Dead Men Write No Code

I am a hypochondriac. In the back of my head I rationalize this as an evolutionary advantage. And in fact, it may have just saved my life.

I work long hours, in a chair, writing code (and of course this article applies to anyone who sits a lot). The sole reason I am writing this is to warn you of the danger you might be in if you are anything like me.

A couple of weeks ago, I got a pain in my lower left leg which almost felt like a sprain, but I knew I had not sprained it. It let it persist for about two weeks figuring that it would go away, but it did not. So, late at night I did what any hypochondriac does, I Googled it.

The first thing that came up was “Deep Vein Thrombosis” or DVT. From that article:

“ Blood clots (deep vein thrombosis DVT and pulmonary embolism PE) affect upwards of 600,000 Americans each year and cause more deaths each year than the more well-publicized occurrences of breast cancer, AIDS, and motor vehicle accidents, yet they are virtually unheard of.”

A DVT is a blood clot in a deep vein (your main circulatory system). The danger is that it can break free and flow to your lungs or heart, and will cause a pulmonary embolism (PE). How do you know if you are experiencing a PE? Well, one of the likely symptoms is that you will be dead.

I called in to my health care provider’s on-call nurse, and I was expecting the usual “probably nothing to worry about, schedule an appointment if it persists.” However, the nurse advised that I have someone drive me to the ER immediately.

The nurse had me coming to the ER based on a protocol that meant my life was potentially in danger, so that made me nervous. I had my blood drawn, x-rays taken, and then an ultrasound. The ultrasound detected some irregularities. It turned out that I had a clot in my system, but not in a deep vein. Such a clot is better than having a DVT, but that clot could have appeared anywhere (or migrated from a DVT), and it can still turn into a DVT or PE if not monitored and tended to. This was a warning shot that happened to hit my leg instead my head or chest. In the doctor’s own words, he told me I could “just as easily be dead right now.” I was lucky, but you might not even get a warning shot. The symptoms are not always clear, or even present for very long. Even if you survive a PE, it will adversely affect you the rest of your life.

The simple truth is that if you are getting blood clots in your 30s (I am 34), there is something horribly wrong with your lifestyle* and you are on the fast track to death, be it from cardiovascular disease or otherwise. Needless to say, this was a wake-up call for me. I had been blind-sided by my own work ethic, and frankly, selfish. Am I ready to leave my wife without a husband or my daughter without a father?

If you think you are not at risk for this because you are young and relatively healthy, let me break some news to you: I am young and “relatively healthy.” Let me explain what I mean by “relatively healthy” — my blood pressure is usually around 110/70, I walk at least 1–3 miles per day (sometimes more), I do push-ups and pull-ups very often (sometimes daily), my blood work checks out as completely normal in every respect (including low cholesterol), and prior to this my checkups revealed nothing abnormal.

However, you can’t go strictly by the numbers. What those numbers don’t reveal is that for the past 5 years I’ve spent the vast majority of it sitting, and very, very little of it with a significantly elevated heart rate.

I am overweight, but not extremely so — I weigh a bit over 200 and my ideal weight is more around 180. If you will forgive the douchey picture, this is me just 6 years ago, weighing 178:

Yes, its a little embarrassing to post this, but I really want to drive home the fact that even letting your health slip over a relatively short time can be dangerous (additional notes on my past exercise history at bottom). Looking at me, you wouldn’t likely tag me as someone who could die early (even at my current state at 20 pounds heavier). If this can happen to me, why not to you? If you think you are simply too young to get a DVT, I have seen cases occur to people in their early 20s.

I neglected my health for several years and I knew something bad was happening to my body. I would sit for up to 12 hours per day working, with small breaks here and there (mostly chores and walking my dogs). I’ve worked 80-hour weeks for the past decade (occasionally 100-hour weeks), but the past 5 years I have been particularly immobile. I have rationalized it with the “wealth before health” attitude that seems to be prevalent in the startup world (even though wealth is not my primary motivator, you get the idea). “I just need to make it through this year, and then I can exercise” and “exercise will kill my productivity” are two lies I have been telling myself for the past several years. I have taken a similar attitude with my diet, which is far from great.

Right now, if you are in my situation, seriously reconsider your life before its no longer an option. Nobody owns your life, and to those who think they do: you are more valuable to them as a healthy person than as a liability. Beyond that, I won’t go into giving you specific advice for being healthy, other than recommending sitting less (if that means getting a standing desk, that is one option)**.

Talk is cheap, and what good are my words if I can’t set an example? Starting tomorrow, I am drastically changing my diet and doing real cardio every day (i.e. running, not walking). I am not sitting until my feet hurt (I even wrote this article standing up). Even if it is embarrassing, I am having everyone hold me accountable and I am reporting my weight to social media every day (I’ll spare you the half-naked photos though until I am healthy again).

Additional Notes:

* As others have since pointed out, there are many potential causes of DTVs and clots, and while your health does play a large role, other things may effect people even in good health — flying and birth control are two common catalysts. I did fly one week prior to my first symptoms, so that was likely a contributing factor. However, I have taken many long flights without a resulting clot, and I think either way I would be less likely to have gotten a clot had I been healthier leading up to this. Even ignoring clots, it is generally good health advice to not sit for too long, exercise, and eat well.

** This is not just to fight off blood clots — sitting for too long is shown to have many adverse health effects, including negating the positive effects of exercise. Standing all day is also shown to be bad for you (if the studies are to be believed).

I am not nor do I claim to be an expert on any of these matters. I could easily be wrong about any given subject. As with anything, take the time to do your own additional research! :)

Notes on my past exercise habits since someone asked (I am omitting many other things I did like swimming, weight lifting, gymnastics, etc):

• 1981–2000 (relatively active growing up, grew up in the outdoors, but never played sports outside of school)
• 2000–2004 (ran 2–3 miles every single day, about 7 minutes per mile)
• 2004–2006 (ran 1 to 2 times per week, same pace)
• 2006–2008 (ran every day, about 2 miles, same pace)
• 2008–2009 (did not run much but did a lot of other types of exercise, not much cardio)
• 2009–2010 (ran 100+ flights of stairs per day, + 1–2 miles)
• 2011 to present (cardio has gradually decreased to a point where I very rarely run, but I walk my dogs every single day 1–3 miles).