One of the unexpected benefits of writing every single day has been the accumulation of reference material. I can send folks a synopsis rather than retyping a topic that I get asked about a lot. So if you want to know how I get healthy, or how I invest, or even how I think about aesthetics this page will serve as a reference for year 1.
But I had a difficult night. I got woken up multiple times with tachycardia. I tried meditating at 1am. An hour later I was back at 140bpm while asleep. The heart rate alert woke me up. I tried some Wim Hoff breathing. Still couldn’t get it down. I took an Ativan I was getting so concerned. That knocked me out but it didn’t do much for my heart rate. I woke up to these readings on my Whoop.
It seemed clear that all the fun and games I had planned for the day were not going to manifest. I went to get additional readings. My pulse oximeter gave me a 94 reading which isn’t awful but it’s not great either. I then went to Welltory and did a long HRV reading. So I’ll be in bed if you need me.
Welltory reading of my HRV suggests my Covid case requires rest
Everyone I know seems to be sick right now. My husband is sick. My media friends are sick. My finance friends are sick. My random internet friends are sick. No one is in bad shape but everyone is miserable. If Omicron is as transmissible as it seems you’ve got a good shot at getting sick in the next month or two even if you are fully vaccinated. Don’t panic. I’ve a ton of experience being sick so let me give you some advice on how to get through the misery in one piece. Being sick is an opportunity. You’ve got this.
Stay in bed: your body has diverted all your energy to your immune system to fight off invaders. You are going to be tired. Don’t try to overcome it with stimulants like coffee. That’s just going to make it worse. Accept that you won’t be as focused or as energetic. The less you try to push through it the faster you get better. Cancel everything. If you want to get back to normal the fastest path to that is letting yourself heal.
Intake lots of nutrients: your body needsall the help it can get. Now is not the time to restrict calories. Eat vegetables and high quality protein. Eat healthy fats. Take a multivitamin. Consider taking Vitamin C and Zinc. Drink broth as it keeps you hydrated and gives you nutrients. Here are some ideas from the Cleveland Clinic.
Take care of yourself: tempting as it may be to order junk food, binge watch tv and doom scroll social media, you need to build up your vitality and constitution. This is what had worked for me. Being in bed tightens up your muscles so do a basic stretching routine for ten minutes twice a day. Don’t overstimulate your autonomic nervous system. Go out in the sun and keep your circadian rhythm normal. Meditate even if it’s only a few minutes. Do deep breathing. Take a hot shower even if you can’t stand up for too long. Brush your teeth and your hair. Talk to to your family and let them know how love them. If you have the strength do something artistic or creative. You must maintain your humanity. That means finding rhythms that build you up.
Accept Help: being sick robs you of many of the building blocks of modern identity. If you have built your self acceptance on concepts like hard work and being productive, it’s going to make you feel shitty when you are in bed and can’t do anything. Being sick is a reminder that self acceptance is the key to happiness. You are more than what you do or produce. You are a human being worthy of love simply because you exist. At your weakest and your sickest you are as worthy as at your best. Be ready to accept help from others so you can accept yourself. Be ready to be cared for by others. You do not owe anyone anything. Your existence is enough.
Chances are you are used to feeling healthy. Being sick is going to rock your reality. But you will overcome it. Cultivating empathy for yourself is the best path for doing so. Don’t judge yourself. Care for yourself as if you were your own child. Without judgement. Good luck!
Imagine you’ve got a disease with a clear biomarker. I’ve got an autoimmune condition called ankylosing spondylitis. One of the ways to spot it on a blood test is to look for an elevated CRP or sed rate.
Maybe I want to find a way to connect with other patients. I provide proof of biomarker to join an autoimmune discord just like you provide proof of ownership of an NFT like they do in the Bored Ape Yacht Club. Maybe I want to join a group of other patients who are pooling their medical data so they can stop being in an N of 1 and have a chance to participate in new research for my own disease. I could join AutoimmuneDAO and contribute to funding, meme-ing, and researching my condition. If we discover a treatment protocol or drug through our DAO we’d have ownership in it. Imagine a token for your own patient DAO. This isn’t as crazy as it sounds. VitaDAO is doing this for longevity research. This is the future that web3 can bring to healthcare.
The value is in the algorithm. But without me and without my data it wouldn’t be worth anything. They have a product and an algorithm because of my biometrics. And yet we’ve found no way to meaningfully integrate ownership and interoperability in healthcare yet.
Let me give an an example. There are multiple companies that make their money by recruiting clinical trial candidates. Why? Because you need aggregate data to run a study. Those companies have the same basic data analytic team as a marketing team at a direct to consumer product company. They know how much a patient (or customer) is worth and the cost to acquire them. You are worth a lot because you represent a demographic that has value in its totality. And yet most clinical trials fail to recruit people because patients just don’t see a benefit to participating. You’ve got no ownership or upside and the costs are significant. So science suffers.
But what if instead of being valuable to marketing and recruiters you could own a portion of the aggregate? Being a token holding biomarker “proof of disease” validated member of a patient research DAO flips the incentives. A breakthrough on a disease that treats you and you’d also own some of the proceeds of it’s intellectual property. Whoever brings web3 to healthcare is going to be doing a significant good for humanity. Web3 can improve diseases, move forward science and get us all paid.
When I injured my ankle two weeks ago I was angry. I had been so focused on doing things. Every day was packed with obligations and routines. Walking, supplements, weight lifting, stretching and appointments all took up huge portions of my day. So I wasn’t exactly thrilled to add in an entirely new thing to my day. I was worried it would set me back on my progress both at work and with my health.
And yet it’s been delightful. I’ve just kind of let things happen. I’ve been in bed. I haven’t been pushing to get in steps or raise my heart rate. I’m just vibing. Whatever the day brings I’m taking it in.
And I feel fantastic. My mind is sharp. I’m moving forward all the projects and investments I prioritize. It feels like by pulling back on all my other routines because I needed my ligaments to heal I’ve suddenly improved everything else in my life. It feels like life is fun again. That I’m spending my time on things that make me happy.
It reminds me of a favorite line from my therapist. “Be a human being not a human doing.” Was it possible in my efforts to improve my resting heart rate or put gains on my lifts that I was affecting my happiness and my intellect? By trying to improve myself had I been making myself miserable? Once again I’m learning that just letting myself live is the best way to achieve my goals. If you feel stuck maybe just chill and vibe for a bit?
I’ve been off my feet all week because of my ankle injury. That means no weightlifting, no long walks, no breaks to raise my heart rate once an hour. I’ve been in a state of rest and recovery. And my mind has never felt sharper.
My quantified self data suggests I’m more recovered than I’ve been the entire year. My resting heart rate is a full 40% better than average. I’ve added in a few new routines to facilitate healing including infrared sauna, applied hot and cold therapy, percussive massage and electro-stimulation. But I really think it’s all the extra rest I’ve been getting.
I can feel it in my desire to do frivolous things just for the joy of it. But I can also feel it in my skyrocketing motivation. Some long term projects are coming into fruition in ways that not only meet my goals but wildly exceed them. Like all of the power I’ve ever imagined having is completely reasonable. I don’t even feel like I need to suffer for it. It’s there because I have joyfully brought myself it it.
It’s quite possible the lesson I should take away from this is that constantly pushing myself for improvements through hard work and pain is completely the wrong approach to getting what I want. That real power comes from letting yourself live within the rhythms of your own life. Letting what you want flow through you means sometimes it will be easy. And that’s ok too. Let yourself succeed with the power of your own unique approach. It’s the most differentiated thing. And difference is always an edge.
Modernity is tough on our bodies. We sit hunched over glowing screens for hours and we call that necessary. We rationalize ignoring our meat sacks as logical. Cartesian logic like “I think therefor I am” is a convenient an excuse for disembodied living. Except eventually it will catch up to you. Maybe not for a while but it will. Maybe you’ve noticed feeling shittier recently.
I’ll tell you how it starts. You feel sluggish. So you stimulate your system. Maybe you drink more coffee and eat more sugar. Then you notice you don’t sleep as well. That makes you even more tired. So you stop moving as much as you did before. You don’t track any of this so it’s hard to notice till the effects compound. Then you notice aches and pains and you think well maybe it is just getting older. Maybe you start to have a back problem and friends tell you they have the same problem.
It’s the slow downward spiral of misery and it’s probably happening to you. It happened to me fast and hard but the path is the same. We accept feeling badly. We accept that deterioration is a fact of life because we’ve got to work and take care of the kids (if you are lucky enough to afford a family). We just accept lower standards of living because we get worn down.
It just doesn’t have to be like that. This shitty quality of life doesn’t have to be the new normal. Fuck the doctors who can’t diagnose you. It’s systemic. You’d be lucky to find one things so broken because it’s a place to start. Most people are justly subtly broken. But it’s not reached the acute stage where our medical system finally kicks in. Doesn’t mean what you feel isn’t real.
The shitty part is next. You’ve got to do the work. You’ve got to change your life. No doctor or health practitioner is coming to save you. They an give you a piece of the puzzle but you’ve got to assemble it. If you commit to getting well it’s going to cost you willpower. Because the path out is hard work. It’s nutrition, sleep, lifting heavy things, going outside everyday, taking supplements and vitamins, meditation and mindfulness. Frankly it’s a lot. I spend a third of my day on it so I can live what’s left well. But I no longer feel subtly shitty all the damn time.
I’ve seen remarkable benefits to the entire mess but it’s taken over a year of dedication to see the compounding effects. Taking vitamins isn’t quite like taking a pharmaceutical that way. But I suppose everything is dependent on dose. And yet I tend to apply a completely different moral valence to my supplements then my pharmaceuticals.
When I was a teenager it felt like the war on drugs had mostly devolved into scar tactics. After school specials, assemblies with terrifying speakers, and the general media landscape showing “this is your brain on drugs” probably gave me an unnecessarily limited view of how to approach drugs. Recreational drugs were bad but I also knew that pain medications were deadly. It didn’t help I had a family member who was an opioid addict.
The running gag on South Park with Mr. Mackey telling the kids that drugs are bad mmm kay logged into my subconscious. And not in a sun skeptical way. I appear to have taken it at face value.
South Park’s Mr Mackey says drugs are bad…mkay?
Except drugs are neither bad or good. I wouldn’t dream of considering my various supplements and vitamins as making me bad or weak. Those keep me healthy and function. I also take prescription medications. Those also keep me healthy and functional. It’s the same thing. I don’t take them for kicks or to get high.
But the idea I absorbed from childhood that I’m supposed to regard things like pain killers with intense skepticism continues to hinder my progress. I was warned by the orthopedist I may need to up the anti-inflammatories I take for my spine as my ligament injury heals. But I am still reluctant to take the prescribed dose. Despite being under the supervision of two doctors.
I’ve got to learn to let go of this attitude. Drugs are good mmmkay? Tinkering and tweaking and looking for improvements are great. No one deserves to be in pain. It’s not morally better no matter what religious nonsense we may have absorbed. Sure pain is a terrific teacher. But it’s perfectly alright to chose to forgo it. We can chose to grow without inflicting any more pain on ourselves than necessary.
One of my favorite hobbies used to be powerlifting. When I had to take time off to control my ankylosing spondylitis (it’s an inflammatory spinal condition) I was simply in too much pain to walk around the block let alone squat 250lbs. But as we’ve controlled my symptoms so efficiently I’ve been able to pick back up weightlifting this fall. I’m overjoyed as this represents full recovery to me.
I’ve been slowing introducing weight using the core barbel lifts using the Starting Strength method. It’s been a blast as I get to have beginner gains all over again after being sedentary. The biggest change in how I train compared to my time before managing a rheumatoid condition is timing my training around my recovery. I used Whoop and Welltory who both measure my HRV or or heart rate variability. It’s basically a measure of how well your autonomic nervous system is coping with stress and turns out to the best predictor of how well I will feel on any given day.
A recovery chart of my HRV with red marking the days I lifted.
I’ve noticed that lifting hits my HRV hard. And it takes time to get it back to a normal place. Sometimes several days. I absolutely cannot not push my recovery frame without making my HRV dip even worse. It’s fascinating to see how well correlated the two appear to be.
On days when my HRV dips my resting heart rate is noticeably worse and using an app like Welltory I can see much more stress I’m under and how damn active my sympathetic nervous system is at work. The stress of recovery is significant. And my symptoms will tend to flare. Pain and fatigue are noticeably worse.
Despite the evidence I have found it mentally challenging for me to trust this stress and recovery process. On bad days when my HRV dips I forget how well I felt on the good days which leads me to some emotional flailing. Instead of trusting the routine I’ll panic at how shitty I feel. I’ve got amnesia about how terrific & productive I can be.
I’ve got to learn to trust the numbers. Otherwise I’ll do stupid shit like push to get something done on a bad day. That activity will take hours of hemming and hawing and willpower and brute force. If I had just waited for a good day to get my shit done chances are the task will take me 5 minutes.
Forcing myself to abide by the recommendations of Whoop and Welltory gets me out of the cycle of flailing. Listening to the data can override my amnesia. If a bad HRV day happens I just don’t try to do ANYTHING. Because I know on a good HRV day I’ll be 1000x more productive. It’s a discipline I need.
Everyone has different capacity. Forcing yourself into the “industrially necessary” routine of a 9-5pm weekday only makes sense if you are in a bigger corporate system and must be reliable even if you are not performing at your best.
Freeing myself from the mentality of being available on a bourgeois schedule is challenging. I hate feeling like I disappoint people by not always being “on” and productive. I feel like availability & reliability matter more than outcome (which is occasionally true but not generally true). The reality is you can have 10x Julie or you can have consistent Julie. I’d pick 10x personally.
The word wellness has become so comically performative that I cannot use it with a straight face. It would require so many disclaimers and apologies and contextual additions to move it beyond the associations with wealthy white women (thanks Gwyneth) it’s not worth the bother. But it’s also equally true most people do not feel well. The feeling of being healthy eludes us.
Our health degrades more quickly than we’d imagined, as if planned obsolescence wasn’t a term for software, but rather a term that describes our bodies as we move beyond our twenties. It feels intimidating to try to staunch the flow of time.
We acquiesce to our obligations, our stresses, our weaknesses and our limits. And our health degrades further. And with each turn of the wheel it seems even more impossible that we could feel any other way. But I promise you this does not have to be your life. You can feel well. I’ve come back from the brink of chronic disease. It is possible. It’s just all extremely boring and time consuming.
It’s hard work and it’s boring and repetitive and frankly your work won’t show results for months or even years. But you are not doomed to lose your health to outside forces simply as a consequence of time, stress or overwork. I’ve written a beginner’s guide to biohacking as well as an introduction to supplements. Anyone can pick up the basics and begin to improve how they feel. Just don’t expect miracles. And yes it’s a position of privilege to pursue most of it. But there are ways.
If you look at one of my typical days I split a third of my life into some type of preventive work. Just in case anyone ever wondered why I don’t socialize much. I put most of that time into my body.
I sleep a full eight hours. I meditate. I go to therapy and group every single week. I do full body compound lifting three times a week. I do steady state cardiovascular work an hour every day. Ok that’s just a fancy way of saying I talk long walks. I take my vitamins. I eat protein and vegetables. I stretch. None of that is privileged or even interesting. It is just slow boring work that builds over time.
