The Irish Medical Times - Wearing your heart monitor on your sleeve: Are wearables helpful or harmful?


But you don’t have to be an athlete, a scientist or even a doctor to start your own trial. Oura, the smart ring company, posted on Facebook a story from a consumer who noted the decrease in their health ‘score’ led them to get a Covid test which proved positive. When Fitbit pushed the blood oxygen feature to our watches, who predicted that we’d come to rely on it?! 

Fitness technology is here to stay, whether you’re strapping devices to your chest, slipping them on your wrist or sticking on a sensory sweater. Wearing a fitness tracker does not guarantee fitness (what?!) but it does act as an accountability partner and a self motivator. 

But, when does self awareness become self harm?

Some people are becoming obsessed with hitting or exceeding fitness goals as dictated by a piece of plastic hanging around the end of their arm. To achieve 10,000 steps a day was a marketing tool which originated in Japan for a pedometer sold in 1965. If we’re taking advice from 1965, there was also a ‘Lava Lamp Day’ that year, so should we all run out and buy lava lamps? (probably). 

Setting some goals and having an app that keeps you accountable is a good idea for the most part. It is interpreting all that data that spews out of your device that can lead to confusion, worry, self obsession and bad decisions. But as the technology is improving and becoming more precise, and as users we are gaining more familiarity with our own stats, I think people are now looking at trends in their data. This is probably the most useful aspect in this new age of biometric biographies. 

This was reinforced for me when I spoke to a Cardiac Physiologist who felt wearables are getting better at recording heart rate but not 100% accurate. She recommended using them as a guide and not to get too obsessed with heart rate. 

Are we achieving a balance in our use of wearables?

Since the ubiquity of wearable smart devices, doctors are seeing an increase in self diagnosed diseases appearing in our Emergency Departments. I have heard of people in rude health calling ambulances because they noticed their heart rate was slightly increasing on their smartwatch (perhaps the closer they watched, the higher it got). In the spirit of ‘dont-throw-the-baby-out-with-the-bathwater’ the cases are given due attention. Some cases are bringing to light unknown heart problems - catching a covert heart problem is a life saved.

However, maybe we can reduce the glitches, blips, interpretation error, user error, red faces and buckets of bathwater. For this to happen, companies selling the technology should take more care to educate users on reading their biometric data. To quote from one of the classics, Spiderman, ‘With great power comes great responsibility’, people are changing lifestyles and making health decisions based on the “medical” information from their wearables, the ‘web’ of communications around this needs to be stepped up.   

I feel the benefits of wearables outweigh the nuisance, for the most part the medical community appears willing to go on this journey with us. One noticeable advantage to a doctor is a patient’s smart device can show their metrics over a span of time, whereas much of the same information gleaned at the doctor’s office, although more precise, is a snapshot.  

There are also safety aspects to some devices, for example, Garmin watches have an ‘incident detection’ feature, if you have a collision it sends a text and email to your emergency contacts with your location. My husband has set this up on his watch with me as his contact. On one unusually long bike ride he came home scratched and bruised and said he had fallen off his bike, had I got the notification...awkward silence…”I didn’t know I was supposed to look at my phone. I thought a button would trigger an alert with Garmin HQ and they would send over a” 

Wearables can also capture events in ‘real time’ such as a panic attack (when you realize your wife thinks you’re living in a James Bond movie) and note how a person’s heart coped with extreme stress in the moment. Of course if wearing the wearable is the cause of the stress should we go back to a good old fashioned biohack - meditation? (you already bought the lava lamp). Of course nowadays there is an app for meditation, so we’re back on the hamster wheel of competitive self examination.

I think we might be at a unique phase in time where doctor, patient and tech-user overlap in a kaleidoscopic venn diagram. As we fight for space in the pathogen petri dish that has become this planet, ‘citizen science’ is having its biggest moment yet. There are apps to assiduously track everything. The latest smart watches run ECGs which have a good hit rate at catching atrial fibrillation. There are tiny sensors you can wear on a fingertip that will monitor your glucose levels. How long before we are making calls to our doctors to inform them that according to our watch we are showing early signs of Parkinson's Disease (and according to our jumper we ate too much Christmas dinner). 

The doctor's role is essential, a wearable cannot diagnose or treat an illness, just suggest there has been a change or abnormality. If you find a nosey neighbour with no filter they may also make suggestions as to the state of your health “You look very tired, did you lose weight? Did you put on weight? Mind yourself now, you look terrible. Do you want me to get you ‘the cure’?” Just in case it needs to be said, in a game of Top Trumps, the doctor card beats the neighbour, the digital reading and the holy relic.

Personally, I am embracing all the tech I can get. I draw the line at Transhumanism, where people look to augment our species with technology in order to live longer as super human cyborgs - that said, I have a defibrillator implanted, so if they take over the world I’m Team Cyborg, see ya later. 

I have a number of health problems yet I am still here, and not in a ghostly way, I look deceptively healthy. My appearance deceives even me, and at times I struggle to restrain my activities to ones more suited to my heart condition. I find having all my heart stats one tap away allows me to get closer to living the life I should have had. It also teaches me when to stop. We’re not all the same and having this detailed tailored information about what is my ‘normal’ and importantly ‘abnormal’ is important, especially to a patient who is alive because of surveillance. 

Ultimately, patients who view the data as extra information, an overall picture, and look for trends will know when it's appropriate to start raising concerns with the professionals. In turn, the doctors who are getting on board and trying it out for themselves will be in better shape down the road (physically and literally). 

What am I getting from Santa for Christmas? A wearable blood pressure monitor bracelet of course, and I’m keeping my fingers crossed for a lava lamp.

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