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Biohacking

Day 374 and Intolerable

I’ve always been prone to extremes. I don’t like to do things half way. Half-assing things is pointless when you’ve got a whole ass. But sometimes this tendency to pull a “Peaches” and go full on even if it physically harms me.

I’ll look for any excuse to push myself. If a diet app tells me to eat whole foods I’ll stress myself on the perfect blend of clean eating. If it’s good to walk 7,000 steps a day I’ll set a goal for 12,000. If I want to write more I’ll commit myself to writing every single fucking day for a whole year. Commitment isn’t my problem. Excess is my issue.

On Friday I had physical therapy for my ligament tear. The therapist was working on evening out the tension points I had from overcompensating. She told me to work a lacrosse ball into my muscles until the pain wasn’t tolerable.

Now for most people this would be good advice. You’ve got to release the tension and work out the tenderness in the fascia. For me it ended up being terrible advice. I pushed so hard I have enormous bruises up and down my leg. But the poor therapist had no idea I’m so dedicated to extremes I’m willing to hurt myself to follow advice. The average person probably shies away from the necessary pressure. Me on the other hand? I’ll push till my body gives up on me.

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Biohacking Emotional Work

Day 368 and Eating Disorder Season

Warning! Before you go any further this post will discuss food, emotional relationships with food, disordered eating, diets and diet culture.

Today is the first Monday of the New Year. That means it is weight loss season online. Despite me having many positive healthy habits including walking, weight lifting, meditation, supplements, sleep hygiene and a moderately nutritious eating routine I found myself upgrading my wellness applications and panicking at stepping on a scale. January is the month where the “wellness” industrial complex gets you. Even though I spend a small fortune on my health even I am vulnerable to the season’s exhortations.

December was a little rough for me so I put on some fat and lost muscle mass. I had an injury that kept me off my feet and then I had Covid. So my routines got a little fucked. Also two towns next door completely burned down in a terrifying urban firestorm. So like it was ok that I lost some progress.

But rather than reintroduce slowly and moderately my good habits, I’m finding myself desperately tempted to go over board on January changes. I spent $199 upgrading Gyroscope to get their nutrition tracking and a health coach. Despite knowing full well what I need to do in order eat better. The trouble is that I fucking hate doing it. So I thought let’s try a health coach why not!

I’ve had a mixed relationship to food my entire life. One of the defining traumas of my childhood was my pediatrician telling my mother I needed to eat more dairy. I hated the stuff and refused milk & yogurt as small child. My doctor’s solution (and I am not making this up sadly) was to not allow me any food till I ate dairy.

My mother attempted to follow his instructions but was stymied by the fact that I wouldn’t budge. I was a stubborn child. I didn’t care that I would be allowed to eat if I just had a spoonful of yogurt or a sip of milk apparently. I went on a full hunger strike. Fearing the worst as her daughter went days without eating, my mother eventually caved but the damage was done. Baby’s first eating disorder!

I continue to have all or nothing attitudes on food. I love to fast because it’s a total solution. I feel in control. My inner child continues to see it as an act of setting emotional and physical boundaries when the adults around me overwhelmed mine. Is also happen to hate running kind of caloric deficit. I’ve got health challenges that do better if I’m at maintenance calories.

Now I’ve successfully managed to heal an out of control immune system and I’ve overcome a significant rheumatoid condition so you’d think “being fat” wouldn’t be a worry of mine. I am proudly an avid biohacker. I actually enjoy taking care of my body these days. But it’s so very easy to slip up in a culture where we treat our bodies as moral failures. Just take a look at Covid discourse and you will see America’s obsession with categorizing each other’s health decisions as “good” and “bad”!

So I urge you to be gentle with yourself in this environment. I’ve written extensively about how to slowly introduce healthier habits in ways that are measurable and kind to yourself. Because I know how hard it is to do so. There is a joke in fitness communities that you should only ever trust a former fatty because the naturally slim just don’t get it. It’s insulting and moralizing in its own way, but it’s also a bit true. Trust your health to the chronically ill as they know how to survive the system.

January can feel like eating disorder season (or at least the first two weeks or so) and it’s alright to participate in your own wellness experiments just as it’s alright to do nothing at all. Be gentle with yourself. I know it’s a tall order. I just spent $200 in a panic about being fat so I know of which I speak. Good habits and a healthy body aren’t made in the first week of the year. That actually takes a lifetime.

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Biohacking Finance Internet Culture Medical Startups

Day 350 and Web3 Healthcare

Imagine you’ve got a disease with a clear biomarker. I’ve got an autoimmune condition called ankylosing spondylitis. One of the ways to spot it on a blood test is to look for an elevated CRP or sed rate.

Maybe I want to find a way to connect with other patients. I provide proof of biomarker to join an autoimmune discord just like you provide proof of ownership of an NFT like they do in the Bored Ape Yacht Club. Maybe I want to join a group of other patients who are pooling their medical data so they can stop being in an N of 1 and have a chance to participate in new research for my own disease. I could join AutoimmuneDAO and contribute to funding, meme-ing, and researching my condition. If we discover a treatment protocol or drug through our DAO we’d have ownership in it. Imagine a token for your own patient DAO. This isn’t as crazy as it sounds. VitaDAO is doing this for longevity research. This is the future that web3 can bring to healthcare.

Quantified self and biohacking have improved my health significantly. But on its own my personal health data has little value. You would maybe pay me a few cents for my biometrics. The real value of that data is in the aggregate. That’s why I pay Whoop to manage my HRV data and why they won’t offer data interoperability.

The value is in the algorithm. But without me and without my data it wouldn’t be worth anything. They have a product and an algorithm because of my biometrics. And yet we’ve found no way to meaningfully integrate ownership and interoperability in healthcare yet.

Let me give an an example. There are multiple companies that make their money by recruiting clinical trial candidates. Why? Because you need aggregate data to run a study. Those companies have the same basic data analytic team as a marketing team at a direct to consumer product company. They know how much a patient (or customer) is worth and the cost to acquire them. You are worth a lot because you represent a demographic that has value in its totality. And yet most clinical trials fail to recruit people because patients just don’t see a benefit to participating. You’ve got no ownership or upside and the costs are significant. So science suffers.

But what if instead of being valuable to marketing and recruiters you could own a portion of the aggregate? Being a token holding biomarker “proof of disease” validated member of a patient research DAO flips the incentives. A breakthrough on a disease that treats you and you’d also own some of the proceeds of it’s intellectual property. Whoever brings web3 to healthcare is going to be doing a significant good for humanity. Web3 can improve diseases, move forward science and get us all paid.

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Biohacking Emotional Work

Day 349 and Vibing

When I injured my ankle two weeks ago I was angry. I had been so focused on doing things. Every day was packed with obligations and routines. Walking, supplements, weight lifting, stretching and appointments all took up huge portions of my day. So I wasn’t exactly thrilled to add in an entirely new thing to my day. I was worried it would set me back on my progress both at work and with my health.

And yet it’s been delightful. I’ve just kind of let things happen. I’ve been in bed. I haven’t been pushing to get in steps or raise my heart rate. I’m just vibing. Whatever the day brings I’m taking it in.

And I feel fantastic. My mind is sharp. I’m moving forward all the projects and investments I prioritize. It feels like by pulling back on all my other routines because I needed my ligaments to heal I’ve suddenly improved everything else in my life. It feels like life is fun again. That I’m spending my time on things that make me happy.

It reminds me of a favorite line from my therapist. “Be a human being not a human doing.” Was it possible in my efforts to improve my resting heart rate or put gains on my lifts that I was affecting my happiness and my intellect? By trying to improve myself had I been making myself miserable? Once again I’m learning that just letting myself live is the best way to achieve my goals. If you feel stuck maybe just chill and vibe for a bit?

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Biohacking Chronic Disease Medical

Day 343 and You Don’t Have to Feel This Way

Modernity is tough on our bodies. We sit hunched over glowing screens for hours and we call that necessary. We rationalize ignoring our meat sacks as logical. Cartesian logic like “I think therefor I am” is a convenient an excuse for disembodied living. Except eventually it will catch up to you. Maybe not for a while but it will. Maybe you’ve noticed feeling shittier recently.

I’ll tell you how it starts. You feel sluggish. So you stimulate your system. Maybe you drink more coffee and eat more sugar. Then you notice you don’t sleep as well. That makes you even more tired. So you stop moving as much as you did before. You don’t track any of this so it’s hard to notice till the effects compound. Then you notice aches and pains and you think well maybe it is just getting older. Maybe you start to have a back problem and friends tell you they have the same problem.

It’s the slow downward spiral of misery and it’s probably happening to you. It happened to me fast and hard but the path is the same. We accept feeling badly. We accept that deterioration is a fact of life because we’ve got to work and take care of the kids (if you are lucky enough to afford a family). We just accept lower standards of living because we get worn down.

It just doesn’t have to be like that. This shitty quality of life doesn’t have to be the new normal. Fuck the doctors who can’t diagnose you. It’s systemic. You’d be lucky to find one things so broken because it’s a place to start. Most people are justly subtly broken. But it’s not reached the acute stage where our medical system finally kicks in. Doesn’t mean what you feel isn’t real.

The shitty part is next. You’ve got to do the work. You’ve got to change your life. No doctor or health practitioner is coming to save you. They an give you a piece of the puzzle but you’ve got to assemble it. If you commit to getting well it’s going to cost you willpower. Because the path out is hard work. It’s nutrition, sleep, lifting heavy things, going outside everyday, taking supplements and vitamins, meditation and mindfulness. Frankly it’s a lot. I spend a third of my day on it so I can live what’s left well. But I no longer feel subtly shitty all the damn time.

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Biohacking Medical

Day 341 and Drugs are Good M’Kay

I am a prolific consumer of supplements and vitamins. I maintain a spreadsheet to keep track of all my inputs. I take a bunch of exotic stuff so it’s easiest to check for interactions and assess impact if I maintain strict consistency.

I’ve seen remarkable benefits to the entire mess but it’s taken over a year of dedication to see the compounding effects. Taking vitamins isn’t quite like taking a pharmaceutical that way. But I suppose everything is dependent on dose. And yet I tend to apply a completely different moral valence to my supplements then my pharmaceuticals.

When I was a teenager it felt like the war on drugs had mostly devolved into scar tactics. After school specials, assemblies with terrifying speakers, and the general media landscape showing “this is your brain on drugs” probably gave me an unnecessarily limited view of how to approach drugs. Recreational drugs were bad but I also knew that pain medications were deadly. It didn’t help I had a family member who was an opioid addict.

The running gag on South Park with Mr. Mackey telling the kids that drugs are bad mmm kay logged into my subconscious. And not in a sun skeptical way. I appear to have taken it at face value.

South Park’s Mr Mackey says drugs are bad…mkay?

Except drugs are neither bad or good. I wouldn’t dream of considering my various supplements and vitamins as making me bad or weak. Those keep me healthy and function. I also take prescription medications. Those also keep me healthy and functional. It’s the same thing. I don’t take them for kicks or to get high.

But the idea I absorbed from childhood that I’m supposed to regard things like pain killers with intense skepticism continues to hinder my progress. I was warned by the orthopedist I may need to up the anti-inflammatories I take for my spine as my ligament injury heals. But I am still reluctant to take the prescribed dose. Despite being under the supervision of two doctors.

I’ve got to learn to let go of this attitude. Drugs are good mmmkay? Tinkering and tweaking and looking for improvements are great. No one deserves to be in pain. It’s not morally better no matter what religious nonsense we may have absorbed. Sure pain is a terrific teacher. But it’s perfectly alright to chose to forgo it. We can chose to grow without inflicting any more pain on ourselves than necessary.

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Biohacking Chronic Disease

Day 322 and 10x

One of my favorite hobbies used to be powerlifting. When I had to take time off to control my ankylosing spondylitis (it’s an inflammatory spinal condition) I was simply in too much pain to walk around the block let alone squat 250lbs. But as we’ve controlled my symptoms so efficiently I’ve been able to pick back up weightlifting this fall. I’m overjoyed as this represents full recovery to me.

I’ve been slowing introducing weight using the core barbel lifts using the Starting Strength method. It’s been a blast as I get to have beginner gains all over again after being sedentary. The biggest change in how I train compared to my time before managing a rheumatoid condition is timing my training around my recovery. I used Whoop and Welltory who both measure my HRV or or heart rate variability. It’s basically a measure of how well your autonomic nervous system is coping with stress and turns out to the best predictor of how well I will feel on any given day.

A recovery chart of my HRV with red marking the days I lifted.

I’ve noticed that lifting hits my HRV hard. And it takes time to get it back to a normal place. Sometimes several days. I absolutely cannot not push my recovery frame without making my HRV dip even worse. It’s fascinating to see how well correlated the two appear to be.

On days when my HRV dips my resting heart rate is noticeably worse and using an app like Welltory I can see much more stress I’m under and how damn active my sympathetic nervous system is at work. The stress of recovery is significant. And my symptoms will tend to flare. Pain and fatigue are noticeably worse.

Despite the evidence I have found it mentally challenging for me to trust this stress and recovery process. On bad days when my HRV dips I forget how well I felt on the good days which leads me to some emotional flailing. Instead of trusting the routine I’ll panic at how shitty I feel. I’ve got amnesia about how terrific & productive I can be.

I’ve got to learn to trust the numbers. Otherwise I’ll do stupid shit like push to get something done on a bad day. That activity will take hours of hemming and hawing and willpower and brute force. If I had just waited for a good day to get my shit done chances are the task will take me 5 minutes.

Forcing myself to abide by the recommendations of Whoop and Welltory gets me out of the cycle of flailing. Listening to the data can override my amnesia. If a bad HRV day happens I just don’t try to do ANYTHING. Because I know on a good HRV day I’ll be 1000x more productive. It’s a discipline I need.

Everyone has different capacity. Forcing yourself into the “industrially necessary” routine of a 9-5pm weekday only makes sense if you are in a bigger corporate system and must be reliable even if you are not performing at your best.

Freeing myself from the mentality of being available on a bourgeois schedule is challenging. I hate feeling like I disappoint people by not always being “on” and productive. I feel like availability & reliability matter more than outcome (which is occasionally true but not generally true). The reality is you can have 10x Julie or you can have consistent Julie. I’d pick 10x personally.

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Biohacking

Day 318 & Boring Health

The word wellness has become so comically performative that I cannot use it with a straight face. It would require so many disclaimers and apologies and contextual additions to move it beyond the associations with wealthy white women (thanks Gwyneth) it’s not worth the bother. But it’s also equally true most people do not feel well. The feeling of being healthy eludes us.

Our health degrades more quickly than we’d imagined, as if planned obsolescence wasn’t a term for software, but rather a term that describes our bodies as we move beyond our twenties. It feels intimidating to try to staunch the flow of time.

We acquiesce to our obligations, our stresses, our weaknesses and our limits. And our health degrades further. And with each turn of the wheel it seems even more impossible that we could feel any other way. But I promise you this does not have to be your life. You can feel well. I’ve come back from the brink of chronic disease. It is possible. It’s just all extremely boring and time consuming.

It’s hard work and it’s boring and repetitive and frankly your work won’t show results for months or even years. But you are not doomed to lose your health to outside forces simply as a consequence of time, stress or overwork. I’ve written a beginner’s guide to biohacking as well as an introduction to supplements. Anyone can pick up the basics and begin to improve how they feel. Just don’t expect miracles. And yes it’s a position of privilege to pursue most of it. But there are ways.

If you look at one of my typical days I split a third of my life into some type of preventive work. Just in case anyone ever wondered why I don’t socialize much. I put most of that time into my body.

I sleep a full eight hours. I meditate. I go to therapy and group every single week. I do full body compound lifting three times a week. I do steady state cardiovascular work an hour every day. Ok that’s just a fancy way of saying I talk long walks. I take my vitamins. I eat protein and vegetables. I stretch. None of that is privileged or even interesting. It is just slow boring work that builds over time.

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Biohacking

Day 314 and Circadian Psych

I’ve been off since Daylight Savings on Sunday and I’m a little grumpy about it. All of my sleep metrics have been down by about 15%, which you wouldn’t think would make a dent in your day but somehow absolutely does. I’ve always been a winter person so I tell myself I don’t mind that it’s getting dark at 5pm but the adjustment is always brutal. Clearly my body minds.

I figure this will all pass in a few days but I resent the feeling of having my body not quite understand the rhythms of the day. It’s like having mild jet lag for no discernible reason. It messes with everything. The sun sets and I think oh it must be dinner time. Except it’s only 5pm and I just ate lunch a few hours ago.

It’s been combined with a few other changes in my routine which has probably compounded the issue. I tell myself I shouldn’t let it get to me. I keep trying to slide myself back to proper regimens. I am getting up at the same time even though it’s an hour earlier. I’m going to bed at the same time. And I’m sure it will pass. But god damn am I in a fucking foul mood. Your body really does keep the score.

Categories
Biohacking Chronic Disease

Day 311 and Conspiracy Care

The current “news” cycle is up in arms about a football player taking medical advice from a podcaster. Depending on who you read this is either a very bad thing or a fight against woke mobs and cancel culture. If you have no idea what I’m talking about there is no reason to dive in further. Don’t upset yourself.

People take advice from people they trust, and sometimes we trust people we perceive as being smarter or even as having higher social status than us. Shortcuts are part of life. And if you have access to someone, say through a parasocial relationship like social media, that you perceive as being well equipped to solve problems you will probably listen to them. Which is a point Eric Weinstein made about Joe Rogan and healthcare that I think is especially salient.

I think we have to understand that people are also looking to Joe as a pass-through for concierge medicine. If you have brilliant Uber-rich people in your life you hear a lot about medicine you can’t afford. Whole body work ups. Multi day examinations. Lots of medical gear.

I didn’t used to have much health care. I went to free clinics and doctors who I could pay $50 cash to for antibiotics without a hassle. It’s probably little wonder that when I had real health care issues I wasn’t prepared for just how bad most care in America is even with health insurance. I thought I’d get good healthcare with a nice insurance plan. But it mostly sucks. I got dismissed, ignored and generally not diagnosed for almost a year. And then I figured out how wealthy people do medicine. And I began healing.

Holy shit is it night and day different what spending real money outside of your health insurance will do. Like Joe I get concierge care. And to the advice I get is pretty far off what you hear from a baseline healthcare practitioner like say the doctor who can only see you for 20 minutes and can’t risk anything that isn’t clearly proven and approved. But someone who doesn’t answer to a big hospital system? They turn out to be much more flexible and will help you work through the risk and reward (and also cost benefit) of a host of different tests, treatments, supplements, devices and diagnostics.

And over the course of about three years I went from functionally disabled and completely unable to work to, well, basically fine. Three years ago I could barely walk and now I’m back to powerlifting and hiking. But the sick thing is I am certain if I were a plebeian I would be on disability for life. I would have at best been prescribed pain medications and left to rot and potentially develop an addiction or two.

So is it any wonder that in a country with a mass chronic disease issue we’d look to wealthy proxies like Joe Rogan and imitate what he says is his care? Fuck no. It’s downright immoral and condescending to suggest that the victims of American healthcare systems shouldn’t try to help themselves. No one else is stepping up to pay for their healthcare.

What is a genuine issue is that without context and a team of professionals you might accidentally become a victim to conspiracy theories. Which is exactly what we’ve seen with a number of Americans. But the line between conspiracy and simply untested or unproven treatment is a lot blurrier than I expected. I had concerns I’d be taken advantage of by functional medicine doctors and holistic practitioners. And surprisingly that just didn’t happen. I was always given context, research, second opinions and supported in making as informed a decision as possible. Doctors are collaborative by nature and my team has encouraged me in my efforts to test and trial a lot.

This kind of care does not come cheap. I’ve spent close to $80,000 on concierge care services over the past year. This includes everything from diagnostics & testing to compound pharmacy and off label pharmaceuticals (get metformin just trust me), to a host of medical devices and treatments as well as the hourly cost of a primary care physician, a prescribing & case physician (it’s not uncommon for different doctors to do medicine management so as to monitor your entire case for interactions) and clinical nursing. Like I said, if I didn’t have money I would still be on disability. I’d estimate only 20% of my progress came from before I went to a more personalized approach. Medicare for all isn’t going to deliver you the kind of care I got.

I don’t really have a takeaway or solutions here. Most people don’t have complex chronic diseases nor do they have the need for the kind of last 20% health optimization that the billionaire class go in for either. But you can do a lot on your own. A lot of health is just preventative care.

I’ve shared a basic biohacking guide for beginners before. Replacing fat with lean muscle and getting your basic nutrient and fitness profile improved should do a lot for many of you (not true of chronic disease patients that’s complex). After you’ve done the basics on your fitness, body composition, and sleep hygiene for 3-6 months you can move on to supplements. You maybe surprise at what you learn and how much it deviates from what is common knowledge about health. Here is a little hack to save you time. Eat protein, lift weights and get sunlight. And stop looking down on people just trying to survive. That makes you feel better too.