Tonic Gets a Shout Out in Shape Magazine

We're excited to share some news: The Tonic Self-Care app was just covered in the August issue of Shape magazine, one of the country's biggest fitness magazines! The brief write-up (look for it on page 90) gives the magazine's readers (women interested in fitness, health, and nutrition) a quick overview of what the app can do. What do you use Tonic for?

Tonic v1.2.1 Released — Usability Improvements

Tonic v1.2.1 is now available on the App Store, a free upgrade for all current users.

This update features several usability improvements suggested by user feedback:

* Streamlined creation of unscheduled events — capture your moods, symptoms, etc. even more quickly

* Journal entry enhancements — to let you express your thoughts more freely, and to write as much as you want

- Journal text now scrolls

- Carriage Return now allowed in journal text

- Commas in journal text are included when exporting data

* Visual indicator to make more obvious that there are options for Daily & Weekly schedules — because some people didn't realize that they could choose every 2nd day, or just weekdays, or every 4th weekend, or ...

* History of entries for a particular tonic can now be deleted in one step — to make it easy to wipe the slate clean

Tonic and Me: Traversing the Winter From Hell

Julie Desch, an early user of Tonic, is just an amazing person. It's not just that she has she achieved middle-age, a rarity amongst people with cystic fibrosis. It's also that she does it in style, continuing to be far more active and athletic than most healthy people. For example, she recently became an RKC (Russian Kettleball Challenge) instructor, surviving a three-day ordeal in which the other participants, not all of whom passed, were hardcore trainers, athletes, and military types (read about this adventure). Even more astonishing is that she managed to do this in between some very serious health episodes, a few months she describes as the "Winter From Hell".

Here she describes how Tonic helped her traverse this difficult period, and offers some advice to other Tonic users:

Tonic and Me:  Traversing the Winter From Hell

There is good news and bad news about getting old with cystic fibrosis.  The good news is that I am getting old with CF!  How great is that?  Although it is happening to more and more people as medical care gets better and the median age of survival creeps upward, it still surprises me every time I have a birthday.  I laugh at my wrinkles, chuckle at hot flashes, and marvel at the fact that I look, well, middle aged.

Living with an unpredictable illness is not all mirth and laughter, though.  Some aspects of getting older are a bit more frustrating, at least for me.  This is where Tonic, a new iPhone/iPad app, enters my story.  As you probably know, staying healthy with CF requires more and more effort with age.  There are more medications to take, more treatments to do, more effort is required to stay fit, to eat well, to manage CFRD, to get enough sleep, enough water, to do whatever it takes to make the plumbing system work well, remember appointments for the doctors and port flushes, to do...pretty much everything.  Yet, just as the “CF care complication” factor increases, the ability of the mind (mine, at least) to keep track of it all begins its downward descent.  This is poor design, but it is what it is.

I noticed it first with Advair.  I can never remember if I have taken it.  I don’t know... I seem to have a mental block.  The block then spread to enzymes, vitamins, children’s names, books I’ve read, etc.  While it’s much cheaper to be able to read the same book (and be entertained) multiple times, too many shots of ProAir or too many Pancrelipase capsules can be problematic.

I have officially dubbed this past winter, “the winter from hell.”  For some reason, I had three episodes of pneumonia with resulting rounds of home IV antibiotics over the span of eight months.  If this wasn’t enough, I cultured MRSA recently, so each round of IV’s included three different medications, all through IV access.  IV meds must be refrigerated of course, and when they come in Entermates (as two of mine did), they need to be removed from the refrigerator a few hours before being used.  When you forget to do this, 1) brrrr, and, 2) the infusion takes forever.  Not to mention that during exacerbations, I do three treatments per day, try to sleep, try to remember to eat (when I have no appetite), and take the usual oral meds, supplements, and vitamins.  I also have follow up appointments with doctors and need to get to the lab for blood draws three times each week.  Did I mention the port dressing changes? I literally needed a flow chart to traverse through my day, or I would forget an essential item.  Of course, most people get admitted to the hospital for this rather intensive treatment time, where, at least in theory, they keep track of these things.  Wink.  But I hate hospitals, and only go in if it is absolutely mandatory.

Enter Tonic.  As luck would have it, I was able to beta test Tonic this “winter from hell." Tonic is an app that helps you to remember and track whatever you need to track.  Setting up Tonic is a simple task.  You simply make a list of all that you want to remember and track.  It took me about 30 minutes because my list of “tonics” was enormous.  When it was done, though, my trusty little iPad would bleep whenever I had to do something.  Take out med (bleep).  Infuse this (bleep).  Take this (bleep).  Eat (bleep).  Weigh yourself (bleep).  Eat more (bleep).  Trust me, the thing was bleeping all day, every day of each exacerbation.  But I was so completely on track!  I missed nothing.  Nor did I do or take anything more than I was supposed to, because you check off each “tonic” as you do or take it.  This is a very satisfying property of Tonic for anal compulsive people who like checking things off lists (like me)

In summary, Tonic is just what I needed at just the right time.  I would recommend it to anyone, whether you have a complicated regimen like mine, or just want to track a few things.  If you decide to give Tonic a try, let me give you two hints.  First, use it for all of the things you do for your health.  Everything. Really.  Meds, sleep, exercise, nutrition, water intake, everything you can think of that you know you want to do to be at the top of your game.  For instance, Tonic even reminds me to journal, to stretch my hamstring muscles, and to meditate

Second, remember that the idea is to make your life easier, not to add another chore to your day.  When my life is so complicated that I really need help, I use Tonic.  But other times (like now) when things are pretty good, I let Tonic fade somewhat into the background.  It still reminds me, but I turn off the “bleep” alarm and don’t always check off all the activities or enter a lot of data.  You will find your own balance.

Julie posted this story on her own blog SickAndHappy, and on a couple of popular sites for the cystic fibrosis community: CysticLife.org and CysticFibrosis.com.

Technology Review covers Tonic

Journalist Emily Singer, with MIT's Technology Review, recently began covering the self-quantification movement in depth, with a series of articles on "The Measured Life".  In this video interview, she spoke with Rajiv Mehta about the Quantified Self, the importance of this movement for healthcare, and about Tonic.

The Self-Quantification Movement — Implications for Health Care Professionals

A few months ago, I was invited by the editors of a relatively new medical journal SelfCare: The Journal of Consumer-Led Health to write a paper for them on the self-quantification movement and what it might mean for doctors. The paper "The Self-Quantification Movement — Implications for Health Care Professionals" has just been published. The revolution in consumer-oriented health technologies, such as Tonic, is one of the major factors in the rise of this movement.

Here's the abstract:

The growing phenomenon of self-quantification – people who observe certain aspects of their lives in great detail, analyze this data, and conduct self-experiments in the interests of improving their lives – is something health care professionals (HCPs) should be aware of. Many self-quantifiers’ efforts are focused on health and HCPs may need to learn how best to interact with such deeply-engaged and knowledgeable patients. HCPs may also benefit from leveraging some of the tools and learnings that stem from the self-quantification movement. This paper examines the self-quantification phenomenon through the experiences of the Quantified Self, a leading organization in this movement, describes the key driving factors, and suggests some implications for HCPs.

In an accompanying Editor's Note, the editors stress how unusual it is for a piece such as this to appear in a medical journal — based not on clinical data, medical research and scholarly references, but rather on consumer activities and opinions — and yet how important it is for healthcare professionals to at least be aware of what's going on. And they urge readers to weigh-in with their perspectives:

The publication of the opinion paper 'The Self-Quantification Movement - Implications For Health Care Professionals' by Rajiv Mehta is unusual for an academic medical journal, in that it presents no new data and does not review publications from the standard medical literature. Furthermore it presents the ideas and attitudes of a consumer movement -‘self quantification’ - that many Health Care Professionals will view with skepticism or even alarm.  Nonetheless consumers increasingly consult sources of health information outside of conventional medicine and have access to sophisticated tools for measuring their own bodily functions. Increasingly, they may use such information autonomously in a form of self care that may circumvent, or even be in conflict with, conventional medicine.  For this reason we believe it is important for HCPs to be aware of such movements and to understand the motivations at work within them.  Engaging with individuals that have such an intense interest in their own health may be difficult but ultimately rewarding for both sides. We would be interested to receive your views on this subject, letters for publication should be sent by email to: editor@selfcarejournal.com. 

It's good to see healthcare professionals paying attention. Dr. Joseph Kvedar, of Partners Healthcare and the Center for Connected Health, also wrote about this on their blog: "From Couch Potato to Quantified Self: This Journey Must be Defined and Encouraged".  While at the moment doctors are mainly worrying about how to keep people from doing anything dangerous, and how such consumer-led data could be used in a clinical setting, I expect that over time they'll also find they have much to learn from self-quantifiers. 

Bobbing for Sleep

At the recent Quantified Self Conference, my friend Seth Roberts talked about his on-going attempts to improve the quality of his sleep. Recently he's had great success improving his sleep by standing on one leg — more specifically, standing on one leg with the knee slightly bent, bobbing up and down slowly until the leg is exhausted, and then doing the same on the other leg. He does this three times a day. (See his blog post to learn the history of this technique and his results.)

I've decided to give this a try. I've had some trouble sleeping well, and this seems like it should be easy to try. If it improves my sleep, wonderful! If not, no harm done.

Using Tonic for this Experiment
I can use Tonic to help me with this experiment: to remind myself do the exercise, to keep track of my exercising, and to track the quality of my sleep. This is easy to set-up in Tonic.

Bobbing Exercise — These screens show how I've set up the tonic for "1-Leg Bobs" and one of my entries. I've used the Notes section to remind myself that I'm to do the exercise "to exhaustion" and not for a pre-determined length of time.

Sleep — These screens show how I've set up the tonic for "Sleep" and one of my entries. I've used the Note section to describe the scale I'm using to rate the quality of my sleep.

And here's what my daily schedule looks like. Seth says to have at least 4 hours between the exercise sessions, so I've set up reminders appropriately. I may do actually do the exercises earlier or later, but the reminders will help when I get too busy and might forget.

Tonic v1.2 Released — Data Export!

Tonic v1.2 is now available on the App Store, a free upgrade for all current users.

Data Export
Yes, you can now export all of your entries from Tonic. Tap on the Envelope button in the Tonics screen to export all of your data, or in the History screen to export the data for just one item.  Either way you'll get .csv files of your data, that you can then import into your favorite spreadsheet, graphing, or data analysis programs.

Customizable Labels
You can now change the default "Amount" label, to make it more appropriate or descriptive. Just tap and hold on "Amount" and then type in whatever you prefer.