Category: Travel

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Aesthetics Travel

Day 1680 and Tricking Your Parasympathetic Systemic Into Offline Relaxation Mode

I was introduced to music curators for what you might call third spaces in the aughts. If you were very good, you might program television show but the work of designing audio atmosphere was often about hospitality.

Boutique hotels, luxury gyms, and luxury boutiques looking to set a mood would hire these talent for playlists that fit into their brand book.

We’ve come to appreciate just how much a full sensory experience encompasses every detail. Decor, lighting or even a house fragrance can all be ruined by overloading your guests with discordant noises.

Unless it’s a nightclub or cocktail lounge, the blending of audio spaces and creating the right vibe to open up your guests to the experience is about settling sympathetic nervous system into the openness that comes with the “rest and digest” chill of the parasympathetic response.

I was part of a team that made playlists for Milk Studio’s New York Fashion Week, looked over the shoulders of the creative director who hired a well known curator for their playlists.

Fashion runway shows in Paris, Milan and New York City would also hire these DJs sometimes being the top of the diffusion spear but they were often collaborating with hotels where the fashionistas stay.m

I saw how the Standard Hotels made choices for their properties and was inspired by their work to get even deeper into the best boutiques and their choices. The beloved Parisian fashion staple Stéphane Pompougnac who became the wildly successful Hotel Costss house DJ.

Hotel Costes 6:
Combining casual glamor, “retro-canaille” and smooth house, this compilation evokes the luxurious, eclectic and elegant atmosphere of Hotel Costes.

Stéphane Pompougnac (born 1968) is a French houseDJ and record producer best known for curating and mixing the Hôtel Costes compilation series

It’s become such a part of my own relaxation and time off routine, I can hear a few bars from Hotel Costes 6 (a particular favorite of mine) and immediately feel calmer. Amazing what a ritual we can make of music. Sure it is silly but you can’t beat decades of somatic learning.

Maybe I’m not always going “a la peche” but my body doesn’t know that. From there, all I need to do is open up an Ian M Banks paperback and I can slip into a short trip of my own. Amazing mow malleable our minds can be to repetition.

Brand collaborations are everywhere you look
Categories
Travel

Day 1677 and Fighting Tourist Traffic in the Era of Infrastructure Underinvestment

I’ve been in traffic for almost two hours and I’ve gone a sum total of 19km or 11 miles. High season is a mess when the world is trying to pack in leisure time all at once.

It doesn’t matter if it’s the entrance to America’s beloved natural parks, a scenic coastal highway or the route to a dysfunctional regional airport. All paths to time off from Montana to the Mediterranean are a mess.

I slathered myself in sunscreen and I’m so glad I made that decision as even inside an air conditioned car with tinted windows I feel the sun beating down on me. Sunglasses and a hat can only take you so far.

There are many places who make big claims of wanting tourism. Sure you hear protests from some of the most popular European destinations about over crowding of attractions and the toll it takes on infrastructure. But it pays the bills for millions of communities.

Still experiencing the stand-still road traffic of a poorly resourced area who hasn’t invested adequately into infrastructure makes you wonder. You say you want the money from tourism but won’t make the capital investments and expenditures to make it work?

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Travel

Day 1675 and Running to Stand Still

The accelerationist types must be feeling smug as the disorientation caused by so much of the world speeding up is a persistent feature of life now.

I’m trying to organize a fairly elaborate vacation that I should have nailed down the details on at least a month ago. I am alas doing it what is functionally last minute and I’m panting at the effort of coordinating preferences, availability, timing and the thousand other logistical details.

We have a range of preferences to accommodate and it’s driving me a little bit nuts and I have no one but myself to blame. I cant manage more than three hours in a sitting position in a car or airplane without hurting. Standing helps but it’s really laying down and relaxing my spine that helps.

The other preferences are more of the one person likes fine dining and Michelin caliber restaurants and another likes delivery and Netflix.

We have to balance intensive activities in hot weather like hiking and sightseeing against the desire to lay out in the sun near a body of water. Really all the classics of different strokes for different folks.

I don’t want to be too ambitious about any of this as I am really just barely out of the woods from July. And I’m being vague about when and where, as I’ll like pretend like we have some amount of operational security. Writing is all about the specific but the best I can do is say it will involve driving and water.

Categories
Chronic Disease Medical Travel

Day 1657 and The Boredom of Summer Surgery

It sounds a little ungrateful to say I’m bored, as I sit comfortably in a nice hotel bed with books, Netflix, room service, and a nice view but I am bored and a little miserable.

Antibiotics, discomfort and surrealism are a challenging combination for existential stability as it turns out.

I can’t do much beyond sitting still and getting up once an hour to walk a couple hundred steps. I have been instructed not to sweat so I can’t go outside much. Even in the evening with a breeze, it’s still hot enough to break a sweat and this is an infection risk.

Beyond sweating, you can’t disturb you wound healing in anyway so I can’t exercise. At best, I can do some light yoga and stretching. Short walks indoors are OK so I can’t walk the hallways but that makes staff nervous. I keep to myself mostly.

Most tragically for me as we don’t have a bathtub at home is that I can’t take a bath or submerge myself in water for weeks. So the gorgeous bathtub is simply taunting me. I love a good tub and this is a great tub.

No submersion in water for two weeks minimum

It’s even worse when I stare out at the beautiful pool. That is obviously an infection risk as well. No splashing around in Norma Kamali pretending at social aspirations. Oh yes Istanbul is the new Florence in July haven’t you heard?

At least the nearby Bosphorus is packed with cargo ships, I have no temptation when seeing the beach to have a dip in the water. I doubt diesel fuel is good for healing.

The highlight of my day is the hotel lounge’s breakfast where there are charming varieties of very Instagram friendly food. It is still in a hotel lounge but it’s a beautiful novelty.

Tea, pomegranate juice and rose honey yogurt

I’ve been annoyed by the variety of influencers who are also healing around me. There are any number of different plastic surgery and aesthetic patients in the guest mix.

If you think a week of blogging about an emergency sepsis slice job on some indelicate bits, imagine how weird it is to see an entire family getting plastic surgery and their daughter (I think?) is live-streaming most of it.

I’ve seen more puffy lips than I have fish on this trip and that’s my fault. I don’t have the strength dress up or walk to the Michelin starred seafood restaurant. Maybe that’s more for the elective surgery types and the emergency infection girlies have just enjoy the tiny yogurts.

That’s almost a bagel and lox set up right?
Categories
Biohacking Medical Travel

Day 1656 and Recovery from Recovery

I’m waiting on pathology lab work but I’m mostly supposed to be resting and healing after surgery on Friday. I feel like crap and I’m scared.

I have no real basis for making judgements on how well I am healing as you can’t just upload imagines of your genitalia adjacent wounds to Claude or Perplexirty. Even Grok is like “no”when you trip the icky lady bits warning sensor coding.

Thankfully it being a Monday I was able to get a short appointment at the hospital with the improbably beautiful and well dressed obstetrician who did my surgery. She seems to think I’m fine and healing normally.

I trust a woman who dresses well. But the antibiotics are just making a hash of my mind, my intestines and my stomach.

Bloodletting? Lost in translation

I’m enjoying the headstart of waking up 9 hours ahead of home and 7 hours ahead of the New York market opening. Now if only I felt smart enough to actually work.

The Cipro is just the absolute worst. I feel guilty complaining as I have such excellent care and a comfortable hotel room in which to recover. But I’m struggling. All the back work and emails will just have to wait I suppose.

I feel like a recovering from my recovery might soon be necessary as my mind-body-gut axis is toppling ass over tits as the nuclear winter of 3 separate antibiotics lays waste to once fertile lands for friendly gut biomes. And this is before I’ve even considered whether I have the right drugs. Pathology reports might suggest fungals.

Categories
Medical Travel

Day 1655 and Healing Waters

I am now forty eight hours post operative and I feel like shit. I was warned but I am not enjoying how the very intense antibiotics make my brain feel.

The first five to ten hours after surgery when the local anesthetic hasn’t fully worn off and your adrenaline is still pumping are the easiest. I was smiling and happy to walk myself to the hotel and I was snapping pictures of the Turkish Cipro in amusement. How cool was all of this?

It didn’t stay cool. The first 24 hours are weird as you are still gooy and gushy so it’s tons of clean up and hand done hygiene. You aren’t allowed to shower yet, so it’s just a liminal state of grossness as you wait for swelling to abate and antibiotics to work.

Well, I’ve passed hour forty eight and I’m brain dead. I can’t think straight. The work I was excited to do in bed as I stared out over the Bosphorus was probably a fantasy.

I’m tired. I’m swollen in very tender areas. The idea of showering is simultaneously appealing and too exhausting to even contemplate. I am staring at the lovely bathtub I can’t use. Suddenly all the sources of water submersion are a threat instead of a joy.

We don’t have a bathtub at home so I only get to relax and soak a tub when a hotel and here is a beautiful one that I cannot use

Despite my exhaustion it’s very hard to sleep well in this situation. I need to keep pressure off the wound so it’s all about pillows and angles. I stayed up playing on Twitter where someone asked how a bottle of water for skincare could possibly sell at such a high price.

Right about now as I contemplate my banishment from the pool, the beach and the bathtub I think about how much I’d enjoy the healing waters of a mineral hydrotherapy spa.

Categories
Chronic Disease Medical Travel

Day 1654 and Post-Operative Exhaustion

As I slowly walked myself out of surgery yesterday, I thought to myself “I actually feel much better!” And I genuinely did.

If you have a gentle stomach, maybe stop reading here. I’m fine. I’m on my way to well. And this will be graphic.

I do feel dramatically better having had the “slouching towards septic” abscess drained of infection as well as removal of the initial pearl style irritant (a 3mm deep entirely horizontal hair growing not up but sideways like an underground fracking tube).

I appreciated having the walls of the abscess pulled out bit by bit in a delicate curettage by my silk sundress clad physician. It was all a success.

But post operative care is hard? I’m a mess. I’m exhausted, loopy, and the hotel’s guest services are concerned enough that they are doing me such kindnesses like sending up tea and maxipads. Turkish hospitality comes from a place of genuine kindness and I need that right now.

It’s been a long journey of stupid to end up in Istanbul to get a smart fix. Going from a squishy movable almond sized lump without any pain six weeks ago to a hard plum sized lump was disconcerting enough. Especially having done my damned preventive care visits with the useless Dr Oetkin in Montana.

Have had two days of prodding, poking, squeezing, moving and ultrasounding done in the Mediterranean, I was swollen, feverish, and all hurt to the touch. I was afraid.

How did I get here? How had my next generation IL-17 managed to cause me so many negative side effects even as I was doing better across all biometrics and across quality of life metrics?

No wonder the doctor in Istanbul was so concerned. All the previous doctors had done was make my situation worse though inaction and delay m, and then the action they took made it worse.

Now I have recovery ahead of me. Last night as I went to pee, I realized why they had padded the upper areas of my underwear with maxi pads. I’ve got no discharge downstairs but on the upper bikini area there was no such luck.

I only needed one stitch to close up thanks to the careful work of the doctor, but a lot of goo came out during the surgery drainage and I was warned there was still more to come, though it would taper off.

I gently washed the area with a cloth and antiseptic soap before application of antibiotic cream (my third type of antibiotic). I gasped as I saw the first lightly red sticky watery fluid gush out rapidly around the stitch. It was so fast and there was so damn much. Bodies are disgusting what else can be said?

I mopped up with a clean moist towel and applied a thick layer of antibiotic cream, but I had learned the deflation of the abscess wasn’t quite done. The swelling, I was told, would take a week or more to full abate.

I’ll be sleeping this off for the day but if you are in Montana with an autoimmune disease and need a dermatologist I’d recommend you stay away from Dr. Tara Oetken at SkincareMT. Without her hasty heuristics and lack of conviction I wouldn’t be in this mess.

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 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