The world is a topsy turvy place and I am doing my best to meet it head on. Physically I’ve managed a surprisingly steady period from December through January, even though I spent a decent portion of that on the road.
I credit this mostly to using antibiotic and anti-fungal regimens prophylactically. The biologic immune suppressant I currently take for my ankylosing spondylitis is quite frankly too good at its job. And I’ve tried quite a few.
That means I am locked in a battle of constant vigilance in order to keep my inflammation numbers down while also not becoming a host to bacterial, fungal or other infections. It’s a balance that is anything but delicate.
In 2025 I had been unable to fight off skin, soft tissue and mucosal infections seemingly at all. Even with extensive protocols for decolonization (intranasal mupirocin, chlorhexidine washes, environmental decontamination) I had four major infections.
The last one (testosterone) helped quite a bit with energy but being energetic doesn’t matter much if you can’t fight off infections.
So while I know there is an individual and social long‑term systemic risk in using antibiotic prophylaxis, I will say it does seem to be helpful in mediating say outbursts of allergens flaring into soft tissue infections from skin breakage or having exposure to molds and fungal growths that fester in old damp buildings and water systems creep their way into any opening available.
Since it is always something, I figure I need to always be trying something. Frankly I am over the push and pull of managing medical care in America. It’s a mess and mostly designed at risk mitigation for the health systems.
I have found going abroad to be much more useful and cost effective in many cases. I may even find that it would be useful to document the experience in a format beyond a blog as I doubt I’m the only person manage complex chronic disease.
I have had a lot of experience with doctors over the last few years. A chronic autoimmune condition isn’t the sort of illness that gets “better” like a virus. It can only be managed.
I have come up with endless ways of collaborating with people who far too often believe they are more informed, powerful and intelligent than me.
Sometimes they are even right about that perception. It’s a frustrating fact of life that doctors value their status occasionally more than their patients.
Today I went to a tourist hospital renowned for its extensive offerings and professionalism. My usual interpreter (it’s in a foreign country as many nations from Mexico to Turkey to South Korea serve American patients) had a number of procedures and visits organized for me. I felt confident I’d learn a lot and maybe find new pathways to healthcare management.
I happened to have an aesthetic elective treatment first. A plastic surgeon met with me to refresh some Botox. That seemed excessive given a nurse does my light work back in Montana but why not get a professional opinion while you have the chance.
I’d intended to spend the afternoon at the hospital doing a number of more productive activities than smoothing my fine lines. I’d set up rheumatology and immunology lines of questioning and I was excited to get some holistic work done including ozone and an IV infusion of vitamins and minerals.
Alas I was stopped in my tracks by a physician who simply would not approve the IV I had set up, the ozone work, nor would she approve the alternatives I suggested (an intramuscular B vitamin shot). I made my case with the interpreter and my AI.
The doctor wouldn’t budge. She even obfuscated suggesting that glutathione was illegal though backed down when it turned out to be a malpractice issue related to compounding pharmacies.
I very much wanted to buff up my immune system, especially having chosen something elective to go first, and I could not make progress. It shut down my whole afternoon. All that was left was tests and waiting.
There was no order the doctor was willing to give for short term immune improvements unless I committed to five weeks of procedures which given it was a tourist hospital seemed a little ironic.
I am demoralized but doctors will be doctors. I never seem to manage to convince them when I really need it. Doctor’s orders are not always for the benefit of the patient. Maybe no one wanted a woman sitting around hooked up to a vitamin infusion. Who knows. I probably would have skipped the Botox though.
It being the new year “the new thing” to talk about is “the new you!” As if you weren’t the same person as you were a few days ago. But you have this convenient convention that allows you to decide now is the time for change.
I used to call this time of year “eating disorder season” but GLP-1s have turned down the volume on that noise. We still have New Year’s resolutions and media just love having a topic tentpole to discuss new trends, habits, and opportunities.
We may not have as much of the fat chatter to contend with anymore (thankfully) but I do have reams of biometrics and plenty of concerns about my own health so the season of changing yourself remains even if the material conditions have improved. The app chatter is still in my head.
My Whoop continues to nudge me on the “aging” metrics and which ones are hurting my healthspan the most. I hide it for a peace of mind but on the latest update it is openly admitting that it’s given me goals that are impossible for me given my limitations.
It’s a relief to see the application get better but of course I’ve know the algorithm and my limitations don’t always mix. It’s been workable when I’m in Montana walking outside but it swings my numbers a lot when I’m in a small apartment in a polluted city. It’s a “short hallway” problem.
I move a lot inside (safer and less polluted) but it doesn’t those short bursts and turns as steps so I push to get more steps counted and it overwhelms my nervous system and immunocompromised state.
And I got to about May and realized I didn’t feel like I needed to put more into the organization. I had 4 medical procedures involving surgery. My father died. My best startups all raised rounds to scale. You can find your own way from there. It’s been a hard year despite the wins.
I’ve been trying to coax myself into taking my final biological injection of the year for most of the day. It’s a very painful shot. The feeling of it is somewhere between stinging and hot sauce being pushed into your subcutaneous fat. It’s spicy
I was filled with optimism that this new variant called Bimzelx might be the one that finally brought down my biomarkers. And it did indeed show promising results. My CRP and SED rates have never been better.
Alas, the cost is quite high. I’ve got no immune system response to speak of when it comes to my skin and soft tissues. I’ve had four major skin infections requiring surgicalintervention and many minor skin infections.
My pain is better so long as I can avoid picking up an infection. I’ve been on antibiotics most of the year. Alas I’ve only had maybe 2-3 weeks without an infection brewing or being beaten into a retreat.
So today may be my last spicy shot. I’ve gone it a full year of adjustment. I don’t relish the prospect of adjusting back to my previous medication as it takes a full year to fully dose on and off these things. But maybe I’ll be lucky and on my final shot in the year I’ll see a change for the better
For someone with clear skin on my face (not even a humble brag), I spend what feels like irresponsible amount of time and energy on my skin health. The rest of my dermis is not as tractable as my face. I’ve been fighting eczema my whole life.
This year has been a particularly challenging, as my the IL-17 immune suppressant Bimzelx, I take for my ankylosing spondylitis and psoriatic arthritis (it’s eczema on the inside), has left me almost catastrophically prone to skin infections.
I’ve had maybe 3 weeks without a disaster (and I traveled) though have still needed doxycycline so I’m optimistic.
I am hoping I can rack up a few more weeks or maybe even multiple months without needing to slice an abscess, manage a deep tissue infection, or get a subcutaneous skin infection.
I do have a new weapon in my battle to keep my skin healthy. I recently acquired a new deep infrared cosmetics mask from Beauty Pie that they are calling “medical grade” but mostly means it has one longer wavelength than their previous mask offering.
Medical-grade LED mask proven to improve the overall skin complexion
Using 1070nm – the deepest penetrating wavelength used in at-home LED devices to date – to reduce under-eye bags and puffiness, and smooth texture and tone
Helps the skin look fresh & hydrated. Using 830nm – supports the skin’s natural restorative and healing function – to boost circulation, improve blood flow, and increase oxygen
Skin looks plump & glowing. Using 630nm – enhances the production of collagen and reduces redness – to leave skin radiant and hydrated
I don’t know if it will do much but the longer wavelength is an improvement on their past mask which required something closer to 4 months of continuous use to see results and I was simply never off of antibiotics that interact negatively with red light long enough to get any results. Theoretically I should see results in a few weeks with the longer wavelengths.
I can’t recommend it yet as I just got it and I’ve only used it twice but I used it on my face, my neck, my left butt cheek where I had the infection from inserting testosterone pellets (long story if you missed that one) and on my scalp to see if I can stimulate some growth on my scalp as I shed a lot of hair this year from the stress.
That’s about 40 minutes of mask time so no joke but also pretty amusing. I hope I can use it enough between antibiotics rounds for a win as infrared is meant to do a world of good for pain and inflammation in addition to cosmetics so I’ll use the heck out of it while I can.
I feel like I got quite a scare and yet you’d think I’d be used to it, as this is all downstream of the interleukin-17 inhibitor that I changed onto at the beginning of the year for my autoimmune condition.
Every single quarter, and in some cases every other month this year, I have had some bizarre skin infection resulting from otherwise pretty benign situations. An infected gland in my eye (twice!) an abscess that turned into a deep tissue infection, and a tiny incision that allowed in a subcutaneous infection all rocked my world.
As much as I am thrilled to see all of my inflammatory numbers rolling in to baseline normal, I just don’t know if I can sustain having a health crisis this frequently for a medication that is supposedly working. It’s working at an extremely high cost to my sanity and body.
And you might say, “Well, the numbers don’t lie.” And I’d agree. But there are many other factors I have to consider, not the least of which is that healthcare access in America is so bad that I have managed two of the four crisis points with medical tourism abroad.
I am going to give my IL-17 inhibitor a full year as dosing on and off biologics is no easy matter and the compounding effects are quite real. But I do very much wonder if in order to go forward I must turn back.
My inner child finds the idea asking if “you want to see something gross” to be funny. Of course, I want to see.
Gore and violence don’t get this reaction from me. I dislike it in movies and in the real world. But to see gross and the weird in the real world. I get it. Maybe lots of humans thinks seeing gross things are cool.
I think it is a bit sweet. It is as a very human reaction go “ewww cool” when faced with non lethal wounds. Maybe it’s truer with boys than girls, but if a kid said “do you want to see something gross?!” in Colorado when I was a tween the answer was a rousing yaah! Gross things are cool.
Maybe it’s a type of survival mechanisms where if we can learn more about what is lethal, and lethal injuries look like, it then improves our Darwinian fitness. We judge risk more accurately.
Flesh wounds need proper care and do turn out absolutely fine. And boy have we improved on the science of wound care since I was a kid. We have evolved past the bandaid.
But even in a hard situation like a fire burn or the dermis getting sliced open, I still had a bit of that bravery of a little girl. That is cool! The bravado of a human who believes we can fix it
If you enjoy a story of plucky Rocky Mountain woman learning to do emergency care for herself and her community I’m glad we shared this time together.
Hopefully you never need these emergency skills. We take learn the risks and practice for them so we may never experience them.
So if you don’t feel this way, I’m giving you your ticket out of here. Stop reading now. But if you want to see something gross stay on.
This is my wound on Wednesday morning after I had the procedure. It’s much bigger a slice than I’d expected but first time practitioners (I asked for the experiment) and while the treatment is safe across most vectors, I was a nervous immune compromised patient who prepared for the worse.
So this a real 10/10 “let’s see how it goes from here” experiment especially if the returns it delivers are real. I hope for the energy, pain tolerance and healing benefits the average patient sees
So I am using a 90 minute full 2 atmosphere protocol already as I go went this treatment. I had also begun testing the GLOW stack from a peptide spot where I trust the owner. I’m helping him test. And this is the recommended stack for recovery.
.01 of the GLOW stack which is a regenerative peptide therapy with three peptides—BPC‑157, TB‑500, and GHK‑Cu—it was made to promote healing, tissue regeneration, and collagen production,
So I am absolutely throwing the gold care package at this. I am taking collagen and biotin, we’ve got the local food and the lack of seed oils, we’ve got the best current standard for peptides on injury and surgical recovery.
And somehow I am still scared. I never heal well or easily. I bruise easily and badly. I was so slow this summer to heal from an abscess surgery. I took a risk and I worried.
But I woke up this morning and my open wound has closed and the bruising has retreated in just five days to this. I’ll be in the scar mitigation territory in no time, and soon it won’t even be visible to the naked eye.
Day 5 of recovery from testosterone pellets
Progressively, the wound has moved from acute bruising and erythema toward decreased inflammation and resorption of bruising, with steady wound closure. Monitoring should continue, but the pattern suggests healthy tissue repair
So I hope you enjoyed seeing something gross. As it is keeping less and less gross by the minute.
Many moons ago, when I was first attempting to get a diagnosis for why I was always in pain and exhausted, I got a battery of allergy tests. I did the “gold standard of allergy testing” called patch testing which is a form of pin prick testing designed to pick up responses that may be delayed.
It was an awful experience. I barely made it through the 5 day trial between the 100 allergen pin pricks and final measurements.
I remember begging the doctor for a way to measure early. I asked if I could take some Benadryl to take the edge off. Alas the only way it would be accurate and covered by my insurance is if I gutted it out.
You are not allowed to shower, sweat, be exposed to UV rays (no going outside) or take immune suppressants that might subdue your body’s response.
I was struggling to breathe, my entire body itched and ached, and I had a migraine so bad I couldn’t see for the stars & dizziness. It’s possible I wasn’t stable enough to have adequately consented to the test but I did get my final results.
Out of 100 common allergens tested it was confirmed I was extremely allergic to 10 of them with another moderate sensitivity set of twenty or so that I should merely try to avoid as opposed to my firm “no go” list.
The dermatologist gave me a sheet with 75 different chemical names and formats that I might encounter in the wild from these core allergens:
I instructed to search ingredient lists for these names any time I purchased a household product, personal care item, cosmetic or other item which might include these ingredients which ranged from nail care to vaccines.
It was honestly quite overwhelming. And some of the above ingredients are in basically everything. I dare you to avoid Limonene for a month.
So my husband and one of our best friends did what any practical minded engineer would do and they made me simple Google sheet where all 75 varietals could be checked if I plugged in the ingredients from any item.
I used it for years. I’d plug in the INCI from every brand I encountered into the sheet no matter what. I gave away a lot of products to friends.
Today it occurred to Alex that we should probably vibe code the thing into a proper web application using Replit so other people could check ingredient lists for their own allergies.
You can set your own allergens or click a few buttons for common allergens and “clean ingredient standards” and run a check for an all clear.
It isn’t super fancy but it doesn’t need to be. It just needed to keep your data safe, be easy to log into so you can securely check and access your personal list and generally functional enough to change and set allergens. We’ve put it on our own little domain just to see how much this will cost to run (and we’ve set up alerts so it doesn’t go bonkers) but we figured this should be accessible and simple.
And while there are other options on the market, most are bloated, overly paranoid and designed for scaring California moms rather than quickly helping people with clear preferences for avoidance and actual tested allergies. So hopefully our pain can help you breathe easier.
Some options for chemicals and irritants you can select on our app. My own settings of allergies and sensitivities
We may have some room for improvement technique with it so I am encouraged if the is as bad as it gets. I am not seeing any benefits from it yet and ugly bruising and a bit of an opening on an incision isn’t so bad.
A lot will depend on how well I recover and how much the hormone actually helps when I’m not healing. I’m also in the luteal horrors phase where my hormones are most ridiculous so I’m curious to see the curve.
The best part of this remains that I have a world class treatment for skin wounds on hand. Hyperbaric chamber oxygen therapy’s best research has been in wound management from burns to slow healing diabetics. So if I have to nurse a wound doing it with oxygen at pressure is actually pretty baller.
And to make it even more on theme, I spent most of my time in there writing out a column on skincare and the Great Male Renunciation of Appearances as part of my beauty shopping column and excuse to write about the secret history of appearance and its power.
