Thursday, December 29, 2011

Radiation in CT scans, x-ray/radiographies and PET scans (III): what to do if my doctor recommends one

This is the last of a series of 3 posts describing:
  1. The value and cost/harm of medical tests involving radiation, purely from a scientific perspective.
  2. Other factors affecting the prescription of these tests.
  3. What to do if a doctor recommends such a test. This post.
CT/PET scans are a good thing, when they are necessary. So, the key is to find out if they are really necessary FOR THE PATIENT (not for the doctor). Without intending to give any kind of medical advice or advice on how you should talk to your doctor (disclaimer!!) these are some of the things I would keep in mind:
  1. Tell the doctor if you took any other CT previously. They may be able to reuse those.
  2. Ask to explain the risks of not taking the CT.
  3. If they ask for a CT with contrast, ask them if they can make first the one without and based on the result, think of doing the one with contrast, or viceversa. Basically, the contrast CT is a full new scan, doubling the radiation...
  4. Ask why the doctor is recommending this test given ALL the symptoms. It should NOT be prescribed as a routine or screening test (unless that is what you want... like some asymptomatic people will do a full body scan "just in case").
  5. Ask them to do all other less harming tests before this one, if there is no emergency/rush. For instance, an MRI is usually a good replacement (watch out with the argument that it is not, more on that below). Also, you could have the possibility of treating the first suspect illness and see what happens. If symptoms persist, then you may have to move to a CT (or MRI...).
  6. You may want to ask for a second opinion. People may not think of that for a CT, but would you do it if they recommend opening you to check if something is wrong inside you? Yes, looks that the two are not comparable, but go through your numbers, check the increased probability of inducing a cancer and then decide if a 2nd opinion is worth...
  7. As explained, other kind of scans, like x-ray or mammograms do have much lower levels of radiation. Concerns arise by the cumulative effects of these over the years, specially when used as prevention. These are certainly harder to discern but I would look at policies, not only local but foreign. For instance, it is common practice to have dental x-rays done yearly in US, as insurance covers it, but is it something that you really need, even if free? A US dentist may say so, but somehow, in Europe, this is not done at all.
  8. If you got the time, take your time on the discussion. You are the one about to get radiated! And leave few days after the talk to think about, research, consider alternatives, etc... For instance, you may want to check into alternative tests, like the possibility of using an MRI.
Please, read this with common sense. You should not delay the diagnosis of a life threatening condition for a one in a thousand probability of inducing a cancer. Also, if you have been diagnosed with cancer, something like a PET to find secondary sites of a metastasis may well justify the much smaller risk of a future cancer. Nevertheless, if you reach the hospital with all the symptoms of a kidney stone and a previous history of kidney stones, you may want to waive the CT scan that most of US hospitals ERs will suggest doing and see how you feel next day... Bottom line, as I started, imaging tests involving radiation are very useful tools and there are many doctors out there using them in the benefit of patients, but there are many too being prescribed routinely, defensively, or out of ignorance...

Good luck and I hope the posts were helpful

Radiation in CT scans, x-ray/radiographies and PET scans (II): the socio-economic environment

This is the second of a series of 3 posts describing:
  1. The value and cost/harm of medical tests involving radiation, purely from a scientific perspective.
  2. Other factors affecting the prescription of these tests. This post.
  3. What to do if a doctor recommends such a test.
One would think that prescribing a medical test should depend only on the scientific trade-offs. Unfortunately there is a pile of evidence pointing to this not being the case, and that other reasons like economic as well as social play a strong influence on such prescriptions. The following is mostly center in US and few of these reasons may not apply to other regions with, for instance, different healthcare systems.

One can find a good introduction in these two articles:
  1. If you Google hard enough, you can find forums where doctors admit prescribing CTs to cover their ass. You can't blame only doctors for that, as the US society as a whole is prone to sue doctors, so, naturally doctors practice defensive medicine.
  2. Patients are also guilty of looking for fast medicine/results. Imaging certainly can help to shorten the diagnosis (like it could do cutting you wide open) but patients just don't think or don't know the effects.
  3. Doctors themselves are not the most knowledgeable out there on radiation and its effects/risks.
  4. Imaging is a good source of income for the medical establishment.
  5. The big imaging instrument manufacturers (GE, Philips, Siemens and Toshiba mainly) do want to sell as many of these machines as possible and apparently in some cases do practice borderline marketing.
  6. Patients rely on the doctor (or the system?) warning them ahead of any risks. Unfortunately, patients do not understand that the warnings are NOT for the patients but to cover the medical establishment against law suits should something wrong happen. The awful beauty of radiation based imaging tests is that its effects can usually only be seen after many years and with no conclusive way to trace them back to the original test. As such, many hospitals, doctors, etc... do no see any reason to warn patients about these risks as they very likely will not be found guilty of a future cancer, and warning the patient may create delays, discussions, or ultimately the patient opposition to such a test. If you think this is an exaggeration, you should wonder why although in some places the consent form for a CT scan may include radiation risks (http://www.medscape.com/viewarticle/542613) on many more (see http://www.mibmri.com/ct_scan_consent_form.html or the Medical City Hospital in Dallas, which I happen to know from first hand) this may be limited to the contrast risks, which are on the same order or lower than the radiation risks.  The effects from the contrast are immediate while the effect from the radiation would take decades to manifest. 
Notice that, for instance, a different health system, like the public one where doctors get paid no matter what they prescribe and where the government is actually pressured to save costs (as taxes are paying for the tests) will create protocols where the test has to be strongly justified.

So, after all this information, what can a patient do to know if the test in needed or not? Please see the 3rd post for some suggestions...

Radiation in CT scans, x-ray/radiographies and PET scans (I): the scientific view

This is the first of a series of 3 posts describing:
  1. The value and cost/harm of medical tests involving radiation, purely from a scientific perspective. This post.
  2. Other factors affecting the prescription of these tests.
  3. What to do if a doctor recommends such a test.
So, let's center this post around the scientific facts. The following table lists typical radiation levels for some of these imaging tests as well as other sources of radiation. Notice that these include mainly x-ray, CT, PET and variations of these. MRI and ultrasound do NOT use ionizing radiation and are considered, in principle, safe:
  1. Natural background: 2.4mSv/year
  2. Air travel crew: 3mSv/year 
  3. Radiation worker federal limit: 50mSv/year
  4. Dental radiography: 0.01mSv
  5. Chest radiography: 0.1mSv
  6. Mammography: 0.7mSv
  7. PET/SPECT : 7mSv 
  8. Chess CT: 8mSv
  9. Pelvic/abdomen CT: 10mSv
  10. CT Angiography: 15mSv
  11. 50% of cases die in 30 days: 3Sv
Notice that:
  1. Just by living, we do get a decent level of radiation (see #1)
  2. That there is a very wide range between tests. For instance, a pelvic CT radiation is like 100 chest x-rays (this number is actually probably conservative).
Question comes on the relation between radiation dose and cancer. The following link can provide some guidance:
http://www.xrayrisk.com/calculator/calculator.php

Notice that:
  1. Risk factors are extrapolations/guesses.
  2. A ballpark is about 0.1% increase in cancer risk for a 10mSv exposure of a 30 year old person.
  3. The younger the higher the risk.
  4. Risk is additive. The more tests you get in your lifetime, the higher the cancer risk.
The actual dose of the test can vary even for the same test. For CT, to exactly compute the dose from a given test (once the test is done and the data of the test obtained from the radiologist), one can follow this example:
http://answers.google.com/answers/threadview/id/742075.html

So, the above would give us the "cost", the "risk" of performing such a test, but what are the benefits? In this context, we all have heard the expression "the benefits outweigh the risks". There are many conditions out there and talking about the benefits or the need of medical imaging would be plain impossible, but basically, one could say that the bigger the radiation the test carries, the better the image and the bigger the benefits, with a CT or a PET scan providing beautiful images and information. Notice that pure information does not imply need for the test. We may already know the reason for the disease (from some other diagnosis) and all what the test would do would be to confirm the diagnosis. Or we could take the path of treating the likely disease without 100% confirmation from a CT scan, and if that solves the problem, then just move on (saving with this approach the radiation and cancer risk). Ultimately, it is for the doctor to explain the benefits and alternatives of such test to the patient and for the patient to decide (see the 3rd post on this topic).

Let's move on now to other factors that may not be necessarily explained by the doctor and that do affect the prescription of imaging tests, at least in US.

Update (3/23/2013). I got across this alert from the Joint Commission  on this topic. May be useful reading...

Wednesday, December 28, 2011

Patientslikeme.com

Working couple of years back in the symptoms of my own illness at the time, I missed many tools that I would have certainly loved to have to find the data I needed, specially when one thinks in the times of the Internet: Free access to journal papers (of research partially paid by MY taxes), forums with good tools to search/screen through the answers, good symptoms search tools, tools to track my symptoms and any other factors and see how those correlated to my evolution or that of other similar patients, etc...

Eventually I managed to cure myself (after repeated failures of my PCP), by covering with ingenuity and hard work for some of the lack of those tools, and along the way, I thought it would be good to create those tools for many other patients. This may look like a very altruistic/philanthropic goal, but ultimately, let's be honest, I or somebody I care about would be benefiting from it in the long run, when illness strikes again.

So, while I was cooking some of those tools/sites, I failed to find a site called patientslikeme.com, till my friend, just yesterday, mentioned it to me. I was hit again by the "duh, I am late again" feeling, but at the same time, I thought that better that somebody does something instead of me thinking about it. I even looked at it with more sympathy when I read about the story of the founder, who came up with this project while fighting his brother's ALS. More here:
http://www.patientslikeme.com/about

So, just signed up and here are just quick thoughts, not so much on the tools/interface/etc (where I do have my opinions) but on the spirit of the site. Honestly, I am a bit disappointed. They do say up front (good that they don't hide that) that they are a for-profit organization. Question is at what expense, if any. Their first core value is: "putting patients first". That sounds exactly what I would have in mind for mine, so, great! So, they don't sacrifice the advance of science, a cure for those patients, etc... in order to make money, right? Errrrr... Well, not really. That's actually not what they mean for that sentence and the detailed explanation can be found here:
http://www.patientslikeme.com/help/faq/Corporate#c_corevalues

"Simply stated, this means "Patients First."  You, our patients, trust us with your most valued health information. We honor that trust, and we are dedicated to advancing the knowledge of your conditions with the information you share."

Not bad, but will they give it 100%? Not really. An example of it can be seen in their research policy:
http://patientslikeme_research.s3.amazonaws.com/Research%20Policy%20May2009.pdf

One of their assets is their patients. Yes! Patients are an asset to them. The information patients disclose is an asset too. And patientslikeme.com will no offer it for free to everybody out there. It is not about protecting patient privacy. They actually will sell it to the buyer. It is about protecting their pockets. If a professor doing a study in MS would like to run a short questionnaire or few test through 100 patients to further advance his research, he can't do that, without permission AND payment: "Please note that we do not have a patient referral service which is free of charge".

Anyhow, do not want to be too harsh on the site. I want to check few more things and I also understand that sites require money to run. Money brings also quality. But "for profit" is just not what I had in mind in this case... I got to think what I would do instead, though... I'll leave for another post thoughts on healthcare financing, but so I am not misunderstood, I do not necessarily look down on anybody that with the current society makes as much money as possible out of sick people... although I do hope for a change in society.

Saturday, November 19, 2011

Firefox in-line translator add-on

Well, found something simple and good:
https://addons.mozilla.org/en-US/firefox/addon/google-translator-for-firefox/?src=ss
 
Just select what you want to translate and pick from the drop down menu "translate...". It'll place the translation where the original text was selected. It is very very similar to the example from Jetpack but I was sick that every time I was switching version of Firefox, my plug-in was not working and I had to port it. So, I though, I will gladly do a donation to this guy. When I got his thank you email, it felt good. World should work like this more... If you like it, consider too making a donation... And by the way, this is based on the free tools from Google. Thanks too!

PS.: That reminds me I still need to donate to the folks of Downloadhelper...

Sunday, November 6, 2011

Ownership of an invention by an employee in Spain

Straight from the law 11/1986, BOE núm. 73, de 26 de marzo de 1986

http://www.oepm.es/cs/OEPMSite/contenidos/NORMATIVA/NormasSobrePatentes_MU_Topografias_CCP/NSPMTCCP_Patentes_Modelos/NSPMTCCP_Patentes_Modelos_Nacionales/Ley11_1986de20demarzo_dePatentes.htm#tit3

The relation is covered under Title IV:
  1. Article 15: Inventions related to the work the employee does are company's ownership, and company does not need to pay anything extra unless the effect of such an invention is way beyond what the employee was paid for.
  2. Article 16: Everything else belongs to the worker. Notice that there is nothing in there on "an area where the company has or may have interest in the future". Only limit is what the worker is paid for, NOT what the company is working in or has interest in.
  3. Article 17: If the inventor uses the company on any way for the invention, the company has the right on the invention. Use the company means, not only using company facilities/tools, but also acquired knowledge within the company.
  4. Article 18: The inventor has to provide all the info related to an invention under articles 15 and 17 to the company in 3 months.
  5. Article 19: This law still applies to inventions filed for patent even a year after the employee has left the company.
  6. Article 20: Details in the University context.
Conclusion: bottom line, this looks to follow the "fairness concept" defended by me in previous posts.

Monday, October 3, 2011

Razors and blades strategy

While talking to a friend of mine on Intuitive Surgical, we discussed their business model of making a killer on the disposable portions of the DaVinci robot. I can see that with patents all over, and with a high barrier of entry, it would be hard to be a competitor for a while, so, that is a place where the famous "razors and blades" strategy would work. Same for instance, on glucose meters. This is a market (health care) also were quality prevails over cost (some times too much). But then, I wonder how Gillete, the named inventor of such a strategy was surviving today? So, I did some digging:
http://www.slideshare.net/rupakfeb7/gillette-final

You can skip the whole thing and jump to page 26: "Gillette no longer had that lock after the 1904 patents expired in 1921, and yet the strategy toward which it was unwillingly pulled worked. Whether that was consumer habit, or the superior quality of the Gillette blades, or something else is something that we cannot divine from the catalogues."
And last page: "And that leaves a hole in the analysis. Gillette had not played razors-and-blades when it could have during the life of the 1904 patents and did not seem well situated to do so after their expiration, but it was exactly at that point that Gillette played something like razors-and-blades, and that was when it made the most money. Razorsand-blades seems to have worked at the point where the theory suggests that it should not have. Why is that? Did Gillette succeed because of quality, or were there powerful, even if hard-to-discern-now locks—psychological or otherwise—between the razors and the blades?"


So, basically the author himself does not know. He proposes couple of thoughts, that maybe are confirmed in slide 24 of http://www.slideshare.net/rupakfeb7/gillette-final. Advertising, branding, etc... Bottom line, it could be quality or it may be beyond quality, the people simply got too much inertia to change or simply is stupid (assuming again there is no quality difference). Seriously, has anybody done the work of evaluating the two to justify paying for the more expensive one? Why would you go through so much trouble, anyhow? I guess that you simply assume the answer and pay for what theoretically is right (more price, better quality). I wonder what would be the strategy of a competitor to take market share away from Gillette. The competitors are not small (Wilkinson, BIC...), and I think the first actually tried (more advertising), but not sure they took market share away. It would also be interesting to check their advertising budget and how much of that affects the price of the blade.


Anyhow, the following article basically seems to say that the shaving experience is truly much better and people will be willing to pay for it. It also says that there will be a huge marketing campaign.
http://www.businessweek.com/bwdaily/dnflash/sep2005/nf20050915_1654_db035.htm



My next thing to investigate ink jets... :)

Saturday, September 3, 2011

Changing the language for your whole Windows XP

Wanted to change all the environment (so, forget about the "I know how to do that, just go to Language settings...") and looking around I finally found a post here:
http://www.knowledgesutra.com/discuss/tftmmm-change-windows-language.om/p_3

The only correction is to pick the right controlset folder (there a few ones). Not the one below, but the current one!

This is just for my records... I copy here his/her posting:

To Change the language of Windows XP
How To Change Windows Xp Language ?
To change the whole system language you should install newer service pack with different Language. Or Uninstall the last installed Service Pack and after change the registrysettings below install it again.

Make always a backup of your Registry at first !

For example
If you have XP SP2 in ENG and want to have it in Italian, you will have toDownload SP3 in Italian, change some registry keys (go to HKEY_LOCAL_MACHINESYSTEMControlSet001ControlNlsLanguageRegistry key, and then change the value date for �Default� and�InstallLanguage� registry value from 0409 to 0410) and you'll be able toInstall it in Italian. 
If no problems occur, you will have the whole system language changed.
Here is the List of numbers that represents each language in registry: 
  1. 0436 = \"af;Afrikaans\"
  2. 041C = \"sq;Albanian\"
  3. 0001 = \"ar;Arabic\"
  4. 0401 = \"ar-sa;Arabic (Saudi Arabia)\"
  5. 0801 = \"ar-iq;Arabic (Iraq)\"
  6. 0C01 = \"ar-eg;Arabic (Egypt)\"
  7. 1001 = \"ar-ly;Arabic (Libya)\"
  8. 1401 = \"ar-dz;Arabic (Algeria)\"
  9. 1801 = \"ar-ma;Arabic (Morocco)\"
  10. 1C01 = \"ar-tn;Arabic (Tunisia)\"
  11. 2001 = \"ar-om;Arabic (Oman)\"
  12. 2401 = \"ar-ye;Arabic (Yemen)\"
  13. 2801 = \"ar-sy;Arabic (Syria)\"
  14. 2C01 = \"ar-jo;Arabic (Jordan)\"
  15. 3001 = \"ar-lb;Arabic (Lebanon)\"
  16. 3401 = \"ar-kw;Arabic (Kuwait)\"
  17. 3801 = \"ar-ae;Arabic (you.A.E.)\"
  18. 3C01 = \"ar-bh;Arabic (Bahrain)\"
  19. 4001 = \"ar-qa;Arabic (Qatar)\"
  20. 042D = \"eu;Basque\"
  21. 0402 = \"bg;Bulgarian\"
  22. 0423 = \"be;Belarusian\"
  23. 0403 = \"ca;Catalan\"
  24. 0004 = \"zh;Chinese\"
  25. 0404 = \"zh-tw;Chinese (Taiwan)\"
  26. 0804 = \"zh-cn;Chinese (China)\"
  27. 0C04 = \"zh-hk;Chinese (Hong Kong SAR)\"
  28. 1004 = \"zh-sg;Chinese (Singapore)\"
  29. 041A = \"hr;Croatian\"
  30. 0405 = \"cs;Czech\"
  31. 0406 = \"the;Danish\"
  32. 0413 = \"nl;Dutch (Netherlands)\"
  33. 0813 = \"nl-be;Dutch (Belgium)\"
  34. 0009 = \"en;English\"
  35. 0409 = \"en-us;English (United States)\"
  36. 0809 = \"en-gb;English (United Kingdom)\"
  37. 0C09 = \"en-au;English (Australia)\"
  38. 1009 = \"en-ca;English (Canada)\"
  39. 1409 = \"en-nz;English (New Zealand)\"
  40. 1809 = \"en-ie;English (Ireland)\"
  41. 1C09 = \"en-za;English (South Africa)\"
  42. 2009 = \"en-jm;English (Jamaica)\"
  43. 2809 = \"en-bz;English (Belize)\"
  44. 2C09 = \"en-tt;English (Trinidad)\"
  45. 0425 = \"et;Estonian\"
  46. 0438 = \"fo;Faeroese\"
  47. 0429 = \"fa;Farsi\"
  48. 040B = \"fi;Finnish\"
  49. 040C = \"fr;French (France)\"
  50. 080C = \"fr-be;French (Belgium)\"
  51. 0C0C = \"fr-ca;French (Canada)\"
  52. 100C = \"fr-ch;French (Switzerland)\"
  53. 140C = \"fr-lu;French (Luxembourg)\"
  54. 043C = \"gd;Gaelic\"
  55. 0407 = \"de;German (Germany)\"
  56. 0807 = \"de-ch;German (Switzerland)\"
  57. 0C07 = \"de-at;German (Austria)\"
  58. 1007 = \"de-lu;German (Luxembourg)\"
  59. 1407 = \"de-li;German (Liechtenstein)\"
  60. 0408 = \"el;Greek\"
  61. 040D = \"he;Hebrew\"
  62. 0439 = \"hi;Hindi\"
  63. 040E = \"hu;Hungarian\"
  64. 040F = \"is;Icelandic\"
  65. 0421 = \"in;Indonesian\"
  66. 0410 = \"it;Italian (Italy)\"
  67. 0810 = \"it-ch;Italian (Switzerland)\"
  68. 0411 = \"ja;Japanese\"
  69. 0412 = \"ko;Korean\"
  70. 0426 = \"lv;Latvian\"
  71. 0427 = \"lt;Lithuanian\"
  72. 042F = \"mk;FYRO Macedonian\"
  73. 043E = \"ms;Malay (Malaysia)\"
  74. 043A = \"mt;Maltese\" 0414 = \"no;Norwegian (Bokmal)\"
  75. 0814 = \"no;Norwegian (Nynorsk)\"
  76. 0415 = \"pl;Polish\"
  77. 0416 = \"pt-br;Portuguese (Brazil)\"
  78. 0816 = \"pt;Portuguese (Portugal)\"
  79. 0417 = \"rm;Rhaeto-Romanic\"
  80. 0418 = \"ro;Romanian\"
  81. 0818 = \"ro-mo;Romanian (Moldova)\"
  82. 0419 = \"ru;Russian\"
  83. 0819 = \"ru-mo;Russian (Moldova)\"
  84. 0C1A = \"sr;Serbian (Cyrillic)\"
  85. 081A = \"sr;Serbian (Latin)\"
  86. 041B = \"sk;Slovak\"
  87. 0424 = \"sl;Slovenian\"
  88. 042E = \"sb;Sorbian\"
  89. 040A = \"es;Spanish (Traditional Sort)\"
  90. 080A = \"es-mx;Spanish (Mexico)\"
  91. 0C0A = \"es;Spanish (International Sort)\"
  92. 100A = \"es-gt;Spanish (Guatemala)\"
  93. 140A = \"es-cr;Spanish (Costa Rica)\"
  94. 180A = \"es-pa;Spanish (Panama)\"
  95. 1C0A = \"es-do;Spanish (Dominican Republic)\"
  96. 200A = \"es-ve;Spanish (Venezuela)\"
  97. 240A = \"es-co;Spanish (Colombia)\"
  98. 280A = \"es-pe;Spanish (Peru)\"
  99. 2C0A = \"es-ar;Spanish (Argentina)\"
  100. 300A = \"es-ec;Spanish (Ecuador)\"
  101. 340A = \"es-cl;Spanish (Chile)\"
  102. 380A = \"es-uy;Spanish (Uruguay)\"
  103. 3C0A = \"es-py;Spanish (Paraguay)\"
  104. 400A = \"es-bo;Spanish (Bolivia)\"
  105. 440A = \"es-sv;Spanish (El Salvador)\"
  106. 480A = \"es-hn;Spanish (Honduras)\"
  107. 4C0A = \"es-ni;Spanish (Nicaragua)\"
  108. 500A = \"es-pr;Spanish (Puerto Rico)\"
  109. 0430 = \"sx;Sutu\"
  110. 041D = \"sv;Swedish\"
  111. 081D = \"sv-fi;Swedish (Finland)\"
  112. 041E = \"th;Thai\"
  113. 0431 = \"ts;Tsonga\"
  114. 0432 = \"tn;Tswana\"
  115. 041F = \"tr;Turkish\"
  116. 0422 = \"uk;Ukrainian\"
  117. 0420 = \"your;Urdu\"
  118. 042A = \"vi;Vietnamese\"
  119. 0434 = \"xh;Xhosa\"
  120. 043D = \"ji;Yiddish\"
  121. 0435 = \"zu;Zulu\"
-reply by Ing, Wop NLD

Notes: as I had my Service Pack 3 already in there, I had to uninstall it. Reboot. Did the changes above and reinstall it again. Now it´s working!! :D

Saturday, July 23, 2011

Google Health RIP

Google Health, a portal from Google to keep track of your health records, sport activities and anything that could be related one way or another to your health, is going to be disconnected at the end of this year, after 3 years of service.

This is very symptomatic. Truth is that I never even looked at it. I wonder how others like Microsoft Health Vault (4 years old) are doing but my guess is that not very good and this link seems to think the same:
http://news.cnet.com/8301-10805_3-20080403-75/microsoft-offers-transfer-tool-to-google-health-users/

They try to point to issues with privacy or hospitals not adopting it... Others say that Google simply couldn't make money out of a service with so much privacy constraints. But to me, this is just one more proof of our behavior  as humans about health. It is something that we don't care about till we lose it. Maybe we are even program to forget about it because we don't want to be obsessed either about the idea that we are not immortal. We want to enjoy life without worry about those things. Of course, I am talking in general, but taking care of our health is something that is seen as "we need to do", not as "we love to do". A warning to many of those "solutions" where people is pouring resources to develop...

Friday, July 22, 2011

Fixing SD card corrupted

Note: I didn't recover the file, so, this is just for my documentation... No solution in here :(

So, my key file on the SDHC card is corrupted. When I try to copy it I get an error saying: "the file or directory is corrupted and unreadable". It is an Excel file, so, when I try to open it, I get "the file may be read-only, or you may be trying...". Whatever.

I run chkdsk and get: dadada file "is cross-linked on allocation unit" da da da, "cross link resolved by copying". It asks me if to convert or not lost chains. I say Yes, it says it did, but I can't really find the 344064 bytes that he claims to have saved in a file. Not sure where he put it. I can't find it either in the root directory ?!? And still can't open the file...
So, the digging starts... Checking the drive in my computer I can see that it is a 3.75GB. I can also see that I bought it at MicroCenter. Then I found this link:
http://usbspeed.nirsoft.net/?g=4gb
Which says:
Product NameVendor NameDrive SizeVIDPIDRead SpeedWrite SpeedSubmitter
Micro Center 4GB USB Flash (New 2010 Case)A-DATA Technology Co., Ltd.3.75 GB125f016.55 MB/Sec3.14 MB/Secjeffd

Isn't the web nice! Thank you guys! By the way, notice that 3.75 x 1,073,741,824 = 4026531840 bytes. I guess that's why they call it 4GB. C'mon!! Anyhow, back to the error.


You can read here http://technet.microsoft.com/en-us/library/cc975110.aspx a small explanation on what cross-link means. Not that it helps, but...

The next thing I want to try, before attempting any fixes is to save an image of the SD card somewhere. Not easy to find a freaking software that does that, but then I found the dd command in Linux. And as I have no Linux around, I found that there is a version of it for Windows: http://www.chrysocome.net/dd. AWESOME!
Open a DOS command window where the dd.exe is sitting and execute dd --list which will give us a list of all drives (here is what I got on mine):

C:\Program Files\dd>dd --list
rawwrite dd for windows version 0.6beta3.
Written by John Newbigin <jn@it.swin.edu.au>
This program is covered by terms of the GPL Version 2.

Win32 Available Volume Information
\\.\Volume{b911133a-fbd0-11dd-b92c-806d6172696f}\
  link to \\?\Device\HarddiskVolume1
  fixed media
  Mounted on \\.\f:

\\.\Volume{b911133b-fbd0-11dd-b92c-806d6172696f}\
  link to \\?\Device\HarddiskVolume2
  fixed media
  Mounted on \\.\c:

\\.\Volume{b911133c-fbd0-11dd-b92c-806d6172696f}\
  link to \\?\Device\HarddiskVolume3
  fixed media
  Mounted on \\.\g:

\\.\Volume{07c70281-38e5-11da-8c54-806d6172696f}\
  link to \\?\Device\CdRom0
  CD-ROM
  Mounted on \\.\d:

\\.\Volume{49dbb16c-2dc1-11e0-ba0d-0014a431fb0f}\
  link to \\?\Device\Harddisk1\SP0
  removeable media
  Mounted on \\.\e:


NT Block Device Objects
\\?\Device\CdRom0
  size is 2147483647 bytes
\\?\Device\Harddisk0\Partition0
  link to \\?\Device\Harddisk0\DR0
\\?\Device\Harddisk0\Partition1
  link to \\?\Device\HarddiskVolume1
  Fixed hard disk media. Block size = 512
  size is 65769984 bytes
\\?\Device\Harddisk0\Partition2
  link to \\?\Device\HarddiskVolume2
\\?\Device\Harddisk0\Partition3
  link to \\?\Device\HarddiskVolume3
  Fixed hard disk media. Block size = 512
  size is 3561546240 bytes

Virtual input devices
 /dev/zero   (null data)
 /dev/random (pseudo-random data)
 -           (standard input)

Virtual output devices
 -           (standard output)
 /dev/null   (discard the data)

One can see the 3 partitions of my HDD, the CD-ROM and the SD card, in e: !! (I know that because anyhow, it appears as e: on my Windows).

Now that I know the drive, I am going to try to create the image:
C:\Program Files\dd>dd if=\\.\e: of=c:\sd.img bs=1M --size --progress
rawwrite dd for windows version 0.6beta3.
Written by John Newbigin <jn@it.swin.edu.au>
This program is covered by terms of the GPL Version 2.

3,850M
3850+0 records in
3850+0 records out

I do it with blocks of 1M (recommended), so, it takes about 5 minutes and done! Now that I got the image, I want to recover the file. Ideally would like to work on the image, not the original, but do not know how to do that. So, I'll trust I have the image and will mess with the SD card directly.

I tried all kind of stuff but didn't work... :(

Testdisk seemed powerful but I only saw that it can do an image. Didn't see that it can help me recovering my file...:
http://www.cgsecurity.org/wiki/TestDisk_Download

Got this one that is supposed to help you get the files you want out of the disc, but didn't seem to work?!?
http://www.powerdatarecovery.com/power-data-recovery.html

Recuva gets to the point of listing the file, but says that 85 clusters are written on top by some other program... Trying to recover it with it gives me a bunch of garbage.
http://www.piriform.com/recuva/download

Also tried this but didn't go very far. Seems limited to 1GB so, didn't get to see anything:
http://www.easeus.com/datarecoverywizard/free-data-recovery-software.htm

Got the Zero Assumption Disk Space Visualizer. Nice to check the disk:
http://www.z-a-recovery.com/download.htm
From the same link, we got too ZAR9. Looks very nice and powerful. Unfortunately, what he recovers is pretty messy with fragments from everywhere :(. Couldn't get the file.

A last trick was to look for temporary files of Excel in the HDD of the computer. Unfortunately, couldn't find any in my home or work one. So, I am doom. Looked for my backup, 4 months old, and live with that :(. SUCKS!!

PS.: For those curious, I used DD to restore the image back into the SD card, as it was before running CHKDSK /f and it worked nicely.

Saturday, July 9, 2011

Tyres for the GTI V

Got 225/45R17

Original tire: Bridgestone Potenza RE050 BW 91W (I guess this is the speed rating W:168mph, one day I'll check them... he he he j/k)
Retails for $243, installed in VW dealership: $289. Discount tire lists: $485 for a pair. (By the way, price is directly proportional to number of tires, nothing hidden...).
UTQG ratings: temp: A, traction: A, treadwear:140  
This tire does NOT have warranty and wears out like hell. First set gone after 15K miles, second after $20k. I drive the car a bit hard and Texas heat must not help, but c'mon!

Time to change, so, looking in Discount Tire at:


Qty Product Information Price Extended

Tire Thumbnail Image
Michelin
Pilot Sport A/S Plus (35209)
In Stock
225/45ZR-17 91Y BSW
A set of 4 tires qualifies for: Michelin Promise Plan (Details)
$167.00 $334.00 Remove From Cart
Tire Disposal Fee $2.99 $5.98
Valve Stems, Lifetime Rotations FREE
Installation & Lifetime Spin Balancing $16.00 $32.00
(2)
TPMS Rebuild Kit
$7.49 $14.98 Remove From Cart
Subtotal $386.96
TX 8.25% Sales Tax $29.28

Total: $416.24 for two tires. 500 A A Z*, 45K miles warranty.


Qty Product Information Price Extended
Tire Thumbnail Image
Continental
ExtremeContact DWS (26859)
Usually Available in 24 Hours
225/45ZR17 91W BSW
A set of 4 tires qualifies for: $30 Rebate with your CarCareONE card (Details)
A set of 4 tires qualifies for: $50 Visa Prepaid Card (Details)
$138.00 $276.00 Remove From Cart
Tire Disposal Fee $2.99 $5.98
Valve Stems, Lifetime Rotations
FREE
Installation & Lifetime Spin Balancing $16.00 $32.00
(2)
TPMS Rebuild Kit
$7.49 $14.98 Remove From Cart
Subtotal $328.96
TX 8.25% Sales Tax $24.50

Total:  $353. 540 A A Z*, 50k warranty















Qty Product Information Price Extended

Tire Thumbnail Image
Hankook
Ventus V4 ES H105 (11844)
Usually Available in 24 Hours
225/45ZR-17 94W XL B
$102.00 $204.00 Remove From Cart
Tire Disposal Fee $2.99 $5.98
Valve Stems, Lifetime Rotations FREE
Installation & Lifetime Spin Balancing $16.00 $32.00
(2)
TPMS Rebuild Kit
$7.50 $15.00 Remove From Cart
Subtotal $256.98

TX 8.25% Sales Tax $18.56


Total: $275.54 for two tires (this is the price of one Bridgestone!), 50k miles/5 years warranty, treadwear: 420, temp A, traction A, Z speed rating (149mph). By the way, VW dealer cost was $348 and needed a rebate...

All tyres got good reviews, so, I had to pick one and I went for the Continental. Just didn't want to risk to get the cheapest one, in case I notice it on the handling. So far, as I am not racing, I didn't feel any difference, even with aggressive street driving. Paid about $720 with all the insurances...

UPDATE: tires lasted easily 30k. I am changing them again for the same tire. They are now called
Continental ControlContact Sport AS (some marketing deal with Discount Tire), and retail for $149. Should be $376.22 without including the warranty rebate for the previous tires which didn't last 50kmiles...