Year: 2025

Categories
Medical Travel

Day 1653 and Slicing Then Cipro

Well it’s been exciting day for me and I may be a little bit high (alas not the fun or good kind) as I just had an abscess surgery in Istanbul.

I’m waiting on the lab work for the culture and pathology but from what I saw come out of the abscess it can’t be anything good as the doctor prescribed multiple antibiotics including Cipro while we wait for results.

Bimzelx has some gnarly side effects and I don’t know how much more slicing up infections I can manage for an immune suppressant biologic. My biometrics are better but 2 eye infections and one abscess surgery that almost went septic isn’t making me feel great about the balance of value on the drug.

I can’t say enough nice things about the Turkish medical system and their treatment of foreign “tourist” patients. It’s my second time this year having my Bimzelx side effects treated here.

A lovely interpreter and patient advocate was with me the entire time. The physician was so empathic. She was astonishingly effective in technique and her whole being moved with an efficient alacrity that was admirable given she was in a floral print silk sundress, high heels and pearls.

Imagine being so good at your job you can squeeze infected goo out of another human that you do it in white silk? I was impressed.

She on the other hand was not impressed by the care I received in America.

“They knew you were immunocompromised and did not insist on an ultrasound and immediate treatment?

What do you mean they said wait and see?”

“I don’t believe the other doctor thought it was a swollen lymph node given the clear folliculitis literature warnings for your biological drug.”

I was headed straight to sepsis and in her mind having multiple doctors leave a high risk patient to “put a compress on it and wait and see” when it was easily 3mm below the skin was malpractice to her.

Quite the big abscess eh? And look at that irritating side ways hair in there so deeply buried

And indeed I am on the kinds of antibiotics you’d expect someone close to septic shock might be on. I am amazed to be doing as well as I am. But I am frankly furious.

I tried to be responsible with preventative care and was ignored. I just kept on going until the small lump became a large lump. Then it rapidly became so swollen and infected it couldn’t be ignored. What a metaphor for the American healthcare share. You try to be responsible and are shown the door till it’s a crisis. And then they can’t even fix the crisis.

On the bright side I’m in a lovely hotel next to the hospital receiving excellent care. I could afford to fly in and get it taken care of without any worries (for the curious this was $2,000 for surgery and follow up care). I was in a very space age room after being in surgery and all my intense antibiotics were hand delivered to me. Now we wait to see what the labs say.

A private recovery suite
Categories
Biohacking Media Travel

Day 1652 and Back in Istanbul

I’m a mess and somewhat scared. This abcess saga has grown from dismissive preventative care visit (which I did did out of an abundance precaution) and ended with me meeting a general surgeon at a Turkish medical tourism hospital tomorrow to discuss labs and my ultrasound. It’s my second time this year so that’s quite an endorsement as a revealed preference.

But I am serious with this sidebar. Don’t go to SkincareMT’s dermatology practice if you have a layered case that needs more involvement. I found Dr Oetken pleasant but entirely unaccountable when a patient needed advice and weightings on a complex case. I should have known better.

I was afraid she would be a box checking paper pusher afraid to give an opinion. But maybe younger doctors are afraid to treat that way given our system. I needed to know is it worth getting a clearer diagnosis before it is a crisis? Is imaging necessary? I have a set of drugs I take with these specific side effects. Given that risk profile and nuance at hand needed the interpersonal relationship that would guide me.

I do endorse SkincareMT’s cosmetic practice, and Addison in particular is fantastic, but their healthcare wing is clearly designed to extract maximum Medicare dollars from Montana seniors. 

My failure to get an ounce of prevention means I’m flown to Istanbul to attempt to get a pound of cure. Don’t worry I was already in the Mediterranean. Not in the way way some think though.

Yesterday we found out by pulling teeth that I had a problem. It’s clear I need this excised and quickly. The ultrasound is gnarly. Drainage, removal of the foreign object, and potential curratage to make sure the walls of the cyst are removed forever are what is needed. 

The sprawling medical tourism complex in Istanbul is amazing and I trust them more than any other system or talent pool on the planet right now.  What they have built is an incredible achievement and in challenging conditions.

Doctors who listen, who educate you on your options, and most importantly are up to date on current research and global innovations so don’t give you glassy eyed stares when you mention a new medication like a next generation IL-17 inhibitor it’s exotic side effects.  American doctors like that are rare and their hands are often tied by our horrific mess of state failure and lack of market innovation. 

I’m relieved to have choices like “general surgeon or gynecological surgeon” and texting discussions with my case lead (a full time liaison for you and your family on the entire case) on how we will handle excision and culture pathology. 

It does feel like I’ll have good choices. But it also seems like I booked less time than is necessary and I don’t know how I feel about that. A week of waiting on labs in a hotel while in pain is scary. Sure I can work and be productive and maybe even do some tourism but I just want this shit sliced out, an IV of the right antibiotic that will work and some sleep. 

I’ve been doing some crazy bi-phasic sleeping as the Mediterranean is hot as hell from noon to 10pm. So I’ve been doing a bit of staying up late and sleeping in to avoid the heat. It’s not clear how much it’s messing with me yet because I’ve got all these odd infection fever doctor nonsense. A quick surgery and some answers can’t come fast. Thankfully I’m at the crossroads of empires.

Categories
Biohacking Chronic Disease Medical

Day 1650 and Trying to be Heard

I don’t think of myself as someone who struggles to be heard. I am loud, I speak up, I have a large social media platform and I don’t mind being impolite if I need to be heard.

And yet, the incidents where I am ignored, dismissed, or even outright insulted seem to be on the rise. I follow the rule of three assholes generally so I have to wonder if it’s me, but nothing makes you wonder more than getting really bad basic medical care.

I am attempting to get a cyst (or abscess or infected lymph node or whatever the heck it may be) diagnosed in a country where I don’t speak the language.

No one can agree what doctor is right. It was a gyno who sent me to a dermatologist who wanted me to go back to a gyno last month.

Now I’ve got a gynecologist who wants me to repeat the conservative management program I’ve been doing for months.

Which hasn’t worked, but she is implacable in her iron lady demeanor. Bactine and warm soaking. Maybe she does understand the immune suppression part? Thankfully I come with receipts.

I carry my patient charts, a synopsis of my diagnosis, the side effects of drug treatment and a short “why I am here and for what.”

A radical change in size & texture on a cyst with no response to antibiotics is exactly what the last four doctors told me to watch for as it signals a need for active management.

Now this shouldn’t need years of bloodwork (which I brought and charted for them) or a paragraph on high risk patient needs or a history of my main medical issues and the rationale for why I am requesting imaging. It’s an abscess that’s growing so figure out what kind, remove it and then we figured out why.

And yet it does require all of this to get anywhere. I spent 5 hours in a doctors office today and two hours in one yesterday.

I’ll waste another two days while they will run new bloods when I have a fresh set from a week ago. And still they fought me like hell on imaging.

Which is the only way to decide on the course of treatment. Instead I should do warm compresses and iodine for a month (sorry the first four months not count?) The temptation to unleash is overwhelming.

It was a fight. I got an ultrasound. And I did get a diagnosis and it needs to be carried out asap. Figuring out a doctor and a recovery plan I trust is going to be hard but that’s a tomorrow problem.

Abcess. Filled with bad shit. There is a hair in it acting the part of irksome pearl. 17×13 mm diameter. 3 mm from skin so it’s not small.
Categories
Biohacking Chronic Disease Medical

Day 1649 and Physician Heal Thyself

I’ve been having some side effects from my new biologic injection Bimzelx. Whenever I travel, I do a spate of doctors appointments before I leave so I can be adequately prepared for likely scenarios. Be prepared is my motto.

I had gone to a dermatologist a month ago to check on a cyst or swollen lymph node in an awkward spot. It’s on my pubic bikini area so I’ve been playing hot potato with dermatologists versus gynecologists.

The dermatologist appointment was so horrifying I’d recommend you stay away from Dr. Tara Oetken at SkincareMT as it was such a degrading and frankly useless experience. I do fully endorse their cosmetic practice and Nurse Addison.

I ended up at the dermatologist as the gynos were like “uhhh it’s on the outside and involves no reproductive organs so you need a dermatologist” and then dermatologist was a bit “its close to your vagina ewwww icky scary did you go to the gyno?”

Yes dear that’s how I got sent to you, this ain’t no picnic for me either.

I was embarrassed but the cyst/enflamed lymph node had been unchanging for a few months (not growing or differing in texture but malleable & squishy). So I checked in, was mostly embarrassed, got no direction that helped and left feeling degraded.

Given my previous issues with meiborn gland infections on my eyelids, I’d been instructed to keep a close eye any side effects common like folliculitis that is common Bimzelx. This was clearly a complex side effect that I’d had multiple issues with all year. The next step was imaging but I could get zero sense in the very short visit of whether or not the doctor felt it was warranted. “It’s up to you” sounds nice until you want a doctor to give you their professional advice.

Well now I’m in a foreign country and the almond sized squishy bit has ballooned in just four or five short days to thrice or quadruple its size, it’s now quite firm and not easy to move around or squish and I’ve got to do the same dance all over with doctors ago don’t speak English.

Thankfully I have artificial intelligence and an interpreter. I’ll get the imaging ultrasound done (AI says get it done immediately based on the differential it did) and then we can see if it’s a cyst or a lymph node that needs an I&D. I started antibiotics 3 days into this ballooning and it has done little to fix it so let’s find out. Hopefully I don’t need someone lancing and squeezing out stuff in a foreign country. But if I do need that I may pop a flight to Istanbul for that.

Categories
Culture Politics

Day 1648 and Dystopian Doomers

I’m fairly well branded as a doomer, so I hate to break ranks with my preparedness brethren, but I’m absolutely sick of the powerful using fear as a tool to control people.

It isn’t a new problem. This is the go-to tactic our species has used insofar as we can verify with written history.

Any time we experience a change of circumstance, material reality or technology, we hear the braying of the old guard and the panic of the precarious.

People complain for two basic reasons. If you are doing well why change a system that benefits you? If you aren’t successful but equally aren’t comfortable with change, then you resent anyone who benefit from change. Fear and resentment are the shadows of the human soul. Envy is the sin of our time.

I personally feel I’ve invested a lot in doing my part to educate people on risks from climate to currency and compute.

I am politically involved in crypto policy as well as fighting fear in artificial intelligence. I helped pass the only piece of AI legislation in the world focused on liberty. I want people to have a choice for how they engage in a virtual future.

I’m not just a nerd about being prepared either. I’ve done my wilderness first responder certification. We left Colorado for Montana for a host of reasons but top of them was a better and freer climate both literally and figuratively. We live this way because it’s a great way to live and when change happens we are hoping to be resilient.

Having all that in mind I was offline for the 4th of July long weekend as it has been a busy year on all of those fronts. So I was sleeping it off. To come back and see a spate of conspiracies over cloud seeding technology was like a punch to the gut. And I’m already feeling like I’m on the outs with some community when it comes to technology and my intentions.

I’ve only met Augustus Doricko of Rainmaker a handful of times but his circle of young technical Christians dedicated to building solutions to our modern problems are why I remain optimistic in fighting for technology and the people who build it.

These kinds of communities of builders exist in an archipelago of anarchic communities across digital and physical worlds that interlay across many systemic problems. These places will succeed no matter the future we face because they understand it’s necessary to build. That is will.

I’ve been lucky to have been the first investor in Isaiah Taylor’s Valar Atomics. He is a part of this builder world and of a part of a clan of physical builders. He faces decades of fear with a cheerful heart. I believe in his vision for energy abundance.

Nuclear energy was buckled under an old environmentalisms that was a proxy for a fear of a future whose risks, however minimal, were too scary to embrace for those in charge and the public they controlled.

I believe in a vision of a better America (and a better ecosystem and a better economy) because we embrace change to build materially better conditions.

I have frankly seen too much pessimism from older generations and cynical power brokers to be silent. The complicit rancor is slowing us down and there is nothing Christian at all about standing in the way of delivering better conditions to our fellow man.

Paradise is lost. In a fallen world we work to do what we can. It isn’t the end of the world. It’s already lost. Now we work because we must. We aren’t building an eschatology to replace the Lord. We build because that is what we are called to do by him.

Categories
Biohacking Travel

Day 1647 and More Sleep

Fifteen hours of sleep and a spa day does fix a week of disrupted sleep. I may need some more downtime of resting and recovery and maybe more water drinking before I have a cogent thought.

Rocky Mountain High
Freedom Thongs
Sweat it out
Categories
Biohacking

Day 1646 and A Little Spa Day

After seeing my sadly “in the red” recovery scores from my Whoop, I felt a bit of a cortisol mitigation effort was in effect. In other words, I took a little spa day.

When I was younger and living in Chinatown , my apartment was above an acupuncture and massage joint that specialized in pressure point work. Going once a week probably saved my life. It was affordable and close and good.

It was always packed with the working class of the area. The prison complex wasn’t too far away, we had a police precinct two blocks down, and the courts buildings system was a block away and enormous warren of humans. A lot of very intense people in tough, sometimes very physical situations needed to have it worked out of their. Kids.

By comparison, my body was easy work for a man who worked on hurt cops and stressed out prosecutors. White girl problems are easy.

So I’ve done a run of sauna and cold work. I’ve had a massage. I have stretched and done breath work and moved around to feel things reset their flow.

I should really remember that heat, cold, oxygen, movement and pressure really do solve most problems. Don’t forget to eat and drink.

Categories
Biohacking Travel

Day 1645 and A Sleep of Prisoners

I’ve had several day’s worth of poor sleep. My sleep debt had reached a good full night’s of rest at over 9 hours. And boy did I make it up and then some last night.

A screenshot of my Whoop’s recovery page

I wasn’t asleep all of those 15 hours according to both Whoop and Apple but it sure felt like I was in deep slumber.

With earplugs and an eye mask in, I felt dead to the world. And what’s worse is I’ve had an entire month of pooor recovery and sleep

The 4th of July is now my independence from a month of poor biometrics

Now on July 4th I have been liberated from a long month of poor biometrics and awful recovery scores. And it only took 15 hours of being in a dark cold hotel room and a build up stress, exhaustion, mistreatment and other sundry social frustrations.

Mixing more strain than recovery into my Whoop cocktail for maximum life

Today really does feel like Independence Day for me. I’ve been freed from a body weighed down by physical realities and I am now free from it.

There is a poem that comes to mind anytime freedom and sleep arise to my conscience thought. A Sleep of Prisoners is a 1951 verse play by Christopher Fry

A SLEEP OF PRISONERS

Dark and cold we may be, but this

Is no winter now. The frozen misery

Of centuries breaks, cracks, begins to move;

The thunder is the thunder of the floes,

The thaw, the flood, the upstart Spring.

Thank God our time is now when wrong

Comes up to face us everywhere,

Never to leave us till we take

The longest stride of soul we ever took.

Affairs are now soul size.

The enterprise

Is exploration into God.

Where are you making for? It takes

So many thousand years to wake,

But will you wake for pity’s sake!

–Christopher Fry

His writing captures something in my imagination with turns of phrase like “the longest stride of soul we ever took” evoking a crossing to the harsh wakefulness of reality. And as he says “it takes so many years to wake, but will you wake for pity’s sake?”

I have been slumbering in both reality and in the metaphorical ties that bound me to others. And today is the day where all Americans ponder how our founding fathers contemplated the reality of waking to the dawn of a new experiment. The American experiment continues and we must remain awake to our role within it. I have many thoughts on this which may now soon flow having awoken from quite a sleep indeed.

Categories
Travel

Day 1644 and Problems Behind Me Sleep Ahead?

I’ve got a comically large sleep debt to work off. My Whoop is screaming at me as it’s been 3 days of not quite getting in an adequate of sleep.

And it’s not as if I was enjoying great sleep for June. It’s possible my new Whoop hardware just has bee algorithm and set of standards as June was mostly dead.

First it was emotional “really in it feelings” that gave me a half night as I woke early as the upset remained.

Then the anxiety of preparing for a long trip while the aforementioned emotional impact hung unresolved (though I had cried it out) which made deep rest out of reach. Four hours is half of my usual needs.

The middle night between issues and my packing day didn’t get me much better sleep. It was a long day of logistics and I never quite came down.


Airplane sleep doesn’t lend itself to dreams

And then I was on an airplane and trying to catch some Zzzzzs but barely managed under three hours. I feel great as I’ve just kept on swimming great white shark style, but I know I’ve got almost a full night of sleep dent built up.

Still it’s hard to feel too badly about things when you look down on the beauty of the world below.

Leaving Montana
Categories
Travel

Day 1643 and Like A Shark

The travel is the kind of stint that requires the logistics of being in perpetual movement across climates and time zones.

I’ve been moving for what feels like 24 hours straight as I did the dance of managing feelings, working to get across to other people, unloading and unpacking and then promptly repacking again as I’ll be on the road for a stint.

I had a shark phase as a child and the lore says the perpetual movement of this ancient predator is required lest it perish. I’d love to know how rest and sleep works in that sort of murky depth as I’d loved to know how we might incorporate it.

As it turns out of the 540 species of sharks only a handful have what’s called Obligate Ram Ventilation which means the faster they swim the more oxygen flows through their gills. If the strop meaning the oxygen drops and they literally die. Great white sharks are the canonical example.

When I am angry I consider the question of whether humans are indeed the apex predators of our environment and if it is in my nature to flow the oxygen and predate upon the wide world who crosses my hungry wrath. My own Christian faith asks for a very different answer and I obey. But the hunger is in all of us.