Author: Julie

Categories
Chronic Disease Emotional Work

Day 196 and Exhaustion

I’m terrified of being tired. It’s the first sign of illness and a trigger of a cascade of traumas for me after fighting for two years to recover my health. The fear I feel when my energy flags is more than mere phobia. It’s the kind of gripping all consuming fear that stops all other emotions from surfacing. It’s a fear that stops joy and anger. It stops my my breathe and chokes out my chest if I pay it too much mind.

I’m already shedding unbidden tears probing a little at the edge of this fear. The fear that exhaustion will never lift sits in my body, scaring me into believing I’ll be trapped forever.

I’m more afraid of fatigue than I am of pain. Pain is complete and totalitarian yes. It limits your world sometimes in the extreme. But pain is not an enemy that cannot be overcome. When pain spikes or throbs I’m equipped with tools to combat it. It’s not that pain isn’t terrifying and all consuming. I’ve written about the challenges of chronic pain. How it robs you of your right mind. But it isn’t an enemy that extracts complete victory either.

I feel I can fight back. Light pain can be tossed out of my consciousness with mindfulness exercises. Even a slight self inflicted pinch can deflect pain. If it’s unbearable there are pharmaceuticals on hand. It’s not that I don’t find pain to be consuming, I do and it is, it’s that it doesn’t feel impossible to conquer. I have tools with varying degrees of efficacy that let me retain my agency with pain.

With exhaustion I have nothing. I fear exhaustion is an enemy I cannot best. There are no tricks for my mind that give me a boost of energy or remove the obstacle of feeling leaden. The tiredness is too complete to be overcome by mantras. There are no drugs for exhaustion. Stimulants can drag me out of bed but the crash afterwards makes it clear the effect was extracted under duress.

A doctor doesn’t mind giving opioids for a patient with spinal swelling but telling them you are tired doesn’t do much. What could they even give you? Caffeine? Aderall? Of course you are tired they say, your body is fighting inflammation. In this moment, I’m overcoming an infection and a poor reaction to anti-virals. An inability to crawl out of bed is a given. Nothing can be done. I just need to ride this out and hopefully it will lift.

But I’m afraid of the tiredness that has taken hold of me this past week. The fear that all of the work and money I’ve put into recovering my help might have been for nothing lingers. I logically know, and doctors confirm, that I’m simply fighting an infection and we had a slight complication with the medication. They say I’ll be feeling well a few days. They asked me to stay in bed for a few days. But I cannot shake the fear that it it’s permanent. The fear that I’ve lost all my progress is real. I just hope I can convince myself that feelings are not facts.

Categories
Chronic Disease Emotional Work

Day 195 and Waiting on Hand & Foot

I’m embarrassed that I need help with minor physical tasks. I’ve got an infection of the self sufficient Americana myth that seems to have taken root right in my very marrow. If you need something done you’d better do it yourself right?

When I was much sicker and undiagnosed two years ago, it felt easier to accept help because surely it must be temporary. There is no harm in needing help if you know you can pay it back tenfold? There is no harm in being unproductive for a time if you can pay it it back with interest.

But what will if can’t pay it back? What if I must rely on the kindness of others forever? Early on I struggled with little things like needing to use a wheelchair in the airport. I told myself stories like“I could walk if I just tried harder and accepted more pain” as I went through the concourse on the way to a hospital stay. I couldn’t pay back fellow travelers for slowing them down. And maybe no one minded that I was sparing myself pain for little inconvenience on their end. Perhaps I could accept small types of kindness.

But what if it’s not temporary? And what if it’s a significant amount of help! What if I do need help with basics for the rest of my life? Thanks to a recent trip my husband took I learned his running of the household increases my capacity by a full 30%. I could do everything just fine on my own but it would make my life much smaller. And it doesn’t seem to make his life any less enjoyable. On the contrary he shines when showing off his excellence in operational matters. It’s possible what I see as an undue burden is something he quite enjoys.

But I can’t quite convince myself it’s a good thing. The self audience myth has a deep hole on me. But if a third of my capacity disapates into tasks like cooking, cleaning, errands, and logistics but I’m enriched and energized by work like writing or working with the media then shouldn’t the choice be obvious?

And yet I still find myself embarrassed and angry about my limitations. . Why did it exhaust me so much to stand and wash lettuce? Or require so much rest to recover from a short run to the pharmacy. Those are small, albeit physical, tasks. My soul feels broken and my body a traitor with these small physical limits.

Whereas other pursuits can be done from bed. And even though it sometimes makes me sad it’s not always my choice, I don’t mind that my world is often limited to lying flat for hours on a mattress. I don’t resent it. In fact, it makes me rather happy. I’ve got the whole world available to me thanks to the internet. I can invest as easily in bed as from a fancy office. Twitter is just as good a connection to the networks of ideas and power as conferences or clubs. Better often.

The only part I resent is feeling like I’m a burden. Like I need to be waited on head and foot like some aristocrat or an ailing relative. Well not like an ailing relative. I am ailing. That part is the. But I can thrive in it with help. I just hope I’m not to embarrassed to take it.

Categories
Chronic Disease

Day 194 and House

The downward pressure I was discussing yesterday is taking me out for a few days. My doctors are torn between whether it’s the virus I’ve been prescribed some exciting news drugs for, or if the exciting news drugs are simply too much for my body to handle. The minimum viable dose in pharmaceuticals can be tricky. Too much and you kill the virus and it’s host. Too little and the suffering continues on.

I was watching the tv show House last night. It seemed like an appropriate show to rewatch as when I first came across the show I wasn’t myself an idea “House” patient felt extremely soothed by it. Would I make to watch a doctor that gets to the heart of odd diagnostics? Who instead of saying “well the tests are normal” says “these tests don’t help us explain the symptoms” and carries on? Why yes I would.

I’m lucky to have a number of doctors who do the same. It makes watching the show enjoyable as I’ve sat through countless diagnostics meetings and drug experiments that sound exactly like the ones on the show. I recognize tests and treatments. I’ve been put on several of the drugs just for the two episodes I watched last night.

We are dosing down on the antivirals for a few days. I’ve been told to get some rest and not to add in any stresses that I can avoid. While I don’t think writing is stressful I do think checking off the box for my daily essay would feel like a relief. So I’m doing that a bit early and keeping it short. If you are inclined to send good energy my way or you are from a tradition that values prayer I would appreciate being in yours.

Categories
Chronic Disease Emotional Work

Day 193 and Downward Pressure

I’ve had a terrific year (pandemic aside) with significant progress on my health. I’ve become used to seeing positive trends, especially within the last six months. But the last month has been a mess for me and the downward pressure is getting to me emotionally. I’m afraid. The fear of a setback is palpable.

I haven’t been able to pinpoint exactly what has been causing a dip in my progress or frankly if it is even a dip, as it could just be a few bad days. It may be that I’m just not progressing as fast as I could have hit some Pareto Principle limit and it’s just going to be a slog to get the remaining gains. Some of my metrics continue to improve (I’m seeing cardiovascular improvements still) but my energy, pain and inflammation seem to be going in the wrong direction.

I’m crushed by the exhaustion in particular. And sadly I know this to be real. Because I take immunosuppressants I am prone to infections. To combat one I was put on a course of antibiotics which seems to have some negative side effects. So now I can’t tell if I am exhausted because I am running an infection or because I’m having a bad reaction to the drugs. Could be both.

I feel angry at my body for this pause in progress. I’ve been working so hard at improvements. When I look at how I spend my time I am often overcome with resentment and envy of healthy people. It saddens me how much more of my life needs to be dedicated to doctors than a normal person. It’s especially frustrating as in the spring I was regularly noting how well I was doing and how much capacity I had to work.

Of course, the benefit of writing every day is I can go back and see what was going on. I’ve been doing plagued by the caprice of my body before.

The trajectory of my health is one of continual improvement but scatterplot is jagged as hell as each day vacillates between health and pain.

It’s my hope that this is just another local minima and I’ll be able back to my “normal” soon. Even if I have hit 80% of my gains I can manage with that. But it’s valuable to recognize the negative emotions as they come so we can let them go.

Categories
Emotional Work Preparedness

Day 192 and Cherries in Air Conditioning

I found myself eating an entire pound of chilled organic bing cherries in bed while binging episodes of Downton Abbey this week. Watching the British aristocracy cope with modernity poorly seemed like an excellent balm for the climate anxiety that has been gripping me during the consecutive heatwaves inflaming the American West.

I’m a doomer and a prepper but recently I’ve felt completely defeated by the looming impacts of climate change. And I’ve been manifesting it is a kind of orgiastic panic of consumption. We had a windfall this year and it has soothes some of the panic I’ve had about having the resources to survive. Maybe it will be miserable but we might have enough wealth to avoid dying.

But I’ve been spending more on petty purchases of comfort. I’ve bought 2lbs of organic cherries, the large carton of organic blueberries, the $15 bags of dark roast coffee for espresso, and the $10 bar of 95% dark chocolate without a second thought. We’ve had sashimi for lunch and on Friday I ordered a lobster roll. We live thousands of miles away from the ocean in Colorado. We don’t grow or fish any of those crops here.

The excuse I’ve been using is that I’m concerned (nay convinced) none of these things will survive the next 25 years except as extreme luxury goods. If I can see the changes coming should I not enjoy the access I have to food that will no longer be available in my fifties? If I can see the end coming why conserve? I’m not Exxon or BP or some giant mining extraction concern in China. My forgoing small luxuries as an individual will do nothing to stop the catastrophe and I would like fond memories of the taste of a cool tart cherry in my twilight years. Burn me at the stake for it I guess.

Categories
Chronic Disease Emotional Work

Day 191 and Logistical Leverage

I hate logistics. It’s not that I am incapable of operational tasks, but I do not find them enjoyable or energizing. I’m happiest working from the 30,000 foot vantage point and most stressed when keeping tabs on the 1,000 foot details. Thankfully I discovered this about myself early in life and had the good sense to choose a life partner that feels the opposite.

My husband is a genius operator and loves logistics. He can find efficient ways to manage nearly everything. He is a COO both professionally and personally. He manages everything about our household. I used to feel a bit guilty about the fact but I’m objectively terrible at home economics as frankly I just get in the way when I try to pitch in. All those sit-com jokes about husbands who can’t fold laundry right? In our house it is reversed. Which is a bit embarrassing as I worked in fashion but bygones. I just get in Alex’s way and he would prefer not to be slowed down by my bumbling efforts.

Recently I had to take on life & home workload in addition to my own. He had to take his first trip since the pandemic began. I haven’t been without him since February of 2020 so it has been a while since I’ve had to manage without him. And wow did it show!

I maintained the same of basics into my system, the same routine, supplements, diet and treatments with the only addition of Alex’s workload. I only added an additional 2 to 3 hours to my time obligations, so roughly an extra 9% my day, but it had close to a 30% impact across all my core metrics.

Because I track so many biometrics on a daily and even persistent basis I know my physical and emotional baselines. Without Alex managing life, my physical capacity dropped across the board over two days. The additional household logistics, errands, cleaning & cooking & overhead dramatically impacted my capacity.

Within 48 hours all my body’s baselines worsened. My HRV went down an astonishing 22%. Whoop gave me recoveries at 33%. My RHR went up by a full 10%. My qualitative pain scores went from consistent 3s and 4s to a 7. My energy scoring went from a perceived 6 to a 2. Gyroscope dropped my health grade from 85 to 78. It was a mess.

It turns out that Alex has added significant capacity to my life. Work that takes him just a few hours a week enables me to thrive. It takes very little from him but it means the difference between barely getting by and having the capacity to work for me.

Maybe it wouldn’t be as easy for another person. Alex is a very high leverage person in general but particularly for me. 10% of my day for a 30% improvement is significant. If your spouse is the operator in your partnership it may be quite fun to quantify their impact. Nothing says I love you quite like proof of how much their efforts impact your biometric data.

Categories
Startups

Day 190 and Neutrality

One of the more influential pieces of art on my worldview is the science fiction comedy Men in Black. Yes you read that right. My philosophy is underpinned by a speech by Tommy Lee Jones.

1500 years ago everybody knew the Earth was the center of the Universe. 500 years ago everybody knew the Earth was flat and 15 minutes ago you knew people were alone on this planet. Imagine what you’ll know tomorrow

I don’t really know shit. I know enough to know I don’t know shit. My mother had a favorite bumper sticker “ask your teenager while they still know everything” which at the time as a teen I found a bit insulting and now as an adult think was quite astute. The more I know the less I know for sure.

Because I’ve slowly come to realize that knowing can be a crap shoot I keep odd company. Arguably bad company. I follow some truly outrageous people on Twitter. I follow hard right partisans and tankie left wing socialists. I follow folks with deep convictions on the irredeemable evils of technology and the most ebullient techno-optimists. It’s hard to talk me into not keeping an eye on all view points. Sure I think some folks are dead wrong but how do I know I’m not one of them?

Not knowing things for certain as saved my life. Medicine has a tendency to interpret data as absolute. Biometric markers and test results can for some doctors have as much authority as a papal decree. Anyone who has been told “well your test results are normal” while still feeling like absolute shit will know how frustrating this can be. Plenty of data points look absolutely normal before a system cascades into failure.

We don’t know as much as we need to believe we know. Our craving for certainty as humans is a significant weakness. The venture capitalist who insists that some metric will determine a crucial outcome is a favorite trope of mine. As if favorable CAC/LTV ratio functions as a warding spell or an attractive margin structure offers protection against a changing consumer preferences. Knowledge isn’t magic. Superstition can just as easily apply to P&Ls as poltergeists.

I find it best to remind myself to take a neutral when approaching entrepreneurs. Maybe I don’t know. Maybe everything I’ve ever known was particular to my circumstances, bias, education quirks or just plain randomness. Maybe one small insight will shift the grounds underneath me and reveal entirely new frameworks for interpreting reality. The unknown unknowns have a habit of springing themselves when you least expect.

It’s often tempting to throw opposing viewpoints into buckets that are easy to dismiss. Venture investors are notorious for this. We dismiss folks for any error we spot. We deride their data. We applaud ourselves for spotting cracks in their plans. Resist this tendency. We must always retain the neutrality of perspective that allows us to change our mental models. What we know to be true might be a lie. We may lack a key piece of context that would unlock a cascade of understanding that changes our entire perspective.

This is why the adage “strong beliefs weakly held” can be so key to success. Changing our minds is a strength. It’s hard to admit to ourselves we’ve gotten something wrong especially if we sunk a lot of time, money and reputation into it. But would you rather be right or successful? Feeling superior can be a delight but not if it gets in the way of what we want in life.

Categories
Preparedness Startups

Day 189 and Cascades

One of the reasons we named the fund we invest out of Chaotic Capital is because I’m obsessed with cascade failures. In complex systems one small change can ripple out in unexpected ways. As players scramble to accommodate these shifts, opportunities for power realignments emerge. This is particularly exciting in systems that are man made as we can only create so much complexity in mechanical systems (unlike biological ones). Most startups are built on technology or engineering that are simple complex systems.

The absolute best description of the risks of a cascade comes from the science fiction television program The Expanse and a botanist named Prax. He is describing a failure in the hydroponics system (which both feeds the people and produces oxygen) on a space station on the moon Ganymede.

Because it’s simple it’s prone to cascades. And because it’s complex you can’t predict what is going to breakdown next or how.

While I’m a doomer and a prepper so it was bound to happen, it was this insight from Prax got me into hydroponics. Cascades and chaos and lettuce fuck yes!

But jokes aside, we’ve got a number of complex systems under strain right now. Supply chains, the financial system, our power grids coping with climate change, and even unemployment benefits are all examples of simple complex systems that are experiencing cascade failures.

I’m not in the mindset to lay a Grand Unified Theory of Simple Complex Systems tonight, because I did experienced one today. Colorado just set another heat record today and my air conditioner crapped out. As I set about closing blinds and checking electrical breakers I worried about how my own survival and comfort depends on cascades not occurring.

What if it had been electrical and my refrigerator went out and not just the air conditioner. Then my $5000 a dose immunosuppressant would go bad. If I can’t have that my spine will swell. Then I’ll be in too much pain to walk. Sure this isn’t a simple complex system exactly but I think it beneficial to go up and down the systems that keep our lives intact. If one system goes down do you survive?

This used to be a topic which we all shied away from. Then the pandemic happened and preppers like myself didn’t look quite so whacky. We told stories about the systems thinking that went into basic preparedness. We got a Nellie Bowles Styles piece. It was a lot of fun. But it belies the seriousness with which the topic of preparedness should be approached.

You probably aren’t prepared for some of the cascades that come as the works gets more chaotic. And no we cannot predict it. Shit is way too complex. It’s fucking chaotic as hell. So get some bottled water. I’ve made it easier. Here is what I keep in my go bags. Do it before the next cascade hits. You won’t regret it. I think Prax would agree.

Categories
Emotional Work

Day 188 and Space

I over scheduled my day today. I figured it was fine as I left some half hour blocks between calls, pitches, errands, workouts and chores. That’s what most lives are like right? You get up, shower, exercise, get the family fed, go to work, have a short lunch break to eat at your desk, go back to work, then you’ve got errands and then it’s back to family obligations.

If that’s what most people’s lives are like it’s no wonder we are in the midst of a rebellion. I’m exhausted. I haven’t had a moment to think or self reflect at all. I feel so far away from myself after the parade of obligations. And I actually meditated and did thirty minutes of “brain training” on my at home EEG. And I went for an hour long walk! So why do I feel like I haven’t had any space today? Those things are restorative right?

It sounds incredibly luxurious when I put it down on paper. I’m doing shit to improve my brain function and I got 10,000 steps (I like to take calls while walking) so why do I feel frazzled? As it turns out I’ve actually faced this problem before. And thanks to my daily exercise of writing I put it down on paper. I can learn from myself.

I benefit from unstructured unencumbered time at rest. It’s not that I need it to be alone time or quiet time as much I need full on rest. I thrive when I have no reason to get out of bed. I do my best reading and synthesizing when my mind is free to wander without any obligation to anything but that space.

When I wrote that I meant it in the context of devoting enough time to active rest. But as it turns out I don’t just need rest on weekends. I need to give myself time in between tasks. I need to let my mind wander off instead of forcing it on to the next activity. I need to take some space to myself between each activity, even if it’s a nice one like a walk, to absorb and synthesize.

I’d encourage you to consider if you are giving yourself enough space to let your experiences integrate back into your mind and body. Sure we all have our obligations but maybe you’d be more efficient at them if you have yourself the space to breathe in between them. On that note I’m going to put on some television and go shit post on Twitter. I need to integrate my learnings from the day.

Categories
Emotional Work

Day 187 and Reactivity

I do not back down from a fight. I think quickly on my feet and enjoy pugilist types who are always looking to land a point or a punch. I think it is fun to scrap and throw a hook. But I increasingly find reactivity to be unappealing. The difference between enjoying a fight and being reactive is simple: fighters are in control and reactives are not.

Reactivity comes from emotions. When someone says “I feel triggered” in popular culture it’s viewed as a funny jokey way of indicating that something set you off. But being triggered has a real meaning in psychology. It’s a reaction to a memory, consciousness or unconscious, that is emotional in nature. Generally it’s in reference to something traumatic.

Traumas exist for most of us in our past. When you go back to childhood what we perceived as a trauma when young may not rationally be worthy of the emotional response we have as an adult self, but it is crucial to remember is actually real to the inner child. It’s hard to remember that feelings are not facts. So when you are triggered it’s because you have gone back to a traumatic time where those feelings were absolutely real. But they are not real now.

I used to be intensely emotionally reactive in my twenties and early thirties. I am still physically reactive and likely always will be. That’s a different issue. I’m talking about emotions. When I was younger I was sensitive to being hurt and abandoned. I nurtured codependency and recoiled from those who I perceived as disliking me. Thankfully my godfather noticed this pattern and how it was making me both miserable and unproductive, and introduced me to an old school Swedish family systems psychiatrist.

Now five years into my practice I am finding that I am able to take a beat and assess “why” I am having an emotional reaction. I can track back it’s source to my childhood. I can parent my “inner child” through the reactivity and get back on track. You will often hear me use lots of feeling words. I feel hurt. I feel sad. These help me stop the emotional reactivity. It’s ok to have feelings. It’s ok to express them. But you must be like the fighter. You must as an adult be in control. Your inner child who experiences the trauma as real will never be in control. That’s ok. It is your job to parent your inner child through it.

Obviously this is incredibly hard work. I slip up every day. But I try to work on my self awareness. I try to control my reactivity so my inner child isn’t puking all over the floor. It’s not that I don’t have reactions or emotions. I do. Big time! But I no longer wish to be emotionally reactive. Nor do I wish to be around those who are. We must work on compassion and empathy so that when someone triggers an emotion in you instead of snapping back you work to understand where they are coming from.