Last spring I began six rounds of chemotherapy which changed the relationship between me and my body forever. The chemo worked so well on the first round, it shut down my immune system and put me in hospital. Then each subsequent round left me weaker and weaker. For a few months, I became my body.

I spent everyday trying to battle the physical side effects of the chemo. And the intellectual part of me which I thought defined me, behaved like a useless relative asking the questions I didn’t want to hear: ‘Aren’t you scared?, ‘What if you don’t get better?’. Finally, I stopped thinking and did what my body asked me: ‘Sip this, chew that, lie down’. I lived from moment to moment and began living completely in the present, I had stumbled upon mindfulness.

One afternoon as I pushed a needle full of the immunostimulator Lenograstim subcutaneously into my stomach, I remembered Stelarc, an artist who upgrades himself surgically because he believes his body is obsolete. And I thought: ‘What a plonka,’ as I was still very sore from having cancer surgically removed from my body. But on reflection, I could see what he meant. I was only my body and so weak I was unable to interact with the world. Someone else was looking after my toddlers, taking them to the park, and doing all the things I could no longer do. I was trapped in my body upstairs on the bed, and I would weep at the thought of getting up to do anything, even reading was beyond me. I too felt that my body needed an upgrade.

I felt that every experience I had was totally physical and raw. Although on an intellectual level I still knew that was not true. We are embodied. We experience the world through our bodies and their limited senses and then our brain interprets the experience in light of our past experiences. There is no such thing as a raw experience.

I even lived this embodiment. Each time I thought of the next round of chemotherapy, I would vomit. Such a reaction is known as anticipatory nausea. And, anything I did in the chemotherapy room: drinking tea and reading my kindle, I was unable to do outside of it without vomiting. My embodiment had reinterpreted the experiences of drinking tea and reading my kindle as vomit-inducing ones.

I realised that it wasn’t just my embodiment which was causing my experiences. It was also other peoples’ embodiment, especially when it came to their perception of my physical appearance. I lost all of my body hair and so when I left the house it was in camouflage. I wore an expensive wig, I drew on my eyebrows and I wore a lot of eye-makeup to distract attention from my missing eyelashes, so people wouldn’t perceive me as sick. On the odd occasion when I would open the front door displaying my bald head and face, people would shrink backwards and look at me with horror or repulsion or fear. In my camouflage, people would treat me as a normal person and judge me on the tube for not giving up my seat to the needy. And the people who knew would say: ‘Oh you look so well, I can’t believe you had cancer.’ Everyone has an experience, or an image of how cancer should look.

Throughout it all, I kept my Matrix residual self image, the image of me which had been the same for over 20 years: Long black curly hair and a fine pair of eyebrows. So, I would get a shock when I saw my bald self in the mirror looking back horrified and repulsed even though I no longer felt my hair on my shoulders after I had asked my husband to cut it. I packed it and posted it myself to a wig charity. My hair had left the building. However, we didn’t have any mirrors in our home in which I could easily catch sight of myself, so I would go days thinking that I was still the same old me. Even when my husband said I looked like a Mekon, I laughed and thought, ‘Well that is just your opinion.’ In my head I was beautiful. I was a warrior. I was Wonderwoman. I had learnt how to reframe my experiences and tell myself positive stories. I had learnt to use narrative therapy.

And because I was focusing on reinterpreting things more positively, I stopped reading into situations. I have always been a people-pleaser, afraid that people won’t like me, or that I am not enough. Intellectually, I know that this is because my embodied mind is working overtime misintepreting other people’s behaviour. Most people aren’t actively disliking me, they are busy thinking about their underpants being too tight or what they are having for tea. They haven’t even noticed me. Sadly, I find a lot of women feel the way I do, it seems to be some warped extension of the mothering instinct. I have a feeling that I am responsible for making everyone happy and should rush about doing just that. As if I had the power?

Several months after finishing chemo, I went to a yoga class. I thought I would only do about 10 minutes and have to rest, but I managed to do the whole thing. It felt amazing. I was there and present and so proud of my body for being able to do yoga, to get into positions and to hold them. I was all of me, complete in my body. I was unaware of anything else until I looked up and saw a woman at the back of the room staring at me. Throughout the rest of the class she kept staring. Why wouldn’t she though? I was beautiful. I was a warrior. I was Wonderwoman. And then when we went over to return the blocks and belts, she told me off for standing on someone else’s yoga mat. It was immediate, she leant across and got hold of me the instant I stepped on it as if she had been waiting for me. I immediately apologised being the people-pleasing sap I am and stepped out of her grip, and then I lay down on my mat for the corpse pose and felt angry: It was a communal mat and I was barefoot and really, WTF? I decided I would talk to her later and got on with relaxing. When I got up I had forgotten what she looked like. How was that possible? And as I walked home I asked myself: What did it matter? Why did I need to say something? In this instance, her behaviour towards me was not my problem. It was sad that instead of using this time to do yoga and feel better, she was for whatever reason, annoyed with me.

And this was a revelation. I grew up in a household where sometimes I would be recounting an incident and then I would get told off because I didn’t respond correctly. I should have said X, or shouted, or shown them. Or, I would get told off because someone would be upset about something else and not about me at all. I just happened to be there able to become a focal point for their annoyances. And this has recurred in different contexts in my life, particularly in my career, which has made me feel bad because somewhere along the line, my embodiment believed that someone else’s inappropriate behaviour was my fault and that I should bend myself out of shape to fix it and make them feel better so that they won’t treat me badly again.

So like the embodied kindle-tea vomiting that I learnt instantly, recognising that a woman telling me off was about her and not about me, was amazing. And it was fitting that this happened in yoga class. Yogis talk about cleaning the lense of perception and see the world as it really is. Through meditation, Yogis attain a healthy state of seeing things as they are rather than the unhealthy stories their embodied selves have learnt to believe. And once this ability to see clearly is combined with the mindfulness of being present in this moment of seeing, great power and wisdom become the norm.

When my hair and eyebrows first grew back they were white, so I dyed them and afterwards I looked in the mirror and felt a distinct sense of: ‘Ah there you are.’ The image in the mirror once more resembled the image in my head, although I had a funky short hairdo and looked like a different me but more me.

And having spent time listening to my body and practising mindfulness, some days I still feel like more me, albeit, a different, funky me. And other days I forget about me and where I have been as I am sucked back into life and the trifles which can make up a day. And every now and again, I remember where I am, and I remember that I am all of me, complete in my body, and once again I recognise that I am more me than I ever was and I welcome that distinct sense of: ‘Ah there you are.’ And why wouldn’t I?

I am beautiful. I am a warrior. I am Wonderwoman.

In 2002, I watched Stelarc at the CHI 2002 conference in Minneapolis, give his keynote speech entitled The body is obsolete.

We used to talk a lot about obsolete software. Nowadays we mostly talk about giving software an upgrade. In the same way, Stelarc is not saying that the body is no longer needed, as that would imply that he believes the body is separate from the mind, as Decartes and his theory of Cartesian Dualism postulates. Instead, Stelarc is saying that the human body needs a redesign to keep up with the mind.

By redesigning his physiology, Stelarc feels that he can extend his philosophy of life because in this technological age, we are overwhelmed with information and we cannot creatively process it. Thus, we need a more creative attitude to the body. Instead of designing ergonomic systems which adapt to the body, why not redesign the body so that it can be more easily plugged into technological advances?

Over the years Stelarc, a performance artist, has experimented with his own body to extend himself. In 2007 he had an ear with a microphone inside attached to his arm, with the aim of connecting it to the internet, so that people could hear what his ear is hearing.

Sterlac is not alone. Computer scientist Kevin Warwick wants to upgrade humans too. In 2002 he had a chip inserted into his left arm’s nerve fibres, which enabled him to control a wheelchair and an artificial hand. The chip also received signals and could stimulate/simulate artificial (meaningful?) sensations in his arm from the signals. I listened to Warwick present his research at Westminster University in 2005. He wanted to take this work further and ‘jack into the nervous system’ in order to override the restrictions of our bodies.

However, humans are constantly bombarded by signals to their senses and have limits on what they are able to interpret at any given time. Because of these limitations, we augment our cognitive capabilities by employing and interacting with the environment around us. We use calendars and write lists so we can use such information when we need it, instead of taking the time to memorise it and store it in our heads. And the information which makes it past the filters of our senses and into our brain is done so in such a way because of our past experiences, which in turn impacts the interpretation of our future experiences.

This interpretative experience of the world is known as embodiment or situatedness (otherwise known as social situatedness). We understand and process knowledge which is situated in social, cultural and physical contexts. We give meaning to the knowledge because of where we are, doing what we do, in a specific moment of time.

So, if you are going to override your embodied nature – or your limitations – by jacking into your nervous system or hearing extra streams of information, you are going to have some new experiences. Your body might learn to adapt, as we humans are adaptable creatures. Alternatively you might have a meltdown.

Alvin Toffler in his book Future Shock popularised the term ‘Information overload’ which describes the difficulties humans can have understanding and making decisions when presented with too much information.

So, the questions that spring to mind when you upgrade your embodiment:

• Is the information meaningful?
• Is it protected? Safe and secure?
• Is it enriching? Has it a purpose?
• Can you wear this technology or perhaps pop it down your underpants instead of having surgery?

Steve Mann augments his reality with wearable computing. Mann wears sunglasses which display constantly streaming information based on what he is seeing. This information assists his memory and enriches his world view because it is situated. It comes with a context and is meaningful to him in that moment and if his technology stops working he can take it off his nose, sit down at his desk and fix it.

In contrast, Mark Gasson deliberately infected his chip implant with a computer virus in order to experiment with the security risks of implantable technology. His implant stopped working but he is leaving it in his arm. He says the experiment was motivated by more and more people getting chip implants.

Many people have surgery for cosmetic reasons, so it should not come as a surprise that people would voluntarily choose unnecessary surgery to augment their healthy bodies with technological implants. However, Stelarc has said that he is constantly redesigning his own body because it is difficult to find people who want to undergo surgery. No surprise there when he lists the various setbacks he has experienced such as infection and necrosis.

Controlling a wheelchair with your mind when your limbs no longer work and an extra ear on your arm transmitting whatever someone is saying when they are standing next to you, are two applications of implantable technology. Both the artist and the scientist are motivated by the desire to upgrade the embodied nature of the human condition because they feel that the human body is insufficient in today’s technological society.

Ironically, robotics researcher Rodney Brooks among others argues that true artificial intelligence can only be achieved by machines that have sensory and motor skills. Robots and machines need bodies. Thus, they need to be embodied and situated to have a context and constraints within which they can successfully interact with the world.

So, as humans aspire to override the very aspects of the body which make them human, robotics research is replicating these human limitations in order to successfully create functioning artificial beings.

We live in interesting times.

I used to read a woman’s blog, everyday. It was amazing: Her drunken, violent mother, her complicated pregnancy, her terrible having a baby experience followed by terrible post-natal depression. It was a detailed slice of life which was compelling to read. One day she wrote that her husband was thinking of resigning from his job to go to another job for money even though his boss had been great to him and it was a bit of a dilemma and what was he to do? Next day, the blog had gone forever, all that was left was an apology for saying too much.

I can only guess that the last entry, before the blog got deleted, jeopardised her husband’s livelihood and it was the kind of the thing she might not have mentioned to any of husband’s work colleagues had she seen them face-to-face.

I remember when I was eight-years-old being with my mother as a woman we had bumped into in the street told us all about about a recent suicide attempt – she took a lot of tablets. At the end of the long, sad story she looked at me as she said,

‘And I lay on the bed and wished that I would never wake up.’

I am probably the same age now as that woman was back then and I wonder would this woman be blogging nowadays? Lots of people do blog about their feelings. Is there any difference between blogging and telling people in the street?

Blogging about something and publishing it online means that you don’t know who you are telling although you have an exact record of what you have said. Telling someone in the street face-to-face means you know whom you have told but you might not remember exactly what you said.

Whether you are saying too much depends on how comfortable you feel sharing whatever you have to say and your state of mind. If you are traumatised the filters that you normally have to stop everything you are thinking come straight out of your mouth, are not always working and sometimes that is not the best time to be talking, especially in front of eight-year olds, even though you have a need.

Talking or blogging can be cathartic and just the thing to make sense of an event. Or, you can, as in the case of the husband-job blogger-woman, say too much and later be sorry because you set into motion events you wish hadn’t happened.

It is easier to be free with your information when there is just you and a computer and no one else. There is a certain fake intimacy of ‘me, you (the computer), and the four walls’. The X million people also on their computers who might read what you are writing, are forgotten about.

When interacting with another person we often tailor what we say depending on what they say. Or, we get prevented from saying what we want to say because this other person has something to say. Or, someone else comes along and we don’t feel comfortable having the same discussion in front of them. On a computer there is no one there to stop you saying exactly what you want to say, exactly how you want to say it. Liberating or dangerous?

It is quite common to read about people being sacked nowadays because they have blogged about their lives and the company they work for feels that its reputation is somehow compromised. This is interesting because people often talk about how they feel about their job when in the workplace. But because they are talking to a limited audience in the canteen or at the coffee machine it doesn’t carry as much weight as if their opinion is all typed up and put online where you have an audience potentially in the millions. The power of the written word does seem to be greater than the spoken one.

Incidently, I have, in recent years, asked my mother about the woman we met in the street and she doesn’t remember it at all. Perhaps, back then she was forever meeting women who wanted to top themselves. Perhaps, she chose discretion. She chose not to remember in case the woman in question didn’t want anyone to remember and be reminded of a difficult time years later. Or perhaps, we said goodbye to this woman and got on the bus to go home and what to have for tea become the most important thing to us.

And perhaps it is the same when reading blogs. We switch off the computer and go back to our lives and we forget a lot of what we have read and eventually these blogs are deleted by their owners and whatever seemed so important then isn’t so, because life is ever changing. Or, since we are all human, and the human condition doesn’t change, perhaps you can’t share too much. Perhaps, sharing our experiences and connecting to others for good or for bad is all we have, whether we do it online or in person.

I am in the market for a new mobile phone. I love my current LG running android but it is a bit battered and after a little family member chewed the buttons it doesn’t work as well, and the camera is very slow. So, I was given a copy of Stuff Magazine The Android Issue and having looked at it for the first time today I am enraged. I am furious.

What has the girl on the cover got to do with anything in this magazine? Turning the pages there is more of her and another girl in progressively silly poses. They are not even interacting with the technology, they are just looking about with a vacant expression only ever seen in porn magazines for men. Android doesn’t need porn style poses to promote its wares. I think my alternative version of this cover is better. Same plastic dollie bird except Barbie has more clothes on and looks pleased with her ipad.

The Stuff magazine cover and its Android article appalls me. The message I guess this cover is aiming for is: Android is ‘sexy’. The message I receive is that this magazine is aimed at and edited by sad porn loving men who like to fumble furtively with their Android apps and believe any sort of technology is a man’s domain. Disturbing to say the very least in 2011. The Internet has opened up the world in so many ways and technology is moving on constantly to make things better and more exciting. But sadly, marketing ‘sexy’ is used to sell more than ever and we are bombarded by unnecessary pictures of scantily clad vacant women.

Come on, you might say, it’s only a bit of fun. It isn’t. It truly isn’t. I am a mother of young girls and a computer scientist. I want to share with them the excitment of a world improved by technology. Cool, accessible technology which makes life easier. I won’t be using Stuff magazine to do that because I don’t want to have to come up with an explanation of what the silly girls are doing in the pictures. Imagine it:

Daughter: What is that girl doing mummy?
Me: Well she certainly doesn’t need to use that stylus when checking the weather app, she hasn’t got to grips with the multi-touch functionality on that HTC phone and she really must pay more attention to what she is doing…

Give me break! Already my eldest has used the term ‘boy’s toys’ and I can tell you that it is not a term she learnt from me.

We don’t need to sex up our technology, especially not to promote Android. Come on Stuff magazine, have some respect for your demographic and stop treating them like porn mad losers.

Newsflash: women do technology. The first computer programmer was a woman.

Today I updated WordPress. Wow! I have blogged in the past about how much I love WordPress, but where have I been? The WordPress community have been busy making everything smart and sexy. The new dashboard and themes make me desperate to write cool blogs (Dream on – I will).

Before my discovery today, I was a little upset to change my Kubrick theme, I read somewhere that it is no longer supported but after I installed my upgrade it worked as beautifully as ever. However, as much as I love its calm blue smartness, I have always secretly hankered for something more without ever wanting to commit to doing anything. Apart from the ‘if it ‘ain’t broke don’t fix it’ adage, scripting is a means to an end with me. If I really need to do something in a scripting language, I hack away blindly and never get it right the first few goes. Sometimes catastrophically.

When I was an industrial placement student, I edited a whole live database system under the tuition of the resident systems security ‘expert’ (who was one creepy guy). I guess he would have told me not to do that but I was 20 years old and didn’t have a very long attention span. Seriously, who does at that age? Anyway, one embarrassing mess later I was highly amused to find out that he hadn’t a single backup of the database in his Hong Kong Book of Kung Fu tricks . It just goes to show you that everyone needs to think carefully about who is going to carry out the essential but boring jobs (university departmental intranets are a total case in point). And if you must also bore your poor students whilst instructing them, make sure you practice what you preach, and it is probably best to get it down in an email so they have clear instructions.

Apart from my hacktastic tendencies, the other reason I hesitated about tinkering with the Kubrick theme was that I liked its simplicity and its clear lines and from a usability point of view, it is easy to read and to process (Where am I? Where have I been? Where am I going?). I have chosen a similar layout on this one and it looks great, but reading it I tire more easily because the text is too wide and hence, more tiring to read. I need a smaller text column. I feel more tinkering coming on.

Luckily that will be easy to do as I have used the child theme approach (great tutorial here : http://www.throwingabrick.com/wordpress/customizing-the-wordpress-twenty-ten-theme.html ). The child theme approach to editing themes is perfect. It lets me overload my code changes in a separate directory without ever messing up the real theme’s code. Fantastic. And then, when tired of scripting, I can use the Appearance Editor in the Dashboard to change colours and had a tinker about. The sidebar is taken care of by the Widgets drag and drop. This mixture of a bit of typing and mouse manipulation is exactly me. I love it. I want to start thinking of cool things to say, up my game, have cool blogs, but I might just have to fiddle with this new theme a bit more first.

Steve Mann, inventor of wearable computing, came to the Ecole Polytechnique Federale de Lausanne in the 1990s when I was PhD student there. He had some difficulty getting on the metro as his head-mounted aerial added several inches to his height.

Watching him struggle to get through the door, I was inspired and excited by a researcher who wore and lived his work. Related MIT websites, where Mann was based, showed me how I could augment my reality by turning a gameboy into a wearable computer. The instructions came with a warning that it would affect my vision, though I would soon adapt to the constant red line. After all, the wearable was a lot smaller than Mann’s.

Today Mann’s wearables are very nifty indeed. Unfortunately, they didn’t escape Canadian airport security officials who unplugged him in Newfoundland and left him unable to function properly. Twenty years of living in an augmented world and having streaming information which assists his memory and enriches his world view cannot be switched off without causing damage.

Are we losing more than we gain?

More and more, it seems that humans cannot move forward with technology without there being a loss. As Mann demonstrated at the airport, augmented humans or cyborgs, can no longer function after being dependent on technology for so long.

Ubiquitious computing, where computers are off the desktop and embedded into our infrastructure so that we interact with them without our knowledge, offers the same results. Yes, it is all sexy to have your phone talking to your keys to remind you where you have left them; or, to have your thermal coffee cup reheat your coffee when it senses that it is cooling; or, to have the lights switch on and play mood-setting music when you enter a room. When it works, it is all very sexy indeed.

Tagged and bound

When things break down, we all grind to halt. You can’t find your keys, your coffee is cold, there are no lights or music in the house, because you have gotten out of the habit of doing these simple tasks. And now you can’t do them without debugging what went wrong. You are useless without your computer yet you are dependent on technology.

And that is an innocuous example application. In the ubiquitious world you are tagged and monitored by the smart badges, invented at Xerox PARC so that others can see how long your toilet break takes, who you are chatting to, and where you are in the building. You are trapped in a more sinister way.

Is this what we want from our technological advances? I’m only asking because it is often what we get. The alternative to controlling invasive applications is to train your users to become absolute system ninjas. But does technology make your ninjas’ lives easier if they have to go on intensive learning curves?

Augmenting reality for good

Augmented Reality (AR) researcher Ronald Azuma introduced such a system with his ultrasound-guided biopsy of breasts. This was an AR application with which I was so impressed that I always use it as an example of technology for good during my human-computer interaction lectures, even if saying breast to a group of 18-year old computer scientists is going to make them titter for the rest of the lecture course.

Azuma says himself that ultrasound-guided biopsy is difficult to learn and perform and needs good hand-eye coordination and three-dimensional (3D) visualization skills to guide the biopsy needle to the target tissue area with the aid of ultrasound imagery. Ultrasound pictures can be difficult to interpret, ask any mum-to-be about the scary information she gets from scans during hospital visits.

Lots more research is needed to augment our worlds usefully, which is why a stand-alone virtual world can sometimes be more attractive.

Virtual Reality

Interpretation isn’t a problem in the virtual world, regardless of whether the computer-simulated environment is real or imagined. Users can normally understand what it going on because virtual reality (VR) simulates the real world. Users learn how to fly aeroplanes or perform medical operations in simulators. The main drawback is that high-fidelity experiences are difficult to create because of processing power, image resolution and communication bandwidth limitations.

The other main problem is interacting with a 3D world. Most VR applications are so specialised, there are no standard interaction techniques. Many ways of interaction have been introduced to give the impression of real world feedback. Datagloves, or wire gloves, react to user hand movements to give the impression of resistance when a user comes into contact with artefacts in the virtual world. The user wears a head-mounted display to see only the virtual world. It is a far cry from the desktop and keyboard and mouse.

VR equipment, like its AR counterpart, is difficult to use, and can leave the user with headaches and other symptoms as the user adapts back to the real world. It is also very expensive which is why it remains in specific domains such as the military. Everyone else uses the cheap and cheerful version: the desktop virtual world.

Desktop virtual worlds: combining old and new

Second Life is one example of a desktop virtual world. It sidesteps interaction problems by keeping the desktop, keyboard and mouse and using old familiars such as instant messaging as a way of communicating. Users don’t have to learn lots of new interaction techniques, they can concentrate on learning the world they are in. Admittedly because it is run over the Internet, it can be clunky and slow. Still, it works well enough for users to create transport systems, IBM training seminars, or psychology courses which demonstrate how real hallucinations can be.

Learning and training takes place in Second Life in a cheap and uninvasive manner without interfering with your users’ brains and leaving them with headaches, or worse still, unable to function in the real world without technological support. Desktop virtual worlds let users choose whether they want to be ninja users or just observers. This leads to more satisfactory user experiences and better interactions. We can lead users gently into different technologies and allow them to feel that they have some control over their interactions and experiences so that they want to use them again.

Remembering what we have learnt

Technology is advancing constantly. And virtual and augmented world applications have the potential to improve our lives in so many ways. But we must learn to apply them usefully and to retain the knowledge we have learnt along the way so that we are enriched by applications, not damaged by them.

The Fresenius Kabi Applix Smart food pump is a masterclass in bad design. There is nothing smart about this food pump and its accessories. It has been designed without taking into consideration the context in which it is to be used. Consequently, some of its accessories are not just safe enough to used around patients and the home and could lead to the compromise of patient safety.

When designing any form of interface, a usability consultant will push for the interface to be: effective and efficient; easy to learn and remember; useful and safe.

After usability comes user experience (in this medical context perceived user satisfaction is enough, as it is never going to be fun to use a food pump on a chronically ill person) which encourages users to feel supported and motivated by a helpful interface.

Fresenius Kabi has failed the user of the Applix Smart food pump on usability and user experience.

Typically, a food pump is used on patients who have medical conditions which prevent them from eating and drinking the amount of calories necessary to sustain them. So, the patient is equipped with a feeding tube and is fed using a feed pump throughout the day and overnight – in hospital or at home, sometimes looked after either by a health professional or a carer (usually a person who is only medically trained to do what the patient needs). Thus, the food pump must address the needs of a range of patients who need diverse but often very precise amounts of feed and the range of users who have little to a lot of technological experience, particularly in medicine.

How not to design a food pump

The Fresenius Applix Smart food pump at first glance looks easy-to-use. It has 10 buttons:

• Two buttons at the top of the pump – one which increases or decreases the alarm volume as you toggle through the options, and one to set a key code.
• Four buttons – two up and two down arrows – to the right of the information display, to set the mls rate per hour and the current volume of mls to give.

Underneath the display from left to right there is:

• The on/off button.
• The information button, which when pressed tells you how many mls you have given and how many you have to give.
• The priming button which when pressed feeds the liquid down from the bag down the line to the end of the tube from the giving set, which is then attached to the patient’s feeding tube.
• The start/stop button.

The not-very-giving giving set on which you can choke

The pump comes with one type of giving set, which is where the feed is stored. The giving set line is fed through the side of the pump and hangs above it. This giving set has a medicine port, which comes off really easily and which a small child could choke on. Children who are chronically ill still experience teething and like to chew and put things in their mouth – particularly the line on the giving set. The medical port is just dangerous, detachable and could easily kill a child.

The giving set line also has a clamp on it. During training we were told never to use the medicine port and the clamp on the giving set and the key code button the pump. No reasons were giving, but it does beg the question why are these features on the giving set if they are never to be used?

There is no way that you can use any other type of set with this food pump, so if you have delivery problems (see customer care), which are quite common with Fresenius Kabi, then you cannot use this food pump at all.

Each feed in the giving set needs an extra 30 mls to prime the lines as they are really long, so you either waste a lot of feed or don’t give your patient enough. This should be mentioned in the literature.

Context is key in good design

Noise control: You may be able to choose the loudness level of alarm from the three preset levels, but you can’t switch it off altogether, so if you set the food pump to run all night and are lying next to the patient to sleep, if that food pump finishes at four in the morning, so does your sleep.

When the stop button is pressed, the alarm will sound every minute. Shouldn’t the user be able to decide how often they need to be told that the pump is on hold?

Backlit screen: A backlit screen is great for when you need to get information in a dim room when your patient is asleep. And an energy saving screen which only lights up when you press the buttons is not the worst idea in the world. But, when coupled with buttons which are small and difficult to see and close together is a terrible idea, especially when the pump has to be running for the screen to light up at all as backlighting doesn’t work in ‘stop’ mode. Fluorescent buttons would have helped visibility and reduced errors (particularly switching the machine on and off which wipes out current totals), especially during the night.

Information: The information button is a great idea. But like the backlighting, the food pump has to be running otherwise you cannot get the amount of mls consumed and mls to give. What is the point of the information if you can’t access it at all times?

Increasing and decreasing volumes: The pump will only let you go up in groups of five mls once you are over 200mls. This is fine if you need to give vast amounts of feed, but what if you don’t? What if the patient is fluid-restricted and every ml counts? You can’t, for example, set the food pump to 499mls – it won’t allow you.

The lack of control to set alarms, food limits, and the inability to access important information as and when required leads to a frustrated user.

Grouping similar tasks together

The order of the buttons doesn’t make any sense at all, and seems to suggest that this pump wasn’t sufficiently tested before it was released.

Cognitively, buttons should be grouped together into similar tasks. So, the on/off button should stand alone – not next to the information button. It is easy, especially in a darkened room when interacting with these non-fluorescent buttons, to switch the pump off when you are looking for information. Ideally, the on/off button should be on the top of the machine where it cannot be touched by accident.

Once the on/off button is off the bottom of the machine the order of the buttons should following the order of how the user interacts with the machine: information, priming, and then stop/start.

The stop/start button is used more often than any other button – as patients vomit and need attending to often – so this button should be situated away from the information and priming buttons so that you don’t start priming more fluid into the patient when he/she is vomiting.

The information button should allow the user to access all information including the total mls consumed at all times whether the pump is running or not. So that the user can make an informed decision at each feedtime as to how many mls to give.

Buttons together which encourage the user to make mistakes, reset totals, and inadvertently feed a patient when the patient is vomiting create angry users and little faith in the food pump.

Accessories to complicate your life

We all love accessories and the backpack which comes with the machine at a first glances looks great. It is compact and has a velcro sealed panel which you open to interact with the pump. However, looks aren’t everything. You have to be really careful how to put the giving set into the backpack otherwise creasing leads to air holes and bubbles in the lines and the pump alarms constantly. You cannot prime the pump and giving set in the backpack at anytime, the alarms go off.

The backpack hole which the feeding line comes out of is not big enough for the giving set line to go through without the medical port falling off and without a big struggle with the clamp.

The pump also comes with a table stand which is awkward. It is slightly too big for a table, so has to be set carefully so that it will remain stable. It is not tall enough to stand on the floor, particularly if your patient sleeps in a cot or a raised bed. It is really heavy too so you have to be very careful where you place it, because if it was to fall on a child’s head, it would kill the child, an adult’s head would probably just need some stitches and the removal of the naso-gastric tube in the case of the resulting hairline fracture.

The clamp holding the pump has to sit at bottom of the table stand which would be fine if the a/c socket where you plug in the main adaptor wasn’t tucked so far under the pump holder that you cannot plug it in without tipping the whole stand and pump onto its side. But a pump clamped at the bottom of a stand which is on the floor is just dreadful.

Safety is key in all design. Medicine ports which can be eaten and stands which need a specific height table so that they are stable and can’t topple over and damage the patient’s skull are dreadful design problems which should be addressed immediately.

Customer Care Fresenius Style

The helpline number issued with the foodpump is 24/7, but interaction with the helpline number is dreadful:

Ringing the number outside office hours to talk about missing deliveries, or deliveries that aren’t yours and which have turned up at 6am can lead to you hearing comments such as: “I don’t care about your deliveries. Get off the line I am a nurse and I am here to deal with dying people.”

Ringing up to complain about how the above nurse thinks she can speak to customers anyway she chooses, leads to comments such as: “We have no formal process for complaint. All that happens is that I print out this apology letter whilst I am on the phone to you and I put it in the post. Do you want one?”

You are never given a time for deliveries so they can arrive from 9am until 6pm on your delivery day and if you ring to ask whether they have any idea what time the delivery will arrive, the answer is always resoundingly no.

Users need to feel that they have some control over their deliveries, their day and that they and their time are respected.

Sometimes, the delivery person has absolutely no idea about where you live and will ring you and ask you for directions. And if a delivery is incorrect, you will have to go through the same dreadful delivery process the following week as Fresenius cannot seem to correct their mistakes the same day.

Accidents waiting to happen

The combination of:

• the ill-designed food pump which supports user errors
• its badly-thought out accessories which encourage accidents and could lead to seriously damaging your patient
• the giving sets which have features which fall off and could potentially choke a patient, and ones which you are advised not to use
• the terrible customer care, along with the lack of respect for users on the telephone and the lack of respect for the user’s time when waiting for deliveries

all add up to terrible usability and worse user experience. It is bad enough that a user needs a food pump, as that means they are looking after someone who is chronically ill. This is a very stressful situation to be in already without being provided with a terrible piece of equipment and being treated dreadfully by the company who provides it.

Fresenius Kabi and their Applix Smart food pump are extremely lucky that they haven’t done more damage; their insensitivity and terrible designs add to users’ stress levels everyday of the week.

Today, I updated both versions of wordpress to 6.2.2 and found that everything works as it should do. A quick google about confirmed that I was getting the error message because my last wordpress upgrade hadn’t worked properly – I should have just reinstalled everything instead of fiddling where I shouldn’t.

There are ways of running two wordpress blogs with one installation, but if you decide to run two completely separate installations of wordpress like I have then you will need to make sure you have two .htaccess files. One in each directory. So, in the home directory my .htaccess (or the relevant lines) looks like this:

RewriteEngine On
RewriteBase /
RewriteCond %{REQUEST_FILENAME} !-f
RewriteCond %{REQUEST_FILENAME} !-d
RewriteRule . /index.php [L]

And, in the /jasmine directory the .htaccess file looks like this:

RewriteEngine On
RewriteBase /jasmine/
RewriteCond %{REQUEST_FILENAME} !-f
RewriteCond %{REQUEST_FILENAME} !-d
RewriteRule . /jasmine/index.php [L]

We have set up a blog here to share our news:

http://www.ruthstalkerfirth.com/jasmine/

Thank you to everyone who has contacted us to say they care. It means so much.