The new graphing functionality (which I’ll cover in the next post) is used to create the best report you can possible hand to your doctor.  Easy to read and understand yet chock-full of helpful numbers and analysis.  Plus you can schedule a report to be emailed to you every week or month so you don’t have to remember to create it.

Why waste time with paper logs?

Dave, a Triabetes Captain

Congratulations to Dave Shack, a Triabetes Captain from 2008 for his recent article in the NYTimes.

The thing that I love about this team is it isn’t just about inspiration (which Dave has in spades).  It is about moving beyond inspiration towards educating and helping the larger community do things they never thought possible.  Dave is the beneficiary and the embodiment of that spirit.  Keep an eye out for the team in 2009; I have high hopes and expectations!

Moving right along….

A continuing problem with websites is the need for you to have a separate username and password for each one.  Eight years ago, I had less than 10, including ones for nytimes.com and the SETI@Home project, which nobly used the computers in student labs on campus to crunch numbers in the quest for E.T., all the while boosting my national rankings in the quest of leading the SETI team computer rankings.  I’ve lost track how many I have today; dozens for work and probably hundreds for various sites on the internet.  I’ve utterly lost count.

While there have been numerous attempts to address this issue of password explosion, it has only been recently that this quest has hit its stride.  OpenID is one of these technologies, and it has incredible industry support.

But first thing first… what is OpenID?

OpenID eliminates the need for multiple usernames across different websites, simplifying your online experience.

Sounds good to me!  But the problem is that no one knows what OpenID is; I have google, facebook, myspace, and yahoo accounts… I want to use one of those!  Who cares about this ‘OpenID’ thing?  Well…!  I think we can have the best of both worlds.  Check out our new sign in page

Now you don't have to keep a separate name and password for SweetSpot

Want to use your account from Facebook?  No problem….

Lets use FaceBook

And that is all there is to it.  We no longer need to store a password; all we know is that you are using your Facebook account and Facebook has said you are who you say you are.

Secure and simple.  I suggest you try it out and let me know what you think!

The Details

I’ve been using this sort of sign in for awhile, where I can start using the same username and password from one site for a host of other services.  I’ve found it to be a pleasure to use.  While I use my Yahoo nickname to access a few sites, there are places where I can get my own OpenID, like at MyOpenID, that offer unique security options like allowing me to use my cellphone to make sure that the person logging into a site is really me.  Ahhh; that warms my paranoid heart!

But OpenID, at least for those of you who inhale tech news, has been around for almost three years and is sort of old news.  YAWN….!  We waited on implementing OpenID because

• It is still changing quite a bit.  The technical foundation is now fairly solid and quite secure, but how we as users interact and use OpenID is still changing quite a bit.
• Which leads to… OpenID can be confusing to use if you are not used to it.  It definitely failed the mom test (sorry mom; you have come a long way, but technology is not your strength ).  We are so used to entering a username and password that anything different requires us to stop and think, which for just getting access to an account is not a good thing.  Here is an opinionated piece on the usability weaknesses of OpenID, based upon the usability research undertaken by Yahoo.  Many are working on improving the usability, and experimenting with different approaches.  The sort of approach we are using at SweetSpot I believe strikes the right balance between the needed flexibility but also ease-of-use.
• It is not the only game in town, and because it is not owned by anyone (unlike Facebook Connect or Microsoft Live ID) some of the large companies only implement part of the OpenID spec or change it slightly to fit their needs.  For example, Google, Yahoo, AOL, MySpace, and Microsoft (to name just a few of the large corporations) all allow their members to generally their ID as an OpenID, but none of them allow an ID from someone else; i.e. Microsoft does not allow you to log into their services with a Google account, and vis a versa (surprise!)
• And last, and definitely most importantly, I only implemented OpenID support when a few folks asked for it (HINT HINT!).  As these things go, I got multiple requests from members asking for OpenID support, all within a matter of days (did you guys coordinate?!), and that was all it took!

I’ve found this to be true in the technology startup culture as a whole: there are plenty of music, collaborative, or communication startups trying to make their mark but I can count on one hand the number of fresh-faced startup companies I’ve run across that are creating products and services aimed at the healthcare market. (Over the years that number may be creeping up, requiring digits on my other hand, but just barely!) I’m specifically talking about companies formed by the kind of whiz kids the venture capitalist was addressing. Yes, there are plenty of small healthcare companies, but they are founded by industry insiders or business people who have cut their teeth in another field and want to apply their knowledge to healthcare. But they bring a different approach than the young entrepreneurs who were in this audience.

Why does it matter?

Healthcare is a serious business with a lot at risk; hardly the place for inexperienced 20-somethings to volley far-fetched ideas? Yet this is exactly why they are needed. They don’t bring financial muscle or marketing prowess to the table, but their bravery–even if born of naïveté–may crack open promising new approaches in healthcare. Diabetes is an apt example: short of a cure, no new technology or wonder drug will have a significant positive impact on the social and financial costs of this chronic illness. Improvements to quality of life and care lie in the realms of collaboration and communication, where the rapid iteration of ideas by young entrepreneurs may be invaluable. Many suggestions will be silly or unrealistic, but some will stick and work in ways we can’t yet imagine.

Is there a call to action?

There is no sure way to pull this group of people into the field, but here are some suggestions:

• Encourage Failure: The healthcare industry goes to great lengths to avoid failure, and with it increased exposure to lawsuits, regulation, and a pounding in the financial markets. Small startups need an environment where they are allowed to fail, and fail early if they must. The scope of a startup is usually small, focused, and pragmatic. Mega-projects or all-encompassing solutions won’t get off the ground at this level. So allow them to launch and fold quickly.
• Incubate: The cost of starting a healthcare technology company has dropped, but it has not plummeted as have costs in the broader technology field. However, there are fewer and fewer sources of funding in the gap between nothing and millions of dollars. Seed capital targeted at healthcare startups is sorely needed. Large companies should be incubating handfuls of small companies, using them to try ideas for a fraction of the cost and risk of doing it themselves.
• Physicians cannot be the only gatekeepers: Doctors are obviously a key part of the system, but they are overworked and stretched to the breaking point. With their patronage as the main route into the healthcare system for small businesses, this is a large roadblock on getting new approaches quickly rolled out. Researchers, nurses, administrators, and social workers all have roles to play and should be allowed to do so.
• Form light and nimble partnerships: skip the heavy legal framework and lengthy due diligence. Avoid requiring financial deposits in the 6-8 figure range as a measurement of your commitment. Make collaborations easy to form and to tear down if need be.

This post has been sitting in my ‘draft’ folder for quite a long time. Since then the economy has continued its turn for the worst and healthcare reform became a major issue in the 2008 presidential campaign. Times are tough but changes are brewing. Time to get back to work!

As a graduate of Bowdoin College, I took these words to heart

…literary institutions are founded and endowed for the common good, and not for the private advantage of those who resort to them for education. It is not that they may be enabled to pass through life in an easy or reputable manner, but that their mental powers may be cultivated and improved for the benefit of society. If it be true, that no man should live to himself, we may safely assert, that every man who has been aided by a public institution to acquire an education, and to qualify himself for usefulness, is under peculiar obligations to exert his talents for the public good.

From a speech by Joseph McKeen at the opening of the college in 1802.

No other motivation is needed.

Lets start with the stream we kept going on Twitter… cleaned up to make it easier to follow. Yes, I fixed a few spelling mistakes… typing on an iphone with ‘auto-correcting’ functionality does not make for top-notch english; my wife Sarah would be aghast!. Before the Twitter stream is a list of everyone who participated and their times. At the bottom are a few pictures from the day (Can someone send me a Triabetes flickr link or something similar?).

Twitter Stream for Triabetes. Click here to view it on twitter
Sat, 11:57:19 a.m.	see everyone at the Welcome Reception – Grey’s Tied House, 3 p.m.!
Sat, 09:13:45 p.m.	Hello world! What a great day – and thanks for being spotters for these athletes! cya manana….
Sat, 11:52:37 p.m.	man, why am I still up when I have to be up at 4:30 a.m.? Sigh…..
Sun, 06:19:09 a.m.	at HQ, getting ready! the BIG DAY
Sun, 06:21:00 a.m.	For those following us out on the course, send msgs to number 40404, and in the message body, type ‘@triabetes I saw so and so on here!’
Sun, 06:32:55 a.m.	the sun is coming up. gorgeous!
Sun, 06:33:54 a.m.	25 minutes until start…. clear sky’s; fingers crossed that it holds
Sun, 06:38:05 a.m.	the excitement is running hi! TONS of people at start… I can see them from the window! Jam packed.
Sun, 06:38:26 a.m.	http://twitpic.com/alkr
Sun, 06:38:42 a.m.	heading down in minutes…. photos on the way
Sun, 06:51:25 a.m.	Pros are off!!!!
Sun, 06:53:19 a.m.	Triathletes are getting into the water. 9 min until start. Many are in the water already
Sun, 06:55:03 a.m.	Wish sending photos was working. *Perfect* Start… Sun is up, mostly clear, high 50’s, a little breeze… Great!
Sun, 06:57:38 a.m.	Most of the athletes are in the water. Just heard a roar from then in the water
Sun, 06:58:12 a.m.	2200 athletes in the water
Sun, 07:00:05 a.m.	Holding the line… Boats getting out of the way… BANG…. Crowd goes crazy!!! They are off!
Sun, 07:00:29 a.m.	It is like white water! WOW
Sun, 07:01:17 a.m.	That is impressive
Sun, 07:04:53 a.m.	http://twitpic.com/almc
Sun, 07:07:34 a.m.	http://twitpic.com/almg
Sun, 07:12:33 a.m.	Swimmers are spreading out now
Sun, 07:14:32 a.m.	Pros are coming around for their second lap
Sun, 07:22:39 a.m.	http://twitpic.com/alo0
Sun, 07:23:11 a.m.	Mandatory bike-lust picture (sorry!)
Sun, 07:24:38 a.m.	Crowds spreading out over a half mile ok the lake.. Some very colorful shirts, some with slogans not appropriate for a family news feed
Sun, 07:26:47 a.m.	http://twitpic.com/aloa
Sun, 07:27:43 a.m.	http://twitpic.com/aloe
Sun, 07:29:15 a.m.	Hot air balloon coming over the lake where the swimmers are
Sun, 07:29:36 a.m.	Here come the pros….
Sun, 07:31:57 a.m.	http://twitpic.com/alon
Sun, 07:33:22 a.m.	Lots of coffee being consumed by this crowd
Sun, 07:34:59 a.m.	Ah, coffee, crowds, little kids all over the place doing what the do best (being cute)… And the smashing pumpkins blaring from speakers
Sun, 07:45:55 a.m.	those on the course who have cameras? call Adam (or come to HQ) and we’ll get them up on the web!
Sun, 07:51:08 a.m.	unscrewing safety locks on 8 story windows so we can get our banner out on the side of the building so people can see it… life is good
Sun, 07:54:07 a.m.	who is writing about triabetes today? send the links in!
Sun, 08:00:04 a.m.	getting prepared for bill carlson (bib # 1574) for coming out of the swim
Sun, 08:04:50 a.m.	bills IN! SMOKING time
Sun, 08:05:22 a.m.	He just ran by the triabetes supply table at the transition area
Sun, 08:08:30 a.m.	@SEAGER Still in the water…. bill just came out
Sun, 08:12:34 a.m.	I don’t know bill’s swim time exactly, but it was somewhere between 60-65 minutes…. for 2.4 miles? (swoon)
Sun, 08:16:49 a.m.	Bill swam in 1:03
Sun, 08:17:01 a.m.	athlete updates live at: http://tinyurl.com/68osuu
Sun, 08:18:02 a.m.	you need these bib numbers to track people: Ann (2079), Steve Ahn(778) Dave (501), Steve Chop (1148), Bill Carlson(1574)….
Sun, 08:18:50 a.m.	Brian (740), joe (1767), Aaron (204), Peter (426), John (543), Larry (1836), Steve Parker (1149)
Sun, 08:20:18 a.m.	you can hear the crowds 5 blocks away on the 8th fl of a building…the transition is happening!
Sun, 08:20:59 a.m.	message @triabetes if you would like specific updates on an athlete
Sun, 08:22:08 a.m.	Peter is in!!!!! That surprised us here as no one knew he was *that* fast
Sun, 08:23:12 a.m.	1:61:52 for peter. Peter, you are a GOD. Smoke the bike buddy!
Sun, 08:25:01 a.m.	Steve Ahn is just in… right behind peter…
Sun, 08:26:06 a.m.	ok, so this is a group of gods…. sharks really
Sun, 08:34:27 a.m.	the adrenaline is pumping at HQ….
Sun, 08:34:37 a.m.	bunch of athletes just came in, in a row
Sun, 08:34:54 a.m.	Steve parker: 1:30 (go steve!)
Sun, 08:35:30 a.m.	joe: 1:25 (nice joe!)
Sun, 08:38:14 a.m.	steve chop: 1:31…
Sun, 08:38:56 a.m.	lots of IronFans (triabetes supporters) on the ramp between swim and bike
Sun, 08:39:23 a.m.	they exit the lake and have to run up a helix car ramp up 4 stories to the top of a parking garage…. it is just lined with spectators!
Sun, 08:39:43 a.m.	The noise is unbelievable! we can hear it blocks away, and those who are there say it is wild
Sun, 08:40:31 a.m.	Dave’s out! 1:32…. great time dave
Sun, 08:44:28 a.m.	haha… just received a note saying dave’s alive. you bet he is!!!
Sun, 08:45:00 a.m.	Perry’s out. 1:40. All right perry!
Sun, 08:45:29 a.m.	for many, the swim is the toughest leg; while it is the first, so you are fresh, it can just take a lot out of ya…
Sun, 08:45:49 a.m.	the word is that they are looking QUITE good
Sun, 08:46:16 a.m.	Larry Smith is out!
Sun, 08:46:32 a.m.	brian is out!
Sun, 08:48:37 a.m.	oh oh… we are getting word that brian came out with peter…but the tracker doesn’t show him having come out of the water. We’ll find him
Sun, 08:53:00 a.m.	everyone is out
Sun, 08:53:36 a.m.	anne is out at 1:46
Sun, 08:54:00 a.m.	larry was out in 1:41
Sun, 08:54:14 a.m.	and John came out with Ann at 1:46
Sun, 08:54:48 a.m.	the triabetes table at the transition area says that brian did indeed come out quite early…. but the tracker isn’t showing that.
Sun, 08:54:59 a.m.	shoot! I hope his chip is working!
Sun, 08:57:49 a.m.	so all athletes are on the bike course… time to go grab some coffee! brb
Sun, 09:09:22 a.m.	word from @ClaudiaLaycock is that anne picked up bike and is through the transition area
Sun, 09:09:44 a.m.	she was on Aaron’s heel
Sun, 09:19:22 a.m.	a bunch of family and volunteers have been stopping by; getting directions, extra tee-shirts, and saying hello. Feel free to do the s a.m.e!
Sun, 09:22:35 a.m.	dave dropped some kit (not sure what…) in the transition area…and asked michelle to look around…so that is what they are doing
Sun, 09:43:06 a.m.	families are popping up out of the woodwork at triabetes HQ; nice folks
Sun, 09:43:42 a.m.	the triabetes folks at the transition area are back; they are completely jazzed. Everyone was looking fantastic
Sun, 09:51:09 a.m.	to put bill’s swim time of 1:03 in perspective, the pro’s were finishing it in 55 minutes; bill was only 8 minutes behind them. hot
Sun, 09:58:37 a.m.	NOTICE: Brian Foster’s chip is NOT working. if you see him, let him know.
Sun, 10:01:45 a.m.	the weather is changing… it was getting quite warm but now it is getting a hazy and overcast…. fingers crossed that it is not a storm
Sun, 10:03:16 a.m.	people have asked about blood-sugars. Only one athlete was a little low…everyone else was just about *perfect*.
Sun, 10:04:51 a.m.	bill and Brian just passed Mt. Horeb
Sun, 10:09:01 a.m.	NOTICE: brian foster knows his chip is not working… he needs to tell an official or transition person (someone in green)
Sun, 10:22:12 a.m.	Hello to Dr. Matt from the Triabetes HQ crew!
Sun, 10:27:42 a.m.	JR from insulindependence is on his way to HQ!
Sun, 10:28:19 a.m.	The finish line is getting setup (though we have some time!)
Sun, 10:32:18 a.m.	http://twitpic.com/am9b
Sun, 10:33:11 a.m.	Ah, some pre-race jitters on the sidewalk; no photo needed
Sun, 10:35:20 a.m.	http://twitpic.com/am9h
Sun, 10:36:44 a.m.	http://twitpic.com/am9s
Sun, 10:41:46 a.m.	http://twitpic.com/amat
Sun, 10:42:15 a.m.	Bill is headed back into Verona on Midtown Rd. Yeah Bill!!!
Sun, 10:42:34 a.m.	Folks relaxing at the starbucks right at the finish line; they are doing mucho business
Sun, 10:53:52 a.m.	They are putting a new chip on brian’s shoe
Sun, 11:08:03 a.m.	Peter and Brian are headed into Verona. Way to go guys!!!
Sun, 11:09:02 a.m.	Estimating bill hitting the next transition between 1:10 and 1:20
Sun, 11:13:50 a.m.	estimating that P is going to finish the bike in 5:45. just tested in the 400s. run estimate=3:45
Sun, 11:14:38 a.m.	race photos on the triabetes facebook page!
Sun, 11:16:28 a.m.	Steve Ahn on Old Sauk Pass- yeah Steve!!!
Sun, 11:17:16 a.m.	Multiple bill sightings throughout Verona. Keep the updates flowing!
Sun, 11:18:04 a.m.	@ClaudiaLaycock thanks for the update.
Sun, 11:18:10 a.m.	Bill is almost halfway- you’re a rockstar.
Sun, 11:21:06 a.m.	What a town. There are runners and bikers all over the place.
Sun, 11:21:56 a.m.	Streams of spectators on bikes heading to Verona. I’m not one of them; on a bus instead
Sun, 11:22:58 a.m.	Aaron just left Mt. Horeb
Sun, 11:30:45 a.m.	Triabetes pics: http://tinyurl.com/69rmu3
Sun, 11:31:25 a.m.	@tricia with some updates (thanks!). Brian and pete still neck and neck, passing the half way mark
Sun, 11:32:14 a.m.	John Moore just went thru stagecoach
Sun, 11:32:26 a.m.	Chris letting us know from the bike course that there is some grade A partying going on. People are having a great time
Sun, 11:33:31 a.m.	Chop, Ahn, and Brady at Midtown.
Sun, 11:35:07 a.m.	The weather is cooling off a bit, with just a slight breeze. Mid to high 60’s
Sun, 11:35:27 a.m.	NOTICE: Does anyone know if Bill is near Verona?
Sun, 11:36:31 a.m.	John Moore on Timber now.
Sun, 11:37:03 a.m.	Parker is on Old Sauk Pass
Sun, 11:39:19 a.m.	Anne is on Old Sauk- way to go Anne!!!!!
Sun, 11:43:30 a.m.	It is a festival out here on the bike course! Thousands of spectators tailgating…
Sun, 11:45:45 a.m.	Bill just got on 92
Sun, 11:45:49 a.m.	16 yr olds on security detail… You don’t see that everyday
Sun, 11:47:32 a.m.	Steve anne just went by Verona HS
Sun, 11:48:20 a.m.	Steve Parker, Anne Findlay, John Moore on Timber Lane- keep it up guys!!!
Sun, 11:52:41 a.m.	An athlete is about 6 min behind steve ahn…. Missed who it was
Sun, 11:54:49 a.m.	Ahn and chop passed half way mark
Sun, 11:55:18 a.m.	Bill passed 92 about 5 min ago
Sun, 11:55:55 a.m.	Hang in there P!!!
Sun, 11:58:36 a.m.	P is on Hwy G
Sun, 11:59:04 a.m.	People have a lot of energy on the bike here… They are universally jazzed
Sun, 12:02:51 p.m.	Miles, you’re the man. Rock on.
Sun, 12:03:33 p.m.	John just passed Verona HS. Looking fantastic, and giving a good wave
Sun, 12:10:31 p.m.	John Moore passed Verona hs about 8min ago
Sun, 12:12:17 p.m.	Bill just cleared Mt. Horeb
Sun, 12:18:04 p.m.	Steve 3.0 just went by Verona hs
Sun, 12:19:04 p.m.	Larry is through old sauk pass! good work!
Sun, 12:19:21 p.m.	Steve just passed Verona
Sun, 12:24:49 p.m.	501 passed Verona hs
Sun, 12:31:57 p.m.	Anne passed Verona, looking top notch
Sun, 12:34:29 p.m.	Dave passed verona hs 9 minutes ago
Sun, 12:38:22 p.m.	http://twitpic.com/amv1
Sun, 12:38:44 p.m.	Hockey on the course; anytime anywhere
Sun, 12:42:50 p.m.	Larry and Aaron at Midtown.
Sun, 12:43:36 p.m.	Wind picking up on the course
Sun, 12:43:45 p.m.	Peter and Brian passed J and Garfoot
Sun, 12:44:21 p.m.	The speedy ones are going through Verona now
Sun, 12:45:35 p.m.	The water stop is awesome… They are doing running handoffs
Sun, 12:48:17 p.m.	Some are coming off the hill towards the aid station and they are flying
Sun, 12:50:20 p.m.	The volunteers on the course are awesome.
Sun, 12:51:11 p.m.	When they make a successful handoff, there is pleasantries passed and they are excited
Sun, 12:57:45 p.m.	Aaron just went through Verona aid station. Cruising!
Sun, 01:03:52 p.m.	Bill Carlson passed S on Timber Ln. Bill is on fire!!!!
Sun, 01:05:53 p.m.	Blair is staked out on Mile 66
Sun, 01:08:47 p.m.	NOTICE: Blair has insulin at 102 mark
Sun, 01:10:23 p.m.	Blair you’re a rockstar.
Sun, 01:17:36 p.m.	HELLO WORLD: Bill Carlson has 21 left to go on the bike and requests a chili dog.
Sun, 01:18:53 p.m.	Steve Ahn headed to cross plains.
Sun, 01:23:24 p.m.	P is on Old Sauk Rd. Keep it up Nero!!!
Sun, 01:25:36 p.m.	Brian Foster is thru Old Sauk Rd. You’re the man, Big B.
Sun, 01:25:55 p.m.	Bill passed Verona aid station: at 102
Sun, 01:26:03 p.m.	We can hear cheering here at HQ!
Sun, 01:26:57 p.m.	Brady is on Garfoot to Cross Plains. Yeah Joe!!!!!!!!!!
Sun, 01:27:54 p.m.	Anne is headed into Mt. Horeb.
Sun, 01:28:42 p.m.	John Moore on Garfoot headed to Cross Plains.
Sun, 01:41:50 p.m.	Peter and Brian just finished Midtown Rd.
Sun, 01:51:33 p.m.	Peter FLEW through vernona
Sun, 01:52:01 p.m.	Brian was one min behind looking awesome
Sun, 01:59:24 p.m.	Aaron is out
Sun, 02:00:02 p.m.	chop is at midtown
Sun, 02:00:31 p.m.	Dave passed Mt. horeb about 10 min ago
Sun, 02:01:18 p.m.	SHOOT: Aaron dropped
Sun, 02:05:11 p.m.	Ahn thru Old Sauk
Sun, 02:06:06 p.m.	Leaving Verona with a full bus of spectators. There is an unbelievable amount of energy considering
Sun, 02:07:32 p.m.	Next to cyclists on bus; they are smoothly passing us
Sun, 02:09:13 p.m.	Oh man! Cyclist crashed at intersection. She got up but her bike looks trashed. Oh that sucks
Sun, 02:11:35 p.m.	I missed the fried milk curds at Verona. I guess I haven’t lived yet
Sun, 02:23:36 p.m.	Update about Aaron coming
Sun, 02:29:47 p.m.	Adam, yer da bomb :-p
Sun, 02:38:34 p.m.	Bill exited T2!!!
Sun, 02:40:01 p.m.	Brady over the big hill and heading towards verona
Sun, 02:41:32 p.m.	Joe had a low bg (38!) that he had to deal with; slowed him up bit I’m glad he can still go!
Sun, 02:45:29 p.m.	john moore cruised through verona and blair reports he is looking gooooood
Sun, 02:46:02 p.m.	for those following and concerned about Peter, we have placed extra insulin (needles and vials, plus 2 extra omni-pods) at T2
Sun, 02:46:58 p.m.	we are sending people to the start and end of the T2 transition to sync up with him…
Sun, 02:47:26 p.m.	SO, things are looking good
Sun, 02:48:07 p.m.	UPDATE: that was quick… it has been confirmed directly that Peter is *OK*
Sun, 02:50:09 p.m.	we are a bit behind on some updates….
Sun, 02:51:16 p.m.	BILL: did the bike at 6:07 and is out on the running course
Sun, 02:52:08 p.m.	Peter: 6:10 bike… yikes! he is also out on the run
Sun, 02:52:38 p.m.	the times we are getting are about 10-15 min delayed
Sun, 02:52:38 p.m.	the times we are getting are about 10-15 min delayed
Sun, 02:53:36 p.m.	oh shoot… the word on Brian’s chip was that it was accidently left on his shoe . So we’ll have times for him soon..
Sun, 02:54:00 p.m.	but when I saw him on Verona at 102 mile mark, he was about 1:30 min behind peter…and he was all smiles!
Sun, 02:55:39 p.m.	We cannot get information about aaron while he is in medical… they won’t allow that… We’re trying to get info from them….
Sun, 02:55:49 p.m.	but he is with medical; so he is with the pros
Sun, 02:57:56 p.m.	anne is at midtown
Sun, 03:00:02 p.m.	Peter and brian are together on the run… arm and arm! on the course together
Sun, 03:00:15 p.m.	parker at midtown!
Sun, 03:02:33 p.m.	dave should be just behind parker
Sun, 03:03:39 p.m.	so for you number folks… peter jumped up his ranking by 250 spots
Sun, 03:09:44 p.m.	blair got some good photos of John from the bus back to downtown from verona
Sun, 03:10:09 p.m.	oh oh…. getting hungry at HQ… feeling grouchy! but what do we have to complain about
Sun, 03:15:22 p.m.	ok, fingers crossed here…. larry is going to be close to the cutoff time for the bike (5:30).
Sun, 03:15:41 p.m.	CHOP is on the run! woa, wasn’t expecting that… he made some great cycling time
Sun, 03:17:20 p.m.	steve chop made some fantastic time on the bike: 6:25. well done steve!
Sun, 03:17:50 p.m.	reports are flying furiously right now… we have our agents sneaking around (but with dead cell phones)
Sun, 03:19:58 p.m.	Miles is down at the medical working on getting information about Aaron
Sun, 03:20:27 p.m.	and miles sure can talk…because he got the race officials to clone brian’s bike/run time off of peter’s… they normally would NEVER do that
Sun, 03:21:30 p.m.	miles; what is your secret?
Sun, 03:23:46 p.m.	I’m taking my transition lessons from Chop; he FLEW through T2… obviously itching for more pain on the run. go steve!
Sun, 03:27:49 p.m.	word from our secret sources is anne is looking MOST excellent, and smiling. what is WRONG with these people? I’m in pain and happy?
Sun, 03:29:11 p.m.	the stands are starting to fill for the pro’s crossing
Sun, 03:29:55 p.m.	the movie crew is moving onto the running course (well, most of them anyway). and saw that sexy brian just run by!
Sun, 03:30:52 p.m.	bill wants a chili dog… well bill, it is on the house!
Sun, 03:31:18 p.m.	the HQ is starting to fill up; time to refuel a bit before heading back on the course (and plenty of bathroom stops for the little ones)
Sun, 03:31:49 p.m.	the little guys are troopers! This is a long day with bus rides, weird eating schedules, little sleep… and they are hopping
Sun, 03:32:22 p.m.	they want to know as much about their athletes as possible; I wish I had something more specific!
Sun, 03:32:31 p.m.	We’ll send them back out again and let them scream to their hearts content
Sun, 03:33:00 p.m.	ahn is in t2
Sun, 03:33:21 p.m.	the crowd is going NUTZ outside
Sun, 03:35:32 p.m.	the pro’s must be close…the crowds outside are really going crazy; 5-8 deep on the sidewalks around here
Sun, 03:36:05 p.m.	the weather is holding out for us! slightly breezy, high 60’s, a bit hazy… we really lucked out so far (knock on wood!)
Sun, 03:37:08 p.m.	joe is in transition… but he is tightening up. Aleve to the rescue. Joe, you are doing very very well
Sun, 03:38:00 p.m.	Still working on finding about Aaron…. miles talked with the med folks and he isn’t with them (right now) and he isn’t in any hospital
Sun, 03:38:39 p.m.	We are wondering if he stopped at a medical tent but did NOT drop out after all…. We’ll keep you posted
Sun, 03:38:56 p.m.	drama, suspense, rumors… we bring it all!
Sun, 03:40:43 p.m.	Joe…. well done. HQ is very excited about your Transition. So is your wife
Sun, 03:41:40 p.m.	Larry is on Timber… he is just before the big hill… we are estimating 60-75 min until finish. SMOKE it larry!
Sun, 03:42:18 p.m.	Ray stopped in HQ… looking a bit sweaty but full of stories from the road. and swapping drives for the camera.
Sun, 03:42:55 p.m.	from ray… hard to shoot today…. shades coming in and out… messing up with the shots.
Sun, 03:43:27 p.m.	I’m getting in the way… asking ray too many questions…. oh, ray is telling me stories that I can’t really share. sorry!
Sun, 03:44:13 p.m.	I wonder if Ray got some of these stories on tape…. heh
Sun, 03:44:39 p.m.	john moore just came through transition
Sun, 03:46:33 p.m.	sighting of john moore from the 8th story.
Sun, 03:47:36 p.m.	ray got shots of everyone… and chatted them up
Sun, 03:48:19 p.m.	Steve Chop said all he wants to do is finish up and see his kids.
Sun, 03:48:33 p.m.	And pete wants a pizza…hahaha.
Sun, 03:50:44 p.m.	joe’s run just started…. I hope you are feeling a bit better joe!
Sun, 03:51:01 p.m.	ray almost got arrested! They didn’t have the proper credentials for the bike; they were threatened… but RAY…ray took it too them
Sun, 03:52:06 p.m.	john said he feels great and is not that tired… fast run to you john
Sun, 03:52:57 p.m.	ahn is fighting a headache…but clear pee. thanks steve (he lost his pricker, but is teating a lot now, went a bit high…but is clearing)
Sun, 03:53:45 p.m.	teating? I can’t spell! He is treating his high and is doing well. On the run and his numbers are coming back down
Sun, 03:56:33 p.m.	Bill said he was having a great day…. but that was after he lost it on the curb during transition… so I guess that is a good thing?
Sun, 03:56:51 p.m.	he is getting prepped for chili dogs
Sun, 03:58:21 p.m.	John is running very well… great transition time and he just jumped into the run… watch out
Sun, 04:00:52 p.m.	ohhhh… I’m looking at some of the footage from the course. Folks, you are in for a treat. the start footage is stunning
Sun, 04:04:02 p.m.	ray is very excited about the footage
Sun, 04:05:02 p.m.	the finish was spectacular…
Sun, 04:05:12 p.m.	(not that I saw it…but that is the word!)
Sun, 04:09:53 p.m.	brian is at picnic point
Sun, 04:10:13 p.m.	that is half way through the first loop… so pretty much at a 10k
Sun, 04:12:19 p.m.	Larry just went through verona… and going at a pretty good click
Sun, 04:13:42 p.m.	about 30-40 minutes to go until larry hits the transition. Go Larry!!!
Sun, 04:21:04 p.m.	bill is at the stadium; enjoying the screaming college students I’m sure… the roar in and around the stadium is supposed to be unreal
Sun, 04:22:35 p.m.	that puts bill about 3/4 through his first loop (of two)
Sun, 04:26:35 p.m.	oh! Ann is on the run!
Sun, 04:26:51 p.m.	wicked fast T2 time to boot
Sun, 04:26:55 p.m.	Nice bike ann; she made up some good time; jumping up in the rankings
Sun, 04:29:42 p.m.	michelle just came back…with some good stories
Sun, 04:29:53 p.m.	joe said “I got this thing”
Sun, 04:32:14 p.m.	aaron cramped terribly…. oh man, that just stinks (and that is saying it politely)
Sun, 04:35:00 p.m.	I missed out on the walking tacos…. frittos with chili. They are raving about it at HQ
Sun, 04:39:36 p.m.	brian is a crazy man out there today. Screaming for his cheerleaders
Sun, 04:45:36 p.m.	oh! brian just finished the half marathon. 8:05 mile. wowzers
Sun, 04:45:52 p.m.	oh! Dave just rolled into T2…and in VERY high spirits.
Sun, 04:50:20 p.m.	parker is in the transition!
Sun, 04:51:10 p.m.	Peter is now in the 2nd part of the marathon….
Sun, 04:51:15 p.m.	his split is looking good
Sun, 04:55:45 p.m.	anne passed through spring and randall on the run
Sun, 04:55:55 p.m.	right near the stadium
Sun, 04:58:36 p.m.	ah, the damage of kids left unsupervised in the HQ… little rascals!
Sun, 05:00:47 p.m.	dave is though the transition! I’m calling to get the scoop from the inside source (his wife!)
Sun, 05:01:47 p.m.	and steve parker just under the building about 4:50
Sun, 05:03:34 p.m.	brian is high on adrenaline right now… running across the street to give *anyone* in a blue shirt a hi-five. brian is an animal.
Sun, 05:05:51 p.m.	ok folks, cheer larry into T2!!!!
Sun, 05:14:52 p.m.	peter and brian are well on their way on the 2nd loop… it sounds like they are approaching or through the stadium
Sun, 05:15:24 p.m.	bill is approaching his first loop. Cheering for ya bill!!!!
Sun, 05:26:41 p.m.	NICE!!!!!!!!! Larry is in T2. go larry go!
Sun, 05:27:21 p.m.	all athletes on the course are now off the bike
Sun, 05:28:08 p.m.	@seager thank you for the updates!
Sun, 05:29:53 p.m.	it sounds like bill is finished with his first lap; he has been spotted on the course!
Sun, 05:34:23 p.m.	larry is out on the course and looking great
Sun, 05:35:16 p.m.	that is fantastic…. talking about gutz… he was close enough to the cutoff that they would have asked him if he wanted to stop the race
Sun, 05:35:54 p.m.	the fact that he is out on the course speaks volumes. Larry, hats off to you. Those watching; cheer him on like crazy
Sun, 05:37:23 p.m.	and larry had a great transition time; he focused and hustled out to the course
Sun, 05:43:21 p.m.	Sorry folks; trying to upload more photos but no luck. The view from hq is awesome
Sun, 05:54:55 p.m.	Ahn and Moore are on their way from the stadium.
Sun, 05:56:29 p.m.	Larry @ Spring and Randall 1st lap
Sun, 05:57:08 p.m.	Ahn, Brady, John back from Stadium
Sun, 06:05:53 p.m.	About 1k from the finish line, spotting for the crew. Lots of gritted teeth and determination
Sun, 06:07:21 p.m.	Heard that bill is still sick on the run, but he is utterly determine to finish…. And still cracking jokes
Sun, 06:09:25 p.m.	Sun is going behind the buildings. The temp is a bit chilly in the shade, which is probably just perfect.
Sun, 06:09:36 p.m.	Joe is c
Sun, 06:10:20 p.m.	Joe is coming in for his first loop… Looking tough and determined
Sun, 06:15:03 p.m.	The Boone boys (ahn and Moore) are running together, coming in for their first lap
Sun, 06:19:19 p.m.	Joe on his way back out for his last loop
Sun, 06:23:55 p.m.	Moore and ahn passed again, running together and cracking jokes between the two of them. Awesome
Sun, 06:39:42 p.m.	Peter is about to cross!!!!’
Sun, 06:40:25 p.m.	He is looking determined but with a VERY relaxed smooth gate
Sun, 06:41:36 p.m.	Just saw Anne! Coming through for completing her first lap. She looked focused. Go Anne!
Sun, 06:46:54 p.m.	Dave is cramping badly, and is going to finish but was planing on visiting an aid station to stretch it out and maybe pick something up
Sun, 06:47:31 p.m.	Pete crossed and it was perfect
Sun, 06:50:47 p.m.	Brian seriously cramped but the man is back on the course and within a few miles of crossing. Guts!
Sun, 07:06:22 p.m.	It is now 12hrs into this most grueling of races, and most everyone still says thank you when you cheer them on
Sun, 07:09:01 p.m.	As they once said ( but for something totally different) nuts!
Sun, 07:10:07 p.m.	Brian is getting very close and is looking STRONG. Cheer him in
Sun, 07:26:21 p.m.	Brian is meeting up with his buddy
Sun, 07:26:52 p.m.	As he said, it was hairy there for a bit, but he made it
Sun, 07:27:33 p.m.	And yes he did!!! With a smile
Sun, 07:32:29 p.m.	Parker is looking very solid. He wants a faster pair of legs, but he likes the rest of himself.
Sun, 07:39:24 p.m.	Dave is now on his second lap. He is hurting quite a bit but everything is showing a massive dose of grit. Let’s bring him home
Sun, 07:40:08 p.m.	Parker came back around to start his second lap with a good pick-me-up
Sun, 07:43:02 p.m.	There goes dave for his second lap, with a power fist in the air
Sun, 07:44:24 p.m.	These people are crazy
Sun, 07:44:48 p.m.	Stating the obvious of course!!
Sun, 07:46:13 p.m.	No updates on joe except that he started his 2nd lap about 100 min ago
Sun, 07:52:12 p.m.	“wet water. Come get your wet water. The best water in Wisconsin”
Sun, 07:54:25 p.m.	There are 9 on the course. Bring them home!
Sun, 07:57:52 p.m.	It is dark out here! Fall is here
Sun, 08:02:29 p.m.	Larry is coming around for his first lap, and he is looking like he has only run a half marathon. It was *great* to see him
Sun, 08:02:54 p.m.	Bill is passing mile 23
Sun, 08:03:15 p.m.	Go bill! The dude defines tough
Sun, 08:05:55 p.m.	Larry might have had a rough bike, but nothing is going to stop him now
Sun, 08:06:42 p.m.	He’s going to be testing soon, but all his kit is in working order
Sun, 08:20:58 p.m.	Steve chop is coming in with a singular focus. The man is finishing right now. Wow is he determined.
Sun, 08:22:56 p.m.	He saw me, kicked it up, and we were barely ready for him. He pulled that out of his suitcase of courage
Sun, 08:28:56 p.m.	The costumes are out! I’m sharing the street with batman and a roman…. Something
Sun, 08:31:41 p.m.	A guy I met on the plane, a stranger, is finishing!!! It is awesome what we are seeing out here
Sun, 08:36:44 p.m.	Chop gave it all at the finish line. He is ok and finished with …. Well, I’m at a loss to describe it
Sun, 08:39:56 p.m.	Chop had to visit the wiZards with IV’s and salt, and came out on top
Sun, 08:42:51 p.m.	Joe Brady is coming in…. With understated courage
Sun, 08:43:35 p.m.	Joe, our hats are off to you. Folks, give him a big cheer
Sun, 08:44:56 p.m.	Chop just wants to see his kids
Sun, 08:56:09 p.m.	Bill is coming in! He hit it hard and really pushed, but the last bit was rough. Yet he refocused and brought it home
Sun, 08:56:51 p.m.	Ahn and moore are on his tail! They might finish together!!!!
Sun, 08:57:58 p.m.	Trifecta! Steve and john ran it together, and looked so strong at the end
Sun, 08:59:32 p.m.	Bill, it wasn’t the race you wanted, but it was a thrill to see you push it. Kudos
Sun, 09:04:37 p.m.	Even batman is inspired
Sun, 09:06:01 p.m.	Here comes the rain! Well, sprinkles really
Sun, 09:06:30 p.m.	Ok.. Rain it is
Sun, 09:21:55 p.m.	This is awesome!!! In the rain comes Anne! With one focus… A lady with a mission. Bring it home Anne!
Sun, 09:25:06 p.m.	The rain is letting up
Sun, 09:27:54 p.m.	We hear that dave is working the miles off, with buckets of courage
Sun, 09:29:26 p.m.	The crazies are out!!!
Sun, 09:39:42 p.m.	The cheese heads are spotted! Now I feel like I’ve been in the cheese state!
Sun, 09:41:38 p.m.	3 to go! They’re coming home
Sun, 09:46:52 p.m.	It is getting quieter on the streets, except for the finish line, which we can here blocks away
Sun, 09:47:24 p.m.	Stop light are blinking
Sun, 09:53:17 p.m.	These people are in such amazing shape, but it has been a mental game for hrs now.
Sun, 10:31:05 p.m.	Parker is coming in! He kept asking where he was going to meet his iron kid; nothing else mattered. The crowd is going to roar him across
Sun, 10:34:19 p.m.	The crowd at the finish line is loud!
Sun, 10:56:33 p.m.	Larry is here! He was running with his son and just looking so solid. Larry, happy 60th!
Sun, 10:57:08 p.m.	So solid, and going at a good smooth clip to boot
Sun, 11:17:54 p.m.	And there it is! DAVE finished
Sun, 11:18:48 p.m.	And what a finish it was! He couldn’t have smiled any bigger. PARTY
Sun, 11:57:22 p.m.	and then my batteries died after that last msg
Sun, 11:57:34 p.m.	Seeing dave cross was the icing.
Sun, 11:58:19 p.m.	The athletes are bed; we are cleaning up hq…and tomorrow the stories start
Sun, 11:58:37 p.m.	they’re yelling in the last of the athletes as there are less than 2 minutes until they close the course!
Mon, 12:00:08 a.m.	and there they go! The red flashing lights bring up a group of athletes…and they are going nuts crossing the finishing line
Mon, 12:00:53 a.m.	there it is!!! The end of Ironman Wisconsin 2008. 12 athletes with Type1. Hats off guys and gal.
Mon, 12:01:00 a.m.	night
Mon, 03:03:45 p.m.	Triabetes thanks everyone for twittering on race day! We’re glad you enjoyed the excitement and thank Sharendipity for headquarter use!

11 of the 12 athletes finished (which is a very high success rate), and there were accidents, suspense, acts of real grit and determination, and awe aspiring moments aplenty.

Stay tuned….

What is Triabetes? There are 12 Type-1 diabetics ^* who also happen to be Ironman athletes. Ironman is an apt description of what it takes to finish one of the toughest endurance races ever to be started on a dare, combining three endurance events (2.4 mile swim, 112 mile bike ride, and a 26.4 mile run) into one colossal event. These 11 men and one woman, ranging from the mischevious Bill Carlson, the very first Ironman diabetic 25 years ago to Dave, the self-proclaimed couch potato how has lost 30 lbs and completely changed how diabetes impacts his life and family.

I’ve run triathlons, so I have an idea of how hard an ironman is, and the commitment it takes to complete one. It is literally a full time job of waking up at 4:30am to run or ride (and then be back in time to wake up your kids or spouse), and then swim or run in the evening; 6 days and 30+ hrs every week….. for 6-12 months. And they are doing it while managing their diabetes.

On race day, for an event that can take up to 17 hrs of pushing your body and mind as far as it will go, diabetes management (as well as keeping tabs on nutrition, salts, sugar, water, heart-rate, lactose-build-up… you get the point) is central for them not only being able to complete the race but also, possibly, placing for a slot to the world-championship in Kona. Here is just a smattering of their diabetes management techniques:

• Multiple insertion sites for an insulin pump, in case one pulls out
• lancet’s tapped to the aero-bar of the bike so they can test every 10 to 20 min while on the bike (for over 50 pricks during the race)
• multiple CGM’s stashed throughout the course in case one breaks
• 3-5 glucose meters on their person at any one time in case of water damage from the elements
• honey and gel packets stuffed into every nook and cranny of their running suite.

I’m in such awe of these folks that my eyes are glazed over with hero worship (and lack of sleep ).

We’ll keep you updated throughout the day.

UPDATE:

^* I’ve been trained never to refer to some as a ‘diabetic’, which many considering degrading and even perhaps a bit manipulative. Obviously this is a debate that everyone in the diabetes community has heard, and it is often left as a personal choice for an individual that I can only respect (and not join in on the debate). With that said, from what I could tell, the athletes refer to themselves as diabetics. It is an interesting observation, especially in light of the extreme nature of Ironman Triathlons (caps are well deserved!) where one has to monitor all sorts of factors and diabetes becomes just another (super) critical component to keep track of.

At SweetSpot we use a cloudbursting architecture (this is a term recently coined by Jeff at Amazon) where EC2 augments our SweetSpot services.  I’ve been eager to move more of the various sweetSpot services to a cloud architecture, and for me, EBS fills in the last missing piece.

To show the power of EBS, lets see how it works for moving MySql to a persistent data store.  And of course we want to make it easy to deploy, automate the backups, and be robust and safe to use.

Before we go through the steps, I’m assuming you have a little working knowledge of EC2, as well as RubyOnRails and Capistrano, and that you have all the java EC2 command libraries installed.  If not, head over to the EC2 getting started guides; trust me, this is a time you will want to read the manual!  We will also be using a modified, pre-release version of Ec2onRails, which is a fantastic ruby gem for running a RubyOnRails environment within the EC2 cloud.  Warning: this gem is packed with all sorts of goodies which makes starting a multi-node cluster literally a 5 minute affair.  Seeing a big 64-bit instance for the database and a smattering of smaller instances come up, all correctly interlinked between the db, application, web, and memcache services, is a true drool worthy event.  You are now forewarned, so be prepared.

Lets go through the steps:

• Install the pre-release gem (Don’t worry, while we will be using a custom gem, this logic is slated for release within the main Ec2onRails gem.)

  sudo gem sources -a http://gems.github.com #if you haven't done this already
  sudo gem install skippy-ec2onrails

• Usually Ec2onRails comes with a corresponding EC2 image, but because we are on the bleeding edge, you will either need to build your own (click here for a how-to) or you can use this temporary image ami-0cf71365.

  ec2-run-instances ami-0cf71365 -k your-amazon-keypair

• While we wait to hear back from Amazon with your instance information, move into your rails application and copy these files over (save the old versions just in case). Then scan through the deploy.rb and s3.yml files, following all the directions.

  wget -q -O Capfile http://github.com/pauldowman/ec2onrails/tree/master/examples/Capfile?raw=true
  wget -q -O config/deploy.rb http://github.com/pauldowman/ec2onrails/tree/master/examples/deploy.rb?raw=true
  wget -q -O config/s3.yml http://github.com/pauldowman/ec2onrails/tree/master/examples/s3.yml?raw=true

• Find the url for your new amazon instance (it should look like ec2-xx-xxx-xx-xxx.compute-1.amazonaws.com) and copy that into your config/deploy.rb file. You can find the new instance information by running this command (and if amazon isn’t ready yet, you will see a ‘pending’ message instead).

  ec2-describe-instances

• Now you are ready to setup and run  your application on your new instance

  cap ec2onrails:setup
  cap deploy:cold

• At this point your application should now be fully deployed on the cloud.  Feeling high yet?  (sorry… I couldn’t help it)
• Lets move your MySql database to an EBS volume.

  cap ec2onrails:db:enable_ebs

• Now that you have an EBS volume with your MySQL information on it, change your primary database role, within your config/deploy.rb file:

  role :db, "ec2-56-xx-xx-xx.z-1.compute-1.amazonaws.com", :primary => true, :ebs_vol_id => 'vol-12345abc'

• Ec2onRails will be taking a snapshot of your MySql database, by default, every two hours.

And there you are, simple as pie!  But wait a second… what are snapshots, you, the observant reader, ask?  

The second most important feature to EBS, besides the fact that it is persistent, is the SnapShot feature.  As the name suggests, Amazon can take a snapshot of your drive at a specific point in time and save it (to S3) for future recovery.  You can pull up any snapshot, create a volume, and attach it to an instance.  While all snapshots, after that first one, store just the changes from the last, or the delta, as far as you are concerned each snapshot is a fully recoverable volume; Amazon handles the baseline and delta changes, and the merging of those, transparently for you behind the scene.  For example, if you have twenty snapshots, and you remove all but the last 3, those last three are still fully recoverable volumes.  Talk about backups being a cinch!  Other uses abound, like grabbing the most recent production snapshot and mounting that to a test server to debug an issue.

Drooling yet?

Helpful links:

• Amazon EC2 Getting Started Guide
• EBS introduction
• EBS Feature Guide
• Ec2onRails gem (pre-release gem)
• Eric Hammond’s guide to moving MySql to EBS, which this work is based from

We covered many topics, but someone asked about eating habits causing diabetes and expressed a sense of deep guilt and shame. Michael, being an experienced psychologist, quickly addressed this, not able to let such a toxic topic fester.

I’ll admit that the comment surprised me. I realized afterward that I rarely hear someone completely blame themselves for their diabetes. I’ve been in a rather insular world with people who have Type 1 or who have had the disease for a long time, so this sense of guilt and personal fault doesn’t often come up. I’m glad Michael jumped in, because I was sitting there feeling a bit stupefied.

I’m somewhat sheepishly going to bypass the issue of what lead up to this person’s guilt: eating habits. It is not an area I am familiar with and it is a minefield of raw emotion. The debate has become incredibly brutal. For example, a study titled “Changes in Perceived Weight Discrimination Among Americans…” was recently published in Obesity, a scientific journal owned by Nature, and here is a group of responses to that article that actually highlight the articles points about discrimination quite well (update: the forum I linked to is self-moderating, so some of the more acidic comments have been demoted).

Instead of focusing on the fault, how can we address that guilt and move forward?

Going back to this particular case, Michael hit it from two angles (we didn’t have a lot of time since this was during a Q & A at a public talk). One was to talk about the root cause of the guilt, which was the belief that eating habits (weight and lifestyle) caused the diabetes. Michael pointed out that the literature doesn’t talk about diabetes as having a single cause so much as a series of risk factors. This long and growing list does indeed include weight and lifestyle, but also age, family history, and race. Outsiders tend to underestimate the complexity of this disease. The second angle was about the need for support in moving through the guilt.

These points seem straight forward, and perhaps self evident. Yet the response from this person was part surprise and part relief; it seems their doctor just handed over some pills, said lose some weight and see you in six months.  There was no framework in which to come to terms with and understand this complex disease.

The challenges of living with diabetes do not lie in the traditional medical realm (barring the search for a cure, of course!). If it was as simple as following exactly what the doctor orders, which could include testing 3-12 times a day and taking the occasional shot of insulin, diabetes would be a significantly lighter burden than it really is. The mental trials facing those who live with diabetes are too seldom addressed.

We have started a blog: yes, another company blog is on the internet!  Yippee.  But hold on, we’ll be doing things a bit differently.  We’ll cover a wide range of topics about dealing with diabetes, startups, and policy chit-chat.    We are sharpening the pencils, throwing away the erasers, and diving in.  Come on over and say hi.  Here are some recent posts you might find of interest:

• Here is where we draw the line.
• The obligatory family story.
• And about life inside a startup.

SweetSpot Fetch improvements, and more devices supported

Before I dive into specifics, we would love to hear from you which devices you would like to see supported next.  Do you use a Cozmo insulin pump or one of those new fancy glucose meters?  Letting us know what you would like to see will help us prioritize what to work on next.

As for new device support, about time, I say!  We are currently rolling out Accu-Chek support and could use your help.  We will be following the Accu-Check compatibility with support for the Dexcomm CGM.  With both of these devices, we could use your help to verify they work on a wide variety of platforms before we open it up to the hordes.  If you are interested in testing one or both, please just respond to this email.

Fancy Reports

The reports that you can generate have been given a serious dose of beauty-juice!  We’ll constantly be tweaking them and making them more interactive, but they are much improved.

• Pretty reports can be scheduled here.

Improving Data Entry

Thank you for your input and suggestions; we’ve been paying attention!  Here is a digest of changes we have made.  It is now much easier to add entries manually.  You can send multiple entries at once by email.  (This is handy, for example, for the school nurse who is keeping track of those in-school numbers: have her email SweetSpot instead!)  You can import your data from CareLink, so add that insulin pump and cgm information! Twitter support is lurking in there as well.  Keep those suggestions coming!

• Learn about sending email here.
• Import data from your old diabetes program.
• Set up Twitter — it couldn’t be simpler.

Website Updates

The housecleaning has not abated!  It is a bit like “Where’s Waldo:” can you spot the tweaks?  If you notice something that we can change to make your life easier, as always, just let us know.

About Us

Curious about who we are?  Here is a virtual introduction.  

I’ll be in New York City the week of May 19th and in the Washington DC/Baltimore area the following week.  It would be great to sync up with those of you located nearby.  So contact me by replying to this email and we can meet up for coffee or lunch/dinner.  My treat. 

Have a nice day!

Adam Greene and the SweetSpot Team

I love essays like these! They purposely bait you, and if they are well written (a little spice is a must), the argument is sound, and they are passionate, as this one is, you can’t put the related thoughts aside. Umair is sounding an alarm bell about lost opportunities to benefit the common good, and I only have respect for his thoughts and critiques.

However, innovation no longer happens with a lightning strike in a laboratory. This idea of aiming for revolutionary ideas is sexy, but empty. What is revolutionary often takes years of incremental improvements and won’t be embraced immediately (the automobile comes to mind). Of course there are exceptions, but generally speaking, thinking big is not the same as delivering big. This has been shown again and again; the graphical user interface was in development for multiple decades before Apple Computers picked it up, and the Internet existed for almost 40 years before the web pushed it into the limelight. Umair’s essay brings up many thoughts of my own — too many to list here at this time, but here are two very different examples from the diabetes world that come to mind:

• iSense is a local Portland, OR company that set out over ten years ago to create a continually running long-term glucose sensor. When I first heard about it way back in the beginning, I was giddy with excitement: a 30-minute appointment to implant the tiny device under your skin, pace-maker like longevity, and continually sending back information to a wristwatch? That is worthy of the over-used ‘revolutionary’ label! Yet as they enter the last phase of trials, they are looking at a competitive marketplace with three similar devices already on the market. To be able to deliver in the face of technical and scientific limitations, iSense has had to scale back the scope. I had the opportunity to visit their labs a few months ago, and what I saw is still an incredibly exciting device with the potential to provide real benefits to people with diabetes. The iSense provides a solid foundation on which to move into artificial pancreas technology. It is a first-generation product with a bright future, but it is entering a marketplace where it will no longer be considered revolutionary.
• Amy Tenderich wrote a well-received piece last year imploring companies to make a drastic departure from the current M.O. when creating and designing diabetes equipment. I would argue that design advancements can indeed be a radical step forward in this space. For example, there is no reason why testing your blood sugar levels should take at least 12 steps every time you do it. This year she has followed up with a much more pragmatic call-to-arms by hosting a design contest to help push the process along. I enjoyed her open letter last year, but I think the design contest is where progress can be made. Yet the scope has had to be scaled back drastically, which will lead to more incremental advances rather than an aggressive break with the current trends.

Only with the advantage of hindsight will we know what is revolutionary. Just as we now look upon Apple and the Internet as being revolutionary, perhaps we will look back at what companies like iSense or individuals like Amy are working on and see how they helped us leap forward.

Meanwhile, take a look at what is happening outside of the parties, the VC realm, and perhaps even Silicon Valley. In the margins that don’t make the news or the seminars at Harvard Business School we’ll find the companies that Umair is looking for.

———-

I highly recommend reading Paul Grams excellent essay The Power of the Marginal.

As we work on providing support for current and next-generation continuous glucose monitors, it has become clear that SweetSpot will soon be storing billions of glucose entries. Yikes! Numbers like these will send shivers through anyone running a lean-and-mean startup.

There are plenty of short-term fixes to improve the efficiency of the database: consolidate columns, move sparsely used columns into their own table, minimize the number of indexes, etc. The same methodology applies at the application layer: minimize interactions with the database, use bulk inserts, minimize object creation, blah, blah, blah. These techniques will actually buy us a fair amount of breathing room, but they aren’t long-term solutions.

Now we get into harder choices.  Microsoft sql server, mysql, postgres, and db2 are examples of Relational database management systems (RDMS) and are what most people think of when they think of a database. RDMS’s are very powerful software packages, yet they are notorious for not being able to scale out. You can throw a lot of expensive hardware at the problem to scale up, but fairly soon you’ll need to consider techniques like summary rollups, vertical and horizontal partitioning, data warehousing, and sharding to try and scale out (see this piece about the difference between scaling up and scaling out). I cut my teeth working on what was at the time one of the top 5 largest known RDMS’s in the world. One of my jobs was to pull information out of this behemoth system; I definitely experienced the pain of implementing some of these techniques. They sound straight forward but can be incredibly expensive to create and maintain. (I haven’t tried sharding, and it sounds like it might come the closest to being able to scale out the database bottleneck. It is a fascinating idea.)

OK, enough of this lecture! Where does CouchDB come into play?

The CouchDB documentation is dripping with drool-worthy keywords: erlang, shared nothing clustering, a RESTful and JSON interface, lock-free concurrency, and ad-hoc and schema-free querying running through a map-reduce system. This all adds up to what can awkwardly be described as a distributed document non-relational database system.

This triggers some serious geek lust (my wife really begs to differ, but I love her anyway).

How does this affect SweetSpot?

• The relational aspect of RDMS’s, being able to say I want to join this information with a little information over here, and mix in from there, is not really needed. SweetSpot’s main data store contains minimal reference information, so it is pretty much storing documents that are retrieved from the database, minimally modified, and then consumed by the calculation engine, a data feed, or the website.
• SweetSpot’s usage patterns tend to be many reads interspersed with large bulk inserts from medical devices and data imports. These two patterns will clash more and more as the system grows, so a lock-free system is very appealing.
• SweetSpot is a heavy user of the data stored within its system; it aggregates and pushes it out to users and eventually to research centers and hospitals (only when authorized by the users; we take our members’ privacy very seriously!), and it runs increasingly complex calculations. A replication and shared-nothing clustering framework gives us more options for structuring our architecture to deal with these cases. For example, we can build a calculation cluster which has a local replicated version of the entries, where it can just hum along running calculations as needed while not slowing down the main application.

I’ll stop right here and proclaim that I am guilty of being a bit too starry-eyed about CouchDB; for one it is terribly slow and resource heavy, it lacks an authorization and security layer, and the API is not quite as flexible as it needs to be.  While there is a long way to go for it to play the sort of role I imagine, it opens up a wide range of possibilities for web applications in general. For example, a web application can have javascript running on the client’s machine, requesting and manipulating JSON directly from CouchDB without the need for a middle layer like RubyOnRails or Spring.

CouchDB is an impressive piece of alpha software, starting with the admin web-interface and finishing with the stupidly simple replication setup. The database is only accessible via a RESTful interface using JSON objects, with views onto data being constructed from javascript functions that wrap a map-reduce system. The developers are moving like wild hares, fixing and improving the system at an incredible rate.  Spend a little time on the IRC channel irc.freenode.net#couchdb and you’ll see what I mean (the performance tuning is just about to get underway, so I was told).  

This is a project worth keeping your eyes on.

Thank you for making it this far, and as a little reward, here are some commands you can use to get started with CouchDB.

• You can kick the tires by following these commands
svn export http://svn.apache.org/repos/asf/incubator/couchdb/trunk couchdb
cd couchdb
#if you don't have a mac, check out the README
sudo port install erlang icu SpiderMonkey
#and go get coffee!
./bootstrap -C
./configure
make && sudo make install
#note: check README on security tips on how avoid running as root...
sudo couchdb
• Get started by going to http://localhost:5984/_utils/index.html. By using FireFox with the firebug plugin, you can poke around to see how the admin interface creates and receives JSON msgs from the database. Slick!
• create a new ‘database’ (it is not really a database but just a way to organize your documents):
  curl -i -X PUT \
-H 'Content-Type: application/json; charset=utf-8' \
http://localhost:5984/mydb
• create a new document:
  curl -i -X POST \
-H 'Content-Type: text/javascript; charset=utf-8' \
-d '{"something":"interesting", "with_goodies":["here", "and", "here"]}' \
http://localhost:5984/mydb  
• let’s go read the new document you created! (take the id returned in the above response and replace ID_HERE with it:
  curl -i -X GET \
-H 'Content-Type: text/javascript; charset=utf-8' \
http://localhost:5984/mydb/ID_HERE
• now that we have a document, you can create views to sort, filter, and generally do some data munging:
  curl -i -X POST \
-H 'Content-Type: text/javascript; charset=utf-8' \
-d "function(doc){ if (doc.something=='interesting'){ map(null, doc.with_goodies); } }" \
http://localhost:5984/mydb/_temp_view  
• And I’ll leave you with this little trick:
curl -i -X PUT \
-H 'Content-Type: application/javascript; charset=utf-8' \
-d '{"_attachments":{"foo.txt":{"content-type":"base64","data":"VGhpcyBpcyBhIGJhc2U2NCBlbmNvZGVkIHRleHQ="}}}' \
http://localhost:5984/mydb/my_docs
  You notice how we use a PUT instead of a POST? PUT is what you use to either modify a document or to create a new document with a user-defined ID, which in our case is ‘my_docs’. Now go to http://localhost:5984/mydb/my_docs/foo.txt; pretty neat, eh?

Happy late New Year to everyone!

I’m very excited to announce a new feature at SweetSpot: Tips and the Tip Jar. We all have garnered ‘tricks of the trade’ from having to deal with diabetes. Some we have picked up from the doctor or from literature, but most of them have been passed by word of mouth or learned from hard trial and error. Enter SweetSpot’s Tips, a place to share what you have learned with others in the SweetSpot community. You can stash your favorite suggestions from other members in your tip jar so you won’t forget.
Fill up your Tip Jar here: https://www.SweetSpot.dm/tips

Snazzy Graphs

The graphs have been gussied up, but the changes go much deeper than a fresh coat of paint. Let me introduce you to the 24-hr digest, a new way for you to see what your glucose levels are doing. Instead of trying to make heads or tails of your glucose levels from Monday through Sunday, the 24-hr digest will show your weekly, bi-weekly, or monthly averages at each time of day. This is a great way to spot trends you may not have previously caught.

Snazzy graphs here: https://www.SweetSpot.dm/home

Changes at SweetSpot HQ

The new year finds us adapting to life with a sassy puppy. Lark chews firewood with abandon, but splinters all over the house are something I and the vacuum can deal with as long as she leaves the shoes alone.

Gratuitous puppy pictures here.

Entering and retrieving your data

We have thrown a handful of improvements your way based upon your fantastic feedback and requests. The data entry screen is simpler and easier to use, you can retrieve your notes and entries into spreadsheet documents, and we now have handy RSS feeds for your consumption. What is RSS? Think of it as your online paperboy delivering news and useful morsels of information right to your computer. Your team can use these feeds to see the team notes or perhaps those recent glucose entries that are outside your ideal range. Definitely contact us if you would like some further explanation or help in using your RSS feed.
Come get your feeds at: https://www.SweetSpot.dm/account/import_export

Website Updates

SweetSpot has had a little housecleaning. Nothing too outrageous,but we have tidied up the sidebars a bit and simplified launching ‘SweetSpot Fetch’ for Macintosh users. Now you can just click on the ‘Fetch device data’ without having to worry about downloading it yet again.

Have a wonderful day!
Adam Greene and the SweetSpot Team

P.S. For those of you in the States, the SweetSpot confessional will be open after a Sunday of junk food and commercials this Super Bowl weekend! Go Pats!

But that is for a future post!  

I’m sort of slogging through this post because I’m sitting in a cafe in Portland, Oregon (perhaps I should admit that I’m taking up space) where delightful distractions abound!  The coffee shop is setting up their used and funky coffee roaster…and the smell is heaven!  There is a gorgeous, playfully mammoth dog outside (mix german shepherd and st. bernard perhaps?) and two little kids playing in the corner, wearing teddy bear overalls complete with hoodies and little furry bear ears.  The final distractions are the melodic remedies of Handel’s Semele and R.E.M’s new album Accelerate.  R.E.M. is back, and being a sucker for foot-tapping alternative pop, I’m really digging their new work.  

Diabetes guilt is a very serious topic, but good things happen around us that are worth noting.  I hope you don’t mind if I share them; they just seemed too good to keep  bottled up.

How is this for a non-business post!