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.

Categories
Chronic Disease Uncategorized

Day 372 and Pace Yourself

I was in an incredible groove yesterday. I’ve been letting go of the awful December I experienced and enjoying the new January energy. If you look at yesterday’s post I was absolutely in the zone. So I pushed myself thinking I can handle full capacity day. Mistakes were made in my enthusiasm. And well I’m probably in need of a rest. I over did it.

I often struggle with pacing and moderation. It’s important for me to remember that I’ve got a history as a workaholic. But I don’t want to feel as if I can’t push myself either. It’s the middle path I must walk. But it is hard to stay on it. I feel like every day I am sliding off the middle path right into the ditch. I’m getting better at getting myself back.

I used to be happy mailing elaborate detours. I’d take every exit on this metaphorical path in the past. But tonight I’m going to remind myself I’ve got a destination. And that is being responsible for keeping myself happy and healthy. So I’m going to get in bed and watch some TV and shitpost on Twitter

Categories
Medical Preparedness

Day 354 and Covid

The worst has happened. After nearly two years of being ambiently aware of Covid as a risk in the world I have tested positive. I honestly didn’t think I had it. I feel a little bit sick. I briefly ran a fever. I mostly felt the malaise from the inflammation. Little did I know that the game had changed with Omicron. That was all Covid.

I think we are in the middle of public communication crisis. The new symptoms for Covid are not severe coughing but the sniffles. And the vaccine doesn’t give you neutralizing immunity. It sure does help reduce the severity of the infection if the mildness of my symptoms are any indication. I worked several days before I realized the extent of the illness. And in no way had we reduced our daily caution. The only time I spent indoors with other people was when I had to go to urgent care for a torn ligament in my ankle.

I’ve got to be honest. This is going to happen to you. It’s happening fast and you probably didn’t see it coming. From when Omicron first got identified to me getting ill was less than two weeks. We have a rapid test shortage which means only those with flexibility and money will know if they are sick.

It’s going to be a very ugly month. Not because anyone is going to get extremely sick. But rather a lot of us are going to be a little bit sick. Let’s be gentle with each other when it happens. We are all going to be really miserable together.

Categories
Chronic Disease Medical

Day 352 and How To Be Sick

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.

Drink lots of water: basic but crucial. Down a full glass of water every few hours. Set a timer. Being hydrated is key to your body flushing out gnarly stuff.

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 needs all 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!

Categories
Biohacking Finance Internet Culture Medical Startups

Day 350 and Web3 Healthcare

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.

Quantified self and biohacking have improved my health significantly. But on its own my personal health data has little value. You would maybe pay me a few cents for my biometrics. The real value of that data is in the aggregate. That’s why I pay Whoop to manage my HRV data and why they won’t offer data interoperability.

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.

Categories
Medical

Day 336 and Inaccessible

I’m probably still in shock. The last 24 hours have been a whirlwind of favor trading and phone calls and begging as we try to figure out the extent of the damage to my ankle. Something is broken but still need an ultrasound and an MRI to assess a full recovery full protocol. We are mostly hoping I can avoid surgery. But we will know more once I meet with the orthopedist tomorrow.

The only upside to this mess is living in Boulder Colorado we’ve got access to the best sports medicine on the planet. We were able to get excellent recommendations on in orthopedic specialist and thanks to wonderful friends secured an appointment within 24 hours.

I’ve also got an incredible primary care physician that has spent the day putting together all of the basics for healing and recovery. She thought of everything from bandaging to mobility aids to supplements. And she makes house calls.

I am however pretty shook up and in a lot of pain. I misjudged crutches this morning and took a terrible fall trying to get to the bathroom. You never notice how inaccessible the basics in life are until you need help getting onto the toilet. I am going to need round the clock help for a bit until we figure out how to install things I can lift myself up on. So maybe my upper body still will improve? But otherwise it’s pretty dehumanizing.

I’m also stuck on the top floor of our three story townhouse as the only way to get down the stairs currently is on my ass with the scoot and lift method. Thankfully Alex doesn’t seem to mind me using his office desk as a dining room table for a bit. They are too narrow to carry me down so this will be a bit tricky for the time being. We can’t have me on the middle floor as there is no bathroom and the downstairs doesn’t have a bed so this will have to do for now.

Categories
Chronicle

Day 335 and Ankle

I was going for a walk and misjudged coming down a stair. We’ve got tiny stairs of rock and wood and hand poured concrete in the courtyard of our complex. They aren’t the most even. I don’t know how I came down so hard but Alex said he heard something as I came down. I tried to get back up and put weight on my foot and immediately collapsed. I must have screened loudly as everyone came running.

I couldn’t make it up the stairs to get back into the house. I had to scoot myself up the stairs using my arms to lift me and shimmying my ass. I kept trying to test if could manage any pressure on it. I had tears running down my face and my iPhone giving me tachycardia warnings.

I initially crawled myself upstairs to get in bed so I could elevate and ice. We weren’t sure if it was a sprain or an actual broken bone or ligament. We called around to see if anyone had doctors who made house calls. The last thing I wanted was a four hour emergency room visit while I was in excruciating pain. But eventually the feedback from a virtual visit was I needed X-rays as it’s not a good sign that I can’t apply any pressure to it.

The urgent care center got me a boot and crutches and I’m waiting on the X-ray results. I am so angry as I don’t want a random health thing requiring surgery and physical therapy and months off my feet. I feel like I just got to a great place with my health recently. To have a set back with my existing issues would have been more of the same. To have something new feels profoundly unfair.

Categories
Biohacking Chronic Disease

Day 322 and 10x

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.

Categories
Biohacking Chronic Disease

Day 311 and Conspiracy Care

The current “news” cycle is up in arms about a football player taking medical advice from a podcaster. Depending on who you read this is either a very bad thing or a fight against woke mobs and cancel culture. If you have no idea what I’m talking about there is no reason to dive in further. Don’t upset yourself.

People take advice from people they trust, and sometimes we trust people we perceive as being smarter or even as having higher social status than us. Shortcuts are part of life. And if you have access to someone, say through a parasocial relationship like social media, that you perceive as being well equipped to solve problems you will probably listen to them. Which is a point Eric Weinstein made about Joe Rogan and healthcare that I think is especially salient.

I think we have to understand that people are also looking to Joe as a pass-through for concierge medicine. If you have brilliant Uber-rich people in your life you hear a lot about medicine you can’t afford. Whole body work ups. Multi day examinations. Lots of medical gear.

I didn’t used to have much health care. I went to free clinics and doctors who I could pay $50 cash to for antibiotics without a hassle. It’s probably little wonder that when I had real health care issues I wasn’t prepared for just how bad most care in America is even with health insurance. I thought I’d get good healthcare with a nice insurance plan. But it mostly sucks. I got dismissed, ignored and generally not diagnosed for almost a year. And then I figured out how wealthy people do medicine. And I began healing.

Holy shit is it night and day different what spending real money outside of your health insurance will do. Like Joe I get concierge care. And to the advice I get is pretty far off what you hear from a baseline healthcare practitioner like say the doctor who can only see you for 20 minutes and can’t risk anything that isn’t clearly proven and approved. But someone who doesn’t answer to a big hospital system? They turn out to be much more flexible and will help you work through the risk and reward (and also cost benefit) of a host of different tests, treatments, supplements, devices and diagnostics.

And over the course of about three years I went from functionally disabled and completely unable to work to, well, basically fine. Three years ago I could barely walk and now I’m back to powerlifting and hiking. But the sick thing is I am certain if I were a plebeian I would be on disability for life. I would have at best been prescribed pain medications and left to rot and potentially develop an addiction or two.

So is it any wonder that in a country with a mass chronic disease issue we’d look to wealthy proxies like Joe Rogan and imitate what he says is his care? Fuck no. It’s downright immoral and condescending to suggest that the victims of American healthcare systems shouldn’t try to help themselves. No one else is stepping up to pay for their healthcare.

What is a genuine issue is that without context and a team of professionals you might accidentally become a victim to conspiracy theories. Which is exactly what we’ve seen with a number of Americans. But the line between conspiracy and simply untested or unproven treatment is a lot blurrier than I expected. I had concerns I’d be taken advantage of by functional medicine doctors and holistic practitioners. And surprisingly that just didn’t happen. I was always given context, research, second opinions and supported in making as informed a decision as possible. Doctors are collaborative by nature and my team has encouraged me in my efforts to test and trial a lot.

This kind of care does not come cheap. I’ve spent close to $80,000 on concierge care services over the past year. This includes everything from diagnostics & testing to compound pharmacy and off label pharmaceuticals (get metformin just trust me), to a host of medical devices and treatments as well as the hourly cost of a primary care physician, a prescribing & case physician (it’s not uncommon for different doctors to do medicine management so as to monitor your entire case for interactions) and clinical nursing. Like I said, if I didn’t have money I would still be on disability. I’d estimate only 20% of my progress came from before I went to a more personalized approach. Medicare for all isn’t going to deliver you the kind of care I got.

I don’t really have a takeaway or solutions here. Most people don’t have complex chronic diseases nor do they have the need for the kind of last 20% health optimization that the billionaire class go in for either. But you can do a lot on your own. A lot of health is just preventative care.

I’ve shared a basic biohacking guide for beginners before. Replacing fat with lean muscle and getting your basic nutrient and fitness profile improved should do a lot for many of you (not true of chronic disease patients that’s complex). After you’ve done the basics on your fitness, body composition, and sleep hygiene for 3-6 months you can move on to supplements. You maybe surprise at what you learn and how much it deviates from what is common knowledge about health. Here is a little hack to save you time. Eat protein, lift weights and get sunlight. And stop looking down on people just trying to survive. That makes you feel better too.

Categories
Emotional Work Politics Reading

Day 306 and Shortcuts

I never really thought of myself as a perfectionist. But I have impossibly high standards for myself that may be unproductive.

While I’m sure some of it innate, some of it is nurture. I went to a school system called Waldorf Schools that didn’t have grades. Every child was evaluated against their individual performance and each class was deliberately taught to the best student in the class not to some perceived middle. That’s left me with a habit of always believing I can improve and also the expectation that our average performance must be comparable to the best.

Of course this is unrealistic if one continues to climb up social, economic, intellectual and cultural ladders. I kept looking for my limit and then finding a new mountain to climb. Know I know there will always be mountains. And that perhaps it’s ok to take some shortcuts on your journey.

I really struggle with shortcuts. So am forcing myself into taking some so I can let go of some of my impossible standards.

I don’t scan books. I read them. So I bought a really bad prepper novel and am forcing myself to take shortcuts in pacing and focus. It’s so bad I don’t have a choice. I have to skip a lot or else I just wouldn’t finish.

I had to go to an appointment today. Normally I’d be sure to shower and wash my hair if I need to be in polite company. I showered yesterday but I just didn’t feel like going to the trouble two days in a row. So I put dry shampoo in my hair and opened up weight wipes for my nether regions. I doubt anyone would have noticed but a shortcut in my grooming routine was pretty liberating.

Today is also Election Day. My hometown has a bunch of local ordnance changes and some important bond related measures. It’s also city council elections. I’ve been following all the ballot issues but I just couldn’t find any city council people I liked. I read all the local papers and they all suck. None of them remotely come into my preference wet. So I took a shortcut. I voted on all the ballot issues and left the city council blank. I just wasn’t going to spend any more time picking lesser evil candidates.

These may seem like pretty different issues and maybe I’m also not fully committed to my civic duty (I’d argue as a democracy it’s a right to abstain from a vote if your conscience cannot condone it). But the point is that instead of getting bogged down in every unrealistic expectation I had of myself I could just take a shortcut.