Best home contouring setup

[yesmaster]

What’s the most ergonomic home contouring setup?

- screen setup
- input device (trackpad, mouse, stylus)
- chair
- desk/standing desk

I contour a fair amount at home and my Apple trackpad is not very good. I’ve never been satisfied with Apple’s mouse. M1 Mac is great though.

I’ve considered iPad/stylus, getting a PC, getting a big TV, etc. What’s worked the best for y’all?

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[elementaryschooleconomics]

I have literally never, in my life, contoured with a trackpad. The idea itself seems like a crime against God.

I do know people who do it, and do it regularly...but like, ew.

Regarding peripherals: I like things from Logitech. They're widely available, relatively affordable, and you don't have to be a professional gamer or PhD in computer science to use them.

I own several Logitech G403 Hero mice. I like them because you can add up to 10g of weights for control. There's several other reasons I like it, but basically, you can't go wrong with the G403 Hero.

Don't overlook what you can do with a keyboard. Logitech and others make them with programmable macro keys. Obviously it might violate various IT policies, but macro keys are helpful if someone say, perhaps, has a job where they have to type in a username and password a lot. I have the Logitech G710+ (which might be an older model, I'm sure they have newer stuff, I've used it since 2017).

Screens - I use a triple monitor setup at home now. Two side by side, and a third above my primary display. I think this is extremely person-dependent, as in I like this but I'm sure someone else would hate it. I exclusively use PCs, so I don't know how Apple devices handle this but - if you want to go beyond 2 screens, you need to have a graphics card that is capable of that.

Chair - I got some gaming chair from Staples. No idea the brand. I literally just went to Staples and sat in gaming chairs and got the one I liked that wasn't super expensive.

Just...please...please stop with the trackpad...

 

[madchemist89]

Work laptop docked to monitors with Logitech mouse. Chair is amazon basics office chair.

 

[sirspamalot]

I do it at the office, and almost never leave after 5pm. I have a very expensive super comfy chair (flexing here, i think life form) and regular dual monitor/mouse/keyboard.

#

 

[Ray D. Ayshun]

I use a mouse, a CTL key, and a SHIFT key.

 

[deleted1111261]

I use a mouse, a CTL key, and a SHIFT key.

Contouring twins!

 

[thecarbonionangle]

I do it at the office, and almost never leave after 5pm. I have a very expensive super comfy chair (flexing here, i think life form) and regular dual monitor/mouse/keyboard.

#

I want to see this super expensive chair

 

[temujim]

What’s the most ergonomic home contouring setup?

- screen setup
- input device (trackpad, mouse, stylus)
- chair
- desk/standing desk

I contour a fair amount at home and my Apple trackpad is not very good. I’ve never been satisfied with Apple’s mouse. M1 Mac is great though.

I’ve considered iPad/stylus, getting a PC, getting a big TV, etc. What’s worked the best for y’all?

wacom 4 lyfe

 

[dieABRdie]

Screens - I use a triple monitor setup at home now. Two side by side, and a third above my primary display. I think this is extremely person-dependent, as in I like this but I'm sure someone else would hate it. I exclusively use PCs, so I don't know how Apple devices handle this but - if you want to go beyond 2 screens, you need to have a graphics card that is capable of that.

I don't think I could ever go back from a triple monitor setup. Being able to have maybe a contouring atlas or website (or both) up while contouring on the middle screen is awesome. I've got it at the office... some day I aspire to have it at home.

In the meantime I've been getting by with this accessory. I have an 18" screen laptop. This hooks right on the back and connects with HDMI and USB-C cables. It folds up and comes with me when I travel.

Robot or human?

For the mouse, nothing special. I've tried one of the "ergonomic" ones where your wrist is in a less pronated position, and could not get used to it at all. Tried a trackball... no way. This ended up being the most comfortable

Robot or human?

Going to give the Wacom a try.

 

[elementaryschooleconomics]

In the meantime I've been getting by with this accessory. I have an 18" screen laptop. This hooks right on the back and connects with HDMI and USB-C cables. It folds up and comes with me when I travel.

Whoa I've never seen something like this.

Walmart+ subscription: DEPLOY

 

[Gfunk6]

I like to contour in the bar of the Four Seasons. Rather than use the “smoothing” function, I find a couple of shots of Johnnie Walker does the trick nicely.

I also enjoy sharing what I am doing with my fellow bar flies. In case they are too drunk to appreciate my awesomeness, I usually take screenshots and post on Twitter and tag ASTRO. It doesn’t violate HIPAA cause it’s a society of professionals.

 

[radoncftw]

I like to contour in the bar of the Four Seasons. Rather than use the “smoothing” function, I find a couple of shots of Johnnie Walker does the trick nicely.

I also enjoy sharing what I am doing with my fellow bar flies. In case they are too drunk to appreciate my awesomeness, I usually take screenshots and post on Twitter and tag ASTRO. It doesn’t violate HIPAA cause it’s a society of professionals.

y tu ET?

 

[radoncftw]

This doesn't answer your question, but I try not to contour at home.
My internet connection is not that great and I have always had a decent amount of lag and things seem to take 2x as long. I try to get to work early (i.e. 6-7am) and knock out contouring before clinic gets busy. I find that finishing up notes or doing IGRT review is much easier from home, so I prioritize contouring at work

 

[gvsudew]

This doesn't answer your question, but I try not to contour at home.
My internet connection is not that great and I have always had a decent amount of lag and things seem to take 2x as long. I try to get to work early (i.e. 6-7am) and knock out contouring before clinic gets busy. I find that finishing up notes or doing IGRT review is much easier from home, so I prioritize contouring at work

Ditto!

 

[Radonky]

Screens - have triple screen setup, but different than ESE. Have a 24 inch one in the center, flanked by two 21 screen monitors.
Mouse - logitech mx518, its an old school gamer mouse, got it for nostalgia and its ergonomic.
keyboard - razer black widow - the nice thing is the wrist rest it has, never had wrist pain or problems. Otherwise just wanted a nice mechanical keyboard
chair - no name chair from amazon
desk - ikea

I recently finished building my PC. Didn't really notice a big difference in performance from from my 5 year old PC though I maxed things out (64gb DDR5 ram, core i-9 13900k, 4Gb NVMe M.2 SSD), so unless you are doing CPU intensive things, any mid tier PC will be more than enough.

 

[elementaryschooleconomics]

I recently finished building my PC. Didn't really notice a big difference in performance from from my 5 year old PC though I maxed things out (64gb DDR5 ram, core i-9 13900k, 4Gb NVMe M.2 SSD), so unless you are doing CPU intensive things, any mid tier PC will be more than enough.

I've been down this road before.

The best thing any of us can do at home, besides repenting from trackpad contouring and apologizing for our sins, is absolutely maxing out internet speed.

Remote work for our jobs is mostly going to take place either through a cloud application (accessed through a browser), a Virtual Desktop environment, or a Remote Desktop environment (where you take over and control your office computer). In all of these scenarios, the bottleneck is server hardware (not under our control) and internet speed (between our home and the outside world, which is marginally under our control).

Assuming you're using a computer built after like, 2015, it would be unlikely that any hardware will make a difference in performance. Sure, if you're using a first gen Chromebook at home and you upgrade to a stock Dell from Best Buy, you'll notice a huge difference. But if you build a home rig with quad monitors that can run Crysis 2 at max specs...it's killing a house fly with a cannon.

Now, if you somehow scored a "thick client" at home, meaning you have an actual local install of whatever TPS your practice uses, hardware comes back into play. But I don't think this is a common situation. I have a laptop "from" Varian that was acquired shortly before I came to my current hospital, but it sounds like we bought it directly "from" Varian. I don't know how open any of the companies would be to taking a homebuilt device and putting their bread and butter software on it.

In short, OBVIOUSLY I'm a giant technology nerd, and my solution for peak home performance was getting the fastest internet available in my area.

(I mean, then I also created a wired ethernet network in my home, and run DoubleShot Pro with my primary desktop connected both on Wi-Fi and ethernet...)

 

[pikachu]

wacom 4 lyfe

i am team stylus as well

 

[Palex80]

If I have to cont

But if you build a home rig with quad monitors that can run Crysis 2 at max specs...it's killing a house fly with a cannon.

Can I play Crysis 2 one one monitor and contour on the other three at the same time?

 

[evilbooyaa]

I don't contour from home b/ cinput lag is horrible and it' snot my internet speeds that are the problem.

That being said I strongly try to minimize how much work I do from home. IGRT and e-mails is fine. Notes is more annoying. Plan review also annoying. Contouring hard no.

 

[drowsy12]

I don't contour from home b/ cinput lag is horrible and it' snot my internet speeds that are the problem.

That being said I strongly try to minimize how much work I do from home. IGRT and e-mails is fine. Notes is more annoying. Plan review also annoying. Contouring hard no.

for me not being able to contour remotely would be hard. Call me picky, but I don't really want someone else contouring my cases routinely. how do you handle when youre away on vacation?

 

[HolySmokes]

for me not being able to contour remotely would be hard. Call me picky, but I don't really want someone else contouring my cases routinely. how do you handle when youre away on vacation?

Finish them before I leave?

 

[yesmaster]

how do you handle when you’re away on vacation?

At some point I’m going to get a wifi hotspot or a starlink receiver for backpacking trips, skiing, cruises. 1 week or more away from the office makes me nervous.

Plus it’d be fun to play Elden Ring in the middle of the Rockies…extra spooky.

 

[temujim]

I don't contour from home b/ cinput lag is horrible and it' snot my internet speeds that are the problem.

That being said I strongly try to minimize how much work I do from home. IGRT and e-mails is fine. Notes is more annoying. Plan review also annoying. Contouring hard no.

Likely to be a server side or software issue if you have those lag problems. Local IT department switched their software provider for virtual desktop/presentation in a fit of pique. Broke my entire home setup with lagging. IT ultimately had to provide an entirely new home setup for me on their dime to solve.

 

[elementaryschooleconomics]

for me not being able to contour remotely would be hard. Call me picky, but I don't really want someone else contouring my cases routinely. how do you handle when youre away on vacation?

Finish them before I leave?

At some point I’m going to get a wifi hotspot or a starlink receiver for backpacking trips, skiing, cruises. 1 week or more away from the office makes me nervous.

This is another thing not commonly talked about in residency training, at least in my experience. If you're big enough to support residents, there's enough docs around to shuttle consults/sims appropriately (at least...there should be, haha).

It can be tough to navigate this if you're solo or in a partnered setup. Part of the reason I left my prior job was being put in situations where I had to sign off on things I didn't agree with.

In my current setup, where I'm solo, I try to minimize sims taking place while I'm on vacation. However, it's not generally possible to block ALL sims from happening for a whole week if you're solo and the only linac around.

So I review anything that was done without me, and replan if necessary. I'm not sure if I'll continue this way forever, but considering the alternative is me contouring and reviewing/modifying plans on vacation (a quick path to divorce), I'm not seeing clear alternatives.

I suspect though, with the speed of AI and its implementation, I will switch to reviewing autonomous AI-generated plans while on vacation by the end of this decade.

 

[drowsy12]

Finish them before I leave?

sims happen when I am away too, and many can wait, but will be some that need timely contours in, especially if I am away for a week or more.

ive never had a problem with connectivity or lag, luckily, so it's pretty easy for me except for the fact that I am working.

 

[radoncftw]

sims happen when I am away too, and many can wait, but will be some that need timely contours in, especially if I am away for a week or more.

ive never had a problem with connectivity or lag, luckily, so it's pretty easy for me except for the fact that I am working.

do you have partners or practice solo? we are all replaceable and most things can wait. of course, an urgent whole brain or cord compression - diff scenario.
the idea that we need to be available all the time is absurd.

surgeons and med oncs take vacation too. i dont think a surgeon is zooming into make sure a covering surgeon fixed the anastamosis leak appropriately.

 

[TheWallnerus]

do you have partners or practice solo? we are all replaceable and most things can wait. of course, an urgent whole brain or cord compression - diff scenario.
the idea that we need to be available all the time is absurd.

surgeons and med oncs take vacation too. i dont think a surgeon is zooming into make sure a covering surgeon fixed the anastamosis leak appropriately.

In any given department there’s gonna be 4 people at least (chief therapist, dosimetrist, physicist, or practice admin) who on any given day have a 10% chance of putting the solo on-vacation rad onc in the mental line of sight of an urgent (but not really urgent) crisis.

Let’s say the solo rad onc is out for five days.

Then the probability the solo rad onc won’t feel the pull of an urgent crisis on a one week/5 day vacay is (1-0.1)^(4*5) = 12%.

The odds are stacked against us.

 

[JustAdocInBox]

I moved from multiple monitors to a single 34 inch curved screen with resolution 3440x1440 that is directly in front of me. These have come down significantly in price. I now have much less neck pain from looking off axis at secondary monitors. I use the windows snap screen feature to divide the display into left and right windows when I need to have two things side by side.

For keyboard and mouse I use the logitech MX keys keyboard and MX Master 3s mouse, both which are awesome.

 

[evilbooyaa]

for me not being able to contour remotely would be hard. Call me picky, but I don't really want someone else contouring my cases routinely. how do you handle when youre away on vacation?

I don't schedule CT sims for the 2 days prior to when I leave. Get all the other ones done. The 1-2 days before I leave on vacation are the most painful simply in terms of being proactive about minimizing the fires I will need to put out while I am on vacation.

CT sims that get done while I'm off get contoured when I return and we incorporate that into the planned time from CT sim to start of treatment.

You're going on vacation but spending time contouring cases remotely? That feels very much like NOT a vacation.

 

[evilbooyaa]

sims happen when I am away too, and many can wait, but will be some that need timely contours in, especially if I am away for a week or more.

ive never had a problem with connectivity or lag, luckily, so it's pretty easy for me except for the fact that I am working.

Do you not have someone covering the clinic during the time you are not present?

 

[metallica81788]

Head and neck case - let's say T2N1 BOT p16+ just gets his teeth pulled a few days before you're out for a week.
He gets CT sim scheduled right in the middle of the week you're not there. You are solo.
What is better - locum that hasn't treated a head and neck in 20 years contours with 2cm expansions vs you contouring it the day you get back from vacation (knowing it's the first priority in the laundry list of things to do upon return)?

I'm solo. My locums coverage is pretty decent (they can do any urgent or palliative things that come in) but there are some things I'm handling myself even if takes a few extra days. I'm not touching contours on a vacation.

 

[TheWallnerus]

Head and neck case - let's say T2N1 BOT p16+ just gets his teeth pulled a few days before you're out for a week.
He gets CT sim scheduled right in the middle of the week you're not there. You are solo.
What is better - locum that hasn't treated a head and neck in 20 years contours with 2cm expansions vs you contouring it the day you get back from vacation (knowing it's the first priority in the laundry list of things to do upon return)?

I'm solo. My locums coverage is pretty decent (they can do any urgent or palliative things that come in) but there are some things I'm handling myself even if takes a few extra days. I'm not touching contours on a vacation.

People still pulling teeth?

 

[metallica81788]

People still pulling teeth?

I'm glad that's what you took from the exercise

 

[thecarbonionangle]

People still pulling teeth?

Is it not needed like RNI?

 

[OTN]

Head and neck case - let's say T2N1 BOT p16+ just gets his teeth pulled a few days before you're out for a week.
He gets CT sim scheduled right in the middle of the week you're not there. You are solo.
What is better - locum that hasn't treated a head and neck in 20 years contours with 2cm expansions vs you contouring it the day you get back from vacation (knowing it's the first priority in the laundry list of things to do upon return)?

I'm solo. My locums coverage is pretty decent (they can do any urgent or palliative things that come in) but there are some things I'm handling myself even if takes a few extra days. I'm not touching contours on a vacation.

I go with option C, which is "contour on vacation"- this has allowed me to take somewhat longer vacations each summer, as everything continues even when I'm not in the clinic. Yes, I do get locums to cover, but I won't ever turn over contours to someone else.

 

[medgator]

I go with option C, which is "contour on vacation"- this has allowed me to take somewhat longer vacations each summer, as everything continues even when I'm not in the clinic. Yes, I do get locums to cover, but I won't ever turn over contours to someone else.

Yep. Dirty little secret of my vacations too. The cloud has been a curse and a blessing

 

[sirspamalot]

Aww cmon, a simple APPA rectangular field don't need no filthy contours..

 

[drowsy12]

I don't schedule CT sims for the 2 days prior to when I leave. Get all the other ones done. The 1-2 days before I leave on vacation are the most painful simply in terms of being proactive about minimizing the fires I will need to put out while I am on vacation.

CT sims that get done while I'm off get contoured when I return and we incorporate that into the planned time from CT sim to start of treatment.

You're going on vacation but spending time contouring cases remotely? That feels very much like NOT a vacation.

I mean spending 45 minutes to contour a case in a 1 week vacation is not a major deal to me. your mileage may vary.

 

[drowsy12]

Do you not have someone covering the clinic during the time you are not present?

you may have missed the part where I said I would rather not have someone else contour my curative intent complex cases, call me picky, we all have our preferences.

luckily contouring from away is super easy for me. no lag.

 

[evilbooyaa]

My SO would be incensed, understandably so, if I couldn't vacation during my vacation due to work for 45-60 minutes. Different strokes for different folks I suppose.

People still pulling teeth?

Uh, when necessary, yes? Look forward to your Soapbox.

 

[TheWallnerus]

Uh, when necessary, yes? Look forward to your Soapbox

just think there’s poor data for preRT extractions, a trend toward more harm than good. Prophylactic extraction is not really a thing in my practice last couple decades and afaik that’s been ok. I was thinking that was the trend du jour… guess not!

https://www.sciencedirect.com/science/article/pii/S0167814023897419

Dental extraction, intensity-modulated radiotherapy of head and neck cancer, and osteoradionecrosis: A systematic review and meta-analysis

To seek evidence for osteoradionecrosis (ORN) after dental extractions before or after intensity-modulated radiotherapy (IMRT) for head and neck cancer (HNC).Medline/PubMed, Embase, and Cochrane Library were searched from 2000 until 2020. Articles on ...

www.ncbi.nlm.nih.gov