Suffered a stroke in 2004 (migrainous infarction). Became half blind. Rested for a good year.
Became a photographer for 8 years, then switched back again to software development.
From then on, the limits were: WFH only, limit stress, run away from job if things go bad again. Nap if brain feels exhausted. Sleep, more and better.
20 years later (53yo), I'd say I'm doing great! Also fitness helps remind me to take care of the body...
Tech has built literal industries of people trying to stress you out, and they mostly don't have actual tech skills or the empathy that comes with them so back it up.
For me, I usually try to avoid anything where the working practices are strongly defined. Agile has long been a bad word.
Unfortunately while the intentions around agile were noble it's pretty much a direct way to burnout or worse. The human mind is not designed to "sprint" run a marathon, metaphorically speaking, forever.
I see older devs being active in the trade well into their 60s but even as I much younger person I don't see how agile development is sustainable for a ~50-year career.
The thing is, the core agile points from the manifesto are pretty much universally fine and can pretty much be boiled down to, "make changes fast, get feedback, gain more understanding faster".
Pretty much everything that's been layered on top though has either nothing to do with the manifesto, or actively breaks it. i.e. there's a burning issue, I'll get to that after my sprint commitment, which was sold to let me finish work, but now only exists to stress me out to squeeze more widgets per unit of time, where the widgets pretty much never actually map back to anything actually tangible.
Scrum is like Spaghetti Carbonara in America. The ingredients are simple and there's a tiny bit of technique involved that anybody can figure out after a few tries. For some reason though almost everybody that makes it decides that they know better than the people that invented it and so adulterates it with peas and onions and garlic and cream and cream cheese and Italian seasoning and parsley and chives until it ends up being Olive Garden Alfredo. If they wanted Carbonara then they would have cooked the Carbonara, not the waterfall with a bunch of JIRA workflows and four-hour meetings layered on top. They just did what they would have done anyway while attempting to sound fancy via obfuscation.
It's not just Agile but the same applies to DevOps.
DevOps is a culture. It can also be the specific subset of highly skilled individuals who were part of or an outcome of said cultures cross pollination. Today DevOps most often means fairly unskilled person hitting pipelines with hammer.
In the end, the same old people with the same old commercial interests adopted the term in a way that benefited them but changed the meaning of the term because change was not actually something anyone wanted.
That's not actually true. To give a silly example: does anyone (seriously) claim that 'true fascism' has never been tried?
Or: liberal democracy (I'm sure you can find a synonym that ends in *-ism) has been tried. It's been doing ok-ish. Obviously it has warts and all. But more importantly: approximately no one ever seriously claims that 'real liberal democracy' hasn't been tried.
Similar for constitutional monarchy, or 'social market economy', or dictatorships, etc. People can mostly agree that the real deal has been tried.
I don’t agree with that though, plenty of places practice agile well. Maybe big corporations don’t practice it well, but startups often do agile correctly and understand the philosophy.
Any principle or practice falls apart when tied to an economy. See also: religion, politics, society at large. I don't foresee that changing in our lifetimes, so make money doing it the wrong way, and do it the right way in your free time.
Inasmuch as Agile was adopted at companies, it's because it was sold to them as a way to provide greater transparency, accountability, and control into a chaotic software development process. The vice president behind the company's "Agile Transformation" probably can't even name point one of the manifesto; "we're doing Scrum with JIRA, therefore we're agile" is the extent of his concern.
You say that, but it was way more stressful pre agile with the fixed date, fuck around for a few months planning, then dev, run out of time then death march to finish, etc.
A lot of young guys like that D-Day style work, then goof off for a while, but not me. Continuous sustainable work is much preferred.
There's a difference between "bad PMs using the tool wrong" and "ordinary, human PMs using the tool in the way that common business incentives would lead you to predict they'll use it".
If the tool is used wrong most of the time, it's at least partially to blame.
"If the tool is used wrong most of the time, it's at least partially to blame."
Only if there were other tools that didn't fall victim to the same business incentives, but they all do.
I've had PMs that find a balance with the business incentives and make it work. If you’re human and make the wrong choices, then most people, including me, will likely call you bad in that context. If they can't stand up to find balance with the business incentives, then they're a bad PM. That doesn't make them a bad person.
I have seen Scaled Agile Framework (SAFe) work in multiple real program teams. Doing it successfully requires total commitment at multiple levels and many organizations are culturally incapable of making the transitions.
To be clear I am not claiming that SAFe is necessarily the best possible methodology. There is certainly room for improvement. But empirically it can work in real life.
The organizations I've seen do SAFe at the top level "coincidentally" have so much in the way of resources that if they do software at the group level at all, they do it like a gentleman farms.
"I mean if something doesn't ever work in real life then its not good."
Are you talking about Agile, Waterfall, or project management in general?
I've seen Agile work just fine. I've also seen it fail miserably. I've seen both of these at the same company with the main difference being how aggressive/delusional the leadership is. The easy test is if your leadership is legitimately ok with your team going home early if you complete your sprint commitment early, and it actually happens on occasion.
It feels like over the past decade or two, every company that builds software has gradually adopted the same terrible practices as is commonly found in game development studios.
That is why more advanced agile methodologies such as SAFe use the neutral term "iteration" rather than "sprint". It doesn't imply anything about team velocity or individual workload.
The term "iteration" was in common use by many of the big 90s proto-agile methodologies (think RUP et al). And XP - which I guess is what most people would regard as the first "true" form of agile - used it too.
SAFe is just an attempt to mush something that like looks like agile to delivery teams together with something that fits into more traditional program management, governance, and strategic direction lifecycle models.
There's no particular magic to it, and it's probably better to think of it in terms of being an "enterprise variant of agile" rather than a "humane variant of agile".
Yes, that's accurate. In the real world sometimes software programs have to make compromises in order to align with actual business needs. Like if you're going to be manufacturing hardware to go with the software or scheduling training for users then you have to apply strict program management discipline to ensure everything comes together at the correct time.
Sure, that's fair. In the real world there are a lot of developers who want to be told what to do, or need to be told what to do because they lack business domain knowledge. A defined methodology like SAFe allows large enterprises to move forward at a steady pace and get some productive work out of those people.
The reality is that in some domains there just aren't many developers who are highly motivated, self directed, and thoroughly understand customer needs. Those people just aren't widely available in the labor market regardless of wages or working conditions. So if management doesn't impose a fairly strict methodology then then the program will collapse.
I'd make a separate case that learned helplessness is a reversible thing, and more highly motivated and self directed devs can be grown.
But leadership has to incentivize not just being a ticket monkey, and needs to mindfully empower people. You can't just flip a switch in a feature factory and say "fly my pretties, be free!"
Sure, that's also fair. But it takes a long time to turn culture around. And in the meantime the company has to continue shipping releases to customers or else they run out of cash and everyone gets laid off.
In my experience of it though (only two workplaces, but not one) it's used for higher level planning, rather than being a 'more advanced agile'. I.e. a SAFe iteration spans some number of sprints greater than one. What are we going to deliver this quarter versus how are we going to break down and monitor progress of the quarter's deliverables week by week. (Don't read that like I like it.)
I think you're confused about the terminology. SAFe doesn't have sprints. Depending on the program planning horizon, several iterations can be grouped together into a larger program increment which typically lasts about a quarter.
Why is anything supposed to be sustainable for a ~50-year career? That’s a long time! Things change and people change.
It’s not like my great grandparents had a passion for farming in South Dakota and that’s why they did it until they dropped dead. It’s all they knew and what they did to survive.
If you gave them the option to tap on a keyboard in an air-conditioned room for 10 or 20 of those years they would’ve taken it.
Agile (or rather modern management) converts human capital into capital as fast as possible. Considering the endless supply of developers and lack of accountability there is no downsides to doing that, you are an externality.
Reminds me of this Indian boss I had whose only agenda used to be calling me up and telling me that others had complaints about my work. After 2 years of listening to his stories, I had to tell him off one morning. I quit about 4 months later. The guy was a completely talentless aggregator. I don't get how some Indian firms promote people and this wasn't a small firm either. He ended up being promoted upwards.
> For me, I usually try to avoid anything where the working practices are strongly defined.
I'm grateful I've managed to avoid this so far. My favorite place to work has been more akin to "we need X done in Y system before Z date, but how and when it's done is up to you".
The worst part is how these people almost always work on the most boring, rote crap. They could be selling mens hair loss medication on the internet (cough) and key individuals in the organization are convinced what they do is life-and-death, future of humanity, work nights and weekends, we're the next Google. It's so deeply cringe-worthy. Meanwhile, I know a ton of people in the traditional pharma industry (e.g. not Novo, but Novo-adjacent); those companies broadly treat their employees pretty well, very minor amounts of overwork, they're well-staffed, some still have pensions, people spend their whole working lives there.
Tech sucks. It's filled with talentless hacks who think "because we use computers" means you've got a blank check to make every individual do the work of three individuals. And then your company gets gutted by private equity anyway, because it turns out hiring talentless hacks and overworking has consequences.
This is a weird take, but I genuinely and deeply believe the world would be a far better place if everyone experienced a life-threatening but recoverable major medical event and/or had children, while young. Perspective-shifting events that are core to the human condition and help ground your reality in work not being everything. By the way: The businesses our society would build would also be stronger.
> WFH only, limit stress, run away from job if things go bad again
I’m facing a similar set of health-based restrictions, it’s edifying and impressive how you’ve pushed through. I’m curious: how do you broach this with potential employers and shape your job search/career path around it?
Applying for pure remote positions puts one in direct competition with younger people who can pull obscene hours with no accommodation needs. Leading with disability/accommodation needs feels like the opposite of the ‘best foot forward’ honeymoon phase salesmanship associated with new jobs, and kinda soul crushing regurgitating the circumstances for chronic illness while hoping for a job. And uncontrollable management changes can eliminate medical protections and acceptable working environments, leading to an enhanced need to be able to hop jobs (exacerbating both the previous situations).
I’m fortunate my primary skills are amenable to straightforward accommodations, but you gotta get the job to do the job…
> kinda soul crushing regurgitating the circumstances for chronic illness while hoping for a job
I have to do this every time now because I have a resume gap. I don’t have to explain in detail, but even revisiting those three years for a brief explanation sucks.
I’m sure there’s an implicit realization that I will likely ask for accommodations when I explain the gap which likely reduces my chances of being hired.
I'd be interested in how you managed the impact to your vision, any particular technology improvements you made? My dad had a stroked over the summer and lost vision on his right side - he's older but still works at a computer and is pretty particular about workflows so I don't want to muddle with what works for him too much.
Hi! I hope your dad gets better soon. My vision got better over 3 months, then more slowly over a year. I keep a "small" blind spot in my field of view (where I can hide my hand).
I didn't need more management of this condition but rest.
I remember the first months, trees felt exhausting to look at because of their complexity, and I couldn't watch an action movie because it felt too intense.
Given enough kids to take care of, a mortgage and other financial/dept obligations, your insurance money might be just a drop in a bucket and your only destination will be a social welfare system. And even that might not save you from having to sell your house or apartment.
This feels like a very naïve viewpoint.
The reality being that you can't rely on insurance at all. You might have insurance but that certainly doesn't guarantee you'll be financially supported through health issues. You'll also be required to engage in legal battles with your insurance company which might be prohibitively complicated after a brain injury.
I got unemployment assistance, I'm french and lived in France at that time.
Be it family, savings or social security, I didn't take a year of vacation. I was trying to pivot to another activity which is difficult in itself, more so after a stroke.
Also before you tell me how good social security is in France :-) you must know my doctor likely caused or amplified the stroke by giving me the wrong treatment at the wrong time, and by not telling me to go to the hospital before 3 full days... and then they let me out. I returned urgently the week after, when a neuro-surgeon freaked out.
No, at least in Germany (pretty sure other western countries too) you are covered after stuff like this. You won't be rich, but enough housing food and your camera.
I'll modestly add that my sight was getting better and wasn't really an obstacle. It started with an activity of carbon ink large format B&W art prints for other photographers... then I became one too.
The "irony" didn't appear to me at that time, someone had to tell me it was ironic!
Why do you guys downvote - is it because the comment sounded snarky? It wasn't meant to be, I think it is (obviously) an impressive feat to work as a photographer when your eye sight is severly limited.
As a migraine sufferer this sounds scary and only today I have learned about it. What was it like? If I may ask. Is there a way to prevent it? I googled it and it seems to appear rather arbitrarily and suddenly.
It's very rare. I was a migraine sufferer, but this is how that time it was different:
- I was under severe stress at work
- I woke up with aura, realised it when looking at the mirror, I had only one eye
- visual symptoms (aura) didn't go away after 1 hour. That's the limit where you MUST seek medical advice
- having "a migraine" that day raised my stress level... because work...
- symptoms persisted... and after getting better over a year, what was left became permanent (blind spot where the migraine started in my field of vision)
DO NOT take triptans during the aura. DO NOT take any vasoconstrictors during aura, since it's a phase where blood flow is restricted. That could have caused my stroke.
When a migraine hits, I take aspirin, stop all stressors, ALL stressors, try to calm down (I've used anxiolytics occasionally), breathe and rest. I'm often off for 2 days. It happens about once a year.
Again, migrainous infarcts are VERY rare. You'll be fine, just let the aura pass, and know to seek medical attention if it doesn't.
Had a stroke 2 months ago at 55, after an entire life (professionally since I'm 16) as a dev. I mostly followed these rules apart from when I got dragged into a project that was sufficiently interesting that I started overworking. 12-14h days.
Just don't do that. I used to do that just fine and that's why I thought I was OK. I mean, I USED to go on in huge coding benders, did'nt I ? Well apparently not at 55, when the pressure has been on for months instead of weeks.
Other things to watch -- diet! With the work came less free time, put on weight etc and all the good habits I had built for years, disappeared.
And the worst bit you can think of is "Oh but I'm so CLOSE to being done, I'll just fix it up later when I can relax". Just don't.
I lost all sensation on the right side. It is coming back slowly. I can still work, didn't lose speech or mobility or strength, I consider myself super-mega-lucky in that.
> when I got dragged into a project that was sufficiently interesting that I started overworking
This is what bites. I have some really narrow interest areas that I can end up being obsessive about, to my own detriment. We have to be careful.
Glad you didn't lose mobility and speech! I also feel lucky. I met others in neuro-rehab in far worse situations. For three months I couldn't walk and now thankfully do so with a stick and ankle brace. The hard stuff isn't the stuff you can see visually though. People see my floppy leg, and might presume that's the main thing, but nope. The big thing is the epilepsy, this constant monster present in the background. It's the invisible stuff that's often hard.
Strikes close to home. 8 years ago I was in a bike accident that took me out for 4 months. I instantly felt dumber. The headaches became a fact of life, and the need to get out of the house early in the day to avoid brain fog creeping in became a routine.
It... sucks. I've still progressed my career and made significant strides, and come to appreciate things that I never would have noticed if I kept on my previous trajectory, and while I don't think about it much anymore, for years it ate at me.
For those in workplaces that treat you well. One suggestion that is not in OP: Tell others, explain, expand, give presentations on what you went through. Not only will it help your environment understand WHAT you are doing, they then are also able to understand the WHY. I've had my share of colleagues with afflictions. Your environment must know to understand! Otherwise, you are only allowing them to react to resulting situations, without understanding of the why. Second order benefit is that if people would do this more, general kindness towards how personal situations influence business situations would rise. We need more kindness, from understanding each other. (I understand this is an advice that does not work for those workplaces where HR is the enemy, the boss is their to get you, co-workers are in a free for all for bonuses and promotions. I hope most of us are not in that kind of work situations.)
Interesting to see all the people in this thread who had a stroke. I had a mild and then moderate cerebellar stroke within a 7 day span about two years ago. I remember being on the stroke neurology floor of the hospital with a lot of bed ridden people who had also suffered them. I know because, within 24 hours, I was doing hourly walking laps with my nurses because I was bored. In other words, I was one of the lucky ones. Within a week I was back at work — not because I felt pressured to by them, they were completely understanding, but because I had no more symptoms that were experienced simply because I was sitting down to work.
I also see some advice about listening to your body after the fact, which I fully agree with. In my case, without going into too much detail, the stroke might not have happened if I had listened to my body beforehand, as it was caused by an injury I could have prevented.
So if I could give any advice from this place of experience it would be to listen to your body, and try to hear it when your fears and ego are shouting.
As I understand it, post-COVID a lot more people are having strokes at younger ages, primarily from PFOs. 10–15% of us are walking around with a small pathway between the atria of our hearts, and if a clot happens to form, it can pop into the other side of your heart and get pumped straight to your brain.
I was exceedingly lucky in that it cleared up on its own after about an hour. I was unable to speak and unable to move so much as a finger or toe on the right half of my body. I was completely incapacitated. They had me in the CT when it cleared up, and I immediately was back to my original self with no lasting defects.
I know a vascular neurologist who says that the average age of his patients has dropped by nearly a decade in the last five years. Many more "young" (<60) men with minor strokes, and more frequent serious strokes in the 40s for both sexes. He's treated as many under 30 y/o stroke patients in the last two years than he did in the first two decades of his career. He's a few years from retirement and basically completely rattled by this sudden shift.
I have an out-there hypothesis I’d want to test. Much of the population has one or more MTHFR mutations, which can increase homocysteine if left untreated and that’s been linked to increased risk in stroke. Treatment includes more B vitamins. I wonder if the declining nutrition in foods and lack of B vitamins has anything to do with this.
I had a stroke roughly eleven years ago. When the stroke started, I got really creeped out. I was in an elevator and I thought a stranger was reaching around me from behind to grab me. It was my right arm. I cracked a joke about it, I didn't know it, but I wasn't soeaking. Just mumbling and making creepy gutteral noises when I thought I was laughing. Then the face droop. Followed by my right hand becoming locked in a fist. It took months on rehab to get it open. And it lost a lot of function.
I haven't had a stroke but I did get a nasty tropical mono when I was young. You never quite recover from that one. I've got ibs since. My stomach just gets tired and stops. My mental focus feels the same. I sleep 9 hours a night, often 10 and I'm still tired.
I feel I always have less stamina than other people.
So this list is close to what I have always preached.
Time as in energy is my most precious resource.
Don't let processes suck the life out of you. They're there to serve the people not the other way around.
Gut directed hypnotherapy has worked wonders for my IBS. The research on it is really solid and was recommended to me by a registered dietician. The one I followed is called Nerva. Might be worth a try for you.
> HEADPHONES, blinders, and 'No'. Eliminate unwanted inputs at the earliest point of entry.
Open-floor offices, non-stop emails and chat messages, several meetings scattered throughout the week and the day.
This kills productivity and increases stress and fatigue for people that need to concentrate to work on complex stuff. There's also the time you need to properly switch contexts.
The word "blinders" really stood out to me in this. Does anyone have a recommendation for something that is literally like horse blinders but for people? I genuinely feel like my peripheral vision is "too adept" and overwhelming sometimes. If I cup my hands around my temples and over my brow, I feel a sense of calm. Trying to find a real product that does this - but I suppose I could just try to prototype my own with an old baseball hat or visor that has some vertical pieces on the side.
This might sound silly: I used post-it notes as human-blinders.
I turnt the post-it note sideways, wrote `FOCUS TIME`, and put it on my temple, to block out my vision in that direction.
I joked about it with my team before, and then just did so when I felt comfortable enough with them. I utilize this strategy at home for deep focus in a chaotic living room setup.
2x Post-its, baseball cap, and over-the-ears noise-cancelling headphones is peak `focus-time` I've found.
I have not had a stroke, but a few years ago I noticed my eyesight was getting strange. There were many other things including a very fuzzy brain, and wanting to stay in bed for weeks. I thought I was just sad until the eyesight issue.
It turned out I had Advanced Neurological Lyme disease. It took a couple years to recover from it. I also have Cluster Headaches, one of the most painful medical conditions known to science. Losing my the ability to think clearly, was worse.
As someone who uses my brain for work, the depression that arose from losing my mental faculties was very significant. I searched TFA for depression and did not see a mention. If anyone is dealing with a neurological issue like this, I would imagine that second order effects like depression are common, correct?
All of that and parenting. Notifications off, camera off, WFH to the max and keeping the journal of where you were before attention was hijacked by the usual suspects.
With burnout it's simple, rest. Get away, go spiritually connect with something new, like laying on a beach or doing something completely new. Burnout is real and will make you _hate_ anything.
I watch for burnout in my teams, and become burned out myself at times, but if you're burning out, tell somebody and get moved elsewhere. Coder doing some star-coder stuff the last 6 months, but can do sysadmin/devops things? Switch to that for a few weeks and come back mentally rested.
Legal protections against burnout I'm not aware of but the illness associated with elevated stress levels and 'burn out' do create other health complications.
Burn out is bad, bad stuff. Once somebody's burned out they can't do _anything_
Pre Texting, Pre Email in the 90s I believe this kind of work was normal. All this self motivated, hyper context switching jobs we all do are relatively new compared to human evolvement. And we see the tax on us.
Reading this, I'm reminded of the idea that we should all care about accessibility, because barring death or radical advances in restorative medical technology, we will all rely on accessibility tech in some way eventually.
Besides what is listed here, have you observed anything that your coworkers or managers can do to help accommodate you? i.e. Is there a version of this for folks working with stroke-surviving software engineers?
The accessibility field is pretty mature, with useful and thorough guidelines like WCAG. But many people in the software industry either ignore accessibility completely, or think it's "only" about the blind, slap some alt text on images, and call it a day.
How strange to come across someone whose medical stuff so mirrors my own. I was just a decade older and don’t have epilepsy symptoms with meds. I can get behind all the advice here. Running out of “juice” and needing a break is very much thing. Before too but more so now. And taking a lot of semi stream of consciousness notes to help my more limited memory is too.
Good advice. I had one young too; I worked long days and had no life outside my company; it was in an economic downturn so I was also burning out (hindsight). I figured out what was important to me and that all changed everything.
Good advice. I didn’t have a stroke but a couple months ago I developed blindness in my left eye. It came down to my optic nerve being inflamed. I was later diagnosed with a rare autoimmune condition called MOGAD which “attacks” the optic nerve. Thankfully my vision is approx 95% recovered by now. But I still can’t read, eg code on my laptop, which is scary (my right eye is basically making up for it). And I’m scared of another attack happening. So I’ve been really looking after my health and trying not to do the 12+ hr coding benders I used to do. I appreciate these tips!
Even when I was young, I discovered that after a certain level of fatigue my coding became garbage, and after a night's sleep I had to delete it and redo it. After this tipping point, I just stop doing the hard stuff. If I still want to work, I work on routine things that didn't take much concentration.
I never understood how people can write complex code when fatigued. I just get negatively productive trying that.
> I discovered that after a certain level of fatigue my coding became garbage, and after a night's sleep I had to delete it and redo it.
My best work happens at 2am, at about 4am I am too tired and get slow and get stuck, I think even then code quality suffers only a little bit.
That's just my experience, I believe it happens because if I am working at that time, I am hyped and or in the zone. There is a sort of second wind involved. The lack of distractions also helps I guess.
Tbh the code I was writing wasn’t that complex from an engineering perspective. During my PhD I was writing “research code” which is more like writing scripts, not a full blown application or library. The most challenging part was translating the math/algorithms to code. And I would just get into a flow state sometimes and could not stop haha. I had a (bad?) habit during my PhD that whenever I was stuck on a problem I just kept bashing my head against it until I solved it (code or math).
Thanks for sharing! I feel the fear of another attack with epilepsy too. It is terrifying. The doom and the walking on thin ice constantly hoping you're not gonna over-step or do the wrong thing. And all that at the same time as trying to live your life fully. Do you have any devices or aid software to help with the not-reading thing? I imagine it's all really fresh still and you're just taking it a day at a time?
Wow, I feel for you, that sounds really scary. Honestly no, I’ve scarcely changed how I work, except for being more strict about keeping a rigid schedule, forcing myself to take breaks, etc. It’s only my left eye that can’t read, the right eye is totally fine. But I do feel the eye strain come on sooner from relying on one eye.
Hmm not sure what you mean. In the case of MOGAD, it actually attacks the lining of the nerve. The MOG means myelin oligodendrocyte glycoprotein, which is a protein in the myelin sheath.
It's very depressing how the article says "you don't have to do it alone! use AI"
ah this age where "not alone" means "AI"...
How about, enjoy good connections with nice people. Both in personal and work. Maybe those people can even see the warning signs and tell you to stop before you have a stroke.
Could honestly change the title to "Tips for stroke-surviving software engineers (or anyone trying to avoid one)". All of us need these fresh little reminders that our brains are very different than the tech we regularly interact with every now and then. Recognize and respect your organic hardware!
Hey folks, my wife is a speech language pathologist who specializes in stroke rehab, I sent her this post and this comment section and she sent me this to share:
As a stroke/neuro rehab speech-language pathologist that is married to a web dev/engineering manager (that obviously sent me this blogpost), everyone reading needs to listen to this author's sound advice for prevention of CVA as well as for post-stroke management. We are seeing younger age strokes more frequently, especially those with jobs that are high stress and low physicality (read: you folks!). Thank you to the writer for spreading this info and awareness… I can confirm it is not as niche as one might think and for best outcomes you have to respond FAST (look at Face, Arm weakness, Speech difficulty, Time to call 911). PSA of the day!
Some of these apply to other neurodivergents like myself.
One thing I struggle with is that the only time I seem to really get in the flow is when no one is around and no one else is working. Some form of stimulant is needed, but no stimulant I can use gets me to the point where I can get into more flow than I can when no one is around. I sometimes dream of how much I could do if I just lived at my office alone. This is sad and frustrating, because I don’t want that life where I cannot have a life of my own and where I cannot interact with people at work or it disables my ability to get things done.
Nutrition and some form of exercise are also incredibly important, especially as you get older. Not everyone needs the same things, so don’t let others tell you what is the “right thing for everyone”- there’s no such thing.
Question to the OP or anyone else that has experienced something similar.
Have you tried grey area or Peptide space medications like Dihexa, P-21, Semax, etc to see if there are any benefits there?
Very much self experimentation but they do work in mouse models as well as Russian medicine. I'm not encouraging anyone to experiment, just interested to see if anyone that has undergone experiences like OP's has experimented.
I have not experienced a stroke or similar but I just started a 6 - 8 week Dihexa course, low dose to test tolerance and I find I am experiencing benefits such as improved recall. I am learning guitar as my test suite. Something I have attempted multiple times before and given up on relatively quickly. 2 weeks in so far.
My intention is to drop the Dihexa at week 8 and then switch to Semax. The theory being that Dihexa improves synaptogenesis but inhibits pruning. Semax allows for pruning but optimizes the efficiency of existing used synapses. Dihexa is an experimental Alzheimer's medication and Semax is a Russian post stroke drug
I'm terrified by the possibility of a stroke that would disable me, not in a way that would let me write here about my experience with it, but leaving me dependent on the care of others. I'd prefer to shuffle off of this mortal coil, but such a sudden event may not allow that choice. So I fantasize about writing a suicide program that would take care of business if I fail to pass a bespoke Turing (delichon) test. But I doubt my ability to write that with enough nines of reliability to be willing to deploy it. I tried to implant that algorithm into my brother, but he declines to go to prison for me, the jerk. If I live long enough maybe AI tech will become reliable enough for this application, but I doubt it will be soon.
This is essentially my greatest fear as well. Most of my supplementation stack revolves around the desire to prevent this. I take ~30 supplements a day.
Thank you for sharing this. Keep up the good work and healing, OP! It's incredible that you've continued to be polite and to do as much as you can through your health struggle. Setting and enforcing boundaries can be difficult for some, especially when you're feeling hazy and not operating at 100%. I like that you pointed out being polite can be expensive sometimes.
This is excellent advice for anyone with knowledge based work though. Distractions, messages, pop-ups, asks, meetings, etc. are the leading reason I don't get as much done as I could. Some of your items could definitely help here.
Maybe it is better to invest cognition budget into more valuable things. Let AI write that test while you learn how Postgres Indexes work, for example.
But if you are sick you cant do X "healthy thing for normal people". If you are sick you cant get that hour of exercise a day and do weight lifting and work out your brain etc.
Oh gosh, even with the laws that should provide cover, the pushback you’ll encounter in academia from so many individuals with limited life experience who are trained only to rigidly follow blanket policies.
But if you feel like you won’t speak up because it’s not that bad, remember the next person who will come after you. When you have the capacity to push systems to do better, it’s better for everyone if you exercise it.
This advice could be translated 1:1 to ADHD (at least in my experience). You have to be very mindful with your attention and energy levels.
I'm wondering if some underlying mechanism in the brain is similar between having ADHD and having suffered a stroke. Or maybe it's just the conscious effort how to handle the symptoms that's similar.
My father recently had a stroke, we both have ADHD, his is untreated. Since the stroke, most of his impacts have been cognitive, not muscular and most of his cognitive issues relate to worsening executive functioning across all executive functions, but particularly exacerbating the worst issues attributed to ADHD.
As you would know ADHD is a problem with regulation, not capacity however with this stroke it appears that his capacity has fundamentally changed and is further impacted by the dysregulation.
It's still early, and we haven't seen the specialist yet but I'm taking this hypothesis to them and (if I remember to) will update/edit here with their response.
In my experience it feels more like the latter - a similar way to manage symptoms rather than a similar root cause. From the article it sounds like OP knows exactly where to spend attention and focus, but needs to guard it carefully (and manage expectations) or else risk falling from their island of stability.
Are there types of disability insurance you can buy that would cover you as a software engineer in case something like this happens and you're not able to go back to work or not work as effectively in this field? Does anyone have experiences with this?
This is applicable to far more than stroke victims. Any manner of brain interference should have the same ruleset. Reading through the comments, this ruleset should apply to everyone regardless of their medical situation. Chiming in with a +1 to fitness, and diet. It helps, massively.
Good tips. Not a stroke survivor but I developed epilepsy as a young adult… Not sure if work/stress had anything to do with it, but stress certainly triggers it!
I’m still able to work as a software engineer, and my career has progressed, but the condition has held me back in a lot of ways.
Isn't it better to prevent than remediate it? It's not rocket science. Mediterranean diet, daily nattokinase, absolutely no alcohol at any time, exercise
> Is being part of a minority prerequisite for personal health care?
Discrimination doesn’t have to be racial. You can be discriminated because of a handicap.
From Cambridge dictionary
> discriminate verb (TREAT DIFFERENTLY)
> to treat a person or particular group of people differently, especially in a worse way from the way in which you treat other people, because of their race, gender, sexuality, etc.
Good to see more awareness of this. 20 yrs working as a developer, suffered a stroke last year (ischaemic), in hospital for a week, back working out of necessity not too long after that. Gravity of the condition never occurred to me until much later; self employed, main income provider for the house, recovery full of fatigue and emotional turmoil. It's a slow road, I think I'm very lucky and definitely main changes are stress management, diet/lifestyle and rebalancing of work commitments. Everyone's different, but it's not as uncommon a condition as people think. But it certainly can be utterly devastating so please do look after each other and yourselves. Brain injury and recovery takes time and because it's not visible it's very easy to forget or overlook that it's there and healing
I think AI as it's currently implemented is a plague upon humanity, but I do appreciate it helping me to locate the word that's on the tip of my tongue and which my battered brain can't seem to draw a neural route to, so that I'm not sitting there for 20 minutes trying to fight the Einstellung effect and brain fog.
Another thing if you are recovering and have limited dexterity in your hands, after trying pretty much ALL the voice recognition I could find, the VScode/copilot assistant is the best by far!
I've now recovered enough that I can type/edit faster, but I still use it; I keep a Worksheet.md tab around and keep a whole running log of stuff, LLM prompts etc
Would remove that keto part, otherwise agree. Keto is great for lowering fat levels but long term effects can be terrible if unsupervised professionally, ie permanent internal organs damage, more than negating any benefits gained.
Not sure why some people can only (mentally but brain drags rest of the body along) exist in extremes, when basically always some sort of moderate middle path is best in all aspects of life.
Keto has no solid association with any improved outcomes in terms of stroke and CVD. The gains are typically because of weight loss in which it is just another variant of CICO. You'd make the same gains in health by simply eating better overall and in accordance with your activity level.
Keto however has numerous well researched negative health outcomes such as elevated LDL, ApoB, etc and these can be dramatically elevated in hyper-responders. Though, the science is also out on if mildly elevated LDL is anything to worry about. It's not a panacea but rather a trade off. Most people can stick to keto better because fats simply taste better and keep you feeling full longer and the alternative is much harder to stick to long term.
It is only known to be effective for treatment resistant epilepsy. Any other benefit either can be equally attributed to the control (CICO + exercise) or are pseudoscience.
Suffered a stroke in 2004 (migrainous infarction). Became half blind. Rested for a good year. Became a photographer for 8 years, then switched back again to software development. From then on, the limits were: WFH only, limit stress, run away from job if things go bad again. Nap if brain feels exhausted. Sleep, more and better. 20 years later (53yo), I'd say I'm doing great! Also fitness helps remind me to take care of the body...
Tech has built literal industries of people trying to stress you out, and they mostly don't have actual tech skills or the empathy that comes with them so back it up.
For me, I usually try to avoid anything where the working practices are strongly defined. Agile has long been a bad word.
I'm glad you're doing well now.
Unfortunately while the intentions around agile were noble it's pretty much a direct way to burnout or worse. The human mind is not designed to "sprint" run a marathon, metaphorically speaking, forever.
I see older devs being active in the trade well into their 60s but even as I much younger person I don't see how agile development is sustainable for a ~50-year career.
The thing is, the core agile points from the manifesto are pretty much universally fine and can pretty much be boiled down to, "make changes fast, get feedback, gain more understanding faster".
Pretty much everything that's been layered on top though has either nothing to do with the manifesto, or actively breaks it. i.e. there's a burning issue, I'll get to that after my sprint commitment, which was sold to let me finish work, but now only exists to stress me out to squeeze more widgets per unit of time, where the widgets pretty much never actually map back to anything actually tangible.
> Pretty much everything that's been layered on top
...and that /is/ topic of discussion every time this discussion happens
Every agile criticism conversation goes like this
A: agile as practiced is bad
B: but the manifesto is solid
It's predictable as the sun rising
Because it's true.
Scrum is like Spaghetti Carbonara in America. The ingredients are simple and there's a tiny bit of technique involved that anybody can figure out after a few tries. For some reason though almost everybody that makes it decides that they know better than the people that invented it and so adulterates it with peas and onions and garlic and cream and cream cheese and Italian seasoning and parsley and chives until it ends up being Olive Garden Alfredo. If they wanted Carbonara then they would have cooked the Carbonara, not the waterfall with a bunch of JIRA workflows and four-hour meetings layered on top. They just did what they would have done anyway while attempting to sound fancy via obfuscation.
"If it had ham, it would be closer to a British carbonara..."
https://www.instagram.com/reel/DK3aeJjyv98/?hl=en
It's not just Agile but the same applies to DevOps.
DevOps is a culture. It can also be the specific subset of highly skilled individuals who were part of or an outcome of said cultures cross pollination. Today DevOps most often means fairly unskilled person hitting pipelines with hammer.
In the end, the same old people with the same old commercial interests adopted the term in a way that benefited them but changed the meaning of the term because change was not actually something anyone wanted.
And usually:
C: Therefore you’re doing it wrong.
And once an “agile guru” enters the conversation:
D: You need my book / seminar / services.
Is agile the socialism of software development methodologies?
(Not for any deeper reason, only that whenever socialism fails, people tell you that 'real socialism' hasn't been tried, yet.)
It's the same with every *-ism.
That's not actually true. To give a silly example: does anyone (seriously) claim that 'true fascism' has never been tried?
Or: liberal democracy (I'm sure you can find a synonym that ends in *-ism) has been tried. It's been doing ok-ish. Obviously it has warts and all. But more importantly: approximately no one ever seriously claims that 'real liberal democracy' hasn't been tried.
Similar for constitutional monarchy, or 'social market economy', or dictatorships, etc. People can mostly agree that the real deal has been tried.
I don’t agree with that though, plenty of places practice agile well. Maybe big corporations don’t practice it well, but startups often do agile correctly and understand the philosophy.
Any principle or practice falls apart when tied to an economy. See also: religion, politics, society at large. I don't foresee that changing in our lifetimes, so make money doing it the wrong way, and do it the right way in your free time.
Nobody gives a fuck about the Agile Manifesto.
Inasmuch as Agile was adopted at companies, it's because it was sold to them as a way to provide greater transparency, accountability, and control into a chaotic software development process. The vice president behind the company's "Agile Transformation" probably can't even name point one of the manifesto; "we're doing Scrum with JIRA, therefore we're agile" is the extent of his concern.
You say that, but it was way more stressful pre agile with the fixed date, fuck around for a few months planning, then dev, run out of time then death march to finish, etc.
A lot of young guys like that D-Day style work, then goof off for a while, but not me. Continuous sustainable work is much preferred.
That's not really Agile's fault. That's PMs overcommitting the team. Those bad PMs would also make unrealistic waterfall schedules.
There's a difference between "bad PMs using the tool wrong" and "ordinary, human PMs using the tool in the way that common business incentives would lead you to predict they'll use it".
If the tool is used wrong most of the time, it's at least partially to blame.
"If the tool is used wrong most of the time, it's at least partially to blame."
Only if there were other tools that didn't fall victim to the same business incentives, but they all do.
I've had PMs that find a balance with the business incentives and make it work. If you’re human and make the wrong choices, then most people, including me, will likely call you bad in that context. If they can't stand up to find balance with the business incentives, then they're a bad PM. That doesn't make them a bad person.
I mean if something doesn't ever work in real life then its not good. Intentions aside.
I have seen Scaled Agile Framework (SAFe) work in multiple real program teams. Doing it successfully requires total commitment at multiple levels and many organizations are culturally incapable of making the transitions.
To be clear I am not claiming that SAFe is necessarily the best possible methodology. There is certainly room for improvement. But empirically it can work in real life.
The organizations I've seen do SAFe at the top level "coincidentally" have so much in the way of resources that if they do software at the group level at all, they do it like a gentleman farms.
"I mean if something doesn't ever work in real life then its not good."
Are you talking about Agile, Waterfall, or project management in general?
I've seen Agile work just fine. I've also seen it fail miserably. I've seen both of these at the same company with the main difference being how aggressive/delusional the leadership is. The easy test is if your leadership is legitimately ok with your team going home early if you complete your sprint commitment early, and it actually happens on occasion.
"Are you talking about Agile, Waterfall, or project management in general?" lol, yes
Agile isn't sustainable for younger people either. But they just get replaced by more younger people. Burn-out in IT is way too common.
It feels like over the past decade or two, every company that builds software has gradually adopted the same terrible practices as is commonly found in game development studios.
Since tech has largely stopped hiring younger people, sounds like a problem.
I have never seen Agile used correctly in practice. Its just mini waterfall with additional annoying ceremonies lumped on top.
That is why more advanced agile methodologies such as SAFe use the neutral term "iteration" rather than "sprint". It doesn't imply anything about team velocity or individual workload.
The term "iteration" was in common use by many of the big 90s proto-agile methodologies (think RUP et al). And XP - which I guess is what most people would regard as the first "true" form of agile - used it too.
SAFe is just an attempt to mush something that like looks like agile to delivery teams together with something that fits into more traditional program management, governance, and strategic direction lifecycle models.
There's no particular magic to it, and it's probably better to think of it in terms of being an "enterprise variant of agile" rather than a "humane variant of agile".
Yes, that's accurate. In the real world sometimes software programs have to make compromises in order to align with actual business needs. Like if you're going to be manufacturing hardware to go with the software or scheduling training for users then you have to apply strict program management discipline to ensure everything comes together at the correct time.
SAFe is not "advanced" Agile. It's training wheels Agile for managers and execs who can't give up control and devs who want to be told what to do.
Sure, that's fair. In the real world there are a lot of developers who want to be told what to do, or need to be told what to do because they lack business domain knowledge. A defined methodology like SAFe allows large enterprises to move forward at a steady pace and get some productive work out of those people.
The reality is that in some domains there just aren't many developers who are highly motivated, self directed, and thoroughly understand customer needs. Those people just aren't widely available in the labor market regardless of wages or working conditions. So if management doesn't impose a fairly strict methodology then then the program will collapse.
I'd make a separate case that learned helplessness is a reversible thing, and more highly motivated and self directed devs can be grown.
But leadership has to incentivize not just being a ticket monkey, and needs to mindfully empower people. You can't just flip a switch in a feature factory and say "fly my pretties, be free!"
Sure, that's also fair. But it takes a long time to turn culture around. And in the meantime the company has to continue shipping releases to customers or else they run out of cash and everyone gets laid off.
> developers who are highly motivated, self directed, and thoroughly understand customer needs
Why would someone with these qualities work for someone else?
In my experience of it though (only two workplaces, but not one) it's used for higher level planning, rather than being a 'more advanced agile'. I.e. a SAFe iteration spans some number of sprints greater than one. What are we going to deliver this quarter versus how are we going to break down and monitor progress of the quarter's deliverables week by week. (Don't read that like I like it.)
I think you're confused about the terminology. SAFe doesn't have sprints. Depending on the program planning horizon, several iterations can be grouped together into a larger program increment which typically lasts about a quarter.
I didn't implement it or name it, just worked in it.
Why is anything supposed to be sustainable for a ~50-year career? That’s a long time! Things change and people change.
It’s not like my great grandparents had a passion for farming in South Dakota and that’s why they did it until they dropped dead. It’s all they knew and what they did to survive.
If you gave them the option to tap on a keyboard in an air-conditioned room for 10 or 20 of those years they would’ve taken it.
Not so sure they would if they knew what it means, beyond tapping keyboards.
Too much software and you start turning into a computer, which obviously doesn't work very well.
They know it's not backbreaking labor...
Agile (or rather modern management) converts human capital into capital as fast as possible. Considering the endless supply of developers and lack of accountability there is no downsides to doing that, you are an externality.
Where can you get an endless supply of (good) developers from?
If you only hire young, there will be new yield every year.
There's a new yield of 40 year olds every year, too.
That doesn't make it endless.
Green cards
There's an endless supply of green cards?
Reminds me of this Indian boss I had whose only agenda used to be calling me up and telling me that others had complaints about my work. After 2 years of listening to his stories, I had to tell him off one morning. I quit about 4 months later. The guy was a completely talentless aggregator. I don't get how some Indian firms promote people and this wasn't a small firm either. He ended up being promoted upwards.
> For me, I usually try to avoid anything where the working practices are strongly defined.
I'm grateful I've managed to avoid this so far. My favorite place to work has been more akin to "we need X done in Y system before Z date, but how and when it's done is up to you".
The worst part is how these people almost always work on the most boring, rote crap. They could be selling mens hair loss medication on the internet (cough) and key individuals in the organization are convinced what they do is life-and-death, future of humanity, work nights and weekends, we're the next Google. It's so deeply cringe-worthy. Meanwhile, I know a ton of people in the traditional pharma industry (e.g. not Novo, but Novo-adjacent); those companies broadly treat their employees pretty well, very minor amounts of overwork, they're well-staffed, some still have pensions, people spend their whole working lives there.
Tech sucks. It's filled with talentless hacks who think "because we use computers" means you've got a blank check to make every individual do the work of three individuals. And then your company gets gutted by private equity anyway, because it turns out hiring talentless hacks and overworking has consequences.
This is a weird take, but I genuinely and deeply believe the world would be a far better place if everyone experienced a life-threatening but recoverable major medical event and/or had children, while young. Perspective-shifting events that are core to the human condition and help ground your reality in work not being everything. By the way: The businesses our society would build would also be stronger.
> WFH only, limit stress, run away from job if things go bad again
I’m facing a similar set of health-based restrictions, it’s edifying and impressive how you’ve pushed through. I’m curious: how do you broach this with potential employers and shape your job search/career path around it?
Applying for pure remote positions puts one in direct competition with younger people who can pull obscene hours with no accommodation needs. Leading with disability/accommodation needs feels like the opposite of the ‘best foot forward’ honeymoon phase salesmanship associated with new jobs, and kinda soul crushing regurgitating the circumstances for chronic illness while hoping for a job. And uncontrollable management changes can eliminate medical protections and acceptable working environments, leading to an enhanced need to be able to hop jobs (exacerbating both the previous situations).
I’m fortunate my primary skills are amenable to straightforward accommodations, but you gotta get the job to do the job…
> kinda soul crushing regurgitating the circumstances for chronic illness while hoping for a job
I have to do this every time now because I have a resume gap. I don’t have to explain in detail, but even revisiting those three years for a brief explanation sucks.
I’m sure there’s an implicit realization that I will likely ask for accommodations when I explain the gap which likely reduces my chances of being hired.
> I’m curious: how do you broach this with potential employers and shape your job search/career path around it?
Could you get the job without these conditions and then drop the bomb on them as a disability accomodation
Whats your stack? (Software). Very impressive after 8 years to come back
Today it's Go-TS-react-node-K8s-mongo-PG-RabbitMQ
Well, I said "I'll never do IT again"... and when I say never, it usually happens in the end ;-)
I'd be interested in how you managed the impact to your vision, any particular technology improvements you made? My dad had a stroked over the summer and lost vision on his right side - he's older but still works at a computer and is pretty particular about workflows so I don't want to muddle with what works for him too much.
Hi! I hope your dad gets better soon. My vision got better over 3 months, then more slowly over a year. I keep a "small" blind spot in my field of view (where I can hide my hand). I didn't need more management of this condition but rest.
I remember the first months, trees felt exhausting to look at because of their complexity, and I couldn't watch an action movie because it felt too intense.
Did you work with something else during your rest period?
I don't think most people wouldn't be able to, financially.
> I don't think most people wouldn't be able to, financially.
Pretty sure you'd be covered in a lot of western countries, and if not you have relatively cheap insurances that cover these things.
Given enough kids to take care of, a mortgage and other financial/dept obligations, your insurance money might be just a drop in a bucket and your only destination will be a social welfare system. And even that might not save you from having to sell your house or apartment.
this means you are underinsured for your lifestyle.
This feels like a very naïve viewpoint. The reality being that you can't rely on insurance at all. You might have insurance but that certainly doesn't guarantee you'll be financially supported through health issues. You'll also be required to engage in legal battles with your insurance company which might be prohibitively complicated after a brain injury.
> This feels like a very naïve viewpoint
It's just an European viewpoint... I know for americans it's like a sci fi movie but it's very real here lol
In France you get ~67% of your salary for 36 months, after that it's case by case.
In Germany you get ~70% of your salary for 78 weeks, private insurances will cover more/longer too, for like < 50 euros a month
I got unemployment assistance, I'm french and lived in France at that time. Be it family, savings or social security, I didn't take a year of vacation. I was trying to pivot to another activity which is difficult in itself, more so after a stroke.
Also before you tell me how good social security is in France :-) you must know my doctor likely caused or amplified the stroke by giving me the wrong treatment at the wrong time, and by not telling me to go to the hospital before 3 full days... and then they let me out. I returned urgently the week after, when a neuro-surgeon freaked out.
You're talking about unemployment or disability?
No, at least in Germany (pretty sure other western countries too) you are covered after stuff like this. You won't be rich, but enough housing food and your camera.
Note: only if you're a German citizen.
Nope, you just need an health insurance, which you'll have if you worked
Ah, I thought you meant the more general Bürgergeld.
> Became half blind. ... Became a photographer
Impressive.
Thank you!
I'll modestly add that my sight was getting better and wasn't really an obstacle. It started with an activity of carbon ink large format B&W art prints for other photographers... then I became one too.
The "irony" didn't appear to me at that time, someone had to tell me it was ironic!
Why do you guys downvote - is it because the comment sounded snarky? It wasn't meant to be, I think it is (obviously) an impressive feat to work as a photographer when your eye sight is severly limited.
Usually one worded complements are frowned upon.
As a migraine sufferer this sounds scary and only today I have learned about it. What was it like? If I may ask. Is there a way to prevent it? I googled it and it seems to appear rather arbitrarily and suddenly.
It's very rare. I was a migraine sufferer, but this is how that time it was different:
- I was under severe stress at work - I woke up with aura, realised it when looking at the mirror, I had only one eye - visual symptoms (aura) didn't go away after 1 hour. That's the limit where you MUST seek medical advice - having "a migraine" that day raised my stress level... because work... - symptoms persisted... and after getting better over a year, what was left became permanent (blind spot where the migraine started in my field of vision)
DO NOT take triptans during the aura. DO NOT take any vasoconstrictors during aura, since it's a phase where blood flow is restricted. That could have caused my stroke.
When a migraine hits, I take aspirin, stop all stressors, ALL stressors, try to calm down (I've used anxiolytics occasionally), breathe and rest. I'm often off for 2 days. It happens about once a year.
Again, migrainous infarcts are VERY rare. You'll be fine, just let the aura pass, and know to seek medical attention if it doesn't.
Thank you very much for this information. I hope you're doing well now!
My dad's suffering with aphasia from a large half brain stroke too.
You give me some hope things will get better for him.
I hope your dad gets better soon. It takes patience, it's a very gradual process, over months if not years.
> WFH only, limit stress, run away from job if things go bad again
Sounds like senior management
I haven't had management roles, but I'm now an entrepreneur...
Had a stroke 2 months ago at 55, after an entire life (professionally since I'm 16) as a dev. I mostly followed these rules apart from when I got dragged into a project that was sufficiently interesting that I started overworking. 12-14h days.
Just don't do that. I used to do that just fine and that's why I thought I was OK. I mean, I USED to go on in huge coding benders, did'nt I ? Well apparently not at 55, when the pressure has been on for months instead of weeks.
Other things to watch -- diet! With the work came less free time, put on weight etc and all the good habits I had built for years, disappeared.
And the worst bit you can think of is "Oh but I'm so CLOSE to being done, I'll just fix it up later when I can relax". Just don't.
I lost all sensation on the right side. It is coming back slowly. I can still work, didn't lose speech or mobility or strength, I consider myself super-mega-lucky in that.
> when I got dragged into a project that was sufficiently interesting that I started overworking
This is what bites. I have some really narrow interest areas that I can end up being obsessive about, to my own detriment. We have to be careful.
Glad you didn't lose mobility and speech! I also feel lucky. I met others in neuro-rehab in far worse situations. For three months I couldn't walk and now thankfully do so with a stick and ankle brace. The hard stuff isn't the stuff you can see visually though. People see my floppy leg, and might presume that's the main thing, but nope. The big thing is the epilepsy, this constant monster present in the background. It's the invisible stuff that's often hard.
Strikes close to home. 8 years ago I was in a bike accident that took me out for 4 months. I instantly felt dumber. The headaches became a fact of life, and the need to get out of the house early in the day to avoid brain fog creeping in became a routine.
It... sucks. I've still progressed my career and made significant strides, and come to appreciate things that I never would have noticed if I kept on my previous trajectory, and while I don't think about it much anymore, for years it ate at me.
Do you still have headaches?
I was also in a bike accident that resulted in brain trauma (not a stroke), and yes, still get headaches 5 years later.
But it does get better with exercise. I was able to reduce weekly headaches to about 1/month.
For those in workplaces that treat you well. One suggestion that is not in OP: Tell others, explain, expand, give presentations on what you went through. Not only will it help your environment understand WHAT you are doing, they then are also able to understand the WHY. I've had my share of colleagues with afflictions. Your environment must know to understand! Otherwise, you are only allowing them to react to resulting situations, without understanding of the why. Second order benefit is that if people would do this more, general kindness towards how personal situations influence business situations would rise. We need more kindness, from understanding each other. (I understand this is an advice that does not work for those workplaces where HR is the enemy, the boss is their to get you, co-workers are in a free for all for bonuses and promotions. I hope most of us are not in that kind of work situations.)
> I hope most of us are not in that kind of work situations.
It is unfortunately very common and becoming more common with the rise of PE.
Sorry what does PE mean here. Thanks
Private Equity.
Interesting to see all the people in this thread who had a stroke. I had a mild and then moderate cerebellar stroke within a 7 day span about two years ago. I remember being on the stroke neurology floor of the hospital with a lot of bed ridden people who had also suffered them. I know because, within 24 hours, I was doing hourly walking laps with my nurses because I was bored. In other words, I was one of the lucky ones. Within a week I was back at work — not because I felt pressured to by them, they were completely understanding, but because I had no more symptoms that were experienced simply because I was sitting down to work.
I also see some advice about listening to your body after the fact, which I fully agree with. In my case, without going into too much detail, the stroke might not have happened if I had listened to my body beforehand, as it was caused by an injury I could have prevented.
So if I could give any advice from this place of experience it would be to listen to your body, and try to hear it when your fears and ego are shouting.
Stroke survivor here checking in.
As I understand it, post-COVID a lot more people are having strokes at younger ages, primarily from PFOs. 10–15% of us are walking around with a small pathway between the atria of our hearts, and if a clot happens to form, it can pop into the other side of your heart and get pumped straight to your brain.
I was exceedingly lucky in that it cleared up on its own after about an hour. I was unable to speak and unable to move so much as a finger or toe on the right half of my body. I was completely incapacitated. They had me in the CT when it cleared up, and I immediately was back to my original self with no lasting defects.
I know a vascular neurologist who says that the average age of his patients has dropped by nearly a decade in the last five years. Many more "young" (<60) men with minor strokes, and more frequent serious strokes in the 40s for both sexes. He's treated as many under 30 y/o stroke patients in the last two years than he did in the first two decades of his career. He's a few years from retirement and basically completely rattled by this sudden shift.
I have an out-there hypothesis I’d want to test. Much of the population has one or more MTHFR mutations, which can increase homocysteine if left untreated and that’s been linked to increased risk in stroke. Treatment includes more B vitamins. I wonder if the declining nutrition in foods and lack of B vitamins has anything to do with this.
i don't know how to word it better than: there's much we don't know yet about the extent of ~"long covid", or "down the road covid outcomes"
> Interesting to see all the people in this thread who had a stroke.
Indeed. My first thought was "....just how common is this?"
Far more common than I thought. My wife had multiple small strokes before she was 40.
I had a stroke roughly eleven years ago. When the stroke started, I got really creeped out. I was in an elevator and I thought a stranger was reaching around me from behind to grab me. It was my right arm. I cracked a joke about it, I didn't know it, but I wasn't soeaking. Just mumbling and making creepy gutteral noises when I thought I was laughing. Then the face droop. Followed by my right hand becoming locked in a fist. It took months on rehab to get it open. And it lost a lot of function.
damn, sorry friend. Must be terrifying to feel your body essentially betraying you.
I haven't had a stroke but I did get a nasty tropical mono when I was young. You never quite recover from that one. I've got ibs since. My stomach just gets tired and stops. My mental focus feels the same. I sleep 9 hours a night, often 10 and I'm still tired.
I feel I always have less stamina than other people.
So this list is close to what I have always preached.
Time as in energy is my most precious resource.
Don't let processes suck the life out of you. They're there to serve the people not the other way around.
Gut directed hypnotherapy has worked wonders for my IBS. The research on it is really solid and was recommended to me by a registered dietician. The one I followed is called Nerva. Might be worth a try for you.
> HEADPHONES, blinders, and 'No'. Eliminate unwanted inputs at the earliest point of entry.
Open-floor offices, non-stop emails and chat messages, several meetings scattered throughout the week and the day.
This kills productivity and increases stress and fatigue for people that need to concentrate to work on complex stuff. There's also the time you need to properly switch contexts.
The word "blinders" really stood out to me in this. Does anyone have a recommendation for something that is literally like horse blinders but for people? I genuinely feel like my peripheral vision is "too adept" and overwhelming sometimes. If I cup my hands around my temples and over my brow, I feel a sense of calm. Trying to find a real product that does this - but I suppose I could just try to prototype my own with an old baseball hat or visor that has some vertical pieces on the side.
This might sound silly: I used post-it notes as human-blinders.
I turnt the post-it note sideways, wrote `FOCUS TIME`, and put it on my temple, to block out my vision in that direction.
I joked about it with my team before, and then just did so when I felt comfortable enough with them. I utilize this strategy at home for deep focus in a chaotic living room setup.
2x Post-its, baseball cap, and over-the-ears noise-cancelling headphones is peak `focus-time` I've found.
there are at least two of us!
Check out pashmina‘s. It’s common to see people wearing them over their heads at EDM festivals if they are feeling over stimulated.
I occasionally use them while I’m working for the reason you mention.
I love my pash. Highly recommend.
Pop the lenses out of glacier glasses?
I have not had a stroke, but a few years ago I noticed my eyesight was getting strange. There were many other things including a very fuzzy brain, and wanting to stay in bed for weeks. I thought I was just sad until the eyesight issue.
It turned out I had Advanced Neurological Lyme disease. It took a couple years to recover from it. I also have Cluster Headaches, one of the most painful medical conditions known to science. Losing my the ability to think clearly, was worse.
As someone who uses my brain for work, the depression that arose from losing my mental faculties was very significant. I searched TFA for depression and did not see a mention. If anyone is dealing with a neurological issue like this, I would imagine that second order effects like depression are common, correct?
I think these are also good strategies for anyone who suffers from mental illness/burnout.
All of that and parenting. Notifications off, camera off, WFH to the max and keeping the journal of where you were before attention was hijacked by the usual suspects.
Which tips would you apply to burnout? Because certainly AFAIK, you don’t really get legal protections from burnout
I finally figured out how to address my burnout with a 10 day Vipassana meditation course (dhamma.org) - hope it potentially helps others as well.
With burnout it's simple, rest. Get away, go spiritually connect with something new, like laying on a beach or doing something completely new. Burnout is real and will make you _hate_ anything.
I watch for burnout in my teams, and become burned out myself at times, but if you're burning out, tell somebody and get moved elsewhere. Coder doing some star-coder stuff the last 6 months, but can do sysadmin/devops things? Switch to that for a few weeks and come back mentally rested.
Legal protections against burnout I'm not aware of but the illness associated with elevated stress levels and 'burn out' do create other health complications.
Burn out is bad, bad stuff. Once somebody's burned out they can't do _anything_
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ADHD...
Most of the advice is good for pre-stroke persons too. Might even avoid having one.
I think it is good advice for everyone.
Pre Texting, Pre Email in the 90s I believe this kind of work was normal. All this self motivated, hyper context switching jobs we all do are relatively new compared to human evolvement. And we see the tax on us.
Thank you for sharing.
Reading this, I'm reminded of the idea that we should all care about accessibility, because barring death or radical advances in restorative medical technology, we will all rely on accessibility tech in some way eventually.
Besides what is listed here, have you observed anything that your coworkers or managers can do to help accommodate you? i.e. Is there a version of this for folks working with stroke-surviving software engineers?
The accessibility field is pretty mature, with useful and thorough guidelines like WCAG. But many people in the software industry either ignore accessibility completely, or think it's "only" about the blind, slap some alt text on images, and call it a day.
We should try to do better.
I feel like any such advice would also be good advice for protecting the health of any of your staff.
How strange to come across someone whose medical stuff so mirrors my own. I was just a decade older and don’t have epilepsy symptoms with meds. I can get behind all the advice here. Running out of “juice” and needing a break is very much thing. Before too but more so now. And taking a lot of semi stream of consciousness notes to help my more limited memory is too.
Good advice. I had one young too; I worked long days and had no life outside my company; it was in an economic downturn so I was also burning out (hindsight). I figured out what was important to me and that all changed everything.
All excellent advice even if you haven't suffered some health issue like stroke.
Going through several panic attacks with stroke-level blood pressure elevation had a similar impact on my worldview and approach to work.
Slow down. Prioritize your own health and well-being. Focus on the essentials and cut out everything else.
If you are in pain, see a doctor before you end up in urgent care like I did.
Good advice. I didn’t have a stroke but a couple months ago I developed blindness in my left eye. It came down to my optic nerve being inflamed. I was later diagnosed with a rare autoimmune condition called MOGAD which “attacks” the optic nerve. Thankfully my vision is approx 95% recovered by now. But I still can’t read, eg code on my laptop, which is scary (my right eye is basically making up for it). And I’m scared of another attack happening. So I’ve been really looking after my health and trying not to do the 12+ hr coding benders I used to do. I appreciate these tips!
> 12+ hr coding benders
Even when I was young, I discovered that after a certain level of fatigue my coding became garbage, and after a night's sleep I had to delete it and redo it. After this tipping point, I just stop doing the hard stuff. If I still want to work, I work on routine things that didn't take much concentration.
I never understood how people can write complex code when fatigued. I just get negatively productive trying that.
> I discovered that after a certain level of fatigue my coding became garbage, and after a night's sleep I had to delete it and redo it.
My best work happens at 2am, at about 4am I am too tired and get slow and get stuck, I think even then code quality suffers only a little bit.
That's just my experience, I believe it happens because if I am working at that time, I am hyped and or in the zone. There is a sort of second wind involved. The lack of distractions also helps I guess.
Exactly the same here, late night would be my most productive. I don’t know how sustainable this is as I mature lol.
Tbh the code I was writing wasn’t that complex from an engineering perspective. During my PhD I was writing “research code” which is more like writing scripts, not a full blown application or library. The most challenging part was translating the math/algorithms to code. And I would just get into a flow state sometimes and could not stop haha. I had a (bad?) habit during my PhD that whenever I was stuck on a problem I just kept bashing my head against it until I solved it (code or math).
Thanks for sharing! I feel the fear of another attack with epilepsy too. It is terrifying. The doom and the walking on thin ice constantly hoping you're not gonna over-step or do the wrong thing. And all that at the same time as trying to live your life fully. Do you have any devices or aid software to help with the not-reading thing? I imagine it's all really fresh still and you're just taking it a day at a time?
Wow, I feel for you, that sounds really scary. Honestly no, I’ve scarcely changed how I work, except for being more strict about keeping a rigid schedule, forcing myself to take breaks, etc. It’s only my left eye that can’t read, the right eye is totally fine. But I do feel the eye strain come on sooner from relying on one eye.
Doesn’t the immune system attack the eyes if not for a protective wall? Or is that just a myth.
Hmm not sure what you mean. In the case of MOGAD, it actually attacks the lining of the nerve. The MOG means myelin oligodendrocyte glycoprotein, which is a protein in the myelin sheath.
OP thank you for this generous text. I would add that these tips are amazing for people with post-covid/long-covid/brain-fog too
Yup! I follow these and I also take walks, those can be helpful to relax and let the mind rest for a bit.
It's very depressing how the article says "you don't have to do it alone! use AI"
ah this age where "not alone" means "AI"...
How about, enjoy good connections with nice people. Both in personal and work. Maybe those people can even see the warning signs and tell you to stop before you have a stroke.
He says to use AI as a knowledge offloading tool. He literally says that he enjoys meetings.
wow I should have expected it to get only more depressing from replies I guess)
I'm not talking about meetings. relationships do not reduce to zoom meetings
and this is not about "knowledge offloading". that's a text file can do it. the key word is "help". the thing people did for each other;)
This was a very good to-the-point post! Applies to everyone, and you only truly seem to wake up to care for your health when you lost it first.
I managed to wake up in my early 30s, by watching my parents' health slowly start failing starting in their 50s.
Yea this is my takeaway as well. All of the advice is applicable to everyone. Health should always come first.
Could honestly change the title to "Tips for stroke-surviving software engineers (or anyone trying to avoid one)". All of us need these fresh little reminders that our brains are very different than the tech we regularly interact with every now and then. Recognize and respect your organic hardware!
Hey folks, my wife is a speech language pathologist who specializes in stroke rehab, I sent her this post and this comment section and she sent me this to share:
As a stroke/neuro rehab speech-language pathologist that is married to a web dev/engineering manager (that obviously sent me this blogpost), everyone reading needs to listen to this author's sound advice for prevention of CVA as well as for post-stroke management. We are seeing younger age strokes more frequently, especially those with jobs that are high stress and low physicality (read: you folks!). Thank you to the writer for spreading this info and awareness… I can confirm it is not as niche as one might think and for best outcomes you have to respond FAST (look at Face, Arm weakness, Speech difficulty, Time to call 911). PSA of the day!
Some of these apply to other neurodivergents like myself.
One thing I struggle with is that the only time I seem to really get in the flow is when no one is around and no one else is working. Some form of stimulant is needed, but no stimulant I can use gets me to the point where I can get into more flow than I can when no one is around. I sometimes dream of how much I could do if I just lived at my office alone. This is sad and frustrating, because I don’t want that life where I cannot have a life of my own and where I cannot interact with people at work or it disables my ability to get things done.
Nutrition and some form of exercise are also incredibly important, especially as you get older. Not everyone needs the same things, so don’t let others tell you what is the “right thing for everyone”- there’s no such thing.
Question to the OP or anyone else that has experienced something similar. Have you tried grey area or Peptide space medications like Dihexa, P-21, Semax, etc to see if there are any benefits there?
Very much self experimentation but they do work in mouse models as well as Russian medicine. I'm not encouraging anyone to experiment, just interested to see if anyone that has undergone experiences like OP's has experimented.
I have not experienced a stroke or similar but I just started a 6 - 8 week Dihexa course, low dose to test tolerance and I find I am experiencing benefits such as improved recall. I am learning guitar as my test suite. Something I have attempted multiple times before and given up on relatively quickly. 2 weeks in so far.
My intention is to drop the Dihexa at week 8 and then switch to Semax. The theory being that Dihexa improves synaptogenesis but inhibits pruning. Semax allows for pruning but optimizes the efficiency of existing used synapses. Dihexa is an experimental Alzheimer's medication and Semax is a Russian post stroke drug
DMSO can allegedly help some people improve after stroke, if applied soon enough.
https://www.midwesterndoctor.com/p/dmso-could-save-millions-...
I'm terrified by the possibility of a stroke that would disable me, not in a way that would let me write here about my experience with it, but leaving me dependent on the care of others. I'd prefer to shuffle off of this mortal coil, but such a sudden event may not allow that choice. So I fantasize about writing a suicide program that would take care of business if I fail to pass a bespoke Turing (delichon) test. But I doubt my ability to write that with enough nines of reliability to be willing to deploy it. I tried to implant that algorithm into my brother, but he declines to go to prison for me, the jerk. If I live long enough maybe AI tech will become reliable enough for this application, but I doubt it will be soon.
This is essentially my greatest fear as well. Most of my supplementation stack revolves around the desire to prevent this. I take ~30 supplements a day.
Thank you for sharing this. Keep up the good work and healing, OP! It's incredible that you've continued to be polite and to do as much as you can through your health struggle. Setting and enforcing boundaries can be difficult for some, especially when you're feeling hazy and not operating at 100%. I like that you pointed out being polite can be expensive sometimes.
This is excellent advice for anyone with knowledge based work though. Distractions, messages, pop-ups, asks, meetings, etc. are the leading reason I don't get as much done as I could. Some of your items could definitely help here.
> Let it hold state so your brain can judge rather than store and needlessly cogitate on stuff.
Isn’t that needless cogitation something that helps creating new links in your brain and helps against cognitive decline in later ages?
Maybe it is better to invest cognition budget into more valuable things. Let AI write that test while you learn how Postgres Indexes work, for example.
But if you are sick you cant do X "healthy thing for normal people". If you are sick you cant get that hour of exercise a day and do weight lifting and work out your brain etc.
This is good advice for non brain damaged engineers too (or maybe I am?)
Oh gosh, even with the laws that should provide cover, the pushback you’ll encounter in academia from so many individuals with limited life experience who are trained only to rigidly follow blanket policies.
But if you feel like you won’t speak up because it’s not that bad, remember the next person who will come after you. When you have the capacity to push systems to do better, it’s better for everyone if you exercise it.
This advice could be translated 1:1 to ADHD (at least in my experience). You have to be very mindful with your attention and energy levels.
I'm wondering if some underlying mechanism in the brain is similar between having ADHD and having suffered a stroke. Or maybe it's just the conscious effort how to handle the symptoms that's similar.
My father recently had a stroke, we both have ADHD, his is untreated. Since the stroke, most of his impacts have been cognitive, not muscular and most of his cognitive issues relate to worsening executive functioning across all executive functions, but particularly exacerbating the worst issues attributed to ADHD.
As you would know ADHD is a problem with regulation, not capacity however with this stroke it appears that his capacity has fundamentally changed and is further impacted by the dysregulation.
It's still early, and we haven't seen the specialist yet but I'm taking this hypothesis to them and (if I remember to) will update/edit here with their response.
In my experience it feels more like the latter - a similar way to manage symptoms rather than a similar root cause. From the article it sounds like OP knows exactly where to spend attention and focus, but needs to guard it carefully (and manage expectations) or else risk falling from their island of stability.
Are there types of disability insurance you can buy that would cover you as a software engineer in case something like this happens and you're not able to go back to work or not work as effectively in this field? Does anyone have experiences with this?
This is applicable to far more than stroke victims. Any manner of brain interference should have the same ruleset. Reading through the comments, this ruleset should apply to everyone regardless of their medical situation. Chiming in with a +1 to fitness, and diet. It helps, massively.
Good tips. Not a stroke survivor but I developed epilepsy as a young adult… Not sure if work/stress had anything to do with it, but stress certainly triggers it!
I’m still able to work as a software engineer, and my career has progressed, but the condition has held me back in a lot of ways.
I haven't had a stroke (yet) but I find all that to be generally good advice. Good read!
Good read. Recovery takes time, and steady small steps help rebuild skill and focus.
https://stroke.jonasr.app/dates/
Quite a recovery. No it's not me, just a dev that works in the same field.
Isn't it better to prevent than remediate it? It's not rocket science. Mediterranean diet, daily nattokinase, absolutely no alcohol at any time, exercise
I don't get it, why is this mentioning "anti-discrimination legislation". Is being part of a minority prerequisite for personal health care?
> Is being part of a minority prerequisite for personal health care?
Discrimination doesn’t have to be racial. You can be discriminated because of a handicap.
From Cambridge dictionary
> discriminate verb (TREAT DIFFERENTLY) > to treat a person or particular group of people differently, especially in a worse way from the way in which you treat other people, because of their race, gender, sexuality, etc.
Employers in most countries are required to make reasonable accommodations for people with disabilities.
Reminds me of Fefe, hope he'll recover one day, too.
Wha? Felix had a stroke? <schocked> Didn't know that.
I haven't had a stroke, and many of these tips are, IMO, important for the unimpaired productive software developer.
I don’t know if this is as niche as the author thinks: there’s a lot of great advice for non-stroke survivors in there too.
Didn't have a stroke, but in addition to developing software, I developed "software" brain issues too.
> You, too, have a limited context window.
Love this!
Good ME/CFS engineer advice too. Thanks for writing up OP
Good to see more awareness of this. 20 yrs working as a developer, suffered a stroke last year (ischaemic), in hospital for a week, back working out of necessity not too long after that. Gravity of the condition never occurred to me until much later; self employed, main income provider for the house, recovery full of fatigue and emotional turmoil. It's a slow road, I think I'm very lucky and definitely main changes are stress management, diet/lifestyle and rebalancing of work commitments. Everyone's different, but it's not as uncommon a condition as people think. But it certainly can be utterly devastating so please do look after each other and yourselves. Brain injury and recovery takes time and because it's not visible it's very easy to forget or overlook that it's there and healing
Excellent advice, for everybody. Thank you!
I think AI as it's currently implemented is a plague upon humanity, but I do appreciate it helping me to locate the word that's on the tip of my tongue and which my battered brain can't seem to draw a neural route to, so that I'm not sitting there for 20 minutes trying to fight the Einstellung effect and brain fog.
Stay away from vibe coding. It will cause more stress and provoke aneurysms -;)
Another thing if you are recovering and have limited dexterity in your hands, after trying pretty much ALL the voice recognition I could find, the VScode/copilot assistant is the best by far!
I've now recovered enough that I can type/edit faster, but I still use it; I keep a Worksheet.md tab around and keep a whole running log of stuff, LLM prompts etc
I would add: 1. Go strictly keto 2. Walk as much as you can
Would remove that keto part, otherwise agree. Keto is great for lowering fat levels but long term effects can be terrible if unsupervised professionally, ie permanent internal organs damage, more than negating any benefits gained.
Not sure why some people can only (mentally but brain drags rest of the body along) exist in extremes, when basically always some sort of moderate middle path is best in all aspects of life.
The permanent internal organ damage is pure bs and scare-mongering.
Obviously you also get those on non-keto diets since non-keto people also get strokes, heart disease, fatty liver...
Keto has no solid association with any improved outcomes in terms of stroke and CVD. The gains are typically because of weight loss in which it is just another variant of CICO. You'd make the same gains in health by simply eating better overall and in accordance with your activity level.
Keto however has numerous well researched negative health outcomes such as elevated LDL, ApoB, etc and these can be dramatically elevated in hyper-responders. Though, the science is also out on if mildly elevated LDL is anything to worry about. It's not a panacea but rather a trade off. Most people can stick to keto better because fats simply taste better and keep you feeling full longer and the alternative is much harder to stick to long term.
It is only known to be effective for treatment resistant epilepsy. Any other benefit either can be equally attributed to the control (CICO + exercise) or are pseudoscience.
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That sounds like a "you" problem. The site's "light mode"/"dark mode" choice seems to follow my system settings just fine.
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it's very helpful though i did'nt suffered a stroke until now
FYI that article is rendering light-grey text on a cream background color here (Safari, iOS), it’s barely readable
Something may be off on your end. I’m on iPhone/Safari, and it’s white on black here.
(Can always try reader mode, if you just want to read the content without worrying about fixing it.)