Tag: Anger

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Medical

Day 1697 and Gut Brain Axis Misery Meets Peptide Season

It would seem I found an antibiotic that disagrees with me. As the tail end of my soft tissue recovery from my abscess surgery and deep tissue infection appears in sight I had a setback with an additional antibiotic.

Cephalexin was one of the top choices on the pathology report from the hospital and recommended as a first line treatment by the surgeon, several artificial intelligence differential diagnostic secondary checks and my primary care doctor.

They did not prescribe it first and I found out why yesterday when I felt as if I’d hurt a shoulder ligament doing, of all things, tai chi. I was despondent over it (ironically another side effect). The gut-brain axis gets weird when you kill off bad microflora.

So yeah not the antibiotic for me. As it turns out we recently learned it’s associated with tendon rupture. Not quite as bad as the other more infamous Cipro. Which ironically I was on with no issues. But Cephalexin has got some risks to tendons and ligaments too.

Being on an immune suppressant (an IL-17 called Bimzelx) for ankylosing spondylitis and psoriatic arthritis has improved a number of biomarkers but also made me susceptible to skin infections. Like the kind that require slicing. Not fun.

Now in the wake of the deep tissue infection, we had a systemic MSSA problem. It was entirely rational to nuke that thing from orbit. Any resurgence needs maximum force to prevent chances for regrowth. You simply have to to be very watchful for side effects in all things now.

I feel like I’m in some awful healthcare version of pimp my ride. Pimp my diagnosis?

“So I heard you had side effects so I gave you a side effect for that side effect.“

And so I’ve been sent down the peptide rabbit hole to see if that might help with tissue healing. My shoulder is probably fine as I stopped quite quickly but a reminder that I need to be watchful of what I’m taking and experiment carefully.

Naturally I’m already considering my risk profile carefully but as it’s peptide season in Silicon Valley (who isn’t on at least a micro dose of a next generation GLP-1 agonist or some new fangled GIP.

Why not add some more to the mix? Strong tissues and lean mass being protective against many a problem. Behold a little Grok breakdown of what I was recommended.

GHK-Cu (Copper Peptide)

GHK-Cu is a naturally occurring tripeptide (glycyl-L-histidyl-L-lysine) that binds to copper ions, forming a complex that plays a role in tissue repair and regeneration. Its mechanism in tendon healing involves several key processes:

  • Collagen and Extracellular Matrix Synthesis: GHK-Cu directly acts on fibroblasts (cells responsible for producing connective tissue) by increasing the production of mRNA and proteins for collagen (types I and III), elastin, proteoglycans, glycosaminoglycans, and decorin. This enhances the structural integrity of tendons during repair. Sources Sources
  • Angiogenesis and Nerve Outgrowth: It stimulates the growth of blood vessels (angiogenesis) and nerves, improving nutrient delivery and innervation to the healing site, which accelerates wound contraction and tissue remodeling. Sources
  • Anti-Inflammatory and Antioxidant Effects: GHK-Cu blocks the release of tissue-damaging free iron from ferritin channels, reducing oxidative stress and lipid peroxidation after injury. It also modulates inflammation to create a favorable environment for healing. Sources Sources
  • Systemic Effects: When administered, it can enhance healing systemically, even if injected away from the injury site, by regulating copper-dependent enzymes involved in cell growth and repair.

Research, primarily from animal models and in vitro studies, suggests these actions lead to faster tendon recovery, but human clinical trials are limited, and it’s not FDA-approved for therapeutic use.

TB-500 (Thymosin Beta-4 Fragment)

TB-500 is a synthetic peptide derived from thymosin beta-4, a protein involved in actin regulation. It primarily aids tendon healing by promoting cellular mobility and regeneration:

  • Actin Upregulation and Cell Migration: TB-500 binds to actin, a key protein in cell structure, enhancing cell migration (chemotaxis) and proliferation. This allows fibroblasts and other repair cells to quickly move to the injury site, accelerating tissue repair. Sources
  • Angiogenesis: It stimulates the formation of new blood vessels, improving blood flow and oxygen delivery to damaged tendons, which supports faster healing.
  • Anti-Inflammatory and Antifibrotic Properties: TB-500 modulates inflammation by reducing pro-inflammatory cytokines and preventing excessive fibrosis (scar tissue formation), creating a balanced healing environment.
  • Tissue Regeneration: In animal studies, it promotes overall wound healing and tissue regeneration, though evidence for tendon-specific effects in humans is anecdotal and lacks robust clinical data.

TB-500’s effects are mostly observed in preclinical research, with potential for muscle, tendon, and ligament repair, but it’s not approved for human use and carries risks.

BPC-157 (Body Protective Compound-157)

BPC-157 is a synthetic pentadecapeptide derived from a gastric protein, known for its protective and regenerative effects on various tissues, including tendons:

  • Fibroblast Activation and Migration: It promotes the outgrowth, survival, and migration of tendon fibroblasts under stress, enhancing cell proliferation and tendon explant growth in vitro.
  • Growth Hormone Receptor Upregulation: BPC-157 dose-dependently increases the expression of growth hormone receptors in tendon fibroblasts at both mRNA and protein levels, facilitating anabolic processes for tissue repair. 19 14
  • Angiogenesis via VEGFR2 Pathway: It activates vascular endothelial growth factor receptor 2 (VEGFR2), leading to the VEGFR2-Akt-eNOS signaling pathway, which promotes new blood vessel formation and improves nutrient supply to healing tendons. 22
  • FAK-Paxillin Pathway and Anti-Inflammatory Effects: BPC-157 activates focal adhesion kinase (FAK) and paxillin, proteins that regulate cell adhesion and motility, while also exerting protective effects against inflammation and organ damage. 24 25 20
  • Overall Tissue Protection: It accelerates post-injury healing in muscles, tendons, and ligaments, restoring function similar to uninjured tissue in animal models. 27 26

Extensive animal studies support BPC-157’s role in tendon and ligament recovery, but human evidence is limited to anecdotal reports, and it’s not FDA-approved, with potential unknown side effects.

Categories
Biohacking Chronic Disease Medical

Day 1694 and Every Last Bacteria

It’s been a strange summer. It has been 41 days since I had surgery to drain an abscess that has become a deep tissue infection.

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.

Categories
Culture Emotional Work Politics

Day 1690 and Ressentiment

Nostalgia can be a bitter poison if you believe the world is getter worse. Optimistic people try to point out the many ways in which our lives are better only to find poisoned barbs dipped in statistics of all ways things are worse.

That poison absorbs into our frail hearts when aimed well. I see how things are worse just as well as any pessimist. Choosing optimism requires us to find antidotes to those poisons, lest we have a full blown case of what the French call “Ressentiment”

It is a terrible disease. Ressentiment literally translates to the English resentment but rancœur (bitterness), amertume (acrimony), and animosité (ill-will) are all part of its dangerous pathology.

Nietzschean scholars will note he meant it specifically as an emotion of feeling of deep-hostility towards those who make you believe you are powerlessness.

In his Genealogy of Morals, Nietzsche sketched out how this feeling of weakness justifies and creates value systems as a defense mechanism of the ego. Rather than overcome these feelings, the ego insulates you in a value system where one never need address real failures or weaknesses.

There is much to criticize in his work, and I am not a Nietzschean myself. But it’s easy to see how much we all live in jealousy and inferiority from time to time. Some of us live there always.

Many moral systems raise up the weak in virtue in order to protect them. Christianity is one of them. There is value in protecting and improving the lowest of us even if I disagree that we should see the powerful as morally inferior. Power and strength and beauty are virtues as well.

As we envy the past or those whose past decisions made our present lives harder we must be cautious that we have not absorbed the poison of ressentiment. Do not justify harm in its name. Do not justify jealousy or envy. Rise up and spit out that poison. Our world can be better and you can be better as you work towards that goal.

Categories
Aesthetics Culture Politics

Day 1679 and Avoiding the See and Be Seen of Luxury Travel as Post-Liberalism Nears

The lingering live embers of Venkatesh Rao’s charnel age have left me with deadened impression in my bodily sensorium. Tasting, breathing, and seeing the culture of now feels somewhere between spoiled and not quite ripe.

One of my minor affectations is periodizing my writing into sardonically named 6-year eras…We’re about to enter the last year of the third age of Ribbonfarm, (2019-24), and I finally have a name for it: this is the Charnel Age. December 21 Ribbonfarm

I have been known to drop an Antonio Gramsci joke from time to time. This is harder to make a joke about though. The age which was being born as Gramsci was imprisoned by the fascists from 1929-1935 surely felt as filled with morbid symptoms and putrefaction.

How it compares to our current perverse extended gerontological Fourth Turning of death and rebirth is yet to be seen.

The old world is dying, and the new world struggles to be born: now is the time of monsters

That quote is a translation of Slavoj Žižek’s which isn’t quite as pithy as the Slovenian made it sound.

La crisi consiste appunto nel fatto che il vecchio muore e il nuovo non può nascere: in questo interregno si verificano i fenomeni morbosi più svariati.”

Or for those lacking Italian skills (which as I do) here is it translated more literally.

“The crisis consists precisely in the fact that the old is dying and the new cannot be born; in this interregnum a great variety of morbid symptoms appear.”

Rao calls charnel vision “a tendency to see things from the perspective of natural processes of transience, death, and decay,” which can feel foreign to the long century of stability.

Americans enforced this order through its dollarization and the financialization . But empires change and even the longest institutional decay can be seen from far enough remove.

And so we have Swiss politicians running to Washington DC as the cosmopolitan upper classes try to enjoy an August off from the always on mania of this interregnum while also keeping an eye on matters.

As it turns out the extra mile to get to an esoteric Dolomite lake or a less well known riviera (might I recommend the Balkan coastlines to the more adventurous). If you need to find me, I won’t tell.

Categories
Culture

Day 1678 and Fiat Prestige and the Inflationary Pressures of Credentialism

America has been rejecting practical workforce training like apprenticeships for over a century. Our military nudged the enlisted into skills but it was access to university education that helped Americans climb the social ladder.

The Servicemen’s Readjustment Act of 1944 or as you probably know, the “the GI Bill” was so successful that by 1947, WWII veterans accounted for 50% of college enrollments.

Social mobility matters a lot to the mythos of America so it doesn’t surprise me that practical skills were not nearly so attractive once we made prestigious colleges more accessible.

When millennials were children the 1992 Higher Education Reauthorization Act (HEA92) made college loans available to all families, regardless of financial need.

And the trend in spending on education and the cost if higher education has been up and to the right ever since. Over the 59-year period from 1963 to 2022, college tuition increased nearly 300% when adjusted for inflation.

Educationdata.org

The effects of the cultural experiment in social mobility some call The Sort where children with good test scores were shuffled into universities and into the managerial class is driving spend and anxiety.

From Max Weber’s Bureaucratic Society of group status competition to Randy Collin’s work in the 70s on the rise of credentialism in the workplace, it seems as if modern industry drove a deep mimetic desire for prestigious university educations to stay ahead socially.

Having skills was not as important as being seen as having the right credentials. The old joke that Harvard launders the rich kids with the smart kids so no one knows who is who doesn’t seem so funny snore.

Last week a picture went viral of a table of Harvard and Stanford graduates in Silicon Valley (mostly Asian students) was all angst as their credentials mean something to them but not necessarily to employers or founders. So what is the point?

The data shows college education spending consistently outpaces inflation. But is it doomed to keep going up and up even if we are getting less from it? Walter Kirn had a turn of phrase in a tweet today I found apt. We have a problem with fiat prestige in America.

Power flows in the country — human, social & intellectual power flows — look bad for the legacy brokerages & gate keepers. Their services are of declining value, their cartel-like arrangements are dissolving & their ability to maintain their own mystique through circular credentialing & prize-giving — the issuance of what one might call “fiat prestige” — is failing. It’s unclear to me what moves they have left

Inflated currency destroys value. Our Federal Reserve worries about being over a 2% inflation rate and yet we let it happen. So why aren’t we more concerned with fiat prestige and its credentialist inflationary pressures? Our system of social credibility is under significant pressure and if I were Harvard I’d be terrified of going fully Zimbabwe on my social capital.

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?

Categories
Biohacking Chronic Disease Medical

Day 1673 and Xenomorph Stitch Fix

My abscess surgery wound has finally sealed up (not over) at 20 days post operative with four rounds of antibiotics. I say up because wounds heal from the bottom up.

Having a deep wound means the four stages of haemostasis, inflammation, proliferation and remodelling can take weeks if not months. I’m very lucky.

Ironically I took this image from a hyperbaric oxygen therapy website. I healed without the aid of HBOT machine we purchased as it was still being routed through chaos of the trade war

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”

All because one damned dermatologist couldn’t be bothered to have an opinion when I sought preventative care because I am a responsible immunocompromised patient. Turns out I really did need an ultrasound and surgery.

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.

A wound in one’s bikini area is a “trust and safety” team’s nightmare. Mike Judge’s “hot dog/not hot dog” classifier sketch from the HBO comedy Silicon Valley got a gender update as I managed my case.

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.

Ever wonder how classifiers in ML work?

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.

Categories
Chronic Disease

Day 1670 and Bile and Spleen

I am, as per usual, having a shitty summer. Once we cross the Solstice it’s me hanging on to sanity by ny nails praying for the return of winter.

I can’t recall a time I had a good summer except perhaps jn the hazy memories of my early twenties when I was probably too stupid, traumatized and physically healthy to know one way or another.

Now I’m smarter, sicker and I’ve done enough emotional work to actually feel it all. Don’t knock that desensitized disassociation kids you may miss it when it’s gone.

Maybe it’s simpler than that. Back in the aughts & the briefly booming Obama ZIRP teens, our global climate weirding just had not hit New York City hard enough for me to have really bad summers.

I always had a window air conditioner and enough cash to run it. Either way, a summer where I wasn’t miserable isn’t a memory I cant access now. It’s sealed off under the pain of the now. The past being a foreign country and all.

I’ve certainly not had a good summer in the last decade. I’ve got daily tracking data from the last six years of my life and the summer is just an unending torment of bad biometrics, pain, cabin fever and seasonal affective disorder. Bet you didn’t know it has a summer variant did you?

I’m always sicker when it’s hot. So it’s just bile and spleen for now. Almost enough to make me want to toss the entire daily logging project till the torment lifts. Since I won’t do that I’ll pour the misery on page.

I can’t wait to see what August has in store for me. My cold comfort is knowing I will be enjoying a long week of financial news. At least that you can do indoors locked up under the air conditioning.

Categories
Community Politics

Day 1669 and Seeing Without A State

We are entering an era where technology is liable to be the scapegoat for a number of problems that are all too human. Seeing state failures and institutional failures and deciding to blame something new rather than human nature is very much human nature

We are looking for someone or something to blame for human nature and the thing that makes the current world different from the hazy memories of childhood are an easy place to start.

The rate of change fights with the basic realities of being evolved apes. And the social dynamics of our ancestors are pretty gnarly so I don’t blame religion for wanting to obfuscate the evidence of our base nature. We have to believe we can be better.

The trade offs involved in providing communal protection has meant submissions to various forms of power and hierarchy and yet we still have social scandals over genes, jeans, semiotics and the perversion of our biology. It’s not a day to discus sex and advertising online.

I look at this chronology of my life and have pride in its daily discipline even as I know being myself online is a risk. I see day 1669 and want to make a nice joke. I believe in the commons and my freedoms within it.

It’s just getting more dangerous to be online. I am considering how I bring myself to a world where I’ve always be extremely present online under my own identity. I want to train the intelligences we develop on top of our digital commons and feel the pull of that responsibility.

Then I see another grid failure. I see a plane crash. We have terrifying realizations that we can’t rely on the systems of the past for where our future is headed.

We have European software developers now noticing what Balaji was pilloried for pointing out. The nation state and the network state are coexisting already as anarcho-tyranny increases.

In American and Western Europe we are already seeing daily examples of anarcho-tyranny. The state can hurt you but not help you. Communal needs we once enabled the state to run and provide can’t be counted on in water, energy, and infrastructure. You have to build systems for yourself where and when you can while you still can.

Categories
Chronic Disease Medical

Day 1664 and Pathology Report

Well, we finally got the culture and pathology reports back from the hospital in Istanbul. For those not following along I had an almost emergency surgery of an abscess that got infected.

And it’s kind of a good news, bad news situation. I dislike the useless preventive care dermatologist who dismissed me even more now.

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.

  1. 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.
  2. 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.