Make the smallest possible change

In another month or so, people will start setting resolutions for become more healthy. But the way we go about do these things tends to fail for most of us.

What if we tried something different this time? What if we pick the smallest possible thing we could try to change? The goal is to maintain whatever change we choose. Maybe the change itself is so small that it may seem unlikely to make a difference. Could a series of tiny changes add up to better health?


There’s too much sugar in everything. In another 10 years, I suspect the we’ll all be told that sugar is the most important ingredient to avoid in our diets. Even though they don’t taste sweet, most breads, pastas, crackers and most carbohydrates break down into sugar (glucose) as soon after we eat them.

Our bodies crank out insulin to get the sugar out of our blood. Insulin tells the liver to turn the sugar to fat for storage. Our bodies burn fat when insulin levels are low. The goal is to keep insulin levels low by avoiding sugar and carbohydrates for better health.

The problem is our bodies become addicted to sugar. Our brains release dopamine when we get a hit of sugar, just like any other drug. If we are used to eating sugar and carbohydrates, it can be difficult to stop. We can wean ourselves off sugar just as with any other drug.

It can be hard, but it’s what we need to do for better health.

People make mistakes

We will all make mistakes. The key is that the systems we use need to be able to catch these mistakes.

When I got up to take over for our overnight nurse, she mentioned that she hadn’t given Cayden one of his medications because it was expired. When I looked at the bottle, there were two places the expiry date was listed and one of them was written wrong. I think they even added this second handwritten label to make it clearer what the actual expiry date is because it can be hard to make out in the small print on the label. But whoever created it made a mistake.

This type of mistake seems to be common with the pharmacy we use. It seems clear that they don’t have a system that can catch these types of errors.


Changing Habits

When I was in undergrad, I remember going to see my family doctor. He made a comment that I should try to lose some weight. I told him that I’d been trying but that it hadn’t been working. I was actually quite active – I would bike everywhere. But I told him I felt like I had a poor relationship with food. I would find myself eating even when I wasn’t hungry.

His response was surprising to me – he said the solution was simple. Whenever I thought about eating, I should make the logical decision to simply not do it. I should go to the gym and hit a punching bag instead.

His idea didn’t work for me. It wasn’t until much later that I understood why – it’s because I had a bad habit and habits are hard to change. What I would have benefited from is some concrete strategies to change my habits.

I’m in the process of testing out some habit change strategies from this book. I’ve been going for about 2 weeks with good success. I’ll report back in another 2 weeks to see if I’m still on track.

One of the habits I’ve built is to post to this site first thing each day and have kept it up.

AI and Job Losses

Many are concerned that the use of AI will increasingly reduce the number of jobs available resulting in mass unemployment. I don’t have a crystal ball and I’m not going to try to make any predictions. However, it is true that people have been worried about the loss of jobs from new technologies coming in. Perhaps it’s going to be different this time. Perhaps.

However, I find it hard to believe that AI will create a shortage of important, difficult, interesting problems to solve. In particular, societally, we are going to need to free up more time to take care of our aging population. We’re going to have more older adults than ever and most of the day to day tasks of caring for people will be very difficult to automate.

Even if we could, I’m not sure we should.


10 ideas for our nursing agency

The nurses that come to watch C overnight are excellent. We love them. But the systems the nursing agency uses for scheduling and communicating with us and with the nurses need improvement. We’ve had some success getting our concerns addressed by the leadership at our nursing agency and we may have developed some credibility with them.

  1. Make sure all your employees understand the goal of the organization. We were a bit surprised by some staff we have interacted with who don’t have a clear idea of what the organization’s mission is.
  2. Send out a survey to parents to ask how things are going each quarter. Parents who fill out this survey are given one hour of nursing care. The survey might include the following questions:
  • How would you rate the quality of the nursing your child receives (please provide a rating from 1-10 with 10 being highest)
  • Have you experienced any scheduling errors over the past three months?
    • If yes, how many errors? How were they resolved (rating from 1 to 10)?
  • Have you experienced any billing errors over the past three months?
    • If yes, how many errors? How were they resolved (rating from 1 to 10)?
  • How would you rate the quality of the communication from our organization (rating from 1 to 10)?
  • Is there anything else you would like to share (free form)?

3. Ask parents to provide positive stories . I think showing the best nurses that they are valued could help keep them in the organization.

4. Send a survey to the nurses to understand how they are doing.

A few of our best nurses mentioned they were feeling burnt out.

5. Show all staff at the organization a video that shares the story what life is like caring for a child with special needs.

6. Ask parents if they want to join an online community hosted by your organization where parents can meet each other and connect.

7. The online community could include a discussion board where people could ask questions and get answers from either parents or healthcare professionals at the organization.

8. Host a public page on your website that includes resources for parents of complex children. (how to setup your home, which suction machine is the best one to buy, what to look for in a wheelchair, etc)

9. Develop a resource to provide a simplified understanding of the different funding sources they should be connecting with and how much they can expect to get from each based on their income.

10. Host webinars quarterly to share the results of the parent surveys and positive nursing stories.


Truth or conspiracy

As human’s we love stories. We’re particularly good at coming up with stories to explain things we don’t understand. Apparently, this ability may have kept us alive in our evolutionary history. Those of our hunter-gatherer ancestors that heard a rustle in the bushes and ran away because they told themselves there was a dangerous animal lurking would survive to pass on this trait to their offspring. Even if the actual cause of the rustling was only sometimes a dangerous animal, this behaviour was protective. Those who didn’t run away would sometimes get eaten and be less likely to pass on this trait.

Now that we don’t typically worry about dangerous animals, this instinct has the potential to get in our way and we sometimes think there is danger in things that are benign.

I recently learned that there are many people who believe that the exhaust trails you sometimes see when an aircraft if flying overhead are made up of heavy metals and other dangerous chemicals for geoengineering (google chemtrails if you are interested).

How can we make sure the things we believe are true? Science. But, I’m not sure how to persuade you that you should believe in science if you don’t already. It makes sense to me if you say you are confused by what you hear about science in the news – this food is good for you one week but bad for you the next week. In a future post, I’ll try to put together my best sales pitch for science.


Malcolm Gladwell has an episode of his podcast on Wilt Chamberlain, who was a famous basketball player. He’s likely best known for being the only player in NBA history to score 100 points in a game. It was surprising for me to learn that he was also the third worst free-throw shooter in NBA history with a 51% free throw average. Then in the 62-63 season he changed his technique. Chamberlain started shooting free-throws underhand or granny style. He improved his free-throw average to 63% that year. It was also the same year he scored points in one game.

Despite the success he saw shooting underhand, he stopped. In his own words:

I felt silly, like a sissy, shooting underhanded. I know I was wrong,” Chamberlain later wrote in his autobiography. “I know some of the best foul shooters in history shot that way. Even now, the best one in the NBA, Rick Berry, shoots underhanded. I just couldn’t do it.

In other words, he didn’t want to be different.

People with disabilities can’t make a choice to stop being different. Everyone says it’s good to be different. But it’s hard.

Stress vs strain

It’s not stress that gets to you. There are a lot of people who deal with high stress but also manage mentally and physically healthy. It’s when you have strain, which results when we can’t resolve a problems in our lives and start to feel stuck. People in high strain environments have higher cortisol in their systems, have more heart attacks, and have more problems with substance abuse and addiction [1].

The key seems to be finding ways to solve the problems we are faced with so they don’t fester and cause strain.