Tag: Biohacking

Categories
Medical Politics

Day 776 and Informed Consent

I’d really like to write about informed consent and whether it is a convenient fallacy to obfuscate the harsh reality that medicine isn’t as black and white as we have been led to believe.

It’s a complex topic so consider this my notebook of scraps and gently judge it’s content as it’s not a full cohesive argument so much as a collection of thoughts I’m working through here. If you feel you are reacting to it strongly please work through why on your own time.

I am on this topic as I am reaching a point of frustration with the discourse around transgender issues and who is responsible for informed consent. We’ve got a spiraling culture war where everyone is ignoring basic facts like children are below the age of consent and thus their parents are responsible.

Our entire legal system is based on the premise that before 18 you have not reached the age of reason and are not fully responsible for your actions. Yes it’s flawed and doesn’t always work that way and we try minors all the time but the fact remains parents are the guardians of their children.

I am oddly both well read and well cited on issues related to informed consent and substituted judgement as I was a medical ethics research assistant at the University of Chicago. I got paid $10 an hour for my troubles so you know my credentials check out (in sarcasm font). Seriously go look I’m an author on a few papers.

Making a choice to engage in almost any medical procedure is risky in ways no one, not even doctors, can fully articulate. Bodies are complicated and abiding by a simple principle like “first do no harm” turns out to be hard calculus.

Sure you can get awfully close to the right answer but you will be pretty far down the calculating differential equations path once it dawns on you that we can get infinitely close to certainty but certainly itself cannot be reached. Turns out math is useful in daily life.

Patients have a right to chose their own risk parameters. Doctors do their best to inform. But the grey area is so wide it’s practically an abyss. Add in making decisions for a minor and it’s all best guesses and other people’s facts. Believe the science means you’ve got to do your own math and it appears most people are innumerate.

I am willing to make big criticism of the transgender panic crowd because they’d prefer to pick and chose convenient narratives like “think of the children” as a defense. I’ve heard that tune before in every other moral panic. And yet it’s still not the government’s job or the doctors job to make the call. It is the parent’s call because children require the substituted judgement of their parents for informed consent.

If this is annoying or unsatisfying to you well that’s a bummer for you. I’d encourage you to read up on how we’ve scapegoated populations in the past to make sure the in-group’s priorities and social mores are sustained. Every moral panic has one. I’d recommend René Girard’s work here.

When we fixate on a vulnerable population the story is always the same. And I believe anyone who is reading this blog is smart enough to grasp that in good faith. And we’ve got a long history of scapegoating people who don’t conform to our majority population’s comforts.

The transgender issue is no different and trying to wedge it into a “but the children” argument runs up against two issues. Most of our American historical moral panics have scapegoated in this exact way. And medicine is simply not so concrete that any treatment for any condition is risk free.

Categories
Emotional Work Medical Politics

Day 765 and Kobayashi Maru for Women

I woke up to a totally off handed tweet of mine going viral. I had done some googling on the cost of pregnancy surrogacy and learned that it would probably cost $200,000 a pop. I’d never really considered the cost as to be honest as I didn’t think I’d be having children that way. The responses to the tweet left me feeling despondent.

Five years ago I did IVF to freeze embryos (and eggs too) and it kicked off a massive health crisis that I only feel I’ve gotten under control recently. It took everything from me. I was on medical leave, I sold my startup, and my marriage got to learn what “in sickness and in health” really means. It was awful. I am crying just remembering.

It took years to get healthy again. Of course, I first had to get stable at all. I spent years, and a huge chunk of savings, biohacking my way back to a body healthy enough to work. I’m thrilled to be back doing what I love most which is working with early stage companies. But work wasn’t the only goal of getting healthy.

I’ve had a fantasy that if I just kept at my biohacking that one day I’d be off all these medications. That I could truly be healed. That all this trouble and heartache wouldn’t be permanent. That I could heal myself. Unsaid in all of that, is that I cannot be pregnant and on the medications that saved my life. How is that for a kick in the teeth.

I’ve got two embryos and ten eggs and a fleeting dying ember of hope that I could ever carry them. I don’t know if having them via a surrogate is my path forward. Maybe there is still hope I could be healthy enough. I frankly don’t know and I’m not ready to say where my fertility is headed.

All I know is that this feels like a no scenario. That having a child in America is a fraught and expensive endeavor even when everything goes right and you are healthy and young. There is no winning as a woman as any decision around family is going to upset someone.

It’s the Kobayashi Maru for American women. Juggling your partner (or partners), your money, your home, your health and your fertility means balls get dropped. You are going to lose somewhere. And it really hurts.

Categories
Internet Culture Politics

Day 764 and Natalism

There are a number of cultural streams in American life that have all aligned around being natalist. You want your country to have babies because it’s good for the economy. And presumably also good for national security.

This fairly basic insight means everyone from techno-libertarians to Catholic homesteaders believes that Americans should be having more babies. It is not just the Quiver-full types having six babies anymore, so are our wealthiest aristocratic titans of industry.

But this alliance is missing some crucial basics. Like for instance the fundamental civilization level things we need to do to make it desirable and affordable to have children. It’s expensive to be pregnant, it’s expensive to raise children, it’s expensive all around to be parents. I spent $40,000 on IVF and it ruined my health. If I counted lost wages and being forced to sell my startup I’m the total costs is seven figures.

I don’t know if you’ve looked at just the costs around having a baby but it will shock you every time you turn a new corner in the fertility space. I learned today you will spend between $100,000 to $200,000 to hire a surrogate. It’s a person’s salary and a lot of medical care so sure that seems right but damn.

I guess I am interested in the math of Natalism to see if I could afford it. I am one of those “tech elites” that thinks we have to have children to drive the innovation of tomorrow. Our future is based on an optimistic hope that maybe we can push for a better future. Humanity won’t continue without children.

But I don’t have a body that is all that healthy without medical intervention. I live a normal life now and can work full time again because I take some exceptional medicine.

But it’s not medicinal regime that can be combined with pregnancy. So if I want to carry a child I have to go off what amounts to life saving medicine. Without it I’d be on bed rest. You can imagine the math I’m doing in my head? Do I want to pour another million into having a family?

So what’s a girl like me to do? Surrogacy right? But I’ve got 10 eggs and 2 embryos so assuming a third of them make it, that’s nearly half a million dollars in surrogacy fees. To get three kids. That’s a heavy price tag on the future. If more of them take it gets even wilder.

Now ok sure I’d rather we encourage a world where younger healthy folks do things naturally but don’t we want everyone going at maximum effort for a better tomorrow? Shouldn’t we want technology to solve this? Where are my artificial wombs at?

Categories
Startups

Day 761 and Calls

Yesterday ended up being a big day for me. A couple projects that have been in the works for months for final confirmations. That meant I spent a lot of time on phone calls yesterday.

I hadn’t planned for Monday to be so busy. I have therapy in the late afternoons so I tend to back my mornings but I still leave enough breaks to come down from the energy and excitement of a big call. I find synchronized communications to be a little overstimulating so I like to meditate and do Wim Hoff breathing to break down my cortisol levels.

But I couldn’t make it happen yesterday. It was too much back to back. I went from an hour long fact checking media call right into my two hour group therapy session. I’d had a few other smaller calls before it as well.

My earbuds were the first to note the issue. With about fifteen minutes left in my two hour Zoom I got the 10% battery left warning from my AirPods. My technology realized it was time to recharge before I did.

And boy was the decay quick. The AirPods went bwoooop and went dead. I could feel myself getting a little dazed myself. As soon as I was off the call I checked my HRV using Welltory and found all my systems were drained. Too many calls has called on too few resources.

Categories
Biohacking Emotional Work

Day 754 and Smooth is Fast

I like to move quickly. With my enthusiasm for generating momentum, I can easily get myself myself into trouble. I’d bet you can remember a time when you accidentally slowed yourself down by trying to go too quickly.

The phrase “slow is smooth, smooth is fast” originates from the SEAL teams but the purpose behind it can be applied to all situations. There are many situations when we want to react quickly and start moving, but in your efforts to move so quickly, you end up slowing down the operation

Chris Fussel, McChrystal Group

I was rewatching William Gibson’s Peripheral and happened to hear the SEAL slogan from one of the main characters Burton. As his sister Flynne scrambles he reminds her that slow is smooth and smooth is fast.

I am taking that to heart today as I’m itching to get a bunch done. But I am still a little jet lagged from being on Europe time and I woke up a little bit sniffly and a low recovery score on my Whoop.

As tempting as it is to beat myself up about feeling behind on work or scold myself for deliberately slowing myself, I am reminded that there is a reason high performance teams like the SEALS believe slow is smooth and smooth is fast.

Categories
Emotional Work

Day 753 and Strong Routines

It feels good to be back in Montana after a long journey home. I’m relieved I won’t be going anywhere for a while. I spent yesterday resting which felt appropriate on Sunday. But today I needed to get myself back into my typical routines. I was up at 6am and immediately began searching for my rhythm.

I am often frustrated by how much energy I put into maintaining a steady restorative routine. I like to live and work hard, but as I get older the best way to maintain productivity seems to be putting good habits at the forefront of my life. I have to fuel myself to go the distance.

I’ve got a number of deals I’m working on this quarter and I’ve got fundraising to do, so I’ve got to make sure I’m on my game.

I dutifully took all my supplements. I worked out. I meditated. I did hot and cold work. I ate a nutritious lunch. I did chores like my laundry and unpacking. I cleaned out my email inbox. I got my schedule in order. I set my goals for the week.

Having had a productive working Monday, it’s now time for Monday evening emotional work. I stack my personal therapy and group therapy back to back on Monday. I usually write afterwards but I thought I’d get down some basics before as I am still just jet lagged enough I might prefer just going to bed afterwards.

Categories
Travel

Day 752 and 24 Hours

I cannot remember the last time I pulled an all nighter. Probably something related to Black Friday sales. But in order to travel back from Prague to Montana I was awake for 24 hours straight across three flights and four separate airports.

I hadn’t really intended to be awake for the entire trip but because one has to pad timing around flights these days, every leg of the trip involved three or four hours between flights or an extended delay that has me running.

I was awake at 5:30am in Prague for a 7am flight that boarded at 7am. I arrived in London at 10am GMT after delays. My Heathrow to Denver flight was meant to department at 1pm. That 9 hour flight was the most pleasant part of the journey but I didn’t want to nap during it as I was concerned it would make my jet lag significantly worse.

I landed in Denver at 3:30pm Mountain time which is 7 hours minus GMT and 8 hours behind Prague so it was 10:30pm for me. I was dragging as that was a long day in and of itself. And frankly I’m used to living off a hub like Denver so a final leg of the journey was a new experience for me.

It was snowing in Denver which had created a significant backlog for takeoffs as everyone needed de-icing. I made a made dash for the 1:30pm Bozeman flight that was delayed to 4pm. I sprinted through Global Entry and back through security but the doors had already closed. I had to wait for my originally schedule 7:30pm flight.

Miraculously that flight was only delayed to 8pm because of the weather but I still found myself sitting in Terminal B for hours as my energy flagged and my spine started to hurt. My body clearly knew it was time for me to be in bed but here I was under florescent lights, eating a Caesar salad at a chain restaurant, waiting for one last flight.

When we boarded at 8pm it was 4am for my internal body clock. Thankfully the 700 mile flight from Denver to Bozeman is only a little over an hour. We touched down at 930pm. By the time I got to Alex waiting for me outside I had been up for exactly 24 hours.

I crossed a contingent, the English Channel, flew over the arctic circle and through another continent, which is an impressive territory to cover in a single day. But what a long day it was.

I slept from 11pm to 10am MTN to make up my sleep debt for the all nighter and I am still pretty tired. That was the equivalent of sleeping till 5pm. It all felt very collegiate to sleep through “the entire day” even though I am now settled back into my original time zone.

My Whoop recovery score was a 24% so I was pretty into the red from the whole experience. But I should be ready to spend the week on the proper time zone so I suppose it was all worth it.

Categories
Biohacking

Day 742 and Careful Balance

I don’t think I’ll be getting my best writing out today. I’m plugging through my work while balancing out my personal chemistry against my obligations.

I am a bit scared to find myself balancing a delicate body chemistry in a foreign country. I don’t care much for taking a steroid like prednisone but when it’s a choice between hives and yellow weeping eyes or a modicum of comfort, you pick comfort.

It’s of course not without its side effects. Steroids make you feel great till they make you feel a bit crazy. They are very good at tamping down every reaction your body has which can ironically give you some autonomic issues. For me it can feel like I’m in fight or flight.

I left my Airbnb as the more I tapered the steroid dose the worse my symptoms got. I’m a little concerned about fighting Airbnb for a refund but better to lose a few hundred dollars than need steroids. I did find a very nice and crucially clean hotel that will do the trick for now.

Categories
Biohacking Travel

Day 741 and Physical Safety

The last four days have been a bit messy for me. I flew to Prague for yet another failed effort to secure a visa for a family friend. My second time in a year to have failed to make any progress with our state department. I am not used to losing.

I very much want to give up on fighting this behemoth. Frankly my body has gotten the memo and decided to force a breather. As soon as it was clear my mission has failed, my body felt safe enough to get on with the business of its rhythms and routines.

My period has been a bit late but it’s here with a vengeance today. I appreciated it if I’m honest. Today I am wrecked with cramps and bloating. I had already caved to a emergency dose of steroids for an allergic reaction over the weekend. So why not add cranks to the experience.

Bodies are pretty smart about figuring out when you can afford a physical issue. They keep you safe through hormone boosts like cortisol and adrenaline. But they are not permanent states you can maintain forever. And now that I’ve been through the gauntlet of the embassy and failed there is no point is holding it all together.

I’ll rest and work today. Any ambition I had to see Prague is probably gone for the time being. I’d hoped to do some tourism before the American work hours in the late afternoon and evening. But I’ll be on my laptop in the Airbnb working and taking Midol instead. My body wants physical safety so I’ll give it to her.

Categories
Biohacking Travel

Day 737 and Jet Lag

Like most people I’ve got my delusions. I am convinced I handled jet lag well. But when I look at my writing history and I’ve written about having jet lag six times

I had an absolutely chaotic travel day yesterday with delayed flights, United canceling my downstream flights when I was forced to buy a new ticket for the first leg of my trip, and an astonishing array of clearly sick individuals. Despite all of that I arrived six hours ahead of schedule. I was alas a complete mess from all the running around and stress.

I woke up far too early for my time zone this morning. I waited for coffee shops to open at 7am. But despite the caffeine I found myself falling back asleep from 10am to noon. I worry I’ve destroyed any chance I have at resetting my circadian rhythm to local time.

I’ve got plans to work East Coast hours while I’m in Europe. I like having the entire morning to myself before everyone wakes up. The hours can be a little lonely on Twitter but that’s probably for the best.

Hopefully by Monday I’ll have settled in and adjusted but right now I’m groggy, itchy (unclear if that’s the jet lag or the pervasive use of scented detergents and the fact that Europeans still smoke) and generally fucked up. My eyes are so red I look like I’ve been smoking weed nonstop. Which ironically might improve the situation.