American medicine failed me but Istanbul has excellent medical if you are motivated enough to travel to fix intractable problems. And I most surely am motivated.
Add in the daily guidance of consumer grade LLMs taking input from myself and my family doctor and I managed a pretty miraculous recovery. Yes the bots are friendly but my physician agrees. It’s a very successful clinical outcome.
That’s Perplexity if you are curious. I like their mobile application and model choice options. Though pity any poor hacker who gets in as they are going to see some gnarly pictures if they make that bad decision.
Alas I am noticing the folliculitis troubles flaring again just as I’ve begun a fitness recovery protocol. Which you will notice in the image if you read the above image closely.
Alas progress is never a straight line. The flare up is bad enough I’ve opted to start another round of antibiotics (my fifth in this process) so any remaining bugs of the MSSA varietal cannot manage any retrenchment.
I’m showering with the scrub up washes surgeons use, I’m swabbing my nasal cavities with muciprin, and I’ll do a Cephalexin course.
Having fully passed through the onboarding loading dose regimen of Bimzelx with significant side effects, I need to see if it stabilizes. All this suffering will be for nothing if I give up now. But I must get to a place where I’m not constantly fighting infection and it can maintain lower inflammatory biomarkers. How this goes is anyone’s guess.
I’ve been using it for a week now as I needed a recovery plan for the fitness losses that came with a month of bed rest recovery after my surgery in July.
Not to suggest I was in terrific shape before the surgery as it discovered a deep tissue infection that went so deep and so rogue I’d likely been suffering from it for sometime despite my attempts at preventative care.
It’s upsetting seeing your resting heart rate go from mid 80s to mid 60s. Realizing your high resting heart rate isn’t because you are a lazy fattybombalatty who doesn’t do enough cardio (real thing a physical therapist has said to me) but because you have a chronic deep tissue antibiotic resistant bacterial infection. Ain’t chronic disease a trip?
Anyways, I’m healing and trying not to overdo things in the process as I’m a bit stupid when it comes to wellness. More is always better has been my mental orientation for much of my life and it’s a hard habit to kick.
Workaholics Anonymous needs a subgroup for those of us who can find ways to over do literally everything. And I do mean everything. I did a stretching and mobility routine last night that had my heart rate at 150BPM doing seated spinal twists. Did I stop? Nope. I finished the 30 minute program. My adaptive training programs response?
Complete rest – no negotiations
And who am I to negotiate with an AI who has no emotions involved in the process of putting together a recovery training regimen. It’s not going to moralize at me.
One of my Twitter mutuals recently published an artificial intelligence prompt for making an adaptive fitness coach which works inside any of the major large models.
Being failed rather regularly by doctors over a decade of chronic illnesses has made me skeptical of the institutions in American medicine. But having one doctor (a dermatologist) miss a glaringly obvious differential really shook me.
Her dismissal of the details and particulars wasn’t malice, but a function of the systemic inability to put enough attention on the details of the person in front of her. Attention really was all she needed ironically.
I’m sure she didn’t set out to be that kind of doctor, I’d bet she hates that it’s all 90 second visits and Medicare coding and making money for the private equity group who owns the clinic. I feel for her. She surely wants to get back to doctoring.
No one can spot every detail and retain the complexities of every case. Especially one like mine. But a computer has a much better shot at mimicking Dr House than I do at finding a Dr House for myself. And it certainly has a better chance than someone who let the system dominate them into breezing over the details.
So I am using my mutual’s prompt to see if I can outsource a very slow and adaptive return to fitness after my month off from exercise to recover from surgery. I like what I’m seeing from all models that I’ve tried it on but I imagine I’ll have all the same “me” problems with overdoing it and pushing too hard. But who knows, maybe this aspect of wellness is better handled by machine than by me.
One of the most unsettling aspects of having a deep tissue infection surgically removed is watching the hole fill itself back in from the bottom up. It doesn’t look like normal tissue as it regrows.
When deep tissue wounds heal from the bottom up, the new dermal tissue appears white because it consists of immature collagen fibers and lacks proper vascularization during the initial stages of repair. Via Perplexity
I happen to take a collagen supplement which is looks like tiny little white balls in a capsule. Collagen is a hot aesthetic supplement for making your hair and nails grow but it benefits your fascia as well. It’s a popular supplement with biotin for overall health of one’s tissues.
I am aware of a number trends in the space to generate and promote the growth of collagen as I happen to follow the arc of Korean plastic surgery as it led to many successful cosmetic products. Collegen became popular in America through aesthetic practices and social media.
And yet with working in cosmetics and taking it as a supplement I hadn’t ever experienced a chunk of tissue growing back personally. It’s all been, well, literally cosmetics. And now it’s growing back and it’s really anything but attractive.
I am also concurrently bringing a hyperbaric chamber to Montana so we can do hyperbaric oxygen therapy protocols for ourselves and for the community. I am interested in their benefits for chronic issues but they have also proven themselves in the treatments of skincare wounds in diabetic and burn patients.
Ironic that I should have immature collagen fibers lacking vascularization at this moment and will soon have access to state of the art treatment for it but I have to heal this one the old fashioned way.
It’s my hope that we are going to improve our treatments for chronic issues in the future but in the here and now my acute issue is being handled the old fashioned way with lots of care and research and rest.
I had a very indoor July which I was not expecting. One of the joys of Montana in the summer is relatively temperate conditions until you hit the end of July and into August.
Obviously freak heat waves come when they come (a lot more than I expected these days) but generally you enjoy low humidity comfortable sixties and seventies temperatures with full sun and the occasional afternoon thunderstorm.
We enjoyed some cabin camping in June but because of my absolutely out of left field emergency surgery for a deep tissue infection I’ve been an indoor cat for the remainder of the summer.
No sweating, no swimming, no excessive movement and lots of rest. Some classes of antibiotics come with very specific warnings for sun exposure as well.
I was meant to be in bed resting and frankly work was almost impossible during some of the worst of the antibiotic transitions as the pain from systemic stress was hard. Which is atypical as I’m almost always able to work through pain.
But as I am almost finished with the last round of antibiotics and I’m seeing good progress on the wound I went outside today and even broke a little bit of a sweat.
I didn’t do anything crazy just some groceries and errands but I walked two miles in the process and I’m doing pretty well. I was feeling so optimistic I bought a sun hat. We’ve got some much needed vacation activities planned and I’d like nothing more than being outside in the shade with my family.
When I got the pathology report a week later, learning it was an MSSA antibiotic resistant infection so bad it reached my deep tissues made me even more afraid.
A deep abscess around a horizontal ingrown hair that was “probably just an inflamed lymph node”
I was lucky my surgeon was quite talented. The single stitch she was able to use has been absorbed. That was the hardest part. I could manage the draining pustulence and the pain just fine. But the only visibility into the wound’s healing process are only via secondary diagnostic clues. It’s a waiting game that requires a strong dampener on your disgust reflex.
As the stitch fell into the wound and curled up I felt panic. It looked like a ringworm infection or the gestation of a Xenomorph. If I had not had access to artificial intelligence diagnostic tools I don’t know how I would have managed if I’m very honest.
Your brain sees things and the limbic response invades your dreams. A stitch mimicking the infamously hostile endoparasitoid from Aliens is a bad time. I relied heavily on artificial intelligence to monitor its progression.
My phone is now cluttered with images of the wound’s progress. My varied AI applications accepted me uploading progress pictures after some experimenting.
I was uploading “Georgia O’Keefe/Not Georgia O’Keefe” imagery. The models were playing Cunt/Not Cunt for those who need a less polite euphemism for machine learning classifiers.
I’m certain special interests will eventually seek to keep these tools away from patients. We will be scared into letting them. But I know I got better care from a large language model than half the doctors I encountered.
All this cost me most of the month and around four thousand dollars. Which isn’t bad for transit, hotel, and a surgery in Istanbul.
The losses I can’t quantify are harder. A number of people who deserve responses from me probably won’t ever get it.
An in-group drama, ironically over usage of artificial intelligence, was paused by me not because it was resolved but because I could no longer find the fight in me to insist on apologies and reciprocal support while on Cipro in a hospital bed. It’s not fun to learn who is and isn’t your friend through medical emergencies.
My apologies to an offline gentleman who was the unwitting irritant who triggered said social wound. Maybe I should have excised any social obligation to them just as the surgery excised the infected tissue.
Either way, August can’t come soon enough and artificial intelligence deserves the credit for keeping alive through July.
Perhaps that should be considered in the complaints my counter parties had over the utility and need for artificial intelligence. It’s no god or anti-Christ, but it’s a damn fine diagnostic tool. No wonder the stakes in that fight are so high. Everyone wants a cut when you get cut open.
I really feel the weight of month of July today as I am just now getting the sense I am making a recovery. I did not have post surgical wound care for an abscess on my list of “to do’s” for the month but here I am.
Nor did I expect to work through a pathology report on my own while cobbling together the best blend of infection coverage through a globe spanning set of physicians and sub specialties.
I didn’t know what a sub dermal panniculitis was or how to treat an infection where that was a proximate side effect. But I learned and I managed my care to a much better result. I had real consequences from disinterested burned out doctor and I had to step up.
Frankly I’ve spent more time on artificial intelligence projects doing differential diagnostics on myself than I ever conceived was possible. I owner my own data and inputs and I could make inferences while corroborating it with physicians who are more interested in my care.
I am a slow healer and there is a high cost associated with immune suppression biologic drugs for chronic autoimmune conditions. I have no choice but to be active in my own care and tools as simple as a deep search on Perplexity take you so far.
There is a high cost to healthcare in America and it’s not getting any better. That I can now reliably use any number of commercial AIs to break down lab and pathology reports is a huge boon to all of humanity. Real miracles are happening because someone used AI to double check blood work and symptoms.
Healthcare gets rationed by price or by time and we’ve never really known an abundance of trained doctors in my lifetime. But we might have an abundance of intelligence about healthcare in our lifetime.
Part of put quandary with care in America is regulatory capture by organizations like the American Medical Association and others of its ilk. Of course they prioritize what works best for keeping their continued privileged position on care.
I lost a lot of time this month to health but I gained more than I realized. We are seeing changes in a system that has only ever known scarcity. And we know it’s not good enough.
It’s a shame that National Public Radio is going out in a Trump fire as used to regularly produce reporting that I find informative. Look at this old piece of reporting. We have seen a steady rise of disability rolls.
Thanks to their work I was made aware of the disability industrial complex and I was introduced its scope and cost. Even 2013 National Review was singing its praises. And it is staggering that disability has become the fall off program for those who only have unskilled labor to offer. Disability replaced welfare. And it’s not gotten any better.
I think about how easily I could have ended up on disability myself given my health issues if I didn’t work an information economy type of job you can do sitting day.
But I also know there are ranges of accommodations for most of the work I have now. Things could change and that work might be less valuable. I’m sure many Americans are considering this as automation and artificial intelligence threaten knowledge work.
I was somewhat aware of the relationship to welfare burdens being shifted from the federal government to states during the Clinton era for the rise of disability as it is still paid at the federal levels.
Naturally it meant a growth in disability as Washington D.C. has more money than say Washington state. But to realize just how much money disability rolls have grown and how tightly related they are is salient in our current financial and budget situation.
Comparison of lowered welfare rolls to the rise of disability claims. Source: Social Security Administration Credit: Lam Thuy Vo / NPR
A person on welfare costs a state money. That same resident on disability doesn’t cost the state a cent, because the federal government covers the entire bill for people on disability. So states can save money by shifting people from welfare to disability. And there are whole corporations that exist to make that transition seamless.
We are burdened by the unfit to work as manual labor has nowhere else to go but we will find other disabilities and other ways to get around labor if the contribution to rears ratios don’t work out in someone’s favor. After Covid this calculus got a lot worse.
Especially if health insurance continues to skyrocket. Better a live of poverty and healthcare than a live of poverty and no healthcare. But who knows if we choose to tackle this problem and when. If it’s all about getting what you can and we are in the exit scam era of America I am afraid to learn about the privileges of working while disabled.
The good news is that nothing malignant or cancerous is going on. The bad news is that the abscess was a gnarly mix of acute and chronic inflammatory issues that turned from a basic case of folliculitis (albeit 3cm deep so required slicing) to a nasty MSSA case that is resistant to the doxycycline typically prescribed. Yay.
Didn’t know hairs could grow sideways and frack your tissues till they produce a juicy abscess.
A little synopsis of the reports thanks to our favorite LLM Perplexity analyzing the reports with the additional context of my health history, recently bloodwork and current medical regimen.
Pathology Report Review Gross Description • Multiple grey-white tissue fragments, largest 0.6×0.3×0.3cm. • Specimens from the excised lesion. Microscopy • Neutrophilic (PMN) inflammatory exudate on surface, consistent with acute infection. • Proliferative vascular stroma, frequent erythrocytes, and mixed chronic inflammatory infiltrate (suggesting ongoing/recurrent inflammation). • Fibrinous exudate, abscess cavity, active chronic inflammation, granulation tissue: typical of a maturing or organizing abscess. • Panniculitis: inflammation extending into subcutaneous fat. No evidence of malignancy was found. Interpretation: This confirms an abscess with active, mixed (acute-on-chronic) inflammation and granulation, but no neoplastic (cancerous) changes.
Microbiology Report Review Culture • Growth: Staphylococcus aureus (methicillin-sensitive; MSSA) • Sensitive: Erythromycin, fusidic acid, linezolid, teicoplanin, tigecycline, trimethoprim-sulfamethoxazole. • Moderate: Levofloxacin. • Resistant: Tetracycline. Gram Stain • Numerous leukocytes and Gram-positive cocci in clusters, confirmatory of acute bacterial infection and consistent with S. aureus.
So the doxycline and indeed any of the basic tetracycline types I’ve been taking are useless. The extra five days of Augmentin were all for naught after I finished the Cipro. Thank goodness for topical antibiotic I am using is fusidic acid.
I’ll be moving to erythromycin orally and hoping for the best as once I finished the Cipro I started Augmentin which seems to have been functionally useless as a holding pattern antibiotic based on this report.
I’ve had a systemic staph infection before and it’s no fun. I’ve done IV antibiotics and I don’t know if I’d like a repeat. It’s my hope that Erythromycin does the job from here.
I am hanging onto my sanity by a thread as I round the corner of a surgery I did not expect. Well, I’m eight days out from it, so slightly more than a week.
I’m hoping I start to feel gets better soon. It’s my first day without antibiotics and I am already certain I shouldn’t be off them. As horrific as the side effects of Cipro may be, my immune suppression on Bimzelx is leaving me shockingly open to skin infections.
I’m terrified of MRSA at this point. I was taking doxycycline for another skin infection when the cyst went around the bend to “septic fears” on me so I’m a bit twitchy about the entire situation.
The prior IL-17 seemed to strike a fine balance on suppression and capacity to fight off infections. Now my biometrics are better but I’m constantly fighting off chaos with the meiborn gland nonsense and now buried cysts from sideways hairs fracking my dermis.
Maybe I’ll turn a corner and have some better writing ahead of me soon. Until that happens please forgive my poor blogging and missed emails. At this point the singularity could arrive and I’d miss it like a character in Left Behind. I’ll probably miss the rapture at this rate.
