Tag: Addiction

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Chronic Disease Politics

Day 618 and Personal Politics

I hesitate to share too much detail about this but, I’m an opioid user.

Actually I’m not hesitant to share that at all, it’s in fact the core salient point I want to make today. I have a chronic disease and sometimes, blessedly more and more infrequently, it can only be effectively treated with pain medication.

Why am I talking about this? And in public no less? Because unless powerful people that have a degree of social, personal and political capital discuss things we deem unsavory we never make any damn progress on humanizing our inhumane responses. And our response to the opioid epidemic is inhumane.

The backlash to the crisis, a mash up of intense scrutiny, government intervention and rigid rules, has now reached a point where it is doing as much harm as the original crisis of overprescribing. And I hope my personal story allows you to see why.

My spinal condition (ankylosing spondylitis) can be so debilitating that the only way I can get out of bed to accomplish basic tasks is by taking a mild opioid called Tramadol. It’s not in the same category as OxyContin or Percocet but it’s not risk free either.

I’m lucky that my condition is relatively well controlled. I don’t need pain medicine all the time and I work very hard on alternative treatments in the hopes that I won’t need it at all in the future. I spent a small fortune making sure I don’t need a core useful medicine. Let that sink in.

I’m not an addict. I am monitored by a team of professionals. Every step of the way is in fact monitored extensively by state and federal systems along with massive insurance and hospital system oversight. It’s the closest I’ve come to experiencing the Panopticon. It’s life altering in its scope. My entire life by necessity has to revolve around when the system deems it safe for me to get a prescription. Not when my doctor thinks I need it. When Uncle Sam does.

I fucking hate relying on something so dangerous and so demonized but also so regulated. I hate that my entire private medical life is so closely monitored by the state. I hate all of it. But, on very bad days, the choice is immobilization or Tramadol. And I’m not at all ashamed to say I pick Tramadol. I want to be a working productive member of society and that’s hard to do when you are unable to move from the pain.

There is no grace in suffering but what it teaches us. And I’ve learned we use pain as a cudgel to control people in our society. That it is so effective is why I am both a libertarian and fiercely against the carceral state. One day it might be you suffering and you won’t deserve it either. And I pray that you will be shown grace in your personal circumstances.

But I’m lucky. I’ve got other pharmaceuticals, like biologic injections which treat inflammatory conditions, that I can rely on. I’ve got THC and CBD for their anti-inflammatory properties. I’ve got good old fashioned steroids like Prednisone. Which interestingly, my physicians universally believe is more dangerous than my Tramadol usage and did actually require an extended titration down as I was physically dependent on it, as your body stops producing the necessary hormones. They’d rather I use Tramadol for flares.

But you notice the government isn’t up in your face with a massive publicity campaign showing cops busting down Prednisone rings. There are no political advertisements showing how an opponent supports big steroid. Even though if you saw Donald Trump after he got Dexamethasone during his fight with Covid it was pretty clear he felt pretty good. Steroids have gotten me far more fucked up and also higher than any opioid ever has. But no massive surveillance program has ever come down on anyone for anti-inflammatory drugs.

Because that would be fucking ridiculous even though it’s just as addictive in driving physical dependencies , just as debilitating and depending on your body chemistry, just as “fun” as narcotics. Fun fact about me, I don’t have whatever chemical makeup that allows an opioid to give me a high. Which as I’ve learned is a saving grace. Not everyone does. That’s kind of the rub. The risk profile on opioids is a bit worse because some pharmaceutical executives lied about the percentages of people who get addicted. Or who found it’s side effects pleasurable in the absence of symptoms. They did not lie about the benefit of not being in pain.

And that ought to give you a good sense of the problem at hand. The iron law of prohibition strikes again. A massive bureaucracy imposing a fix that intervened in crude and inflexible ways is causing more suffering than it fixes. It wasn’t the intent but it is the outcome.

The iron law of prohibition is a term coined by Richard Cowan in 1986 which posits that as law enforcement becomes more intense, the potency of prohibited substances increases. Cowan put it this way: “the harder the enforcement, the harder the drugs.”

Because doctors were lied to about the risk profile of certain types of opioids in the first place, the backlash is now as bad as the original sin the pharmaceutical companies committed.

Regular law abiding people are getting fucked in their treatment plans because hard enforcement is making it harder to get the low dose drugs. We treat Tramadol users with arthritis with the same tools as as criminals addicted to illegal fentanyl. I know shocker that the American federal government can be as evil as Purdue.

But also historically you know it’s true. And now a huge portion of normal people like me, who just want the benefits of not being in constant pain, are being turned into an over surveilled over controlled population. And I’m not saying there are no risks. But who do you want deciding that? A doctor who knows you well? Or the government? Yeah I’d pick the doctor too.

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Biohacking Chronic Disease

Day 601 and New Limits

The past couple of days have been super intense. Heck, the past month has been a lot. I passed out last night with my phone in my hand a bit after 9pm and woke up well after 8am this morning. My Whoop indicated I had high strain for the past two days and needed more recovery.

Still I went about my usual routines but soon found myself yawning and struggling to keep my eyes open after eating lunch. I felt lucky I hadn’t scheduled much today. I got back into bed figuring I would read a little bit. I kept drifting off. So much for being productive this afternoon.

One of my biggest fears is doing too much. Because I’ve been a workaholic in the past, I have a lingering sense of unease anytime I can tell I’ve been pushing myself for a few days. It used to be that my body would simply crash if I applied too much pressure, but as my health is at about 80% improved from my initial diagnosis I can no longer rely on such direct feedback.

I say that like it’s a bad thing but it’s a huge relief that I can modestly over do things and not immediately find my body crashing into a rest period. But it also means I have to be much more conscious of my own needs for rest and recovery as it’s no longer quite so obvious when I’ve done too much. This represents both a huge achievement for me and also a transitional moment in which I must find new boundaries.

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Emotional Work

Day 589 and Mental Health

Trigger warning: discussing depression and oblique references to suicidal depression. If you are in crisis please call 988.

I had a scare this morning. Someone I love is going through some stuff. I didn’t know if they were safe for a short period and I found myself frightened by the prospect of losing them.

When I learned they were safe I was relieved but also angry because how dare they scare all of us like that? I scrambled to cope with my own feelings and a desire to engage in codependent behaviors. I called my therapist and pulled myself together.

While I don’t suffer from depression it’s not an entirely foreign concept to me. It has felt closer over the pandemic as I’ve seen others struggle. I have family members and friends who live with varying degrees of chronic depression and I have witnessed first hand how much strength it takes live with it. I have chronic pain and I don’t think it is even in the same ballpark of debilitating as depression.

I’m not any kind of expert and my advice is mostly me talking into the wind so please only take what serves you. But what I’ve learned is that people genuinely do care about mental health if you want to seek a connection. We want to help. We want to help those that want to help themselves. Your people do love you and you may have more of them than you realize.

Sometimes it feels impossible to ask for help. Maybe you cannot ask friends or family because of any number of reasons. But that doesn’t mean you are alone or no one is here to help. There are hotlines. There are 12 step meetings. There are apps and services. As one internet friendly to another you are not alone. If you need mental health care please take whatever step feels feasible even if it’s just a text message into the either. You can do it.

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Chronic Disease

Day 559 and Stuck

I got stuck on the couch today. I’m not entirely sure why but I’m in the middle of a massive symptom flare. The pain is so acute and unrelenting that if I so much as sit up from bed I’ll get stuck in that position. I made the mistake of trying to eat lunch on the couch around noon and didn’t work up the capacity to get back into bed for over an hour.

This is becoming a theme on bad days. I’ll find myself upright for forty minutes completely unintentionally because moving, even to a more comfortable position laying down, is so painful I will put it off until I simply cannot remain upright anymore. It’s just that bad. Even the higher grade pain management isn’t doing shit. I’m just stuck in the pain until an even worse pain develops.

That’s probably a good metaphor for life. We will stay in an uncomfortable position until it’s so intolerable we simply must change. And I’d love to wax philosophic about that but I mostly mean it literally. If you’ve ever wondered how I got popular on Twitter, it’s simply because it’s the only thing I can do when I’m physically stuck in place by pain. I thank the internet Gods that this has been monetizable through investing or I don’t know what I would do.

You could almost surely correlate the number of tweets I send with the pain scale of my day. If I’ve tweeted more than 50 times on any given day it’s probably because I am over a 7 on the pain scale. It’s 2pm and I’ve tweeted 32 times today not including my DMs. I keep hopping the pain will abate enough that I can shower but it doesn’t show any signs of letting up today.

Frankly I’m just relieved it’s only my spinal pain and not anything else more exotic. Earlier this week I was dealing with being itchy and then I had a migraine that took 48 hours and several Imitrax to break. Regular old spinal pain is at least a recognizable and normal return to form. But until this nerve storm abates I’m stuck. At least until something worse comes along.

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Emotional Work

Day 438 and That’s Enough

I attended a schooling system developed by an Austrian man called Rudolf Steiner. It’s commonly known as Waldorf schools. One of its hallmarks is a lack of comparative grades.

Steiner believed that grades forced teachers and students into a curriculum that taught to the middle of the class. The tyranny of the median student meant slower students felt stupid and frustrated and smarter students felt bored and disengaged. Only the average child did well in a graded system. And no one is ever truly average. A graded system fails us all.

Waldorf schools teach a pedagogy that is holistic and geared to meeting each individual child at their unique level. It uses a variety of techniques like having children make their own textbooks (called main lesson books) so they are never conforming to some idealized medium standard. At it’s highest ideal it means being compared only to your past performance. You don’t compare yourself to other students. There is no ideal grade at which a student will think “I am the best” as that is fruitless. How will the best student ever bother to improve if they always get a perfect score? Grades hamper the cultivation of genius.

This sounds idyllic right? Always improving yourself without external markers that say you are good or bad or even average. That’s the dream. A perfect schooling system. And if I am being honest it absolutely was what provided me with the curiosity and desire to always be learning. It sustains my career now.

But every shining light casts a shadow. A system without grades. A system without comparisons or averages also means you never ever get to win. I never got a gold star as child. I never got an A. I never got a trophy. I missed out on millennial laziness cultural tropes. I would have killed for a participation trophy as a kid.

Because nothing was ever good enough. Because I always knew I could do more. I could always improve. There was no resting on your laurels. I never got a chance to say I was the best in my class. I never got to win. Because I internalized there was no winning. There was only ever improving. I was always improving. I felt like Sisyphus. Except the bolder never rolled down the hill. The hill just kept on going. The mountain had no summit. It was only improving. I never felt like I could rest. I never felt like something was good enough. Because tautologically it couldn’t be.

The consequence of this system for me as an adult is that I never feel like I’ve done well such that I can ever rest. Even if I’m objectively the best compared to others, I remember the ethos of school. The school that said next time you can do better. Next time you can push harder. Next time you can improve even more. If you’ve ever seen the movie Gattaca it’s the scene where the hero wins because he never ever saves anything for the swim back.

I’ve yet to balance the shadow cast by the light of Waldorf school. I desperately want to feel like I’ve won. Not because I need to feel better than anyone else. But because I struggle to stop. I yearn for rest. To have a finish line. To have some mile marker or trophy or award that says I’ve done enough. One day I’d like to give myself that. Maybe I should find a trophy or ribbon store and buy myself something that says “That’s Enough.”

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Emotional Work Startups

Day 402 and The Most Me

I am coming slowly into 2022 in its fullness. Perhaps I am living in seasonal time this year. I am feeling the wholeness of what the moment brings and January is about becoming. So it wasn’t surprisingly that clarity of purpose has been sharpening for me. I am ready to commit to self acceptance as the theme of my year.

I felt somehow today that the only thing that really mattered for my success in the world was radically altering any perception I had of myself as negative. That I was here to love even the parts of myself that cause me shame and fear. The only thing that will take me where I want to go is loving myself. That self love was actually the key to all troubles personal and professional.

“You know, loving awareness—even if you haven’t heard the phrase before, you know what it is. Those moments of spacious, calm, thorough, tranquil connection with whatever portion of existence you’re currently exposed to, where nothing is being challenged or conceptualized, but rather is just allowed to appear, in radiant suchness, without resistance or fear.”

How I Attained Persistent Self Love

I’ve discussed the emotional work I do on the blog at length. The Family Systems Therapy and it’s exploration of the inner child. The shadow work and integrating of the whole of oneself. But I do often reject the crucial step of feeling like I am fundamentally alright. I am ok. I am enough.

I’ve committed to “a bit” where I lavish myself with self improvement and luxuriate in needing to make every measurement better. I’m obsessed with finding metrics to improve. And so I give myself little problems to fix. Maybe I’ll eat poorly so I can feel bad about my body composition. When instead I could just eat what I like and accept that maybe I’ve made other priorities than my figure. I don’t need to agonize over trivial shit.

But equally I don’t need to agonize over big shit. So I’m not a perfectly credentialed super star. I’m more of an eccentric. I don’t live like other people so I see other things. My existence is the selling point. If what I bring to the table is what you want then I am the right partner for you. If am I not then well tautologically I’m not for you. Partnerships are accepting what everyone brings.

So through the end of this year I am going to bring self love and acceptance to my writing here. In letting myself be seen I can more fully bring myself to my partners. Being a startup investor that means I must be present for my founders, their teams, and my own LPs and stakeholders. I’m bringing the full depth of my being because that’s also going to bring the best returns. Because being ok. Accepting the moment and it’s inhabitants? That brings us the creative potential to solve whatever is in front of us without judgement.

Categories
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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Emotional Work

Day 345 and Trust

I’ve not always been accepting of my own weaknesses. Instead of focusing on how well I can hone my super powers, I’ve occasionally fixated on where I lack innate talent. I’m not particularly adapt at operations or logistics but I feel bad about it. I am however genuinely top tier when it comes to narrative & attention. Somehow I don’t feel equally good about this.

I’ve tried to work in teams where my talents & weaknesses are balanced out by others. I like teamwork now in a way I didn’t fully appreciate when I was younger. I’ve learned to trust my own value. And I am able to emotionally trust the people around me.

The psychological safety that comes from trusting yourself and others is a lifelong process. Even a few years ago I’d struggle to not compulsively overwork to overcome my weaknesses. When I should have been honing my unique talents.

I’ve got an opportunity over the next few days to really trust one of my teams. We’ve got a deliverable that isn’t in my area but I’d crucial to success. I could spend my extra energy worrying over it and making an attempt to contribute just so I felt useful. Or I can emotionally let go and appreciate the trust I have in others.

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Emotional Work

Day 327 and Suffering Gives You Choices

I perceive suffering as a positive and even necessary thing. Discomfort is part of any growth process. Learning is often painful. Work is suffering. The act of enduring opens our lives. I believe suffering creates choice. Thanks Calvinism?

I’m not suggesting my belief that suffering is choice is a good belief. It’s quite likely a self limiting belief for me. I am a workaholic after all. I’m just noting that I believe in the benefits of suffering. I will punish myself even if I don’t always deserve it.

But if I continue in a black and white view of suffering I’m not living my live in freedom. Ironically I lack choice. I need to ask myself Can I get what I want in life if I do not suffer for it? I feel like I see a river in my life that I call choice. One bank is the border of suffering county and the other is easy land. I’d like to feel free to ferry across the river when it suits my needs. Maybe it doesn’t have to be a hard border. Maybe I can have a country in my mind of expansion and possibilities that sees the benefit of the occasionally painful process but also enjoys an aside life because of it.

What I am saying is it is ok to pull it back. Do less. I mindfuck myself into needing to suffer because I believe it will bring progress. But what if progress is possible when things are easy and joyful?. I need to see that choice is freedom. The freedom to choose what makes sense at the time.

Every time I feel like I have no choice I need to stop. Breathe. Say I’m trapped. And I can shift it. I can have choice without suffering. I can have choice without sacrifice. And you can too.