Saturday, November 28, 2009

Review: My Place laptop desk in bed (with dimensions)

The My Place laptop desk is intended to raise your laptop out of your lap, while simultaneously providing an incline for the keyboard, which makes typing more comfortable, especially when reclining. It's perhaps the most affordable laptop bed desk; just $35 at amazon, and at the moment, $30 at Bed Bath and Beyond ($20 + tax, after the ubiquitous $10 off coupon).

I bought it with the hope of using it while laying in bed, as in the Laptop Laidback and other similar products you can only buy online for ~ $100. It's not well suited to that purpose however. The underside of the desk is quite close to the ground (both front and back), so you have to lay absolutely flat (you can't put more than a small pillow under your knees). Conversely, the surface where the laptop rests is relatively high, making it difficult to find a comfortable angle for typing, esp. if you want to lay flat instead of propping your back and head up with a couple pillows. Indeed, if you do set the angle sufficiently high (~45deg.), the entire platform becomes unstable because it's too front/top-heavy. Even worse, if you have a ThinkPad, or any other laptop with a curved front underside, the lip of the desk isn't really tall enough to keep the laptop from sliding off. To be fair, the desk wasn't really designed with lying flat in mind. But at least for me, that's the only in-bed position in which I'm pain-free, and therefor the only position I'm interested in using it in.

If you are willing to sit partially up while using the desk, it might be worth considering, however. If so, here are a quick set of pros and cons to consider.

  1. Folds into a very compact package, for easy transport.
  2. Though it's made of plastic, it's relatively stiff plastic, and relatively light. I wouldn't want to go hiking with it, but it's certainly easy to carry around the house, etc.
  3. The incline for the desk is adjustable across ~10 increments.
  4. The desk height can be doubled by unfolding the legs.
  1. The desk comes in two heights: too low (because of the poor clearance on the underside), and too high.
  2. The desk isn't very stable because the legs are not very far spread apart, front to back. I wouldn't use it on a soft surface, especially when the legs are unfolded for double-height.
  3. The distance between the lower clearance and the bottom edge of the laptop is 2.5" (see picture), trapping you under the laptop (indeed, on a hard surface, the "desk" actually puts pressure on my lap), while making the laptop itself too high up for ergonomic use (in my opinion).
  4. The mousepad can also be raised on an incline, but after a few degrees it starts to slide down, making that feature not so useful. And because 25% of the desk is taken up by the mousepad, the laptop necessarily must be offset to the left, which isn't very ergonomic for typing.
This post is part of a series summarizing the various laptop stands that can be used in bed.

Monday, November 16, 2009

Sulindac & TNF-A mediated pain: a bad combination?

Sulindac is a generic NSAID. TNF-A is regulatory chemical in the body that has been implicated in many inflammatory diseases (rheumatoid arthritis, ankylosing spondylitis) - more TNF-A causes greater inflammation. Interestingly, taking Sulindac can actually increase TNF-A, at least in special circumstances. According to a 2009 study in rats (Sulindac metabolism and synergy with tumor necrosis factor-alpha in a drug-inflammation interaction model of idiosyncratic liver injury), sulindac, when administered with a another inflammatory agent, can significantly increase the amount of TNF-A in the blood as compared to the inflammatory agent alone.

This reduction may be specific to the inflammatory agent (lipopolysaccharide), but it may also occur for any cause of inflammation (ie rheumatoid arthritis, or ankylosing spondylitis, though these are chronic, and the lipopolysaccharide injection was not). It's important to note that the same study found no TNF-A increase when the rats were only injected with sulindac. Something has to cause the TNF-A to be present before sulindac can make it worse.

Other interactions between sulindac and TNF-A have been documented. One paper found that sulindac made TNF-A more effective at killing cancerous cells. Great, but if TNF-A is instead causing needless inflammation then perhaps here too sulindac is increasing it's efficacy. Another paper also suggests that Sulidac can make TNF-A a more effective cancer cell killer.

While it's too early to conclude anything, there are lots of NSAIDs on the market, so it might be prudent to take something else if Sulindac has no special appeal for you. Which is to say, it's not going to cause extra damage, but it might not be as effective.

Two papers have compared sulindac to other common NSAID treatments for AS. A 1979 double-blind cross-over study found that patients preferred taking Indomethacin to Sulindac, though the effect was small, and there was no clinically assessable difference (I prefer indomethacin, myself)in pain. Another study compared diclofenac and sulindac, and found mild evidence that diclofenac was slightly more effective (I also prefer diclofenac).