consult your care team to determine if any medications need to be stopped or changed based on your health situation.

With that being said, let me set the scenario here.

I used a bunch of drugs to test out Apple’s system, and to see how well it can track drug interactions and interaction factors. First, let’s check out the list of drugs:

1. Crestor (generic name is rosuvastatin) - cholesterol medicine.

2. Zocor (generic name is simvastatin) - this is the same drug category as above, used for cholesterol medicine.

3. Simvastatin - literally the same drug as Zocor.

4. Rifampin - used for treating tuberculosis.

5. Lisinopril - blood pressure medication. 

6. Accutane - for severe acne.

7. Chantix - for smoking cessation.

8. Promethazine VC with Codeine - used to treat cold, stuffiness, and allergy symptoms.

After putting in your medications, you get a list of drug interactions that pop up. When you enter the interactions page, you will see “Current Factors” at the top. These life factors can look for interactions between your medications and said life factors. Apple currently provides three life factors:

1. Alcohol consumption

2. Marijuana

3. Tobacco

With all life factors turned OFF, there was 1 Serious and 4 Moderate interactions.

After turning ON all 3 Interaction Factors, the number of interactions increased to 8 Serious and 4 Moderate, which is no surprise.

Although technically all of the drug interactions are present, there are fine details that many people might not be aware of. A thorough pharmacy based system would find a few more discrepancies. 

Let’s look at my list of drugs from above once again:

1. Crestor (generic name is rosuvastatin) - cholesterol medicine.

2. Zocor (generic name is simvastatin) - this is the same drug category as above, used for cholesterol medicine.

3. Simvastatin - literally the same drug as Zocor.

4. Rifampin - used for treating tuberculosis.

5. Lisinopril - blood pressure medication. 

6. Accutane - for severe acne.

7. Chantix - for smoking cessation.

8. Promethazine VC with Codeine - used to treat cold, stuffiness, and allergy symptoms.

Drugs 2 and 3 are duplicates, and drug 1 is in the same category as 2 and 3. In a pharmacy drug utilization review system, these 3 drugs would pop-up as 2 or even 3 separate drug interactions, and would require consultation with the patient. Odds are the patient is stopping one medication and starting another, or they have switched from a brand name to a generic. Apple’s interaction checker however doesn’t give you these warnings. 

Does Apple’s drug interaction checker screen for pregnant patients?

In its current version of iOS 17 Developer Beta 1, Apple’s drug interaction checker is not designed to screen for pregnant patients. Here’s the process that I used to find out.

I changed my gender in the Health app to female and added an active pregnancy that is currently nearing 3 months. I wanted to trigger more life factor interactions, since some of these drugs on my list are a big no no during pregnancy. 

After adding my pregnancy status, I still had the same 8 severe and 4 moderate interactions. I even gave the phone a few days to perhaps “sync” the pregnancy information and maybe it would trigger some sort of alert. After a few days, I checked the drug interaction checker again and it still had the same 8 severe and 4 moderate interactions. There was nothing in the medications section indicating that Apple was aware that I was pregnant, and there was nothing in the pregnancy section that triggered any alerts based on my drug profile and substance use. There was no warning to stop drinking alcohol, or to stop using tobacco or cannabis due to direct fetal harm, even though I was “using” all those substances.

Now let’s disregard the life factors and just think about the medications and the active pregnancy. If these drugs were in a patient’s profile at a pharmacy and the patient had a pregnancy status of positive, the computers would sound red alarms: 

Let’s look at the list of drugs again (for the 3rd time now!):

1. Crestor (generic name is rosuvastatin) - cholesterol medicine.

2. Zocor (generic name is simvastatin) - this is the same drug category as above, used for cholesterol medicine.

3. Simvastatin - literally the same drug as Zocor.

4. Rifampin - used for treating tuberculosis.

5. Lisinopril - blood pressure medication. 

6. Accutane - for severe acne.

7. Chantix - for smoking cessation.

8. Promethazine VC with Codeine - used to treat cold, stuffiness, and allergy symptoms.

Drugs 1, 2, and 3 would be considered very high risk to the fetus.

Drug 5 is considered Pregnancy Category D, which means positive evidence of human fetal risk.

Drug 6 is considered Pregnancy Category X (not allowed at all during pregnancy), and with this drug in particular there is up to a 35% chance of severe birth defects. 

As you can see from such a patient drug profile, a successful pregnancy would most likely not happen. 

Now in fairness to Apple, they do state the following to let people know that not all interactions might be caught by the Health app:

“Health is not able to check for all potential interactions. More information is available on the labels of your medications. Discuss any questions about your medications with your care team.”

Is Apple’s drug interaction checker flawed?

Right now, Apple’s drug interaction checker works in a bubble. It can take hundreds of drugs, along with the life factors of alcohol, tobacco, and cannabis use, and spit out every interaction between these factors. 

While I believe that Apple has made great progress by adding a medication log and even providing drug interactions, it still requires more work. The pregnancy section of the Health app needs to talk to the medications section in order to make it a more robust and reliable system that holistically looks at the person’s health. I believe this is a work in progress for Apple, and in due time they will get there since they have a strong focus on health and fitness.

Even when Apple does get there, remember to always seek professional advice from your healthcare team in regards to your medications and health concerns.